THE USE OF INJECTABLE PLATELET RICH FIBRIN IN CONJUNCTION TO GUIDED BONE REGENERATION FOR THE MANAGEMENT OF WELL CONTAINED RIDGE DEFECT AT THE TIME OF EXTRACTION

Background: Osseous defects resulting from periodontitis or from prior extracted teeth can complicate implant placement and/or restorative treatment. Grafting of these sites can develop better ridge morphology for implant placement or to support either fixed or removable prosthetics.
Objectives: This study aims to evaluate the effect of using injectable platelet-rich fibrin as adjunctive to Genesis bone graft and collagen membrane on the management of contained ridge defect at the time of extraction prior to implant placement. Moreover it compares this effect to that resulting from using the same bone graft and membrane alone.
Patients and methods: This study was conducted on fourteen patients selected from the outpatient clinic of the Faculty of Dentistry, Alexandria University. The Patients were divided equally into two groups: Group I (study group): consists of seven patients with severe maxillary anterior ridge defects.  Ridge augmentation was performed using Genesis bone graft combined with injectable platelet–rich fibrin, followed by application of absorbable membranes to stabilize and protect the grafts. Group II (control group): consists of seven patients with severe maxillary anterior ridge defects.  Ridge augmentation was performed using Genesis bone graft only, followed by application of absorbable membranes to stabilize and protect the grafts.
Results: there was a statistically significant difference between the 2 groups regarding the percent of change in alveolar bone width and density between preoperative and six months postoperative. However, the percent of change in the height of the labial plate of bone showed statistically insignificant difference between the 2 groups.
Conclusion: Guided bone regeneration before implant placement either at time of extraction or after extraction to avoid further bone resorption, helps to increase the alveolar ridge dimensions and improve its morphology (staged approach). The adjuvant use of injectable PRF with its high growth factor content may contribute to more favourable and predictable bone formation at the grafted site.