Histomorphological Comparison of Platelet Rich Fibrin Combinations for Ridge Preservation.

Abstract

Background: Most commonly used techniques to preserve ridge dimensions following tooth extraction involve bone substitutes and membranes to cover the graft. The use of autologous Platelet Rich Fibrin (PRF) is a recent introduction to be used as a membrane as well as mixed with the graft material. PRF is an inexpensive autologous gel enriched with platelets from venous blood that is easily processed in a clinical setting and contains growth factors including PDGF, TGF-β, VEGF, EGF and IGF1. The aim of this case report is to compare the histomorphologic results of various combinations of PRF, freeze dried bone allograft (FDBA) and polylactic acid membranes (Guidor) in extraction sockets in a single patient. Material and Methods: A 49-year old female patient with a 12 pack-year smoking history presented for extraction of maxillary teeth for an implant retained complete denture. On the day of surgery, 40ml of venous blood was drawn and centrifuged to produce four PRF gels. Two PRF gels were minced and mixed with FDBA. Two clots were processed to be used as membranes to cover the sockets. Teeth #s 4, 6, 11, and 13 were extracted with minimal trauma and sockets were thoroughly debrided. Varying combination of FDBA, PRF, and Guidor membranes were used for ridge preservation grafting in the four sockets. Four and half months following extraction, trephine cores were taken at the time of implant placement and submitted for histological analysis. Results: Clinical healing was uneventful at all sockets but soft tissue healing appeared slightly rapid on sites covered with PRF membranes. However, histologic healing showed more vital bone formation around residual graft materials with Guidor membranes sites. Conclusions: Within the limits of this case report, although PRF membranes seemed to slightly enhance soft tissue healing, the use of Guidor membranes appeared to improve bone remodeling.