Evaluation of Decortication Combined With APRF And GBR on Immediate Implant Placement Outcomes In The Posterior Mandibular Region - A Prospective Clinical and Radiographic Study

Hamdi, Omar Emad; Shaarawi, Amr Mohamed; Mosallam, Elham; Said, Hosam E

doi:10.21608/edj.2025.397689.3527

Evaluation of Decortication Combined With APRF And GBR on Immediate Implant Placement Outcomes In The Posterior Mandibular Region - A Prospective Clinical and Radiographic Study

Document Type : Original Article

Authors

¹ Msc Student, Oral and Maxillofacial Surgery, Oral and Dental Medicine, Delta University For Science And Technology: Al Mansurah, Dakahlia, Eg

² Assistant Professor, Periodontology Department, Faculty of Oral and Dental Medicine, Delta University For Science and Technology, Daqahlia, Egypt

³ Lecturer Oral and Maxillofacial Surgery at Must

⁴ Associate Professor, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Delta University, Egypt

10.21608/edj.2025.397689.3527

Abstract

Aim of the study: The current study aimed to evaluate the effect of A-PRF with decortication with Guided bone regeneration that's done in the posterior mandibular region with dental implant insertion.
Materials and Methods: This randomized clinical study included 14 patients were requiring implant placement at the posterior mandibular region with insufficient bone volume. Patients were randomly assigned to two groups (n=7 per group). The non-decorticated Group (Group A) received GBR with a xenograft and A-PRF. The decorticated Group (Group B) received the same treatment combined with buccal cortical bone decortication. Outcomes were evaluated at baseline and after 4 months. Radiographic outcomes included changes in bone height and bone density (Hounsfield Units) measured using Cone Beam Computed Tomography. Clinical outcomes included implant stability, Probing Pocket Depth, and Modified Sulcus Bleeding Index.
Results: The Decortication Group (Group B) demonstrated significantly greater bone deposition on the buccal surface (p=0.031) and significantly higher bone density across all measured surfaces (mesial, distal, apical; p<0.01) compared to Group A. Clinically, Group B showed a significantly greater increase in implant stability (p=0.025), significantly lower probing pocket depths (p<0.05), and a lower bleeding index at all surfaces except the mesial surface.
Conclusion: The adjunctive use of cortical decortication with A-PRF and GBR in posterior mandibular implant sites significantly enhanced bone density, improved implant stability, and promoted healthier peri-implant soft tissues. This combined approach appears to be a valuable technique for optimizing the quantity and quality of regenerated bone and overall clinical and radiographic outcomes.

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