PRF를 이용한 발치와 보존술, PRF socket preservation

PRF & Socket Preservation

 

J Dent. 2016 Jun 20. pii: S0300-5712(16)30114-2. doi: 10.1016/j.jdent.2016.06.005. [Epub ahead of print]

Dimensional changes of the post extraction alveolar ridge, preserved with Leukocyte- and Platelet Rich Fibrin: A clinical pilot study.

Anwandter A¹, Bohmann S², Nally M³, Castro AB⁴, Quirynen M⁵, Pinto N⁶.

Author information

• ¹Periodontology and Oral Implantology, University of the Andes, Chile.
• ²Oral Prosthetic and Surgical Implantology, University of the Andes, Chile.
• ³Graduate School of Periodontology and Implant Dentistry, Faculty of Dentistry, University of the Andes, Chile.
• ⁴Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Periodontology, Belgium. Electronic address: anabelen.castrosarda@kuleuven.be.
• ⁵Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Periodontology, Belgium.
• ⁶Graduate School of Periodontology and Implant Dentistry, Faculty of Dentistry, University of the Andes, Chile; Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Periodontology, Belgium.

Abstract

OBJECTIVES:

This clinical trial explored the clinical and radiographic dimensional changes of the alveolar ridge in the first 4 months after tooth extraction in combination with the application of Leukocyte- and Platelet Rich Fibrin (L-PRF).

METHODS:

Eighteen single rooted maxillary and mandibular sockets were filled with L-PRF without soft tissue closure. Clinical measurements (bone sounding) were performed using a customized acrylic stent and radiographic measurements were accomplished using Cone Beam Computed Tomography (CBCT), immediately after tooth extraction and after 4 months.

RESULTS:

The clinical observations indicated a mean horizontal resorption of 1.18±2.4mm (p=0.8) at the crest, 1.25±2.0mm (p=0.57) and 0.83±2.0mm (p=0.78) at 2mm and 4mm apical to the crest, respectively. The buccal plate demonstrated a mean vertical loss of 0.44±3.5mm (p=0.9), the centre of the socket had a significant filling of 5.72±3.6mm (p=0.0001) and the oral cortical plate had a mean vertical gain of 0.09mm±1.57mm (p=0.9). The radiographic analysis demonstrated a mean vertical bone loss of 0.27±2.5mm (p=0.9) on the buccal and of 0.03±1.6mm (p=0.9) at the oral crest. The width of the alveolar ridge had a mean loss of 1.33mm±1.43mm.

CONCLUSIONS:

Within the limitations of this pilot study, it can be concluded that L-PRF might show clinical benefits for ridge preservation.

Copyright © 2016 Elsevier Ltd. All rights reserved.

KEYWORDS:

Cone-beam computed tomography; Extraction socket; Leucocyte and platelet rich fibrin; Ridge preservation; Socket preservation; Tissue regeneration

 

Eur J Dent. 2016 Apr-Jun;10(2):264-76. doi: 10.4103/1305-7456.178298.

Socket preservation by beta-tri-calcium phosphate with collagen compared to platelet-rich fibrin: A clinico-radiographic study.

Das S¹, Jhingran R¹, Bains VK¹, Madan R¹, Srivastava R¹, Rizvi I¹.

Author information

• ¹Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India.

Abstract

OBJECTIVES:

This study was primarily designed to determine the clinico-radiographic efficacy of platelet-rich fibrin (PRF) and beta-tri-calcium phosphate with collagen (β-TCP-Cl) in preserving extraction sockets.

MATERIALS AND METHODS:

For Group I (PRF), residual sockets (n = 15) were filled with autologous PRF obtained from patients' blood; and for Group II (β-TCP-Cl), residual sockets (n = 15) were filled with β-TCP-Cl. For the sockets randomly selected for Group II (β-TCP-Cl), the reshaped Resorbable Tissue Replacement cone was inserted into the socket.

