Guided Bone Regeneration Combined With PRGF for Atrophic Edentulous Maxilla (GBR-PRGF-Maxil)
Guided Bone Regeneration Combined With Plasma Rich in Growth Factors for Vertical and Horizontal Augmentation of the Atrophic Edentulous Maxilla: A Prospective Clinical Case Series With One-Year Follow-up
This prospective interventional clinical study evaluated guided bone regeneration combined with plasma rich in growth factors for vertical and horizontal augmentation of the atrophic edentulous maxilla.
Participants with severe maxillary ridge atrophy requiring bone augmentation before implant-supported rehabilitation underwent guided bone regeneration using a composite graft of autogenous bone and anorganic bovine bone mineral combined with plasma rich in growth factors. Barrier membranes were stabilised with titanium pins, and lateral-window sinus floor elevation was performed when indicated. Implants were placed using a delayed protocol at re-entry after 6-9 months.
Radiographic bone height and width were assessed by cone-beam computed tomography before surgery, immediately after surgery, at 6-9 months, and at 12 months. The study also recorded graft dimensional stability, implant placement, and surgical or postoperative complications.
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
Severe atrophy of the edentulous maxilla may limit fixed implant-supported rehabilitation because of insufficient residual alveolar ridge height and width. Guided bone regeneration is used to reconstruct deficient ridges before implant placement, while plasma rich in growth factors may provide an autologous fibrin matrix enriched with platelet-derived mediators.
This prospective clinical study assessed a guided bone regeneration protocol combined with plasma rich in growth factors for reconstruction of the atrophic edentulous maxilla. Eligible participants presented with an edentulous atrophic maxilla requiring vertical and/or horizontal ridge augmentation before implant placement. The surgical protocol included guided bone regeneration using a composite graft of autogenous bone and anorganic bovine bone mineral in a 60:40 ratio, combined with plasma rich in growth factors prepared from autologous blood. The grafted area was covered with a barrier membrane stabilised with titanium pins. Titanium-reinforced PTFE membranes were used for defects requiring vertical space maintenance, while collagen membranes were used for horizontal augmentations. Lateral-window sinus floor elevation was performed simultaneously when indicated by posterior maxillary anatomy.
Cone-beam computed tomography was obtained pre-surgically, immediately post-operatively, at 6-9 months, and at 12 months. Linear vertical and horizontal bone measurements were performed at three standardised maxillary reference sites: the lateral wall of the nasal cavity, the medial wall of the maxillary sinus, and the zygomatic apophysis. Bone gain was calculated in millimetres and as percentage change relative to the pre-surgical dimension. Graft resorption was calculated between the immediate post-operative and 12-month assessments. Implant placement and intraoperative or postoperative complications were also recorded.
Tipo di studio
Iscrizione (Effettivo)
Fase
- Non applicabile
Contatti e Sedi
Luoghi di studio
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Porto, Portogallo
- Faculty of Dental Medicine, University of Porto
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
Age 18 years or older. Fully edentulous maxilla requiring implant-supported fixed oral rehabilitation. Atrophic maxillary alveolar ridge requiring vertical and/or horizontal bone augmentation before implant placement.
Residual alveolar ridge width below 6 mm and/or residual bone height below 10 mm, as assessed by cone-beam computed tomography.
ASA physical status I or II. Clinical indication for guided bone regeneration, with or without simultaneous maxillary sinus floor elevation.
Adequate oral hygiene and willingness to comply with postoperative instructions and follow-up visits.
Written informed consent provided.
Exclusion Criteria:
ASA physical status III or higher. Uncontrolled systemic disease contraindicating oral surgery or bone regenerative procedures.
Uncontrolled diabetes mellitus or other systemic condition expected to impair wound healing or bone regeneration.
History of radiotherapy to the head and neck region. Current or previous intravenous antiresorptive or antiangiogenic therapy associated with risk of medication-related osteonecrosis of the jaw.
Active oral infection at the surgical site. Untreated periodontal disease or poor oral hygiene incompatible with regenerative surgery.
