Document Type : Original Article
Authors
1
B.D.S. Faculty of Dentistry, Suez Canal University, 2013, Dentist at the Ministry of Health
2
Professor of Clinical Pathology, Faculty of Medicine, Suez Canal University
3
3Professor of Oral and Maxillofacial Radiology, Faculty of Dentistry, Suez Canal University
4
Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Suez Canal University
Abstract
Background: Platelet-rich fibrin (PRF), is a second-generation platelet concentrate;
leucocyte- and platelet-rich fibrin (L-PRF) is a modified PRF biomaterial that has been
proven to enhance bone healing, therefore, may be used to promote osseointegration
around immediate dental implants. Aim: To assess the utilization of L-PRF in bone
healing around immediate dental implants. Patients and methods: Eighteen dental
implants were placed in patients with badly decayed bilateral mandibular anterior or
premolar teeth indicated for extraction and implant placement utilizing the split-mouth
technique. Patients’ side was randomly allocated into two groups, (n = 9 implants/
group) where: Group I (control): The control side received immediately placed
implants without L-PRF after extraction; Group II (study): The study side received
immediately placed implants with L-PRF membranes placed around the osteotomy
site immediately after extraction and implant insertion. Clinical assessment of implant
stability was performed using the Ostell device where ISQ readings were recorded
immediately after implant placement then after 6 months. Pre-operative radiographic
assessment was performed via CBCT, then, post-operative follow up was carried out
using periapical digital radiographs, immediate post-operative, then after 3 and 6
months; bone density was measured using IDRISI Kilimanjaro software around the
implant in the osteointegration zone, which is the implant–bone interface. Results: The
mean of clinical test (Ostell ISQ readings) was 62.2 (±3.8) and 67.8 (±3.4) at immediate
post-operative and 68.3 (±3.6) and 81.4 (±6.17) at 6 months for both control and L-PRF
groups; respectively. Upon comparing group I to group II, there was no significant
difference was seen immediate post-operative between both groups, however at
6-months, a highly significant difference was observed between both examined groups
where the L-PRF group exhibited significantly higher Ostell readings (p= <0.001). The
mean of radiographic relative bone density was 132.6 (±15.38) and 150.5 (±13.28)
immediate post-operatively, then, density values recorded 121.3 (±14.64) and 141.8
(±17) after 3 months, and 151.7 (±16.68) and 186.5 (±19.03) after 6 months for the
control group and the L-PRF group respectively. Results showed statistically significant
changes in the control and L-PRF groups throughout follow-ups whereas comparison
between both groups showed significantly higher density values in the L-PRF group
especially after 6 months. Conclusion: Use of Leucocyte-platelet-rich fibrin may show
improvement in implant stability and bone healing as well as increased bone density
around immediate dental implants.
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