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To compare the survival and clinical performance of implants placed in sites previously augmented with autogenous bone grafts covered by either a platelet-rich fibrin (PRF) membrane (PRF group) or a standard procedure (gold standard) involving coverage of the autogenous bone graft with deproteinised bovine bone mineral and a resorbable collagen membrane (control group).

Background: A clinical and radiographic study of implants (1)

author: Jens Hartlev,Sren Schou,Flemming Isidor, Sven Erik Nrholt | publisher: drg. Andreas Tjandra, Sp. Perio, FISID

Background

Implant-supported single crowns are characterised by high long-term survival and few biological and technical complications, which typically includes peri-implant marginal bone loss, screw-loosening and fracture of veneering material complications [1,2,3]. To achieve a successful treatment outcome, the implants must be inserted in sufficient bone volume of an adequate quality to obtain primary stability enabling establishment of osseointegration [4, 5].

In many patients, this can be challenging due to extensive atrophy of the alveolar ridge after tooth loss [6] which compromises implant placement in a correct anatomical position [7, 8]. In cases where extensive reduction of the alveolar bone causes inability to achieve primary stability of the implant, the gold standard for lateral ridge augmentation involves an autogenous bone graft harvested from an intraoral donor site covered by a deproteinised bovine bone mineral (DBBM) and a resorbable collagen barrier membrane [9, 10]. The survival of implants placed in lateral augmented autogenous bone is high and comparable to that of implants placed in native bone [11,12,13].

However, the use of a barrier membrane may increase the risk of bone graft exposure due to soft tissue dehiscences, thereby compromising the success of the bone augmentation procedure [14]. Leukocyte and platelet-rich fibrin (PRF) is a platelet concentrate derived from a blood sample provided by the patient and produced without any anticoagulants [15, 16]. In vitro studies have demonstrated a positive effect of the use of PRF on cell proliferation, migration and adhesion in addition to anti-inflammatory and angiogenetic properties [17], which may have a beneficial clinical effect in bone augmentation procedures. Furthermore, the ability of PRF to inhibit osteoclastogenesis [18] may reduce bone resorption during the healing period. The PRF matrix can be compressed into a membrane, which has proven to be suitable as a scaffold for periosteal and osteoblastic tissue engineering [19, 20].

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