Maxillary sinus surgery with autologous or allogenic graft with platelet-rich plasma/fibrin for dental implants: a systematic review

Abstract

Introduction: In the context of bone grafts and regenerative processes, the maxillary sinus acts in the equalization of barometric pressures in the nasal cavity, which is lined by a membrane called Schneider's membrane. When grafting procedures are needed, our focus is often on the type of biomaterial to be used, and the success and predictability of our results do not depend only on the biomaterial. Objective: It was to perform a systematic review of the main clinical approaches of maxillary sinus surgery with autologous and/or allogeneic graft, using platelet-rich plasma or fibrin. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from December 2022 to January 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2005 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 125 articles were found, 55 articles were evaluated in full and 27 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 25 studies with a high risk of bias and 20 studies that did not meet GRADE. It can be concluded from the present study that there is no statistical superiority observed between platelet-rich plasma, PerioGlas, or Bio-Oss in terms of their use as a grafting material along with the immediate implant placement procedure. Furthermore, the combination of autograft/xenograft and plasma rich in growth factors in the periosteal pocket flap technique is a simpler, cheaper, and faster technique than the guide bone regeneration technique to achieve moderate lateral bone augmentation in implant treatment. Tricalcium β-phosphate is a promising biomaterial for clinical situations that require bone augmentation. However, the addition of platelet-rich plasma results in decreased bone loss around dental implants.