Safety and Feasibility of Extended Platelet-Rich Fibrin as a Solo Barrier Membrane for Ridge Preservation: A Case Series.

introductionPlatelet-rich fibrin (PRF) has been commonly utilized for ridge preservation techniques either to introduce supraphysiological concentrations of autologous growth factors to the defect area (typically when mixed within a bone graft) or utilized alone as a solo "barrier" membrane. Noteworthy, however, one of the commonly reported drawbacks of PRF is its relatively short resorption period characterized by lasting roughly 2 weeks. This may therefore be insufficient for complete soft tissue closure and/or preventing soft tissue cells from infiltrating into the bony compartment. Recently, it was discovered that by heating plasma and denaturing albumin using the Bio-Heat technology, the resorption properties of PRF could be extended from a standard 2-3 week period toward 4-6 months. The aim of the present human case series was to investigate for the first time the safety and applicability of utilizing this novel 100% autologous extended-PRF (e-PRF) membrane for ridge preservation. MATERIALS AND

methodsTwenty-two patients requiring 22 single tooth posterior extractions were included in this case series. In all cases, atraumatic extractions were performed, and the sites were grafted using a combination of bone allograft and standard PRF to create "sticky bone." Noteworthy, the barrier membrane utilized over top of the bone graft was the novel e-PRF, which was utilized as a solo membrane in place of standard collagen or polytetrafluoroethylene (PTFE) membranes. Cone-beam computed tomography scans were taken immediately after extractions and at 3 months postoperatively. Ridge width at 1, 3, and 5 mm apical to the crest, and buccal and lingual height dimensions were recorded at both time intervals. Additionally, buccal bone thickness at 1, 3, and 5 mm apical to the crest was recorded at baseline.

resultsAll extraction sites healed uneventfully without any postoperative complications. No clinical signs of infection or other complications were detected. The mean change in ridge width at 1, 3, and 5 mm apical to the crest was -1.27 ± 0.70, -0.94 ± 0.80, and -0.69 ± 0.79 mm, respectively. The mean change in buccal height and lingual height was -1.25 ± 1.16 and -0.94 ± 1.07 mm, respectively.

conclusionsThe use of e-PRF membranes in place of collagen membranes for ridge preservation was shown to be an effective, safe, and predictable treatment modality. The e-PRF membranes can be fabricated at low cost with a barrier function that resorbs much more slowly over time when compared to standard PRF membranes. While this preliminary report demonstrated successful outcomes, additional randomized controlled clinical trials investigating soft tissue outcomes of the e-PRF membranes when compared to more conventionally utilized membranes are further necessary to support these novel findings. CLINICAL RELEVANCE: The use of e-PRF membranes in ridge preservation is a safe, predictable, and all-natural alternative to traditional membranes.