. 2024 Jul 25;12(8):1661.

doi: 10.3390/biomedicines12081661.

Sinus Floor Augmentation with Synthetic Hydroxyapatite (NanoBone^®) in Combination with Platelet-Rich Fibrin: A Case Series

Luís Francisco¹, Manuel Francisco², Rosana Costa^{1

3}, Miguel Nunes Vasques^{1

3}, Marta Relvas^{1

3}, António Rajão^{4

5}, Luís Monteiro^{1

3}, Paulo Rompante¹, Fernando Guerra^{6

7

8}, Marco Infante da Câmara^{1

3

9}

Affiliations

¹ Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal.
² Clinical Assistant Professor Postgraduate Implant Program, Famalicão Unit, University Institute of Health Sciences (IUCS-CESPU), Av. Marechal Humberto Delgado, 14, 4760-012 Vila Nova de Famalicão, Portugal.
³ Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal.
⁴ Associate Laboratory i4HB-Institute for Health and Bioeconomy, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal.
⁵ Applied Molecular Biosciences Unit (UCIBIO), Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), 4585-116 Gandra, Portugal.
⁶ Institute of Oral Implantology and Prosthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.
⁷ Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.
⁸ Laboratory of Hard Tissues, Dentistry Department, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.
⁹ Coordinator of the Postgraduate Implant Program, Famalicão Unit, University Institute of Health Sciences (IUCS-CESPU), Av. Marechal Humberto Delgado, 14, 4760-012 Vila Nova de Famalicão, Portugal.

PMID: 39200126
PMCID: PMC11351586
DOI: 10.3390/biomedicines12081661

Sinus Floor Augmentation with Synthetic Hydroxyapatite (NanoBone^®) in Combination with Platelet-Rich Fibrin: A Case Series

Luís Francisco et al. Biomedicines. 2024.

. 2024 Jul 25;12(8):1661.

doi: 10.3390/biomedicines12081661.

Authors

Affiliations

¹ Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal.
² Clinical Assistant Professor Postgraduate Implant Program, Famalicão Unit, University Institute of Health Sciences (IUCS-CESPU), Av. Marechal Humberto Delgado, 14, 4760-012 Vila Nova de Famalicão, Portugal.
³ Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal.
⁴ Associate Laboratory i4HB-Institute for Health and Bioeconomy, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal.
⁵ Applied Molecular Biosciences Unit (UCIBIO), Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), 4585-116 Gandra, Portugal.
⁶ Institute of Oral Implantology and Prosthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.
⁷ Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.
⁸ Laboratory of Hard Tissues, Dentistry Department, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.
⁹ Coordinator of the Postgraduate Implant Program, Famalicão Unit, University Institute of Health Sciences (IUCS-CESPU), Av. Marechal Humberto Delgado, 14, 4760-012 Vila Nova de Famalicão, Portugal.

PMID: 39200126
PMCID: PMC11351586
DOI: 10.3390/biomedicines12081661

Abstract

Several techniques have been described for maxillary sinus graft augmentation, including the lateral window technique and crestal approach with osteotomes or osseodensification. Platelet-rich fibrin has been used in maxillary sinus lift procedures due to its ability to accelerate soft and hard tissue healing. The aim of this study was to evaluate the potential of PRF in combination with the synthetic hydroxyapatite NanoBone^® to enhance bone regeneration in sinus floor elevation with the lateral window technique. Out of the 50 individuals screened in a preoperative assessment visit from the CESPU-Famalicão clinical unit and intervened upon between January 2023 and December 2023, only 6 patients who met the study's inclusion criteria consented to participate. In a split-mouth study, twelve sinus graft surgeries were carried out. Our observations reveal that for the test group (NanoBone^®/PRF), there is a 27.5 ± 4.9% increase new vital bone, 23.0 ± 3.7% increase in inert bone particles, and 49.4 ± 2.8% increase in connective tissue. Meanwhile, for the control group (NanoBone^®), there is a 19.5 ± 3.0% increase in new vital bone, 23.4 ± 5.7% increase in inert bone particles, and 57.0 ± 3.5% increase in connective tissue. The results strongly indicate that mixing liquid PRF with NanoBone^® does not have a negative influence on the amount of viable bone formation, and it seems to slightly increase the amount of new bone formation and revascularization in sinus bone graft procedures with the lateral window technique compared to the single use of NanoBone^®.

