Efficacy of Autogenous Platelet-Rich Fibrin Vs Slowly Resorbable Collagen Membrane With Immediate Implants in the Esthetic Zone

• Published in: The Journal of oral implantology Vol. 47; no. 4; pp. 342 - 351
• Main Authors: Abdel-Rahman, Fakhreldin H., Salem, Ahmed S., El-Shinnawi, Una M., Hammouda, Nelly I., El-Kenawy, Mohamed H., Maria, Ola M.
• Format: Journal Article
• Language: English
• Published: Abington Allen Press Inc 01.08.2021
• Subjects: Anticoagulants; Atelocollagen; Biomaterials; Blood platelets; Bone grafts; Bone growth; Bone healing; Bone implants; Collagen; Collagen (type I); Dental implants; Dentistry; Fibrin; Growth factors; Loading; Maxilla; Membranes; Occlusion; Oral hygiene; Osseointegration; Patients; Platelet-derived growth factor; Prostheses; Radiography; Regeneration; Sutures; Thrombospondin; Transforming growth factor-b1; Vascular endothelial growth factor
• ISSN: 0160-6972; 1548-1336
• DOI: 10.1563/aaid-joi-D-20-00124

The dimensions of this gap are influenced by the socket morphology and the implant width and design.5 It was reported that immediate bone healing and osseointegration took place with rough surface implants when a bone-to-implant horizontal defect of ≤2 mm was present.6 Horizontal defects more than 2 mm did not show predictable bone healing.5 Thereafter, guided bone regeneration with different combination protocols have evolved into practice and have shown successful clinical results.7 Collagen membranes appeared as a part of regenerative dentistry in the late 80s, to control soft tissue occlusion and allow the underlying bone to heal.8 Thereafter, collagen membranes became an essential component of ridge augmentation, socket preservation, and guided tissue regeneration.9 A recent preclinical study supported the idea that collagen membranes enhance bone regeneration.10 Recently, Choukroun's platelet-rich fibrin (PRF) was introduced to promote tissue healing in oral-related surgeries.11 Platelet-rich fibrin is a homogenous fibrin biomaterial that is produced simply from autogenous blood samples.12 This concentrate is molded into a membrane form for easier clinical application.13 Platelet-rich fibrin contains different growth factors, such as transforming growth factor-β1 (TGF-β1), platelet-derived growth factor AB (PDGF-AB), vascular endothelial growth factor (VEGF), and matrix glycoprotein thrombospondin-1. Shows series of photographs and radiographs of immediate implants with platelet-rich fibrin (PRF) application in the esthetic zone. (a) A photograph shows nonrestorable maxillary right central incisor to be extracted for immediate implant placement. (b) A standardized periapical radiograph of the maxillary right central incisor for initial bone level evaluation. (c) A convenient blood sample collected from the peripheral venous blood of each patient in sterile 10 mL tubes (no anticoagulant added) and centrifuged immediately at 3000 rpm (400g) for 10 minutes. (d) A photograph shows the drilled implant site to the desired dimensions. (e) A photograph shows the implant placed in its planned site with a cover screw on top. (f and g) Photographs show the residual gap between the socket wall and the implant thread grafted with deproteinized bovine bone mineral (DBBM) (f), then PRF membrane was positioned and stabilized over the graft (g). (h) A photograph shows interrupted sutures made after releasing incisions performed to allow for better flap adaptation around the implant neck. (i) A standardized periapical radiograph shows an immediate postoperative position of an implant replacing a maxillary right central incisor. (j) A photograph shows the final prosthetic restoration placed. (k) A standardized periapical radiograph shows complete healing with satisfactory bone level around the implant at 12 months postimplant loading. Shows series of photographs and radiographs of immediate implants with collagen membrane application in the esthetic zone. (a) A photograph shows nonrestorable maxillary right first premolar to be extracted for immediate implant placement. (b) A standardized periapical radiograph of maxillary right first premolar for initial bone level evaluation. (c) A photograph shows the commercial collagen membrane used in this group. (d) A photograph shows the drilled implant site to the desired dimensions. (e) A photograph shows the implant placed in its planned site with a cover screw on top. (f and g) Photographs show the residual gap between the socket wall and the implant thread grafted with DBBM (f), then a slowly resorbable collagen membrane was positioned and stabilized over the graft (g). (h) A photograph shows interrupted sutures made after releasing incisions performed to allow for better flap adaptation around the implant neck. (i) A standardized periapical radiograph shows an immediate postoperative position of an implant replacing a maxillary right first premolar. (j) A photograph shows the final prosthetic restoration placed. (k) A standardized periapical radiograph shows complete healing with satisfactory bone level around the implant at 12 months postimplant loading. According to the manufacturer, Hypro-Sorb membranes are biphasic bilayer membranes of pure, crystalline atelocollagen (99.9% collagen type I, free of telopeptides) of sterile bovine origin.