Effect of Autologous Growth Factors in Maxillary Sinus Augmentation : a Systematic Review

Purpose: The aim of the present study was to systematically evaluate the effect of autogenous platelet concentrates on the clinical and histomorphometric outcomes of maxillary sinus augmentation. Materials and Methods: MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched using a combination of specific search terms. Furthermore, a hand searching of the relevant journals and of the bibliographies of reviews was performed. Prospective comparative clinical studies were included. Implant survival and histomorphometric outcomes were evaluated. Results: Twelve studies were included. Four hundred forty-five sinus floor augmentation procedures were considered. No difference in implant survival was reported between test and control groups. Six studies reported a beneficial effect of platelet concentrates based on histomorphometric outcomes, while another six studies found no significant effect. A large heterogeneity was found regarding study design, surgical techniques, graft materials, clinical and histomorphometric outcome variables, and methods for preparing platelet concentrates. Favorable effects on soft tissue healing and postoperative discomfort reduction were often reported but not quantified. Conclusions: A clear advantage of platelet concentrates could not be evidenced. Standardization in the experimental design is needed in order to detect the true effect of platelet concentrates in maxillary sinus augmentation procedure, especially regarding postoperative quality of life.