Levantamento bilateral do seio maxilar por acesso lateral com xenoenxerto bovino e fibrina rica em plaquetas autóloga: relato de caso e análise de viabilidade clínica
DOI:
https://doi.org/10.62331/2965-758X.v3.2025.64Palavras-chave:
Levantamento da membrana Schneider, Seio maxilar, Xenoenxerto, Fibrina rica em plaquetas, Adjuvante bioativo, Regeneração óssea, ImplantodontiaResumo
A reabsorção óssea pós-extração e pneumatização sinusal na maxila posterior representam desafios críticos para reabilitação com implantes, exigindo técnicas regenerativas como o levantamento do seio maxilar (LSM) com biomateriais. O objetivo do estudo foi relatar a eficácia clínica da associação entre xenoenxerto bovino e fibrina rica em plaquetas (PRF) no LSM bilateral por acesso lateral. Paciente do sexo feminino, 54 anos, com reabsorção óssea severa, foi submetida a elevação da membrana schneideriana e preenchimento do espaço sub-sinusal com compósito de Cerabone® e PRF autóloga. Após 6 meses, tomografia confirmou consolidação óssea adequada, permitindo instalação estável de implantes e resolução da disfunção mastigatória. Conclui-se que a técnica combinatória demonstrou viabilidade, com formação óssea satisfatória e benefícios atribuíveis às propriedades bioativas da PRF (aceleração da cicatrização e vascularização). Inconsistências na literatura reforçam a necessidade de estudos controlados para validar sua eficácia osteogênica sinérgica.
Referências
da Silva AJC, Arruda FJS de. Desafios na implantodontia: biomateriais e sua contribuição na reabilitação de maxilas atróficas. Biosciences and Health. 2025; 3:1-7. https://doi.org/10.62331/2965-758X.v3.2025.71
Santos MEC dos, Arruda FJS de. Prótese parcial removível associada a implantes dentários - relato de caso. Biosciences and Health. 2025; 3:1-9. https://doi.org/10.62331/2965-758X.v3.2025.63
Alshamrani AM, Mubarki M, Alsager AS, Alsharif HK, AlHumaidan SA, Al-Omar A. Maxillary sinus lift procedures: an overview of current techniques, presurgical evaluation, and complications. Cureus. 2023; 15(11):e49553. https://doi.org/10.7759/cureus.49553
Andrés-García R, Ríos-Santos JV, Herrero-Climent M, Bullón P, Fernández-Farhall J, Gómez-Menchero A, et al. Sinus floor elevation via an osteotome technique without biomaterials. Int J Environ Res Public Health. 2021; 18(3):1103. https://doi.org/10.3390/ijerph18031103.
Fischer JL, Riley CA, Kacker A. Sinonasal complications following the sinus lift procedure. Ochsner J. 2023; 23(2):147-151. https://doi.org/10.31486/toj.22.0125
Sheikhi M, Haghighat A, Lourizadeh N, Tavangar H, Aryaee P. Evaluation of the effect of direct sinus lift surgery on maxillary sinus volume by Mimics software. Natl J Maxillofac Surg. 2023; 14(2):198-207. https://doi.org/10.4103/njms.njms_155_22
Farias IOB, Bahia RRC, Barreto MA, Pinto FS, Fernandes AC de S. Lateral window maxillary sinus lift surgery: case report. RGO. 2022; 70:e20220031. https://doi.org/10.1590/1981-86372022003120210042
Schiavon L, Perini A, Brunello G, Ferrante G, Del Fabbro M, Botticelli D, et al. The bone lid technique in lateral sinus lift: a systematic review and meta-analysis. Int J Implant Dent. 2022; 8(1):33. https://doi.org/10.1186/s40729-022-00433-3
Virnik S, Cueni L, Kloss-Brandstätter A. Is one-stage lateral sinus lift and implantation safe in severely atrophic maxillae? results of a comparative pilot study. Int J Implant Dent. 2023; 9(1):6. https://doi.org/10.1186/s40729-023-00471-5
Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part V: histologic evaluations of PRF effects on bone allograft maturation in sinus lift. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 101(3):299-303. https://doi.org/10.1016/j.tripleo.2005.07.012
Simonpieri A, Del Corso M, Vervelle A, Jimbo R, Inchingolo F, Sammartino G, et al. Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 2: bone graft, implant and reconstructive surgery. Curr Pharm Biotechnol. 2012; 13(7):1231-56. https://doi.org/10.2174/138920112800624472
Arshad S, Tehreem F, Rehab Khan M, Ahmed F, Marya A, Karobari MI. Platelet-rich fibrin used in regenerative endodontics and dentistry: current uses, limitations, and future recommendations for application. Int J Dent. 2021; 2021:4514598. https://doi.org/10.1155/2021/4514598
