Fang Jiao, Xin Xi-Rui, Li Wen, Wang Han-Chi, Lv Hui-Xin, Zhou Yan-Min
Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun 130021, Jilin Province, China.
World J Clin Cases. 2021 Feb 6;9(4):960-969. doi: 10.12998/wjcc.v9.i4.960.
In this case, platelet-rich fibrin (PRF) was added to guided tissue regeneration as a biomaterial in proper order for immediate planting in aesthetic area with periapical infection.
With the history of endodontic failure in maxillary central incisor, a 34-year-old female patient required the extraction of maxillary anterior residual root and immediate implantation. Cone beam computed tomography and clinical observation were used to assess the regeneration of soft and bone tissue. Before operation, cone beam computed tomography showed the anterior residual root had serious periapical periodontitis with insufficient labial bone in the aesthetic zone. The patient underwent immediate implant placement and reconstruction of the bone substitution by modified guided bone regeneration. The barrier was a three-layer structure of PRF-collagen membrane-PRF that covered the mixture of PRF and Bio-Oss to promote both osteogenesis and soft tissue healing. At 6 mo postoperatively, the definitive crown was placed after accomplished finial impression. One-year follow-up showed a satisfactory aesthetic effect with no obvious absorption of the labial bone and soft tissue.
The use of PRF in combination with guided bone regeneration can serve as a reliable and simple adjuvant for immediate implanting in infected socket and result in a stable osteogenic effect with good aesthetic outcome.
在本病例中,富血小板纤维蛋白(PRF)作为生物材料按适当顺序添加到引导组织再生中,以便在根尖感染的美学区域立即种植。
一名34岁女性患者有上颌中切牙牙髓治疗失败史,需要拔除上颌前牙残根并立即种植。采用锥形束计算机断层扫描和临床观察评估软组织和骨组织的再生情况。术前,锥形束计算机断层扫描显示前牙残根患有严重的根尖周炎,美学区域唇侧骨量不足。患者接受了即刻种植,并通过改良引导骨再生进行骨替代重建。屏障为PRF-胶原膜-PRF三层结构,覆盖PRF与Bio-Oss的混合物,以促进成骨和软组织愈合。术后6个月,完成最终印模后放置最终冠。1年随访显示美学效果满意,唇侧骨和软组织无明显吸收。
PRF与引导骨再生联合使用可作为感染牙槽窝即刻种植的可靠且简单的辅助手段,产生稳定的成骨效果,美学效果良好。