Journal of Oral Implantology October 2012 - (Page 621)

CASE REPORT Use of Plasma Rich in Growth Factor for Schneiderian Membrane Management During Maxillary Sinus Augmentation Procedure Silvio Taschieri, MD, DDS1,2 Stefano Corbella, DDS, PhD1 Massimo Del Fabbro, BSc, PhD1,2* The aim of this pilot study was to present a novel technique for the management of the Schneiderian membrane during maxillary sinus lift surgery using plasma rich in growth factors (PRGF). Eight maxillary sinuses were augmented in 8 patients. Two small perforations of the Schneiderian membrane occurred during the lifting procedure, which were solved using the PRGF clot before grafting the site with PRGF and anorganic bovine bone. With the exception of 1 patient who experienced pain following an acute sinus infection after 3 days of uneventful healing, the patients’ postoperative quality of life was generally good. The most common complication (50% of cases) was hematoma, which disappeared after 1 week. Despite the limitations of this study concerning the sample size and the study design, the use of PRGF may be helpful in reducing complications following sinus lift surgery. More well-designed studies, with larger sample size, are needed to validate this protocol. Key Words: sinus lift, platelet derivative, PRGF, Schneiderian membrane, sinus-lifting complication INTRODUCTION mplant rehabilitation of posterior edentulous maxilla could be a challenging procedure especially when residual bone height is reduced due to bone atrophy. Maxillary sinus-lifting technique is a common surgical technique to augment bone volume in atrophic posterior maxilla, to accommodate implant insertion and subsequent prosthetic rehabilitation.1–3 While a sinus lifting with a lateral approach was indicated in a case of less than 5–6 mm of residual bone height in the vertical dimension,4–6 a transcrestal approach was demonstrated to be successful when at least 5 mm of bone height is available.7,8 ` Universita degli Studi di Milano, Department of Health Technologies, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. 2 ` Universita degli Studi di Milano, Centre for Research in Oral Health, Milan, Italy. * Corresponding author, e-mail: massimo.delfabbro@unimi.it DOI: 10.1563/AAID-JOI-D-12-00009 1 I When a sinus lift with lateral approach is performed, a number of complications can occur.9 Perforation of the Schneiderian membrane is the most common complication during sinus-lifting surgery, with a mean reported incidence of 19.5% (range, 0% to 58.3%).1,10 The perforation, if not adequately treated, could cause a chronic sinusitis and dispersion of graft material in the form of particles into the sinus cavity.9 It has been reported that sinus membrane perforation does not necessarily indicate the need to abort the sinus augmentation surgery once the injury is repaired.11 However, perforation management is not considered an easy and fully predictable procedure, especially when larger tears are present.12–14 Infection-related sequelae are other serious complications that can occur after the sinus-lift procedure. Infection of sinus and graft is one of the main causes of early failure of implants placed in the posterior maxilla after sinus surgery.15,16 Postsurgical infection as well as the surgical Journal of Oral Implantology 621

Table of Contents for the Digital Edition of Journal of Oral Implantology October 2012

Should the Implant Fit the Patient or Should the Patient Fit the Implant?
Histologic and Biomechanical Evaluation of Alumina-Blasted/Acid-Etched and Resorbable Blasting Media Surfaces
Impact of Dental and Zygomatic Implants on Stress Distribution in Maxillary Defects: A 3-Dimensional Finite Element Analysis Study
Precision of Implant Placement With Stereolithographic Templates: A Pilot In Vitro Study
An Evaluation of Biocompatibility of Indigenously Produced Pure Titanium: An Experimental Study in Rabbits
Relationship Between Smoking and Bleeding on Probing
Stress Analysis in Platform-Switching Implants: A 3-Dimensional Finite Element Study
Acrylic Resin Polymerization in Direct Contact to the Abutment and the Temperature at Bone-Implant Interface: A Pilot In Vitro Study
Clinical Application of Stereolithographic Surgical Guide With a Handpiece Guidance Apparatus: A Case Report
Fixed Rehabilitation of Severely Atrophic Jaws Using Immediately Loaded Basal Disk Implants After In Situ Bone Activation
A Functional Open-Tray Impression Technique for Implant-Retained Overdenture Prostheses
Use of Plasma Rich in Growth Factor for Schneiderian Membrane Management During Maxillary Sinus Augmentation Procedure
A Technique to Facilitate the Fabrication of Provisional Restorations for ITI Solid Abutments
Influence of Etiologic Factors in Peri-Implantitis: Literature Review and Case Report
Simplistic Partially Limiting Surgical Guide for Flapless Implant Placement: A Case Report
Types of Implant Surgical Guides in Dentistry: A Review
Rehabilitation of Atrophic Posterior Maxilla With Zygomatic Implants: Review

Journal of Oral Implantology October 2012