Lie SAN, Claessen RMMA, Leung CAW, Merten HA, Kessler PAWH. Non-grafted versus grafted sinus lift procedures for implantation in the atrophic maxilla: a systematic review and meta-analysis of randomized controlled trials. Int J Oral Maxillofac Surg. 2022; 51(1):122-132. https://doi.org/10.1016/j.ijom.2021.03.016
da Silva HF, Goulart DR, Sverzut AT, Olate S, de Moraes M. Comparison of two anorganic bovine bone in maxillary sinus lift: a split-mouth study with clinical, radiographical, and histomorphometrical analysis. Int J Implant Dent. 2020; 6(1):17. https://doi.org/10.1186/s40729-020-00214-w
Jamcoski VH, Faot F, Marcello-Machado RM, Melo ACM, Fontão FNGK. 15-Year retrospective study on the success rate of maxillary sinus augmentation and implants: influence of bone substitute type, presurgical bone height, and membrane perforation during sinus lift. Biomed Res Int. 2023; 2023:9144661. https://doi.org/10.1155/2023/9144661
Miron RJ, Fujioka-Kobayashi M, Sculean A, Zhang Y. Optimization of platelet-rich fibrin. Periodontol 2000. 2024; 94(1):79-91. https://doi.org/10.1111/prd.12521
Damsaz M, Castagnoli CZ, Eshghpour M, Alamdari DH, Alamdari AH, Noujeim ZEF, et al. Evidence-based clinical efficacy of leukocyte and platelet-rich fibrin in maxillary sinus floor lift, graft and surgical augmentation procedures. Front Surg. 2020; 7:537138. https://doi.org/10.3389/fsurg.2020.537138
Baru O, Buduru SD, Berindan-Neagoe I, Leucuta DC, Roman AR, Tălmăceanu D, et al. Autologous leucocyte and platelet rich in fibrin (L-PRF) - is it a competitive solution for bone augmentation in maxillary sinus lift? A 6-month radiological comparison between xenografts and L-PRF. Med Pharm Rep. 2024; 97(2):222-233. https://doi.org/10.15386/mpr-2719
Pardal-Peláez B, Córdoba-Llorente JR, Belarra-Arenas C. Sinus lift through the use of a surgical guide: a case report. Int J Comput Dent. 2020; 23(4):377-386. Disponível em: https://pubmed.ncbi.nlm.nih.gov/33491933/
Otero AIP, Fernandes JCH, Borges T, Nassani L, Castilho RM, Fernandes GVO. Sinus lift associated with leucocyte-platelet-rich fibrin (second generation) for bone gain: a systematic review. J Clin Med. 2022; 11(7):1888. https://doi.org/10.3390/jcm11071888
Egierska D, Perszke M, Mazur M, Duś-Ilnicka I. Platelet-rich plasma and platelet-rich fibrin in oral surgery: a narrative review. Dent Med Probl. 2023; 60(1):177-186. https://doi.org/10.17219/dmp/147298
Dominiak S, Karuga-Kuźniewska E, Popecki P, Kubasiewicz-Ross P. PRF versus xenograft in sinus augmentation in case of HA-coating implant placement: a 36-month retrospective study. Adv Clin Exp Med. 2021; 30(6):633-640. https://doi.org/10.17219/acem/134202
Ortega-Mejia H, Estrugo-Devesa A, Saka-Herrán C, Ayuso-Montero R, López-López J, Velasco-Ortega E. Platelet-rich plasma in maxillary sinus augmentation: systematic review. Materials (Basel). 2020; 13(3):622. https://doi.org/10.3390/ma13030622
Rocha CA, Arantes RVN, Cestari TM, Santos PS, Assis GF, Taga R. Maxillary sinus lift response to platelet-rich plasma associated with autogenous bone, ceramic biphasic HA/β-TCP (70:30), or deproteinized bovine bone. Int J Implant Dent. 2020; 6(1):79. https://doi.org/10.1186/s40729-020-00277-9
Malcangi G, Patano A, Palmieri G, Di Pede C, Latini G, Inchingolo AD, et al. Maxillary sinus augmentation using autologous platelet concentrates (platelet-rich plasma, platelet-rich fibrin, and concentrated growth factor) combined with bone graft: a systematic review. Cells. 2023; 12(13):1797. https://doi.org/10.3390/cells12131797
Wang H, Wang J, Guo T, Ding X, Yu W, Zhao J, et al. The endoscopically assisted transcrestal sinus floor elevation with platelet-rich fibrin at an immediate implantation of periapical lesion site: a case report. Medicine (Baltimore). 2019; 98(27):e16251. https://doi.org/10.1097/MD.0000000000016251
Nguyen XT, Le LN, Do TT, Le KPV. Increasing bone regeneration in maxillary sinus augmentation using platelet-rich fibrin: an interventional pre-post study. J Contemp Dent Pract. 2024; 25(9):814-819. https://doi.org/10.5005/jp-journals-10024-3747
Gasparro R, Di Lauro AE, Campana MD, Rosiello N, Mariniello M, Sammartino G, et al. Effectiveness of autologous platelet concentrates in the sinus lift surgery: findings from systematic reviews and meta-analyses. Dent J (Basel). 2024; 12(4):101. https://doi.org/10.3390/dj12040101
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Copyright (c) 2025 Lucas Romero Trevisan, Farid Jamil Silva de Arruda
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