RESULTS:

Clinically, there was a significantly greater decrease in relative socket depth, but apposition in midcrestal height in Group II (β-TCP-Cl) as compared to Group I (PRF), whereas more decrease in buccolingual width of Group I (PRF) than Group II (β-TCP-Cl) after 6 months. Radiographically, the mean difference in socket height, residual ridge, and width (coronal, middle, and apical third of socket) after 6 months was higher in Group I (PRF) as compared to Group II (β-TCP-Cl). The mean density (in Hounsfield Units) at coronal, middle, and apical third of socket was higher in Group I (PRF) as compared to Group II (β-TCP-Cl). There were statistically significant apposition and resorption for Group I (PRF) whereas nonsignificant resorption and significant apposition for Group II (β-TCP-Cl) in buccal and lingual/palatal cortical plate, respectively, at 6 months on computerized tomography scan.

CONCLUSION:

The use of either autologous PRF or β-TCP-Cl was effective in socket preservation. Results obtained from PRF were almost similar to β-TCP-Cl; therefore being autologous, nonimmune, cost-effective, easily procurable regenerative biomaterial, PRF proves to be an insight into the future biofuel for regeneration.

KEYWORDS:

Beta-tricalcium phosphate; extraction socket; platelet-rich fibrin; type I collagen

 

J Oral Implantol. 2016 Apr;42(2):164-8. doi: 10.1563/aaid-joi-D-15-00001. Epub 2015 Sep 21.

Extraction Socket Management Utilizing Platelet Rich Fibrin: A Proof-of-Principle Study of the "Accelerated-Early Implant Placement" Concept.

Kotsakis GA¹, Boufidou F², Hinrichs JE¹, Prasad HS³, Rohrer M³, Tosios KI⁴.

Author information

• ¹1   Department of Periodontics, University of Washington, Seattle, Wash.
• ²2   University of Athens Medical School, Athens, Greece.
• ³3   Hard Tissue Research Laboratory, University of Minnesota, Minneapolis, Minn.
• ⁴4   Department of Oral Pathology, Dental School, University of Athens, Athens, Greece.

Abstract

Dental implants are widely accepted as the golden standard for the rehabilitation of an edentulous site following the extraction of a tooth. The ideal time for implant placement is dependent on the time required for partial or complete tissue healing and the adequacy of socket dimensions. The use of autologous growth factors is a promising new concept that aids clinicians in minimizing treatment time and increasing patient satisfaction. The purpose of this paper is to introduce a protocol for "accelerated-early" implant placement. In this protocol, platelet rich fibrin is employed to accelerate soft and hard tissue healing and to provide a better-healed recipient site for accelerated, early implant placement. Histological analysis revealed that at 6 weeks postextraction, the application of our approach resulted in delicate newly formed bone showing intense osteoblastic activity surrounded by connective tissue as well as areas of mineralized tissue. The present study is a proof-of-principle study of the acceleration of the physiologic postextraction healing sequelae with the use of autologous growth factors. The accelerated-early implant placement concept is a bioengineered protocol that may aid clinicians to achieve increased primary stability, by placing implants in ridges in an advanced stage of bone healing, while offering patients the benefits associated with early implant placement. Controlled studies are warranted to verify the reproducibility of this treatment concept and identify specific indications where the use of the presented technique can lead to significant clinical results.

KEYWORDS:

PRF; early implant placement; extraction; platelet rich fibrin; socket preservation

 

J Craniofac Surg. 2013 Jul;24(4):1088-94. doi: 10.1097/SCS.0b013e31828b6dc3.

Influence of platelet-rich fibrin on alveolar ridge preservation.

Suttapreyasri S¹, Leepong N.

Author information

• ¹Department of Surgery, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand. srisurang.s@psu.ac.th

Abstract

AIM:

The aim of this study was to investigate the influence of platelet-rich fibrin (PRF) on early wound healing and preservation of the alveolar ridge shape following tooth extraction.

METHODS:

In this clinical trial, 20 symmetrical, premolar extraction sockets using split-mouth design were randomly selected with PRF or blood clot. The evaluations of wound healing, alveolar ridge contour changes, and crestal bone resorption were performed in dental casts and periapical radiographs (T0, initial; T1, 1 week; T2, 2 weeks; T4, 4 weeks; T6, 6 weeks; T8, 8 weeks).

