Clinical, histomorphologic and radiographic comparison of natural mineralised hidroxylapatit grafts with combination of natural mineralised hidroxylapatit grafts and plasma-rich protein in human maxillary sinus augmentation operation

Osseointegrated oral implants are widely used to restore total or partial edentulism. İmplant placement in the posterior maxilla is often complicated due to the insufficient bone volume caused by atrophy of the maxillae and pneumatization of the maxillary sinus.The sinus floor elevation is an internal augmentation of the maxillary sinus, which is intended to increase the vertical bony dimension in the lateral maxilla in order to make the use of dental implants possible. Many techniques have been described to achieve grafting of the maxillary sinus mucosa.Resent efforts to improve wound healing have focused on autogenous sources of bioactive mediators, such as platelet-rich plasma which offer the potential to enhance the biological activity of bone replacement grafts.Prosthetic rehabilitation of the edentulous maxilla using endosteal implant is able to sinus elevation and grafting. It is supported that using of bioactive mediators appropriates for improve bone regeneration time.In our study, for the cases where implant is not possible at atrophic maxillary posterior parts, sinus base elevation and graft materials were applied in order to build the necessary bone volume.The aim of this thesis study is to evaluate the produced bone?s quality, quantity, volume and period of healing process clinically, radiologically, histologically and histomorphogicaly.22 sinus elevation operations under local anesthesia performed on 16 patients who had applied to Dicle Dentistry Faculty, with no systemic illnesses which may affect healing. Before operations, panoromic graphy and conical beam 3D dental tomographies (i-CAT®, USA ) of all patients were taken. 12 of sinus elevation operations were performed by using natural mineralized hydroxyapatite (HA, Apatos, OsteoBiol®) and then mucoperiosteal flap premier was closed by installing a collagen membrane (Evolution Membran, OsteoBiol®) that can be resorbed on bone window. In other 10 sinus elevation operations, along with mineralized hydroxyapatite, platelet-rich plasma (PRP) mixtures produced from the patients? own blood samples were used. Then mucopeirosteal flap premier was closed by installing a collagen membrane that can be resorbed on bone window.Panoromic graphy and computerised tomographies of the first group of patients were taken following a-8 month-healing period and for the second group following a-4-month healing period. After that, following bone biopsy taken through trephine frezzes, dental implants were installed. At the end of 4 month healing period, biopsy samples were taken from 2 patients in the first group. The samples were evaluated histomorphologically.Resultly; In histomorphologic evaluation, core biopsies taken from patient using PRP+Natural Mineralized Hidroxylapatit after 4. month were seen greater bone formation, osteoid tissue and lameller matrix. But no significant differences were statistically observed between them.