Allison N. Rascon
Yu Cheng Chang
Hobani, Nour, Rascon, Allison, N., Chang, Yu Cheng
University of Pennsylvania School of Dental Medicine, Department of Periodontics
Guided Tissue Regeneration (GTR) is a fascinating advancement in periodontics. Since the 1980’s, there have been many developments in regeneration procedures, with biologics aimed at mimicking, inducing, and regulating activity of the natural events that happen in the healing area with the purpose of promoting regeneration of the tissue. Various biologic agents have been introduced in the field of dentistry. Platelet-rich fibrin (PRF) is a blood-derived fibrin network containing clusters of activated platelets and leukocytes. PRF acts as a scaffold or growth factors, which accelerate wound healing, involves multiple growth factor. The application of platelet-rich fibrin has become increasingly popular in periodontal regenerative procedures as a result of it's ability to greatly enhance healing.Methods
58-year-old female patient presented to the periodontics clinic via referral for severe bone loss around the lower anterior incisor. The patient wished to do whatever viable option exists in order to save the tooth. GTR was presented, along with the use of PRF, in order to optimize results of healing. Patient agreed, risks and benefits were discussed, and consent was obtained. Topical anesthetic was applied, and local anesthetic was followed (2 carpules lidocaine 1:100000 epi, 1 carpule lidocaine 1:50000 epi). A full thickness mucoperiosteal flap was raised using sulcular incisions on the buccal and lingual from tooth #23 to tooth #25. All granulation tissue was removed via hand instruments and laser. SRP was performed with Gracey curettes. Two-wall osseous defect was present on mesial of tooth #24. Patient consented to having blood drawn for PRF. The defect was grafted with cancellous bone graft and Bioguide collagen membrane, as well as PRF. Simple interrupted and vertical sutures were placed with polypropylene suture. Post-operative instruction was provided to the patient, in addition to the written instruction sheet.Results
The four-month post-operative radiograph reveals results commensurate with improved bone levels and more ideal periodontal health, as can also be observed in the periodontal examination.Conclusion
This case report provides tangible evidence that the application of using platelet-rich fibrin membrane is a viable option in helping guided tissue regeneration procedures. Enhanced healing can be observed and there is clinical and radiographic evidence that predictable results can be obtained when utilizing PRF in a GTR procedure.