Replacement in the esthetic zone can be very unpredictable and difficult to manage in cases with extreme bone and soft tissue loss. In this case report (2.5‐year follow‐up), we demonstrate that the use of platelet‐rich fibrin in combination with bovine bone can result in a stable, esthetic outcome.

Aims The aim of the present study was to assess the association between dental implant stability and peripheral blood cell composition and levels of coagulation factors in patients treated with alveolar ridge preservation with platelet‐rich fibrin (PRF) and bovine bone substitute. Materials and methods Fifty patients were included between 2015 and 2017. PRF was prepared from autologous blood, in which blood cells and coagulation factor levels were measured. PRF and bovine bone were placed in the socket, followed by closure with PRF membrane. Implants were placed 14 (±2.5) weeks postextraction. The implant stability quotient was measured at t = 0, t = 10 days, t = 7 weeks, and t = 17 weeks by resonance frequency analysis. Results Erythrocyte count was inversely associated with PRF membrane length, but not with implant stability. Conversely, platelet count did not correlate with membrane size but inversely correlated with implant stability at 7 and 17 weeks. In addition, implant stability was directly correlated with levels FXIII (t = 0, p < .01), active von Willebrand factor (VWF; t = 0 and 7 weeks, p < .05), and total VWF (t = 7 weeks, p = .012). Conclusion Implant stability following alveolar ridge preservation with PRF and bovine bone substitute is associated with circulating blood cells and coagulation factors. In particular, fibrin structure, VWF, and FXIII may be important modulators of implant stability.

Background: Primary and secondary implant stability is of high importance for survival and success of dental implants in the short and long term. Measurements of implant stability during healing provide the opportunity to monitor the course of the osseointegration process.Purpose: To compare implant stability quotient (ISQ) by resonance frequency analysis (RFA), recorded with two different devices after implant placement.Materials and methods: Patients with the need of single tooth extraction in posterior sites of the maxilla and the mandible were treated in a surgical center. All patients received additional augmentation with a bovine bone substitute and platelet-rich fibrin (PRF) after atraumatic tooth extraction. After a healing period of 10 weeks, 28 self-tapping titanium-implants were placed. Implant stability was recorded with two different devices (Osstell and Penguin) at the time of implant insertion (T0), 10 days later (T1), and after 7 (T2), or 17 weeks (T3).Results: No implant was lost, and no postoperative complication occurred during follow-up. Patient cohort comprised 9 female (32.1%) and 19 male patients (67.9%), with a mean age of 52.8 years, 64.3 years, respectively. Mean overall insertion torque was 43.6 Ncm at implant placement with no significant difference between implant location, age, or gender. No patient dropped out. During observation period, a significant increase in mean ISQ was recorded with both devices. Significant positive correlations between insertion torque and ISQ were recorded with both devices at T0, T2, and T3. No significant differences were observed in ISQ-values between both devices, and measuring directions at any point of measurement.Conclusions: Within the limitations of this cohort study, both devices were suitable for RFA-measurement and revealed comparable results. Due to the cordless design, handling of the Penquin device was more comfortable. Reusability of the Penguin MultiPeg-transducers may offer an additional benefit with regard on ecological aspects.

Treatment with Platelet Rich Fibrin results in increased oral implant stability, which is associated with peripheral blood cell-and coagulation parameters. BACKGROUND PRF is a membrane clot clinically used to accelerate wound healing and bone regeneration. PRF membranes are prepared from the patient's own blood using a dedicated centrifugation protocol. In oral implantology PRF has been used to improve osseointegration of dental implants achieving improved implant stability. AIMHow PRF improves osseointegration is unknown and therefore we analyzed implant stability development in time in patients treated with autologous PRF. Furthermore, we studied the influence of blood cell-and coagulation parameters on PRF characteristics and oral implant stability outcome. Abstract ref. # 15228 METHODSPRF membranes were prepared according to Choukroun et al. (2001). We included 50 patients to study the effect of platelets, leukocytes and erythrocytes (Sapphire hematology analyzer, Abbott, USA) and coagulation parameters PT, APTT, fibrinogen (STA-Max coagulation analyzer, Stago, France) on PRF characteristics. The oral Implant Stability Quotient (ISQ) using Ostell TM ISQ resonance frequency analysis (Osstell, Sweden) was used to correlate blood values with the clinical outcome.