{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T22:58:13Z","timestamp":1788044293494,"version":"build-2784847793"},"reference-count":55,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2020,3,15]],"date-time":"2020-03-15T00:00:00Z","timestamp":1584230400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This randomized controlled clinical trial evaluated the effect of mineralized plasmatic matrix (MPM), comprised of synthetic graft and platelet concentrates, on new bone formation and volume stability over time in maxillary sinus lifting (MSL). Unilateral MSL was performed in 20 patients with either beta-tricalcium phosphate (\u03b2-TCP) or MPM grafts (10 sinuses each). Six months postsurgery, specimens were obtained with a trephine bur prior to implant placement in 39 cases. Volumetric changes in sinus augmentation were analyzed between 1 week (T-I) and 6 months (T-II) postsurgery. Histomorphometric and histological analyses of biopsy samples revealed mean new bone percentages of 35.40% \u00b1 9.09% and 26.92% \u00b1 7.26% and residual graft particle areas of 23.13% \u00b1 6.16% and 32.25% \u00b1 8.48% in the MPM and \u03b2-TCP groups, respectively (p &lt; 0.05). The mean soft-tissue areas in the MPM and \u03b2-TCP groups were 41.48% \u00b1 8.41% and 40.83% \u00b1 8.86%, respectively (p &gt; 0.05). Graft reductions between baseline and 6-months postprocedure in the \u03b2-TCP and MPM groups were 17.12% \u00b1 13.55% and 14.41% \u00b1 12.87%, respectively, with significant graft volume reduction observed in both groups (p &lt; 0.05) while there is no significant difference between MPM and \u03b2-TCP groups (p &gt; 0.05). Thus, MPM, representing growth factors in a fibrin network, increases new bone formation and has acceptable volume stability in MSL procedures<\/jats:p>","DOI":"10.3390\/ijerph17061918","type":"journal-article","created":{"date-parts":[[2020,3,18]],"date-time":"2020-03-18T08:13:27Z","timestamp":1584519207000},"page":"1918","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Histologic, Histomorphometric, and Clinical Analysis of the Effects of Growth Factors in a Fibrin Network Used in Maxillary Sinus Augmentation"],"prefix":"10.3390","volume":"17","author":[{"given":"Ihsan Caglar","family":"Cinar","sequence":"first","affiliation":[{"name":"Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul, 34093 Fatih, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahattin Alper","family":"Gultekin","sequence":"additional","affiliation":[{"name":"Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul, 34093 Fatih, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7121-0257","authenticated-orcid":false,"given":"Alper","family":"Saglanmak","sequence":"additional","affiliation":[{"name":"Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul, 34093 Fatih, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serdar","family":"Yalcin","sequence":"additional","affiliation":[{"name":"Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul, 34093 Fatih, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vakur","family":"Olgac","sequence":"additional","affiliation":[{"name":"Pathology and Oncology Cytology Department of Institute of Oncology, Istanbul University, 34093 Fatih, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1661-7529","authenticated-orcid":false,"given":"Eitan","family":"Mijiritsky","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck and Maxilllofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, 5219100 Ramat Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,3,15]]},"reference":[{"key":"ref_1","first-page":"313","article-title":"Bone healing and soft tissue contour changes following single-tooth extraction: A clinical and radiographic 12-months prospective study","volume":"23","author":"Schropp","year":"2003","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_2","first-page":"48","article-title":"Maxillary sinus pneumatization following extractions: A radiographic study","volume":"23","author":"Sharan","year":"2008","journal-title":"Int. J. Oral Maxilofac. Implant."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/j.joms.2008.11.023","article-title":"Methods to treat the edentulous posterior maxilla: Implants with sinus grafting","volume":"67","author":"Chiapasco","year":"2009","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1111\/j.1600-0501.2009.01697.x","article-title":"Long-term changes in graft height after maxillary sinus floor elevation with different grafting materials: Radiographic evaluation with a minimum follow-up of 4.5 years","volume":"20","author":"Zijderveld","year":"2009","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_5","first-page":"613","article-title":"Grafting of the maxillary sinus floor with autogenous marrow and bone","volume":"38","author":"Boyne","year":"1980","journal-title":"J. Oral Surg."