Sinüs Tabanı Augmentasyonu Sonrası Kemik Hacmi ve Yoğunluğunun CBCT ile Karşılaştırmalı Değerlendirilmesi: Alloplastik Greft, i-PRF ve Venöz Kandan Üstün

Özet (abstract)

Rehabilitation of the posterior maxilla with dental implants is challenging because of limited residual bone height and poor bone quality. Transcrestal sinus floor elevation is a minimally invasive technique that increases bone volume and density, facilitating implant placement. Although venous blood, injectable platelet-rich fibrin (i-PRF), and synthetic alloplastic grafts have been proposed to enhance bone regeneration, comparative evidence regarding three-dimensional endo-sinus bone volume and regional bone density remains limited. This study evaluated and compared these outcomes following transcrestal sinus floor augmentation using venous blood, i-PRF, an alloplastic graft, and without graft material. This prospective randomized controlled trial included 64 participants with posterior maxillary residual ridge height of 4–6 mm. Participants were allocated by computer-generated block randomization into four groups ( n = 16): without graft, venous blood, i-PRF, and alloplastic graft. All underwent transcrestal sinus floor elevation using the CAS kit with simultaneous implant placement and 0.5 cc of the allocated material. Three-dimensional endo-sinus bone volume and regional bone density were assessed by CBCT after 6 months using Planmeca Romexis ® software by a blinded assessor. Intergroup comparisons were performed using one-way ANOVA with Tukey post-hoc tests (α = 0.05). Significant differences were observed in three-dimensional bone volume ( P < .001), with the alloplastic graft group demonstrating the greatest endo-sinus bone volume. Bone density was significantly higher at the apical, buccal-apical, and palatal-apical regions ( P < .001), whereas no significant differences were observed in the mid-sinus regions. Venous blood and i-PRF showed modest increases compared with blood clot alone, with no significant differences between them. Alloplastic graft-assisted transcrestal sinus floor augmentation resulted in greater three-dimensional bone volume and higher apical bone density at 6 months compared with autologous grafting and no-graft approaches. Among the evaluated approaches, the alloplastic graft group demonstrated the highest measured bone volume and bone density values. i-PRF was associated with radiographic bone formation but did not demonstrate a comparable volumetric outcome. The no-graft and venous blood groups showed comparatively lower radiographic bone volume. These findings suggest that alloplastic grafting may provide favorable 6-months radiographic outcomes following transcrestal sinus floor augmentation; however, longer-term clinical and histological studies are needed to confirm these findings and clarify the underlying biological mechanisms. Clinical Trials Registry of India (CTRI/2025/03/083409) on 25/03/2025.

Yazarların özeti; kaynağından alınmıştır. BMC Oral Health, 2026 · DOI ↗