Clinical and Radiographic Evaluation of Leucocyte Platelets – Rich Fibrin in Bone Healing around Immediate Dental Implants

Background: Platelet-rich fibrin (PRF), is a second-generation platelet concentrate;leucocyte- and platelet-rich fibrin (L-PRF) is a modified PRF biomaterial that has beenproven to enhance bone healing, therefore, may be used to promote osseointegrationaround immediate dental implants. Aim: To assess the utilization of L-PRF in bonehealing around immediate dental implants. Patients and methods: Eighteen dentalimplants were placed in patients with badly decayed bilateral mandibular anterior orpremolar teeth indicated for extraction and implant placement utilizing the split-mouthtechnique. Patients’ side was randomly allocated into two groups, (n = 9 implants/group) where: Group I (control): The control side received immediately placedimplants without L-PRF after extraction; Group II (study): The study side receivedimmediately placed implants with L-PRF membranes placed around the osteotomysite immediately after extraction and implant insertion. Clinical assessment of implantstability was performed using the Ostell device where ISQ readings were recordedimmediately after implant placement then after 6 months. Pre-operative radiographicassessment was performed via CBCT, then, post-operative follow up was carried outusing periapical digital radiographs, immediate post-operative, then after 3 and 6months; bone density was measured using IDRISI Kilimanjaro software around theimplant in the osteointegration zone, which is the implant–bone interface. Results: Themean of clinical test (Ostell ISQ readings) was 62.2 (±3.8) and 67.8 (±3.4) at immediatepost-operative and 68.3 (±3.6) and 81.4 (±6.17) at 6 months for both control and L-PRFgroups; respectively. Upon comparing group I to group II, there was no significantdifference was seen immediate post-operative between both groups, however at6-months, a highly significant difference was observed between both examined groupswhere the L-PRF group exhibited significantly higher Ostell readings (p= <0.001). Themean of radiographic relative bone density was 132.6 (±15.38) and 150.5 (±13.28)immediate post-operatively, then, density values recorded 121.3 (±14.64) and 141.8(±17) after 3 months, and 151.7 (±16.68) and 186.5 (±19.03) after 6 months for thecontrol group and the L-PRF group respectively. Results showed statistically significantchanges in the control and L-PRF groups throughout follow-ups whereas comparisonbetween both groups showed significantly higher density values in the L-PRF groupespecially after 6 months. Conclusion: Use of Leucocyte-platelet-rich fibrin may showimprovement in implant stability and bone healing as well as increased bone densityaround immediate dental implants.