Bone Regeneration With Autologous Biomaterial; Rapid Induction of Vital New Bone in Maxillary Sinus Floor by Platelet Concentrate Alone at 23× Baseline (PRP23×): A Case Report

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Abstract

To date, most clinicians and researchers have been using platelet concentrate within the range of 4× to 8× baseline. In this case report a new procedure involving strategic pooling and triple spin was developed and used to concentrate platelets to 23× baseline. The concentrate alone was infused into morselized resorbable collagen sponge, activated with calcium chloride and autologous thrombin, then placed as an autologous graft into the left sinus floor of a healthy 80-year-old woman. The floor of the sinus had ∼2 mm of bony height. A computed tomography scan taken after 5 months showed that new bone was formed and it was as dense as native bone around the surgical site. From the computed tomography scan bone density analysis using Hounsfield Units revealed that the bone formed was D3 bone (518.3 ± 224.9 Hounsfield Units) and it was as dense as native bone on the axial, coronal and sagittal slices. Histomorphometric analysis of 2 bone core biopsies taken after 6 months showed that 1 core had 34% bone of which 98% was vital new bone and the other core had 39% bone of which 100% was vital new bone. The height of the bone formed in the sinus floor was 12 mm. It was also characterized by good trabecular pattern and connectivity. The quality of the bone generated was such that 2 endosseous implants were placed and torqued to 30 N cm after the cores were removed.

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