{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T02:50:48Z","timestamp":1775098248648,"version":"3.50.1"},"reference-count":50,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T00:00:00Z","timestamp":1644278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Bone regeneration procedures represent a major challenge in oral surgery. This study aimed to evaluate a composite PRF\/particulate xenograft in guided bone regeneration. Methods: Edentulous patients with horizontal ridge deficiencies in the anterior maxilla and candidates to an immediate-loading full-arch rehabilitation were included. Horizontal linear measurements indicating bone gain were assessed from computer beam computer tomography (CBCT) scans obtained at pre-surgery, post-surgery, and the 12-month follow-up. Mean bone values were presented as mean \u00b1 95% CI. Non-parametric tests were used as appropriate, and the effect size was calculated with Cohen\u2019s d repeated measures. Results: Eighteen patients were rehabilitated with 72 implants. The mean horizontal bone width was 4.47 [4.13\u20134.80] mm pre-surgically, 9.25 [8.76\u20139.75] mm post-surgically, and 7.71 [7.28\u20138.14] mm 12 months after. Conclusions: PRF associated with a xenograft seems to promote an effective horizontal bone gain. Randomized clinical trials are needed to confirm the benefits of this surgical approach.<\/jats:p>","DOI":"10.3390\/jcm11030894","type":"journal-article","created":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T23:37:48Z","timestamp":1644363468000},"page":"894","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Guided Bone Regeneration in the Edentulous Atrophic Maxilla Using Deproteinized Bovine Bone Mineral (DBBM) Combined with Platelet-Rich Fibrin (PRF)\u2014A Prospective Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5544-3744","authenticated-orcid":false,"given":"Jo\u00e3o Manuel Mendez","family":"Caram\u00eas","sequence":"first","affiliation":[{"name":"Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n\u00b0 50, 1070-064 Lisbon, Portugal"},{"name":"Faculdade de Medicina Dent\u00e1ria, Universidade de Lisboa, 1600-277 Lisbon, Portugal"},{"name":"LIBPhys-FCT UID\/FIS\/04559\/2013, Faculty of Dental Medicine, University of Lisbon, 1600-277 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8481-237X","authenticated-orcid":false,"given":"Filipe Ara\u00fajo","family":"Vieira","sequence":"additional","affiliation":[{"name":"Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n\u00b0 50, 1070-064 Lisbon, Portugal"}]},{"given":"Gon\u00e7alo B\u00e1rtolo","family":"Caram\u00eas","sequence":"additional","affiliation":[{"name":"Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n\u00b0 50, 1070-064 Lisbon, Portugal"}]},{"given":"Ana Catarina","family":"Pinto","sequence":"additional","affiliation":[{"name":"Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n\u00b0 50, 1070-064 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6783-7740","authenticated-orcid":false,"given":"Helena Cristina Oliveira","family":"Francisco","sequence":"additional","affiliation":[{"name":"Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n\u00b0 50, 1070-064 Lisbon, Portugal"},{"name":"Faculdade de Medicina Dent\u00e1ria, Universidade de Lisboa, 1600-277 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1966-8281","authenticated-orcid":false,"given":"Duarte Nuno da Silva","family":"Marques","sequence":"additional","affiliation":[{"name":"Instituto de Implantologia, Avenida Columbano Bordalo Pinheiro, n\u00b0 50, 1070-064 Lisbon, Portugal"},{"name":"Faculdade de Medicina Dent\u00e1ria, Universidade de Lisboa, 1600-277 Lisbon, Portugal"},{"name":"LIBPhys-FCT UID\/FIS\/04559\/2013, Faculty of Dental Medicine, University of Lisbon, 1600-277 Lisbon, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1111\/clr.12873","article-title":"Reconstruction of the severely atrophic edentulous maxillae with calvarial bone grafts","volume":"28","author":"Mertens","year":"2016","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"s192","DOI":"10.11607\/jomi.16suppl.g5.3","article-title":"Maxillary Implant-Supported Fixed Prosthesis: A Survey of Reviews and Key Variables for Treatment Planning","volume":"31","author":"Gallucci","year":"2017","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1600-0501.2011.02375.x","article-title":"A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans","volume":"23","author":"Tan","year":"2012","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1111\/j.1600-051X.2009.01482.x","article-title":"Alveolar