RESULTS:

Platelet-rich fibrin clinically showed early healing of soft tissue covering socket orifices in the first 4 weeks. At the first week, the horizontal resorption on buccal aspect of PRF (1.07 ± 0.31 mm) was significantly less than that of the control (1.81 ± 0.88 mm). Platelet-rich fibrin demonstrated the tendency to enter the steady stage after the fourth week following tooth extraction, whereas in the control group the progression of buccal contour contraction was still detected through the eighth week. Radiographically, the overall resorption of marginal bone levels at mesial and distal to the extraction site in PRF (0.70, 1.23 mm) was comparable to that of the control (1.33, 1.14 mm). Although the PRF group demonstrated faster bone healing compared with the control, no statistically significant difference was detected.

CONCLUSIONS:

This preliminary result demonstrated neither better alveolar ridge preservation nor enhanced bone formation of PRF in the extraction socket. The use of PRF revealed limited effectiveness by accelerated soft-tissue healing on the first 4 weeks.

 

Implant Dent. 2013 Jun;22(3):295-303. doi: 10.1097/ID.0b013e3182906eb3.

Clinical and histological evaluation of postextraction platelet-rich fibrin socket filling: a prospective randomized controlled study.

Hauser F¹, Gaydarov N, Badoud I, Vazquez L, Bernard JP, Ammann P.

Author information

• ¹Department of Oral Surgery, Oral Medicine, Oral and Maxillofacial Radiology, School of Dental Medicine, University of Geneva, Geneva, Switzerland. fabien@hauser.net

Abstract

OBJECTIVES:

The aims were to investigate whether the use of platelet-rich fibrin membranes (PRF) for socket filling could improve microarchitecture and intrinsic bone tissue quality of the alveolar bone after premolar extraction and to assess the influence of the surgical procedure before implant placement.

MATERIAL AND METHODS:

Twenty-three patients requiring premolar extraction followed by implant placement were randomized to three groups: (1) simple extraction and socket filling with PRF, (2) extraction with mucosal flap and socket filling with PRF, and (3) controls with simple extraction without socket filling. Implant placement was performed at week 8, and a bone biopsy was obtained for histomorphometric analysis.

RESULTS:

Analysis by microcomputed tomography showed better bone healing with improvement of the microarchitecture (P < 0.05) in group 1. This treatment had also a significant effect (P < 0.05) on intrinsic bone tissue quality and preservation of the alveolar width. An invasive surgical procedure with a mucosal flap appeared to completely neutralize the advantages of the PRF.

CONCLUSIONS:

These results support the use of a minimally traumatic procedure for tooth extraction and socket filling with PRF to achieve preservation of hard tissue.

Rev Med Brux. 2010 Nov-Dec;31(6):521-7.

[The use of platelet concentrates: platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in bone reconstruction prior to dental implant surgery].

[Article in French]

Baeyens W¹, Glineur R, Evrard L.

Author information

• ¹Service de Stomatologie et de Chirurgie Maxillo-faciale, Hôpital Erasme, Bruxelles.

Abstract

The autologous platelet concentrates--Platelet-Rich Plasma (PRP) and Platelet-Rich Fibrin (PRF)--are used in various medical fields, particularly in oral and maxillofacial surgery. These concentrates contain high levels of growth factors, including the 3 isomers of PDGF (platelet-derived growth factor), 2 of the numerous transforming growth factors (TGF-beta), the insulinlike growth factor (IGF), the epithelial growth factor (EGF) and the vascular endothelial growth factor (VEGF), which are the key elements in wound healing, particularly in bone regeneration. Platelet concentrates are easy to apply in clinical practice and offer potential benefits including rapid wound healing and bone regeneration, and can therefore be considered to be new therapeutic adjuvants. In dental implant surgery they are used in bone reconstruction prior or concomitant to implant procedures, and also for dental extraction socket preservation. Their use result in enhanced bone graft density and maturation. A literature review on the use of PRP/PRF in maxillofacial and dental implant surgery is proposed.