Powering Bone Regeneration
Platelet-rich fibrin (PRF) is showing promise as both a standalone and adjunctive material in sinus augmentation. Research points to its potential to accelerate healing, improve bone formation, and reduce residual graft material.
Since the original sinus lift techniques were introduced in 1980, innovations in biomaterials have continuously shaped how clinicians approach maxillary sinus augmentation. One such innovation, platelet-rich fibrin (PRF), has gained attention for its regenerative potential. As a natural concentrate of growth factors, PRF is now being studied not only as an adjunct to bone grafts but also as a primary material in select cases.
The versatility of platelet-rich fibrin to promote bone healing with regards to sinus augmentation has been documented in recent years both as a sole material but also in combination with other biomaterials. Traditionally, sinus lift procedures, as described by Boyne and James in 1980, involved access to the sinus via a lateral window.1 The use of graft materials, including autogenous bone, allografts, xenografts, and combinations of the various materials, have been well studied as part of the traditional sinus lift.2
The use of PRF in a sinus lift procedure represents a different modality to maxillary sinus grafting. When used in combination with grafting material or independently, PRF can provide a reservoir for growth factors to act directly on osteoblasts, fibroblasts, and endothelial cells.3 This interaction can lead to tissue regeneration, potential to recruit circulating stems cells, and the ability to promote wound closure using epithelial tissues.
A recent systematic review found that nine out of 13 controlled studies reported positive results for PRF in soft tissue regeneration and wound healing. Histomorphometry assessments have shown that new bone formation with the combination of PRF and biomaterials ranges from 17% to 45%, compared to 13% to 33% with biomaterials alone.4 Meta-analysis indicated a 1.98% increase in new bone formation with the addition of PRF to biomaterials, though these findings were not statistically significant and exhibited moderate heterogeneity across studies. Regarding residual biomaterial, pooled analysis demonstrated a statistically significant reduction of 4.60% when PRF was used.
While more high-quality studies are needed to establish definitive clinical protocols, the current data suggest that PRF can enhance both soft and hard tissue outcomes in sinus augmentation. With its ability to promote healing and reduce reliance on synthetic materials, PRF may play an increasingly central role in the future of minimally invasive and biologically driven implant dentistry.
References
- Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980;38:613-616.
- Al-Moraissi EA, Alkhutari AS, Abotaleb B, Altairi NH, Del Fabbro M. Do osteoconductive bone substitutes result in similar bone regeneration for maxillary sinus augmentation when compared to osteogenic and osteoinductive bone grafts? A systematic review and frequentist network meta-analysis. Int J Oral Maxillofac Surg. 2020;49:107-120.
- Miron RJ, Zucchelli G, Pikos MA, et al. Use of platelet-rich fibrin in regenerative dentistry: a systematic review. Clin Oral Investig. 2017;21:1913-1927.
- 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;13:622.
This originally appeared in Luan KW, Narvekar A. Unlocking the regenerative power of platelet-rich fibrin. Decisions in Dentistry. 2025;11(2):40-45.
