Evaluation of the Efficacy of Flowable Leukocyte and Platelet–Rich Fibrin versus Hyaluronic Acid as Bioactive Implant Coatings (Randomized Controlled Clinical Trial)

Abstract

Background: osseointegrated dental implants are often left load-free during the healing period. Many trials have been conducted to improve osteointegration to minimize loading time and ultimately raise patient satisfaction.Aim of the Study: to assess the effectiveness of flowable L-PRF and hyaluronic acid as bioactive coatings for dental implants, to decrease loading time.Material and Methods: 30 sites indicated for implant placement in the mandibular posterior region were selected and divided into 3 groups. In test group I; 10 implants were coated with flowable L-PRF and in test group II; 10 implants were coated with Hyaluronic acid while in the negative control (group III) the remaining 10 implants were left uncoated. After osteotomy; all implants were installed. Clinical assessment of implant stability was carried out immediately post-insertion (primary stability) and then 2 and 3 months post-insertion (secondary stability) using Resonance Frequency Analysis. Radiographic assessment of marginal bone level was evaluated immediately post insertion and 3 months later before loading. Results:The results of this study revealed that implants coated with flowable L-PRF showed less marginal bone loss than those coated with hyaluronic acid or the uncoated ones (median of marginal bone loss at 3rd-month post insertion was 0.35mm, 0.37mm and 0.51mm respectively). On the other hand, implants coated with HA showed better secondary stability at 3rd-month post insertion with a median of (89.50) compared to (82.50) for flowable PRF and (79.00) for the uncoated control group. Conclusion:bioactive implant coatings can enhance osseointegration and decrease loading time.