A 6-month histologic and histomorphometric assessment of xenograft or xenograft combined with plasma rich in growth factors versus autogenous bone in sinus augmentation: a randomized controlled trial

Egyptian Dental Journal 2019; 65 (3): 2067-2076


The purpose of this study was to evaluate the effect of combining the PRGF to Xenograft on quality of the newly formed bone in open sinus lifting procedures after six months.


Thirty maxillary sinuses were augmented in twenty five patients, 18 males and 7 females, who had less than 5 mm of bone height. Maxillary sinuses were randomly allocated into one of three groups; the study group I, where the sinus was augmented using autogenous bone taken from the patient’s chin, group II, in which the sinus was augmented using Xenograft mixed with saline, group III, in which the sinus was augmented using Xenograft mixed with Platelets rich in growth factors (PRGF). After 6 months healing period, core biopsies were harvested and implant was simultaneously placed in the same site. Comparative microscopic and histomorphometric analysis were conducted and statistically analyzed. Implant loading was done after 6 months healing period.


After 6 months, the results of this study showed that there was no adverse effect noticed in any case during the follow-up period. Histological findings showed that the addition of PRGF promotes bone maturation preceding the bovine grafted material alone. The histological stained specimens of group III revealed a picture more or less resembling group I (autogenous bone). The amount of the residual graft particles in the group I and III were found to be less than group II.


Combining PRGF to the xenograft improved the handling characteristics and the quality of the bone after 6 months in maxillary sinus augmentation procedure. Although PRGF combined to xenograft promoted bone maturation preceding the bovine grafted material alone, it did not prove to be superior to the autogenous bone which remains to be the gold standard for grafting.

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