Heavy smoking or unwillingness to comply with perioperative smoking restrictions.
Pregnancy or breastfeeding. Inability to understand the study procedures or provide informed consent. Inability or unwillingness to attend scheduled follow-up visits. Any medical, anatomical, or behavioural condition judged by the investigator to interfere with surgery, healing, follow-up, or interpretation of outcomes.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: N / A
- Modello interventistico: Assegnazione di gruppo singolo
- Mascheramento: Nessuno (etichetta aperta)
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
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Sperimentale: GBR Combined With PRGF
Participants with an atrophic edentulous maxilla requiring vertical and/or horizontal bone augmentation before implant-supported rehabilitation underwent guided bone regeneration combined with plasma rich in growth factors.
The procedure used a composite graft of autogenous bone and anorganic bovine bone mineral combined with PRGF.
Barrier membranes were stabilised with titanium pins, and simultaneous lateral-window sinus floor elevation was performed when clinically indicated.
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Guided bone regeneration was performed for reconstruction of the atrophic edentulous maxilla.
Autogenous bone harvested intra-orally was combined with anorganic bovine bone mineral in a 60:40 ratio and mixed with autologous plasma rich in growth factors.
The grafted area was covered with a barrier membrane stabilised with titanium pins.
Titanium-reinforced PTFE membranes were used for defects requiring vertical space maintenance, while collagen membranes were used for horizontal augmentations.
Lateral-window sinus floor elevation was performed simultaneously when indicated.
Implants were placed using a delayed protocol at re-entry after 6-9 months.
Altri nomi:
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Change in Vertical and Horizontal Maxillary Bone Dimensions
Lasso di tempo: Pre-surgery, immediately post-operative, 6-9 months, and 12 months
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Vertical and horizontal bone dimensions were measured using standardized cone-beam computed tomography at three maxillary reference sites: the lateral wall of the nasal cavity, the medial wall of the maxillary sinus, and the zygomatic apophysis.
Bone gain was calculated in millimeters and as percentage change relative to the pre-surgical dimension.
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Pre-surgery, immediately post-operative, 6-9 months, and 12 months
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Graft Resorption
Lasso di tempo: Immediately post-operative to 12 months
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Graft resorption was calculated as the percentage change in vertical and horizontal bone dimensions between the immediate post-operative CBCT and the 12-month CBCT assessment.
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Immediately post-operative to 12 months
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Number of Dental Implants Placed
Lasso di tempo: 6-9 months after augmentation
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Number of dental implants placed during delayed implant placement at re-entry following guided bone regeneration.
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6-9 months after augmentation
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Incidence of Surgical and Postoperative Complications
Lasso di tempo: From augmentation surgery to 12 months
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Intraoperative and postoperative complications were recorded, including infection, graft loss, membrane-related complications, and other adverse events.
Complications were classified according to severity and whether they affected graft integrity.
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From augmentation surgery to 12 months
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Collaboratori e investigatori
Sponsor
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Studia le date principali
Inizio studio (Effettivo)
Completamento primario (Effettivo)
Completamento dello studio (Effettivo)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
- Riassorbimento osseo
- Malattie ossee
- Malattie muscoloscheletriche
- Atrofia parodontale
- Malattie parodontali
- Malattie della bocca
- Malattie stomatognatiche
- Malattie della mascella
- Malattie mascellari
- Perdita ossea alveolare
- Mascella atrofica
- Peptidi
- Aminoacidi, peptidi e proteine
- Proteine
- Procedure chirurgiche, operative
- Fattori biologici
- Odontoiatria
- Procedure chirurgiche orali
- Procedure chirurgiche orali, preprotetico
- Peptidi e proteine di segnalazione intercellulare
- Alveolar Ridge Augmentation
Altri numeri di identificazione dello studio
- 5/2022 FMDUP-PRGF
- 5/2022 (Altro identificatore: Ethics Committee for Health of the Faculty of Dental Medicine, U. Porto)
Piano per i dati dei singoli partecipanti (IPD)
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Descrizione del piano IPD
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