Effect of leukocyte-platelet-rich fibrin in bone healing around dental implants placed in conventional and wide osteotomy sites: A pre-clinical study

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Benalcazar Jalkh, Ernesto B. ; Tovar, Nick ; Arbex, Leticia ; Kurgansky, Gregory ; Torroni, Andrea ; Gil, Luiz F. ; Wall, Brittany ; Kohanbash, Kimia ; Bonfante, Estevam A. ; Coelho, Paulo G. ; Witek, Lukasz

• Document type: Journal article
• Source: JOURNAL OF BIOMEDICAL MATERIALS RESEARCH PART B-APPLIED BIOMATERIALS; v. N/A, p. 9-pg., 2022-06-30.

Abstract

Leukocyte-platelet-rich fibrin (L-PRF) has been suggested for gap management for immediate implant placement when the distance is greater than 2 mm. However, there remains a paucity in hierarchically designed research to support this application. The present study aimed to evaluate the effect of L-PRF on the osseointegration parameters of dental implants placed after conventional osteotomy of surgically created bone defects that simulate post extraction sockets in a canine model after 3, 6, and 12 weeks in vivo. Eighty dental implants (Intra-Lock, Boca Raton, FL) were placed in the radius of 13 beagle dogs. The experiment consisted of 4 groups (n = 20 implants/group): 1) Regular osteotomy (Reg n/L-PRF); 2) Regular osteotomy and implant placement with L-PRF membrane (Reg L-PRF); 3) Wide osteotomy with no gap management performed, where an osteotomy/bony defect (6 mm of diameter and similar to 5 mm deep) was created to simulate immediate implant placement in post-extraction sockets, and the gap was left for spontaneous healing (Wide nL-PRF); and 4) Wide osteotomy with L-PRF gap management (Wide L-PRF). L-PRF membranes were obtained by blood drawn from each subject and centrifuged at 2700 rpm (408 RCF-clot) for 12 min. In the experimental groups where L-PRF was utilized, the membrane was inserted into the osteotomy site prior to implant placement. Six dogs had implants placed in the radius for 3 weeks; and 7 dogs had implants placed in the left radius for 6 weeks and in the right radius for 12 weeks. At the corresponding experimental time points, samples were harvested, and subjected to histological processing for qualitative and quantitative analyses, via bone-to-implant contact (BIC) and bone-area-fraction occupancy (BAFO). Qualitative analysis demonstrated increased amounts of bone formation around the implant and within the healing chambers over time for all groups. While comparable histological features were observed for both Reg groups (L-PRF and nL-PRF), the gap management performed in Wide L-PRF group resulted in effective gap filling with improved bone growth in close proximity to the implant surface. Quantitative analyses of BIC and BAFO yielded higher values for both variables at 3 weeks for Wide L-PRF (similar to 38% and similar to 56% respectively) compared to Wide nL-PRF (similar to 20% for BIC and BAFO) (p < .03). No statistical differences were detected between Wide groups at 6 and 12 weeks, neither between Reg groups, independent of the association with or without the L-PRF membrane at all healing times. L-PRF placed within wide osteotomies, prior to implant placement, resulted in increased early bone formation compared to unfilled wide osteotomies at the early healing time (3 weeks in vivo). (AU)

• FAPESP's process: 18/03072-6 - Experimental 70% Al2O3-30% ZrO2 composites: structural characterization and survival probability before and after aging
• Grantee: Ernesto Byron Benalcazar Jalkh
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 12/19078-7 - Development and processing of Al2O3-ZrO2 translucent composite for CAD/CAM monolithic prostheses: the effect of aging on biaxial flexural strength
• Grantee: Estevam Augusto Bonfante
• Support Opportunities: Research Grants - Young Investigators Grants
• FAPESP's process: 19/00452-5 - EXPERIMENTAL 70%Al2O3-30%ZrO2 ZTA COMPOSITES: MECHANICAL, ESTRUCTURAL AND TOPHOGRAPHICAL CHARACTERIZATION
• Grantee: Ernesto Byron Benalcazar Jalkh
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate
• FAPESP's process: 16/18818-8 - Multi-User Equipment approved in grant 2012/19078-7: ElectroPuls E3000 Linear-Torsion All-Electric dynamic test instrument package
• Grantee: Estevam Augusto Bonfante
• Support Opportunities: Multi-user Equipment Program