Published online Feb 6, 2021. doi: 10.12998/wjcc.v9.i4.960
Peer-review started: October 26, 2020
First decision: November 20, 2020
Revised: December 2, 2020
Accepted: December 16, 2020
Article in press: December 16, 2020
Published online: February 6, 2021
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.
Core Tip: In spite of the high-risk of immediate implantation in infected areas, there is a unique advantage. In this case report, the process of tooth extraction, implant placement and platelet-rich fibrin have been combined in one appointment, which significantly shortened the course of treatment the patient required. Furthermore, the existence of the platelet-rich fibrin was adopted to alleviate the inflammatory reaction and promote tissue recovery.