Guided bone regeneration with platelet rich fibrin

Barrier membranes have played an important role in regenerative dentistry since the mid-1980s by preventing infiltration of fast-growing soft tissues from slower-growing bone and mineralized tissues. These concepts were first applied to teeth as the guided tissue regeneration (GTR) concept and were shortly thereafter utilized in bone as guided bone regeneration (GBR), in order to augment the area intended for implant placement. Over the past years, new developments have been made with respect to the osteoconduction and biocompatibility of different bone-grafting materials as well as barrier membranes. While original PTFE nonresorbable membranes were first utilized. But they required a second surgical procedure, to remove the membrane. This strategy was responsible in increasing the patient’s morbidity. More recently various biodegradable collagen membranes, biodegradable polymers, as well as platelet rich fibrin (PRF) have been introduced as next-generation membranes for GBR procedures. In a similar fashion, bone-grafting materials were first utilized as passive materials without any biological components. But nowadays these materials have gained additional advantages by incorporating biologics to speed up new bone formation. These biological materials include various growth factors and bioactive modifiers. Despite bone morphogenetic proteins being accepted as the gold standard biological component to facilitate new bone formation, an existing wave of research derived from platelet concentrates (platelet rich plasma (PRP)) have been found to speed angiogenesis, which is a key component for bone regeneration. While the effects of utilizing PRP has been heavily questioned in the literature due to their incorporation of anti-coagulants, a second generation of this product entitled: Leukocyte-Platelet Rich Fibrin (PRF), has gained more popularity in dentistry due to its easier preparation protocols and additional handling benefits in GBR procedures

Keywords:

Bone material , GBR , PRP , L-PRF , Dental implant