Vasileios Ntontoulos

Albumin-based Hydrogel in Transcrestal Sinus Augmentation: Research & clinical perspective

Hydrogels concern the development of materials (mainly proteins) with healing properties, for the construction of scaffolds for biomedical applications. An innovative protocol of albumin hydrogel with autologous platelet factors is presented as a minimally invasive alternative to open sinus membrane elevation, the dominant implant-based treatment method of high morbidity for posterior maxillary atrophy. The clinical sample of the closed protocol consists of 20 patients with an average residual bone height of 3.7 mm. The PAC (Piezo-Alb-CGF) Protocol includes: a) Transcrestal access with or without flap, b) Piezo-surgical membrane preparation using the Sinus Intralift technique, c) Hydrodynamic membrane detachment-elevation, d) CGF platelet membrane in the sinus cavity, e) Denatured Albumin Hydrogel, mixed with Autologous Growth Factors (CGF), as a Slow-Resorbing Osteoinductive Graft (6 to 8 weeks) within the space between the membrane and the sinus floor, f) Bone graft (optional), (g) Implantation, (h) Wound closure, evaluation for the next 4-6 months postoperatively. All implants placed in 20 patients showed adequate to high primary stability without post-op complications. CBCT and panoramic radiographs also showed new bone formation and complete osseointegration.
The albumin-based Hydrogel regenerative properties with platelet-derived growth factors (CGF) promote new bone formation, minimize postoperative patient morbidity, and reduce the healing period (4-6 months) compared to the classic open technique. The Pac-Protocol ensures uniform and safe hydraulic membrane elevation and bi-cortical fixation of the implants, even in cases with residual bone height of 1-6 mm, an indication for an open lateral window.

Vasileios Ntontoulos, D.D.S., MSc, PhD candidate

Born in Katerini, Greece, in 1965. Graduated from the School of Dentistry at the Aristotle University of Thessaloniki in 1989. Working as a private practitioner, emphasizing full implant rehabilitation, regenerative techniques, and aesthetic dentistry since 1991. Followed ongoing training and updated his knowledge by participating in seminars and conferences in Greece and abroad. In 2020, he completed a Master’s Program in “Advanced Oral Surgery and Dental Implantology" (Master Second Level / EQF 7) in the Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”. In parallel, he has actively participated as a speaker at Greek and international conferences and as an author in publications in Greek and international scientific journals on topics related to the areas of oral surgery, dental implantology, regenerative dentistry (hard and soft tissue regeneration combined with autologous growth factors & stem cells), and minimally invasive implant and sinus surgery. He has been a PhD student in the Department of Oral Surgery, Implantology and Radiology (School of Dentistry, Aristotle University of Thessaloniki, Greece) since March 2025.
He has excellent knowledge of Greek, English, and French.