Use of platelet- and leukocyte-rich fibrin (L-PRF) as an alternative for tissue regeneration in sinus lift surgery

Abstract

This study aimed to understand how fibrin rich in platelets and leukocytes acts as an alternative for tissue regeneration in surgeries for maxillary sinus elevation. This integrative review was developed in six steps, where the guiding question was formulated according to the PICo strategy. Thus, a total of 142 publications were searched and a total of 23 articles were selected for this review after applying the inclusion and exclusion criteria. Platelet- and leukocyte-rich fibrin (L-PRF) has been increasingly investigated as a potential bioactive substance for more effective bone regeneration, not only because it is considered an easily obtained autogenous material, but also due to its high concentration of fibrin, platelets and leukocytes, assisting in the process of angiogenesis, thanks to its growth factors, which contributes to bone formation when associated with grafts, as it multiplies fibroblasts and osteoblasts. Furthermore, for the surgical method, the use of L-PRF decreases the dispersion of the graft particles used, helping to condense more mineral and consequently resulting in a smaller volume introduced into the maxillary sinus, thus minimizing the time to obtain vertical bone height. However, since the preparation is properly autologous, the amount of L-PRF acquired is insufficient, causing a disadvantage in its use. In this sense, we realize the importance of L-PRF in maxillary sinus elevation surgery, as it is a simple, cheap and the most accessible technique for the production of autologous fibrin membrane or platelet concentrate.