},{"key":"ref_6","first-page":"23","article-title":"Maxillary sinus augmentation with the xenograft Bio-Oss and autogenous intraoral bone for qualitative improvement of the implant site: A histologic and histo-morphometric clinical study in humans","volume":"16","author":"Yildirim","year":"2001","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.ijom.2011.10.001","article-title":"Maxillary sinus lift with solely autogenous bone compared to a com-bination of autogenous bone and growth factors or (solely) bone substitutes. A sys-tematic review","volume":"41","author":"Rickert","year":"2012","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1054\/ijom.2003.0465","article-title":"Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic augmentation procedures: A prospective study","volume":"33","author":"Nkenke","year":"2004","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_9","first-page":"371","article-title":"A prospective multicenter randomized clinical trial of autogenous bone versus beta-tricalcium phosphate graft alone for bilateral sinus elevation: Histologic and histomorphometric evaluation","volume":"20","author":"Szabo","year":"2005","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_10","first-page":"26","article-title":"Six-year clinical and histologic study of sin\u00fcs lift grafts","volume":"11","author":"Wheeler","year":"1996","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1243\/09544119JEIM770","article-title":"Bone grafting, orthopaedic biomaterials and clinical need for bone engineering","volume":"224","author":"Brydone","year":"2010","journal-title":"Proc. Inst. Mech Eng. H."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/0278-2391(94)90401-4","article-title":"Autologous fibrin adhesive in mandibular reconstruction with particulate cancellous bone and marrow","volume":"52","author":"Tayapongsak","year":"1994","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e37","DOI":"10.1016\/j.tripleo.2005.07.008","article-title":"Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part I: Technological concepts and evolution","volume":"101","author":"Dohan","year":"2006","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1016\/j.tripleo.2005.07.009","article-title":"Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part II: Platelet-related biologic features","volume":"101","author":"Dohan","year":"2006","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e51","DOI":"10.1016\/j.tripleo.2005.07.010","article-title":"Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part III: Leucocytes activation: A New feature for platelet concentrates?","volume":"101","author":"Dohan","year":"2006","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.archoralbio.2010.01.004","article-title":"Choukroun\u2019 s platelet-rich fibrin stimulates in vitro proliferation and differentiation of human oral bone mesenchymal stem cell in a dose-dependent way","volume":"55","author":"Doglioli","year":"2010","journal-title":"Arch. Oral Biol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.21873\/invivo.11398","article-title":"Application of Platelet-rich Plasma and Tricalcium Phosphate in the Treatment of Comminuted Fractures in Animals","volume":"32","author":"Szponder","year":"2018","journal-title":"In Vivo"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1002\/jor.21152","article-title":"Platelet-Rich Plasma on Calcium Phosphate Granules Promotes Metaphyseal Bone Healing in Mini-Pigs","volume":"28","author":"Jungbluth","year":"2010","journal-title":"J. Orthop. Res."},{"key":"ref_19","first-page":"2639564","article-title":"Effect of Bone Regeneration with Mineralized Plasmatic Matrix for Implant Placement in Aesthetic Zone","volume":"2017","author":"Amine","year":"2017","journal-title":"Case Rep. Hindawi Case Rep. Dent."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/0278-2391(89)90225-5","article-title":"Simultaneous maxillary sinus floor bone grafting and placement of hydroxylapatite-coated implants","volume":"47","author":"Kent","year":"1989","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/S0142-9612(96)00177-9","article-title":"High-precision, cost-effective cutting system for producing thin sections of oral tissues containing dental implants","volume":"18","author":"Piattelli","year":"1997","journal-title":"Biomaterials"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1111\/j.1600-0501.2011.02308.x","article-title":"Comparative histological results of different biomaterials used in sinus augmentation procedures: A human study at 6 months","volume":"23","author":"Iezzi","year":"2012","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1038\/sj.dmfr.4600601","article-title":"A clinical study of changes in the volume of bone grafts in the atrophic maxilla","volume":"30","author":"Johansson","year":"2001","journal-title":"DentoMaxilloFac. Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1034\/j.1600-0501.2002.130113.x","article-title":"Clinical results of alveolar ridge augmentation with mandibular block bone grafts in partially edentulous patients prior to implant placement","volume":"13","author":"Cordaro","year":"2002","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"289","DOI":"10.2485\/jhtb.26.289","article-title":"Mineralized plasmatic matrix to enhance the bone grafting technique","volume":"26","author":"Sghaireen","year":"2017","journal-title":"J. Hard Tis Biol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1034\/j.1600-0501.2003.140212.x","article-title":"Sinus floor augmentation with beta-tricalcium phosphate (beta-TCP): Does platelet rich plasma promote its osseous integration and degradation?","volume":"14","author":"Wiltfang","year":"2003","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/j.tripleo.2011.04.029","article-title":"A comparative study of the effectiveness of sinus bone grafting with recombinant human bone morphogenetic protein 2-coated tricalcium phosphate and platelet-rich fibrin-mixed tricalcium phosphate in rabbits","volume":"113","author":"Kim","year":"2012","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_28","first-page":"7267062","article-title":"Effectiveness of Platelet-Rich Fibrin as an Adjunctive Material to Bone Graft in Maxillary Sinus Augmentation: A Meta-Analysis of Randomized Controlled Trails","volume":"2019","author":"Liu","year":"2019","journal-title":"Biomed. Res. Int."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1111\/clr.13044","article-title":"Maxillary sinus augmentation with leukocyte and platelet-rich fibrin and deproteinized bovine bone mineral: A split-mouth histological and histomorphometric study","volume":"29","author":"Nizam","year":"2018","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1111\/j.1600-0501.2005.01166.x","article-title":"Maxillary sinus floor grafting with b-tricalcium phosphate in humans: Density and microarchitecture of the newly formed bone","volume":"17","author":"Suba","year":"2006","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_31","first-page":"432","article-title":"Maxillary sinus floor augmentation using a b-tricalcium phosphate (Cerasorb) alone compared to autogenous bone grafts","volume":"20","author":"Zijderveld","year":"2005","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_32","first-page":"357","article-title":"Biomaterial resorption rate and healing site morphology of inorganic bovine bone and beta-tricalcium phosphate in the canine: A 24-month longitudinal histologic study and morphometric analysis","volume":"19","author":"Artzi","year":"2004","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1590\/S0102-86502014000100009","article-title":"Effect of platelet-rich fibrin and beta tricalcium phospate on bone healing. A histological study in pigs","volume":"29","author":"Yilmaz","year":"2014","journal-title":"Acta Cir. Bras."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.curtheres.2013.05.002","article-title":"The use of platelet-rich fibrin in combination with biphasic calcium phosphate in the treatment of bone defects: A histologic and histomorphometric study","volume":"75","author":"Bolukbasi","year":"2013","journal-title":"Curr. Ther. Res. Exp."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"269","DOI":"10.4314\/ejhs.v24i3.11","article-title":"Platelet rich fibrin (Prf) and \u03b2-tricalcium phosphate with coronally advanced flap for the management of grade-II furcation defect","volume":"24","author":"Sambhav","year":"2014","journal-title":"Ethiop. J. Health Sci."},{"key":"ref_36","first-page":"52","article-title":"Treatment of peri-implant defect with modified sandwich bone augmentation. Case report and follow-up","volume":"74","year":"2008","journal-title":"N Y State Dent. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1902\/jop.2010.100605","article-title":"Is platelet concentrate advantegeous for the surgical treatment of periodontal diseases? A systematic review and meta-analysis","volume":"82","author":"Bortolin","year":"2011","journal-title":"J. Periodontol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s10006-017-0609-2","article-title":"Immediate post-extraction implants with or without pure plateletrich plasma: A 5-year follow-up study","volume":"21","author":"Taschieri","year":"2017","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.tripleo.2005.07.012","article-title":"Platelet-rich fibrin (PRF): A second-generation platelet concentrates. part v: Histological evaluations