Immediate Postextraction Implant Placement Using Plasma Rich in Growth Factors Technology in Maxillary Premolar Region: A New Strategy for Soft Tissue Management
Achieving an excellent aesthetic outcome in postextraction dental implant placement in the anterior maxilla is a challenging procedure for clinicians. In fact, there is an increased risk for soft tissue recession at the facial aspect which may require supplementary connective tissue grafts to accomplish the final aesthetic result. The aim of this case report is to describe a regenerative technique using autologous plasma rich in growth factors fibrin plug for preservation of soft tissue architecture around an implant immediately placed into an extraction site in the anterior maxilla. Such a procedure allowed for guided bone regeneration without the need for vertical releasing incisions and primary healing, thus showing a pleasant gingival contour at the facial aspect after a single stage surgery. Integrating this technique into common practice could provide important benefits for the patients regarding aesthetics, without any risk of infection or transmission of diseases.
Figure 1. (a) Preoperative buccal view of the crown on tooth number 4 showing a thin periodontal biotype. (b) Buccal view of the final prostheses 1 year after delivery. Figure 2. (a) The preoperative radiograph shows a periodontal radiolucency at the distal aspect of the root of tooth number 4. (b) The final radiograph shows the loading of the implant prostheses at 1 year of follow-up.
Figure 3. (a and b) The plasma rich in growth factors (PRGF) autologous fibrin plug was placed and stretched above the fixture head to isolate the grafted socket. (c) The PRGF autologous fibrin plug was secured to the surrounding attached gingiva with an absorbable suture to obtain a safe and predictable secondary healing. The crossing of the central suture incorporating the fibrin plug ensures its stabilization during the period of initial healing. (d) Soft tissue healing after 1 week. (e) Soft tissue healing after 1 month. Figure 4. A composite ovate was placed at site number 4 and bonded to the adjacent teeth in order to stabilize and induce the soft tissue architecture.
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