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Methods : The effect of PRF (platelet-rich fibrin) inserted with a split-flap technique on soft tissue thickening and initial marginal bone loss around implants: results of a randomized, controlled clinical trial [2]

Methods : The effect of PRF (platelet-rich fibrin) inserted with a split-flap technique on soft tissue thickening and initial marginal bone loss around implants: results of a randomized, controlled clinical trial [2]

author: Julia Hehn, Thomas Schwenk, Markus Striegel, Markus Schlee | publisher: drg. Andreas Tjandra, Sp. Perio, FISID

After the implantation, standardized digital X-rays were taken with parallel technique (baseline) (illustration 9). For each patient, an individual customized digital film holder was fabricated to ensure a reproducible radiographic analysis. Patients were instructed to avoid chewing hard nutrition in the treated area and to use chlorhexidine mouthwash and a soft brush twice a day for the first 2 weeks. Sutures were removed after 7 to 10 days.

Three months later, a second measurement of crestal, buccal, and lingual tissue thickness and intraoral radiographs were carried out as mentioned above. A small mid-crestal incision was made and cover screws were replaced by healing abutments. Due to the minimal invasive reentry procedure, no sutures were needed. Within the following 2 weeks, one-piece, screwed, full ceramic crowns were inserted as definite restorations (IPS Emax®, Ivoclar Vivadent, Schaan, Liechtenstein; composite: Multilink Implant®, Ivoclar Vivadent, Schaan, Liechtenstein) (illustration 10). In a 6-month follow-up from baseline, patients were recalled for maintenance and another digital X-ray was taken.

The evaluation of the peri-implant bone remodeling was carried out by an independent examiner, who was not involved in the surgical process. Bone loss at the mesial and distal side of each implant was measured with an image analysis software (Kodak dental imaging software, version 6.13.0, 2013). A calibration of length measurement was performed in every radiograph to avoid radiographic distortion (reference value - implant length and width).

Data of 31 patients (10 patients of test group and 21 patients of control group) were analyzed with STATISTICA (version 9.1, StatSoft, Inc., Tulsa, USA) and BiAS (version 10.11, Epsilon, Frankfurt, Germany). No data points were missing.

The analysis focused on the following aspects:

Comparison of tissue thickness (crestal, buccal, lingual) at baseline and 3-month data in test and control groups

Comparison of tissue gain/loss between test and control groups

Comparison of mesial and distal bone level at baseline, 3-month and 6-month data in test and control groups

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