MANAGING MAXILLARY BONE LOSS USING GROWTH FACTORS IN PRE-IMPLANT THERAPY

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Cardas Adelina, Stratan Ion, Moraru Daliana, Tibeica Andreea, Agop-Forna Doriana, Norina Forna

Abstract

Bone augmentation and sinus lift procedures are critical components of implant dentistry, particularly for patients experiencing insufficient bone volume in the maxilla due to tooth loss and maxillary sinus pneumatization. The integration of Plasma Rich in Growth Factors (PRGF) into these procedures has demonstrated substantial promise in enhancing bone regeneration and improving implant stability. This comprehensive literature review synthesizes findings from various studies and case reports to evaluate the efficacy, mechanisms, and clinical outcomes of using PRGF in these dental interventions.

PRGF, derived through a specific centrifugation process, concentrates essential growth factors such as Vascular Endothelial Growth Factor (VEGF), Platelet-Derived Growth Factor (PDGF), and Insulin-Like Growth Factor (IGF). These factors are pivotal in promoting wound healing, angiogenesis, and the formation of the extracellular matrix. Notably, PRGF is distinct in its exclusion of leukocytes, which minimizes pro-inflammatory effects and fosters a more conducive healing environment.

Several studies have underscored the efficacy of PRGF in sinus lift procedures. A retrospective study by Dragonas et al. (2020) reported a remarkable implant survival rate of 95.8% one year post-augmentation using PRGF combined with various bone grafts. Additionally, a case report by Raţiu et al. (2018) documented significant osseous regeneration over eight months following augmentation performed solely with PRGF and fibrin clot, with histological examination confirming new bone formation.

Comparative studies have revealed that PRGF can achieve regenerative outcomes comparable to those of autogenous bone grafts while mitigating associated morbidity. A split-mouth study by Anitua et al. (2009) demonstrated higher new bone formation and a 100% implant survival rate in PRGF-treated sites. Similarly, Torres et al. (2009) found that PRGF-enhanced grafts exhibited superior histomorphometric outcomes compared to controls.

Clinical case studies further highlight PRGF’s potential. Raţiu et al. (2018) detailed a case of complete bone regeneration in a patient with significant posterior maxillary atrophy following a PRGF-assisted sinus lift. Another study by Dragonas et al. (2020) noted that while the use of xenografts posed a higher risk of implant failure, the overall success rate remained high when PRGF was incorporated.