Keywords: biomaterials; maxillary sinus augmentation; platelet-rich fibrin; sinus floor augmentation.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

**Figure 1**
A visual representation of the surgery. (a) Bony window with Acteon Satelec^® piezoelectric device; (b) Schneiderian membrane elevated; (c) Aggregation of NanoBone^® with liquid fibrin; (d) Biomaterial insertion in the sinus cavity; (e) Straumann^® Fex collagen membrane over the bony window.

**Figure 2**
Harvesting of the bone specimen with a 2.5 mm diameter trephine bur. (a) Surgical site; (b) Trephine drill with collected bone; (c) Trephine drill with bone specimen in a 10% formaldehyde sterile vial.

**Figure 4**
Newly formed bone, residual bone graft material, and connective tissue for both control (NanoBone^® alone) and test groups (NanoBone^®/liquid fibrin). Bars represent the mean and standard deviation of individuals results. (A) New vital bone, (B) particles, (C) new vital bone + particles, and (D) connective tissue. (*** p < 0.0005).

**Figure 5**
Histologic results in both groups: (a) test group; (b) control group. 10 × 0.5 magnification and toluidine blue staining.

**Figure 6**
Histologic results in both groups: (a) test group; (b) control group. 10 × 0.5 magnification and toluidine blue staining.

**Figure 7**
Histologic results in both groups: (a) test group; (b) control group. 10 × 0.5 magnification and toluidine blue staining.

**Figure 8**
Histologic results in both groups: (a) test group; (b) control group. 10 × 0.5 magnification and toluidine blue staining.

**Figure 9**
Histologic results in the test group. 10 × 0.5 magnification and toluidine blue staining.

**Figure 10**
Histologic results in both groups: (a,b) test group; (c) control group. 10 × 0.5 magnification and toluidine blue staining.

**Figure 11**
Histologic results in the control group. 10 × 0.5 magnification and toluidine blue staining.

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Cited by

Efficacy of platelet-rich albumin and fibrin gel in two-stage lateral sinus lift: a prospective study.
Barakat M, Khalil A, Albash Z. Barakat M, et al. Ann Med Surg (Lond). 2025 Jul 25;87(9):5409-5416. doi: 10.1097/MS9.0000000000003589. eCollection 2025 Sep. Ann Med Surg (Lond). 2025. PMID: 40901151 Free PMC article.

References

1. Choukroun J., Diss A., Simonpieri A., Girard M.O., Schoeffler C., Dohan S.L., Dohan A.J., Mouhyi J., Dohan D.M. 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;101:299–303. doi: 10.1016/j.tripleo.2005.07.012. - DOI - PubMed
1. Carreño J.C., Aguilar-Salvatierra A., Gómez-Moreno G., Carreño E.M.G., López-Mateos M.L.M., Perrotti V., Piattelli A., Calvo-Guirado J.L., Menéndez-Núñez M. Update of Surgical Techniques for Maxillary Sinus Augmentation: A Systematic Literature Review. Implant Dent. 2016;25:839–844. doi: 10.1097/ID.0000000000000467. - DOI - PubMed
1. Lundgren S., Cricchio G., Hallman M., Jungner M., Rasmusson L., Sennerby L. Sinus floor elevation procedures to enable implant placement and integration: Techniques, biological aspects and clinical outcomes. Periodontol. 2000. 2017;73:103–120. doi: 10.1111/prd.12165. - DOI - PubMed
1. Fontes Pereira J., Costa R., Nunes Vasques M., Salazar F., Mendes J.M., Infante da Câmara M. Osseodensification: An Alternative to Conventional Osteotomy in Implant Site Preparation: A Systematic Review. J. Clin. Med. 2023;12:7046. doi: 10.3390/jcm12227046. - DOI - PMC - PubMed
1. Fukuba S., Okada M., Nohara K., Iwata T. Alloplastic bone substitutes for periodontal and bone regeneration in dentistry: Current status and prospects. Materials. 2021;14:1096. doi: 10.3390/ma14051096. - DOI - PMC - PubMed

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Sinus Floor Augmentation with Synthetic Hydroxyapatite (NanoBone^®) in Combination with Platelet-Rich Fibrin: A Case Series

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Sinus Floor Augmentation with Synthetic Hydroxyapatite (NanoBone^®) in Combination with Platelet-Rich Fibrin: A Case Series

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