HISTOMORPHOLOGICAL EVALUATION OF MAXILLARY AUGMENTATION AREAS AND SCHNEIDER’S MEMBRANE PLASTICALLY CLOSED BY VARIOUS METHODS

Oleh Mokryk, Denys Kasiyan

ABSTRACT

Aim of the study. The aim of this study was to investigate, under experimental conditions and by means of histomorphological examination, the effect of platelet-rich fibrin on reparative osteogenesis in areas of maxillary bone augmentation and the effect of autologous fibrin glue on regeneration of the injured Schneiderian membrane. Materials and methods. The experimental studies were performed on sexually mature outbred rabbits (21 animals), in which open sinus lift procedures were carried out under intravenous anesthesia, with deliberate perforation of the Schneiderian membrane during the intervention. Depending on the methods used for plastic closure of the created defect, the rabbits were divided into two experimental groups: the main group, consisting of 12 animals, and the control group, consisting of 9 animals. In both groups, the perforated area was closed with an “Ossix Plus” collagen membrane, and maxillary bone augmentation was performed using the osteoplastic material “Cerabone Botiss”. However, in the main group of animals, autologous fibrin glue was preliminarily applied to the collagen membrane, and the osteoplastic material was mixed with platelet-rich fibrin. Results. In the control group of animals, 10 days after surgery, histological examination revealed morphological manifestations of an acute inflammatory reaction in the areas of Schneiderian membrane perforation; after 30 days, traces of hemorrhages or wall-adherent hematomas were observed in the lumen of the maxillary sinuses; after 90 days, while separate areas of the bone defect were replaced by mature fibrous connective tissue. In rabbits of the main group, on postoperative day 10, moderate inflammatory infiltration of the Schneiderian membrane mucosa was found in the biopsy specimens; after 30 days, morphological signs of reduction of the inflammatory process in the perforated area and complete restoration of its anatomical integrity were observed; after 90 days, osteoid had formed in the augmentation areas of the anterior wall of the maxillary sinus, and in separate zones it was already being replaced by mature bone tissue. Conclusions. Autologous fibrin glue ensures tight sealing of the Schneiderian membrane perforation area, stable hemostasis, and an anti-edematous effect, and accelerates its regeneration. Under the influence of platelet-rich fibrin (PRF), in the maxillary augmentation graft of rabbits, 3 months after osteoplastic procedures, osteoid formation is completed and mature bone tissue is formed more actively, which is confirmed histomorphologically.