bone dimensional changes of post-extraction sockets in humans: A systematic review","volume":"36","author":"Slot","year":"2009","journal-title":"J. Clin. Periodontol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1111\/prd.12219","article-title":"Horizontal bone-augmentation procedures in implant dentistry: Prosthetically guided regeneration","volume":"77","author":"Chiapasco","year":"2018","journal-title":"Periodontology 2000"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/S0901-5027(03)00132-2","article-title":"Changes in facial form relative to progressive atrophy of the edentulous jaws","volume":"33","author":"Sutton","year":"2004","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1111\/j.1708-8240.2011.00428.x","article-title":"Three-Dimensional Esthetic Analysis in Treatment Planning for Implant-Supported Fixed Prosthesis in the Edentulous Maxilla: Review of the Esthetics Literature","volume":"23","author":"Bidra","year":"2011","journal-title":"J. Esthet. Restor. Dent."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"835","DOI":"10.11607\/prd.3209","article-title":"The Lip-Tooth-Ridge Classification: A Guidepost for Edentulous Maxillary Arches. Diagnosis, Risk Assessment, and Implant Treatment Indications","volume":"37","author":"Pollini","year":"2017","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"14","DOI":"10.11607\/jomi.2014suppl.g1.1","article-title":"Horizontal ridge augmentation in conjunction with or prior to implant placement in the anterior maxilla: A systematic review","volume":"29","author":"Kuchler","year":"2014","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"995","DOI":"10.11607\/jomi.8297","article-title":"Influence of Bone Anatomy on Implant Placement Procedures in Edentulous Arches of Elderly Individuals: A Cross-Sectional Study on Computed Tomography Images","volume":"35","author":"Cordaro","year":"2020","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_11","first-page":"S91","article-title":"Patients\u2019 preferences towards minimally invasive treatment alternatives for implant rehabilitation of edentulous jaws","volume":"7","author":"Pommer","year":"2014","journal-title":"Eur. J. Oral Implant."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"s19","DOI":"10.11607\/jomi.16suppl.g1","article-title":"Bone Augmentation of the Edentulous Maxilla for Implant Placement: A Systematic Review","volume":"31","author":"Aghaloo","year":"2017","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Caram\u00eas, J.M.M., Marques, D.N.D.S., Caram\u00eas, G.B., Francisco, H.C.O., and Vieira, F.A. (2021). Implant Survival in Immediately Loaded Full-Arch Rehabilitations Following an Anatomical Classification System\u2014A Retrospective Study in 1200 Edentulous Jaws. J. Clin. Med., 10.","DOI":"10.3390\/jcm10215167"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"596","DOI":"10.11607\/jomi.4051","article-title":"Alveolar Ridge Split on Horizontal Bone Augmentation: A Systematic Review","volume":"30","author":"Elnayef","year":"2015","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1016\/j.ijom.2013.12.004","article-title":"Are there specific indications for the different alveolar bone augmentation procedures for implant placement? A systematic review","volume":"43","author":"Milinkovic","year":"2014","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_16","first-page":"167","article-title":"The Efficacy of Horizontal and Vertical Bone Augmentation Procedures for Dental Implants: A Cochrane Systematic Review","volume":"2","author":"Esposito","year":"2009","journal-title":"Eur. J. Oral Implant."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"87","DOI":"10.11607\/jomi.5461","article-title":"Guided Bone Regeneration with Collagen Membranes and Particulate Graft Materials: A Systematic Review and Meta-Analysis","volume":"33","author":"Wessing","year":"2018","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"622","DOI":"10.11607\/jomi.6290","article-title":"The Fate of Lateral Ridge Augmentation: A Systematic Review and Meta-Analysis","volume":"33","author":"Elnayef","year":"2018","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/s10006-019-00777-y","article-title":"Horizontal ridge augmentation using xenogenous bone graft\u2014Systematic review","volume":"23","author":"Carvalho","year":"2019","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1111\/j.1600-0501.2012.02522.x","article-title":"Long-term outcome of implants placed with guided bone regeneration (GBR) using resorbable and non-resorbable membranes after 12\u201314 years","volume":"24","author":"Jung","year":"2013","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1097\/00006534-198805000-00004","article-title":"Healing of Bone Defects by Guided Tissue Regeneration","volume":"81","author":"Dahlin","year":"1988","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1007\/s00784-017-2133-z","article-title":"Use of platelet-rich fibrin in regenerative dentistry: A systematic review","volume":"21","author":"Miron","year":"2017","journal-title":"Clin. Oral Investig."