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Results : 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 [1]

Results : 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 [1]

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

At time of surgery, the patients ranged in age from 33 to 79 years (mean age 53.8 years).

The first surgeries for implant placement in the test group were carried out as described above. Two layers of a PRF matrix were placed on top of the implant. Though surgical flaps were all sutured completely free of tension, a post-operative dehiscence above the implant could be observed in all test patients within the first week. This process resulted in a complete loss of mucosal and augmented tissues above the implant. The open areas were healed by secondary intention (illustration 11). The wounds in the control group healed uneventfully by primary intention; no dehiscences occurred.

Due to ethical reasons, the test group had to be terminated after 10 patients. The already recruited, remaining patients were consequently all added to the control group. Finally, the study was finished with a total number of 31 consecutive patients (16 males and 15 females, 10 patients in the test group, 21 in the control group).

No drop-out occurred within the 6 months. All implants were clinically osseointegrated and stable and showed no sign of infection.

Crestal mucosa thickness in test group dropped from 2.20 mm ± 0.48 SD at baseline to 0.90 mm ± 1.02 SD at reentry. This loss was statistically significant. Buccal mucosa thickness was 1.85 mm ± 0.41 SD at baseline and 2.15 mm ± 0.78 SD at 3-month follow-up, and lingual thickness started from 1.55 mm ± 0.44 SD and resulted in 1.80 mm ± 0.63 SD. Buccal and lingual data did not reach statistical significance. Within the limited data provided by the early termination of the study, it can be stated that PRF under the condition of a split-flap design failed to improve the thickness of the mucosa.

In the control group, crestal mucosa thickness decreased from 2.64 mm ± 0.48 SD at baseline to 2.62 mm ± 0.61 SD at 3-month follow-up. Buccal and lingual mucosa was 2.29 mm ± 0.54 SD resp. 1.62 mm ± 0.55 SD at baseline and dropped to 2.36 mm ± 0.48 SD resp. 1.86 mm ± 0.53 SD. The differences of all three measuring points were not statistically significant (Figs. 1 and 2).

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