In this case, the patient presented with missing 14,15,16,17 and 1-2 mm of residual bone height. Initially, the clinician tried to lift the sinus using ultrasonic piezoelectric vibration and hydraulic pressure using a crestal approach. This technique is known as the hydrodynamic piezoelectric internal sinus elevation (HPISE). However, due to the drainage of exudate, the decision was made to switch to a lateral approach. Following membrane elevation and confirmation of an intact sinus membrane, concentrated growth factors (CGF) is inserted into the sinus cavity. Like,
platelet rich fibrin (PRF), CGF is a second generation of platelet concentrate, that utilizes the patient’s venous blood alone to trigger platelet activation and fibrin polymerization. Unlike PRF using constant centrifugation speed, CGF utilizes altered centrifugation speed (from 2,400 – 2,700 rpm for 12 minutes) to produce much larger, denser and richer fibrin matrix containing growth factors.1,2. Following implant placement, “sticky” bone was used to augment the buccal and crestal defects. “Sticky” bone refers to a mix of particulate bone powder, and autologous fibrin glue (AFG), which is obtained during CGF preparation. You can read more about “sticky” bone in this article: Utilization of Autologous Concentrated Growth Factors (CGF) Enriched Bone Graft Matrix (Sticky Bone) and CGF-Enriched Fibrin Membrane in Implant Dentistry (page 11).
1. Corigliano M., Sacco L., Baldoni E. CGFuna proposta terapeutica per la medicina rigenerativa. Odontoiatria n°1- anno XXIXmaggio 2010, 69-81.
2. Rodella LF, Favero G, Boninsegna R, et al. Growth factors, CD34 positive cells, and fibrin network analysis in concentrated growth factors fraction. Microsc Res Tech. 2011;74(8):772-777.