Implant Site Preparation Application of Injectable Platelet-Rich Fibrin for Vertical and Horizontal Bone Regeneration: A Clinical Report
Guided bone regeneration (GBR) using a combined injectable platelet-rich fibrin (i-PRF), leukocyte- and platelet-rich fibrin (L-PRF), and biocompatible bone substitute material, is a convenient and effective method to augment a combined vertical and horizontal bone defect. This approach can create sufficient bone quality and quantity for implant surgical sites. A 55-year-old Asian woman presented with a severe bone defect in posterior mandible. The edentulous mandibular alveolar ridge was severely resorbed vertically and horizontally. A GBR procedure using i-PRF and L-PRF combined with particulate bone graft was performed. Postoperative cone beam computed tomography scans, 8 months after the augmentation, revealed a large regeneration of the alveolar bone sufficient for implant placement. A combination i-PRF/L-PRF and particulate bone graft may provide biologically active molecules and a scaffold for osteogenesis. This treatment protocol may be a viable option for a large bone defect required augmentation before implant placement.
Preoperative clinical photograph and radiographs. (a) Preoperative lateral view of the defect. (b) Radiographic lateral view of the defect. (c) Radiographic cross-sectional view of the defect.
Figure 2. Surgical placement of the graft. (a) Before graft approximation. (b) Graft approximation. (c) Complete graft placement without membrane. (d) Sticky bone.
Figure 3. Membrane positioning. (a) First collagen membrane. (b) Second collagen membrane. (c) L-PRF placed on top of the collagen membrane. (d) Preparation of PRF.
Pre- and postoperative CBCT scans. (a) Pre- and postoperative images. (b and c) Pre- and postoperative images before removal of tent screws. and (d) Pre- and postoperative measurements of bone gain.
Clinical bone gain. (a) Clinical bone gain before tent-screw removal. (b and c) Clinical bone gain.
Figure 6. Histologic examination of new bone. (a and b) Bone sample harvesting. (c and d) Histologic examination showing normal new bone formation.
Figure 7. Implant placement. (a and b) Implant surgical placement. (c and d) Measurement of implant primary.
Definitive prosthesis in function. (a) Lateral view of implant prosthesis. (b) Occlusal view of implant prosthesis. (c) Periapical radiograph of implants. (d) Periapical radiograph of implant prosthesis. (e) Periapical radiograph obtained 24 months after restoration insertion.
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