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1016\/j.joms.2018.01.012","article-title":"Management of Facial Pyoderma Gangrenosum Using Platelet-Rich Fibrin: A Technical Report","volume":"76","author":"Fortunato","year":"2018","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_24","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_25","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1080\/09537104.2017.1293812","article-title":"The impact of the centrifuge characteristics and centrifugation protocols on the cells, growth factors, and fibrin architecture of a leukocyte- and platelet-rich fibrin (L-PRF) clot and membrane","volume":"29","author":"Pinto","year":"2018","journal-title":"Platelets"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1111\/jcpe.12612","article-title":"The use of leucocyte and platelet-rich fibrin in socket management and ridge preservation: A split-mouth, randomized, controlled clinical trial","volume":"43","author":"Temmerman","year":"2016","journal-title":"J. Clin. Periodontol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"4373","DOI":"10.1007\/s00784-020-03303-7","article-title":"Improved growth factor delivery and cellular activity using concentrated platelet-rich fibrin (C-PRF) when compared with traditional injectable (i-PRF) protocols","volume":"24","author":"Katagiri","year":"2020","journal-title":"Clin. Oral Investig."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1007\/s00784-020-03420-3","article-title":"Evaluation of local hemostatic efficacy after dental extractions in patients taking antiplatelet drugs: A randomized clinical trial","volume":"25","author":"Brancaccio","year":"2021","journal-title":"Clin. Oral Investig."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1111\/jcpe.13123","article-title":"Biomaterials and regenerative technologies used in bone regeneration in the craniomaxillofacial region: Consensus report of group 2 of the 15th European Workshop on Periodontology on Bone Regeneration","volume":"46","author":"Sanz","year":"2019","journal-title":"J. Clin. Periodontol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.ijom.2018.06.003","article-title":"Effects of leukocyte\u2013platelet-rich fibrin (L-PRF) in different intraoral bone grafting procedures: A systematic review","volume":"48","author":"Dragonas","year":"2019","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1111\/clr.12143","article-title":"A randomized and controlled clinical trial of two different compositions of deproteinized bovine bone and autogenous bone used for lateral ridge augmentation","volume":"25","author":"Mordenfeld","year":"2014","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.11607\/jomi.4675","article-title":"Ceramic-Veneered Zirconia Frameworks in Full-Arch Implant Rehabilitations: A 6-Month to 5-Year Retrospective Cohort Study","volume":"31","author":"Marques","year":"2016","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_33","first-page":"420","article-title":"The influence of full-arch implant-retained fixed dental prostheses on upper lip support and lower facial esthetics: Preliminary clinical observations","volume":"2","author":"Calvani","year":"2007","journal-title":"Eur. J. Esthet. Dent."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"593","DOI":"10.11607\/jomi.4967","article-title":"Changes in Lip Profile of Edentulous Patients after Placement of Maxillary Implant-Supported Fixed Prosthesis: Is a Wax Try-in a Reliable Diagnostic Tool?","volume":"32","author":"Uhlendorf","year":"2017","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.dental.2015.01.006","article-title":"Tissue engineering for bone regeneration and osseointegration in the oral cavity","volume":"31","author":"Pilipchuk","year":"2015","journal-title":"Dent. Mater."