Clinical Effects Of Platelet-rich Fibrin In Reconstruction Of Jaw Bone Defects

Objective: To evaluate the clinical effects of platelet-rich fibrin(PRF) assole bone graft in bone defect reconstruction and peri-implant boneaugmentation.Methods: Ten cases of implant restoration with bone defects and fourcases of bone cyst extirpation were selected. Before surgery, whole bloodabout10-40ml was aspirated in plastic tubes without anticoagulant andcentrifuged immediately at3500rpm for15minutes to obtain PRF. Thesurgery was performed with local anaesthesia. The midcrestal incision wasmade at the anticipated site. Buccal mucoperiosteal was reflected in a fullthickness approach. Implantation was initiated at the implant site with a2.0mm round bur. A2.0mm twist drill was then advanced to a depth that wasmeasured from the preoperative radiograph. Gradually enlarged the bone,then place the implants. The PRFs were used to fill the bone defects and thecavity beneath the elevated sinus membrane in the implant surgery and alsoused as fillings of cyst cavity. All patients were followed up postoperativelyafter the first week,3months, and6months. The clinical evaluation included assessment of complications during surgery and postoperativehealing (inflammation, wound dehiscence, and pain). X-ray examinationswere taken immediately after operation as well as postoperatively after3and6months. Radiographic evaluation focused on the amount and densityof mineralized tissue present in the sinus augmentation area.Results: At up to3months of loading, including single crown4casesand7cases of fixed bridge, all restored implants were clinically stable, theearly survival rate is100%.24hours after surgery,5patients felt no pain,while8cases felt slight pain and1patient felt strong pain.7days aftersurgery, the mucosal flap with normal color, no edema were13cases. Onlyone case of maxillary sinus lifting patient had orbital swelling, andrecovered2weeks later. No postoperative complications were noted.Compared with preoperative X-ray, all implants have good osseointegration,peri-implant bone mineral density increased. For smaller defects of bonearound implants and maxillary sinus, new bone could always fill the cavityand implants were stable; For large bone cavity like the cavity after jaw cystcurettage, solely use the PRF can promote the growth of new bone, but inthe short term, it can not completely fulfill the bone cavity. The defects andcavities were filled with new bone, but the bone mineral density was lowerthan the normal bone after three months. While, after six months, both thebone density and the amount of new bone in the grafted area increased.Conclusions: This clinical observation confirmed that solely used PRF can promote bone regeneration and repair the bone defect. It can not onlyaccelerate the small peri-implant bone defect repair, but also plays a role inlarge bone defects regeneration. PRF, therefore, is a simple, safe andinexpensive bone grafting materials, the effect of which in jaw bone defectregeneration is reliable. The use of PRF avoids from the pain of collectingbone from patients and the disadvantages of the use of artificial bone, andexpands the operation indications. However, the long-term effect of boneregeneration and the combination with other materials remains to be furtherstudied.