of PRF effects on bone allograft maturation in sinus lift","volume":"101","author":"Choukroun","year":"2006","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1111\/j.1600-0501.2011.02245.x","article-title":"Volumetric changes of the graft after maxillary sinus floor augmentation with bio-oss and autogenous bone in different ratios: A radiographic study in minipigs","volume":"23","author":"Jensen","year":"2012","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1111\/clr.12174","article-title":"A retrospective analysis of the resorption rate of deproteinized bovine bone as maxillary sinus graft material on cone beam computed tomography","volume":"25","author":"Wu","year":"2014","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e144","DOI":"10.1097\/SCS.0000000000002393","article-title":"Evaluation of Volumetric Changes of Augmented Maxillary Sinus With Different Bone Grafting Biomaterials","volume":"27","author":"Gultekin","year":"2016","journal-title":"J. Craniofac. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1111\/clr.12551","article-title":"Volume stability of hydroxyapatite and \u03b2-tricalcium phosphate biphasic bone graft material in maxillary sinus floor elevation: A radiographic study using 3D cone beam computed tomography","volume":"27","author":"Ohe","year":"2016","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1111\/j.1600-0501.2005.01182.x","article-title":"Changes in thevolume and density of calvarial split bone grafts after alveolar ridge augmentation","volume":"17","author":"Smolka","year":"2006","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.jcms.2012.09.007","article-title":"Volume changes of autogenous bone after sinus lifting and grafting procedures: A 6-year computerized tomographic follow-up","volume":"41","author":"Sbordone","year":"2013","journal-title":"J. Cranio-Maxillo-Facial Surg."},{"key":"ref_46","first-page":"117","article-title":"Histologic and clinical comparison of bilateral sinus floor elevations with and without barrier membrane placement in 12 patients: Part 3 of an ongoing prospective study","volume":"20","author":"Tarnow","year":"2000","journal-title":"Int. J. Periodont. Restor. Dent."},{"key":"ref_47","first-page":"73","article-title":"The effects of resorbable membrane on human maxillary sinus graft: A pilot study","volume":"24","author":"Choi","year":"2009","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_48","first-page":"88","article-title":"Histologic and clinical observations of resorbable and nonresorbable barrier membranes used in maxillary sinus graft containment","volume":"12","author":"Avera","year":"1997","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1111\/j.1600-0501.2007.01487.x","article-title":"Evaluation of three-dimensional changes after sinus floor augmentation with different grafting materials","volume":"19","author":"Kirmeier","year":"2008","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1111\/j.1600-0501.2011.02384.x","article-title":"Histologic and histomorphometric evaluation of a synthetic bone substitute for maxillary sinus grafting in humans","volume":"24","author":"Tosta","year":"2013","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_51","first-page":"273","article-title":"Histomorphometric comparison of a biphasic bone ceramic to anorganic bovine bone for sinus augmentation: 6- to 8-month postsurgical assessment of vital bone formation. A pilot study","volume":"28","author":"Froum","year":"2008","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s40729-019-0181-7","article-title":"Evaluation of bone formation following the osteotome sinus floor elevation technique without grafting using cone beam computed tomography: A preliminary study","volume":"5","author":"Wongchuensoontorn","year":"2019","journal-title":"Int. J. Implant. Dent."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1097\/ID.0000000000000884","article-title":"Osseodensification in Implant Dentistry: A Critical Review of the Literature","volume":"28","author":"Elsayyad","year":"2019","journal-title":"Implant. Dent."},{"key":"ref_54","first-page":"1","article-title":"The Efficacy of Recombinant Platelet-Derived Growth Factor on Beta-Tricalcium Phosphate to Regenerate Femoral Critical Sized Segmental Defects: Longitudinal In Vivo Micro-CT Study in a Rat Model","volume":"15","author":"Badwelan","year":"2018","journal-title":"J. Investig. Surg."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Luvizuto, E.R., Tangl, S., Dobsak, T., Reich, K., Gruber, R., Sonoda, C.K., and Okamoto, R. (2016). Effect of recombinant PDGF-BB on bone formation in the presence of \u03b2-tricalcium phosphate and bovine bone mineral matrix: A pilot study in rat calvarial defects. 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