Regenerative Potential of Platelet-Rich Fibrin in Maxillary Sinus Floor Lift Techniques: A Systematic Review

Background: Platelet-rich Fibrin (PRF) represents a type of autologous biomaterial investigated through the years by in vitro and in vivo studies to assess the real inductivity properties, presumed due to the growth factors presence. This systematic review aims to evaluate the efficacy of PRF in sinus lift procedures, compared and/or in addition to Deproteinized Bovine Bone Materials (DBBM) according to emerging scientific evidence. Materials and Methods: Selected databases were PubMed, Scopus, and Cochrane Library. The search strategy included the following terms: "PRF", "platelet concentrate", "autologous platelet concentrate", "platelet-rich fibrin", "bone grafts" or "DBBM", "xenografts" or "Bio-Oss", "maxillary sinus lift", "maxillary sinus elevation", "maxillary sinus augmentation". Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Results: Four studies were included in the systematic review, evaluating clinical, histological, histomorphometric, and radiological data. Three of four studies reported no statistically significant differences between the test and control groups. In one study, the presence of Leukocyte-Platelet Rich Fibrin (L-PRF) could allow earlier implant placement, achieving the same clinical, histological, histomorphometric, and radiological results of bone regeneration at an earlier time, compared to the DBBM used Conclusions: The regenerative potential of PRF associated with DBBM resulted in a valid alternative in the bone regeneration procedure to DBBM grafts. Further new studies are needed, with more rigid protocols, to investigate the potential of platelet concentrates in sinus lift techniques and to evaluate the real inductivity properties of DBBM.