Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 6, 2021; 9(4): 960-969
Published online Feb 6, 2021. doi: 10.12998/wjcc.v9.i4.960
Immediate implant placement in combination with platelet rich-fibrin into extraction sites with periapical infection in the esthetic zone: A case report and review of literature
Jiao Fang, Xi-Rui Xin, Wen Li, Han-Chi Wang, Hui-Xin Lv, Yan-Min Zhou
Jiao Fang, Xi-Rui Xin, Wen Li, Han-Chi Wang, Hui-Xin Lv, Yan-Min Zhou, Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun 130021, Jilin Province, China
Author contributions: Zhou YM contributed to conceptualization; Xin XR, Fang J and Wang HC contributed to formal analysis; Fang J was involved in project administration; Zhou YM implemented supervision; Xin XR, Fang J and Li W contributed to writing the original draft; Fang J, Lv HX and Zhou YM contributed to writing and revisions.
Supported by Department of Finance of Jilin Province, No. JCSZ2019378-21 and JCSZ2019378-27; Jilin Scientific and Technological Development Program, No. 20200201302JC.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Min Zhou, DDS, PhD, Chairman, Chief Doctor, Department of Dental Implantology, Hospital of Stomatology, Jilin University, No. 1500 Qinghua Road, Chaoyang District, Changchun 130021, Jilin Province, China. zhouym1962@126.com
Received: October 26, 2020
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
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

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.

Keywords: Immediate implant, Platelet rich-fibrin, Periapical infection, Esthetic zone, Guided bone regeneration, Case report

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.