L‐PRF block for horizontal bone augmentation, clinical results and histology‐ a prospective case series.

Abstract

Background: The use of platelet concentrates, like Leucocyte and Platelet Rich Fibrin (L‐PRF) has increased in the last few years. Their application in bone augmentation procedures showed encouraging results. The L‐PRF block is a graft with high concentration of growth factors, platelets and leucocyte. This technique may enhance the development of mature lamellar bone without using autologous bone. Aim/Hypothesis: The objective of this study was to investigate the use of the L‐PRF block for horizontal bone augmentation and subsequent implant placement. The L‐PRF block may be a suitable alternative to the use of autologous bone graft for augmentation procedure. Material and Methods: This study was designed as a prospective case series. Subjects in need of a horizontal bone augmentation procedure were treated with the L‐PRF block (1‐1 mixture of particulated xenograft with chopped L‐PRF membranes and Liquid Fibrinogen). The grafts were covered with a collagen membrane fixed with titanium pins and protected by L‐PRF membrane. The horizontal ridge width was evaluated prior to augmentation and at 6 months healing. Linear measurements were assessed using cone‐beam computed tomography. Outcomes were defined as‐ the gain in ridge width (mm), the occurrence of any adverse event, and biopsy specimens examined histologically. Results: Twenty‐nine patients (17 female, 12 male) with a mean age of 51.2 (±17.1 years) and presenting 36 sites with horizontal alveolar deficiencies were treated. One graft had a complication during healing. 50 implants were placed and survived with an average follow‐up of 12 months. A statistical significant gain in alveolar ridge width was achieved at the crest, mid‐crest and apical levels. Superimposition of pre‐operative (T0) and post‐healing (T2) CBCT scans revealed an average linear horizontal bone gain of 4.6 mm measured on cross‐sectional images. Histologic analysis showed connection of the DBBM particles with a dense network of newly formed bone with different degrees of maturation. Conclusions and Clinical Implications: Within the limitations of this study, the L‐PRF block technique can be regarded as a successful technique for bone augmentation procedures. This GBR technique seems a suitable alternative to autogenous bone grafts to augment deficient alveolar ridges. [ABSTRACT FROM AUTHOR]