Use of platelet rich fibrin for the treatment of peri-implant bone defects

Dental implants, with its increasing success, have become a popular treatment method. However, this condition has brought about increasing implant complications.Peri-implant bone loss has been attributed to several different factors, including poor surgical management, failure to achieve osseointegration, premature loading, biomechanical overload, peri-implant infection, and impaired host response.Peri-implant infection and biomechanical overload are etiologic factors that can contribute to progressive bone loss after implants have been in function. They require early recognition and treatment.Different protocols in treatment of peri-implant bone loss are proposed depending on the severity of the lesion. These treatment protocols include non-surgical periodontal treatment, local or systemic antimicrobial applications, flap surgery, resective flap surgeries with implantoplasty and regenerative methods using barrier membranes and bone grafts.Platelet rich fibrin (PRF) enhancing wound healing and regeneration through local delivery of autologous bioactive agents has been used widely to accelerate soft-tissue and hard-tissue healing.The aim of this study was to investigate and compare the clinical effectiveness of PRF application and conventional flap surgery for the treatment of peri-implant bone loss.Eleven men and eight women participated in the study. A total of 43 implants in 19 patients were evaluated. Twenty-nine implants in test group (PRF) and 14 implants in control group (flap surgery) were treated.Full mouth clinical parameters including pocket depth (PD), bleeding on probing (BOP), plaque control record (PK), the distance between implant neck-mucosa (MCEK), the distance between implant neck-pocket base (CAL) were measured at six sites for each implant.All clinical measurements were recorded before treatment, first month and third month after the therapy.According to the results of our study, BOP scores decreased in both groups. Plaque percentages did not change in both groups.PRF group revealed higher mean CD reductions when compared with flap surgery group. CD values were affected by the type of defects in PRF group. According to this, higher CD reductions were established in 1a, 1c and 1e defect types.Clinical attachment gain was higher in PRF group when compared with flap surgery group. Mean CAL values were affected by the type of defects in PRF group. Class 1a and 1e defects exhibited higher CAL gain in PRF group.According to mean MCEK values, gingival recession decreased in first month and third month in PRF group. However gingival recession increased in flap surgery group at first and third month.Within the limitations of this study, the present data indicated that PRF application in peri-implant bone loss provided better clinical results when compared with flap surgery.