Lifting of the maxillary sinus: complementary use of platelet rich plasma, autologous bone deproteinised bovine bone. Case report [Rialzo del seno mascellare: uso complementare di plasma arricchito di piastrine, osso autologo e osso bovino deproteinizzato. Caso clinico.]

The present paper describes a clinical case in which autologous bone, removed during an operation from the maxillary tuberosity, platelet rich plasma (PRP) and deproteinised bovine bone (Bio-oss, Geistlich) were used as graft material in a bilateral maxillary sinus lift procedure. During the same operating session, it was planned to carry out the lift of the maxillary sinus, employing a "combined" graft (autologous bone, PRP, deproteinised bovine bone), and to insert 6 fixtures at maxillary level, 3 in each quadrant, and 6 fixtures at mandibular level. The use of PRP, or rather of the platelet gel derived from it, represented an improvement compared to standard bone graft techniques. A graft consisting of autologous bone and PRP (with or without deproteinised bovine bone) makes it possible in fact to carry out more demanding operations, such as a major lift of the maxillary sinus, without the need for a block graft, but employing autologous bone particulate, which is easier to find. Furthermore, a "combined" graft is easily malleable and adjustable and can be adapted perfectly to the bone defect in which it is inserted. Finally, it guarantees a better quality of cure both in terms of speed and degree of mineralisation. This is very important if we consider that usually, lifting of the maxillary sinus is carried out precisely to guarantee adequate bone volume in cases where bone has been lost and to permit the insertion of osteointegrated implants.