Topic

[Others]  Ridge Preservation with PRF + bone graft


Hello Dr. Jin,


Got an interesting case.

I want to do Exo # 47 & 16, prf with bone.

 

Patient wants future implants …. Any suggestions?
Thanks !


Inderjit~


by Bernard Jin at Fri, Jan 28, 2011 3:30 AM

11052 Views | 5 Replies


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Bernard Jin Replied at Fri, Jan 28, 2011 10:16 PM

Many clinicians have similar issues with dislodging prf & particulate bone allograft when suturing - I tended to notice this if I overfilled the graft site. Might I suggest slightly underfilling the site. I realize that with PRF, the tendency is to utilize everything that was harvested - but that comes with experience with more cases. Great Case, Inder! Well done. Maybe you could keep us up do date with its progress (future photos & radiographs). Cheers, Bernard Jin



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Bernard Jin Replied at Fri, Jan 28, 2011 7:09 PM

The images above were too large: Below are duplicates of the images re-sized.



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Bernard Jin Replied at Fri, Jan 28, 2011 7:06 PM

Reply by Dr. Inderjit~ Hey Dr Jin Very excited it went very well! Lots of granulation tissue, which i curettage, placed prf mixed with bone(in serum), prf membrane and then Collaplug & sutures. (However the suturing was little difficult while hooking tissue, bone and prf particles were coming out, i wonder if there is any easier way) Sure you can post on the forum, you can put my name if you want too. Thanks for your input, i really appreciate. Inderjit~



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Bernard Jin Replied at Fri, Jan 28, 2011 6:56 PM

Hi Inderjit! Great case for it! Will you be taking photos? I typically take this approach: - provide Local Anaesthesia first so it can work while you perform the PRF prep. - perform phlebotomy & spin vacuettes for PRF prep, I would draw 8 vacuettes for both sites. (4 per site) - perform extraction of the teeth (proper debridement with surgical curette would aide in healing) - hydrate the allograft in the serum collected from the PRF - before mixing the allograft with the PRF, wick the serum away with sterile 4x4 gauzes - so the bone is still moist (BM) - fragment the 3 PRF membranes into tiny pieces as I had demonstrated in the class - mix the (BM) with the PRF fragments. - place the PRF fragments into the sockets, then pack the uncut PRF membranes into the socket (try not to overfill) - because the PRF will only last slightly less than 2 weeks, you would need to try to achieve primary closure. Alternatively, you could cover the socket with either Collaplug, Bovine Collagen membrane (type 4) or connective tissue graft - which simply has a role of maintaining a barrier for a couple of weeks or more. - suturing is important - if you are using a collaplug, bovine membrane or CT graft to close the socket, make sure you use a figure-8 horizontal mattress suture to secure the site. Hope that helps. Let me know how it goes. Cheers, Bernard Jin



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Bernard Jin Replied at Fri, Jan 28, 2011 6:53 PM

Radiographs submitted by Dr. Inderjit~