},{"key":"ref_36","first-page":"1","article-title":"Guided bone regeneration in staged vertical and horizontal bone augmentation using platelet-rich fibrin associated with bone grafts: A retrospective clinical study","volume":"6","author":"Monteiro","year":"2020","journal-title":"Int. J. Implant Dent."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1111\/clr.13605","article-title":"Histology of augmented autogenous bone covered by a platelet-rich fibrin membrane or deproteinized bovine bone mineral and a collagen membrane: A pilot randomized controlled trial","volume":"31","author":"Hartlev","year":"2020","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1111\/jcpe.12877","article-title":"Leucocyte- and platelet-rich fibrin block for bone augmentation procedure: A proof-of-concept study","volume":"45","author":"Cortellini","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"128s","DOI":"10.1177\/0022034515594780","article-title":"Effectiveness of Lateral Bone Augmentation on the Alveolar Crest Dimension: A Systematic Review and Meta-analysis","volume":"94","author":"Figuero","year":"2015","journal-title":"J. Dent. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/prd.12039","article-title":"Horizontal bone augmentation by means of guided bone regeneration","volume":"66","author":"Benic","year":"2014","journal-title":"Periodontology 2000"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1111\/j.1600-0501.2010.01939.x","article-title":"Histological and histomorphometrical analyses of biopsies harvested 11 years after maxillary sinus floor augmentation with deproteinized bovine and autogenous bone","volume":"21","author":"Mordenfeld","year":"2010","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1089\/ten.teb.2016.0233","article-title":"Platelet-Rich Fibrin and Soft Tissue Wound Healing: A Systematic Review","volume":"23","author":"Miron","year":"2017","journal-title":"Tissue Eng. Part B Rev."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"508328","DOI":"10.1155\/2014\/508328","article-title":"Correlation between Density and Resorption of Fresh-Frozen and Autogenous Bone Grafts","volume":"2014","author":"Lumetti","year":"2014","journal-title":"BioMed Res. Int."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1016\/j.ijom.2013.04.020","article-title":"Tomographic evaluation of iliac crest bone grafting and the use of immediate temporary implants to the atrophic maxilla","volume":"42","author":"Castagna","year":"2013","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1111\/cid.12040","article-title":"Block Allograft Technique versus Standard Guided Bone Regeneration: A Randomized Clinical Trial","volume":"16","author":"Amorfini","year":"2013","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1097\/ID.0000000000000684","article-title":"The Effect of Implant-Induced Artifacts on Interpreting Adjacent Bone Structures on Cone-Beam Computed Tomography Scans","volume":"27","author":"Sheridan","year":"2018","journal-title":"Implant Dent."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1743","DOI":"10.1902\/jop.2010.100162","article-title":"Bone Regeneration around Implants in Periodontally Compromised Patients: A Randomized Clinical Trial of the Effect of Immediate Implant with Immediate Loading","volume":"81","author":"Shibly","year":"2010","journal-title":"J. Periodontol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"503","DOI":"10.11607\/jomi.8509","article-title":"Clinical Outcomes of Immediate Implant Loading with Fixed Prostheses in Edentulous Maxillae: A Systematic Review","volume":"36","author":"Jiang","year":"2021","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1034\/j.1600-0501.2003.00950.x","article-title":"Critical review of immediate implant loading","volume":"14","author":"Gapski","year":"2003","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Attanasio, F., Antonelli, A., Brancaccio, Y., Averta, F., Figliuzzi, M.M., Fortunato, L., and Giudice, M. (2020). Primary Stability of Three Different Osteotomy Techniques in Medullary Bone: An in Vitro Study. Dent. J., 8.","DOI":"10.3390\/dj8010021"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/3\/894\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:16:10Z","timestamp":1760134570000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/3\/894"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,8]]},"references-count":50,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["jcm11030894"],"URL":"https:\/\/doi.org\/10.3390\/jcm11030894","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,8]]}}}