الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
 |  | from | 170 |  |  |
| | | from | 170 | | |
Abstract
Alveolar ridge preservation (ARP) is an alternative treatment option to immediate implant at the time of tooth extraction to minimize alveolar ridge resorption and maximizing bone formation within the socket for future implant placement. That includes bone substitute covered with membrane or by flap advancement to achieve complete or partial wound closure.
Using bone graft in the presence of infection is a sensitive procedure. Before grafting procedure in infected socket, infection must be controlled to maintain a field suitable for bone regeneration and prevent deficient bone formation. Certain protocol is followed for grafting any chronic infected socket which include complete removal of infected tissues, primary closure and maintaining adequate blood supply to the graft to ensure success.
L-PRF is a natural scaffold that contains leukocytes and platelets trapped in strong fibrin network. Fibrin provides natural reservoir for growth factors liberated from platelets degranulation. L-PRF can be used in extraction socket as a filling material and to enhance the natural healing process simultaneously. L-PRF mixed with bone graft in socket preservation has many advantages of enhancing graft volume and quality by creating regeneration room sealed from the oral cavity to avoid open healing state and subsequent biomaterial loss and infection.
The present study was performed to evaluate the use of L-PRF versus L-PRF mixed with particulate xenograft in alveolar ridge preservation after extraction of a tooth with chronic infection histologically and radiographically.
This study included thirty patients divided in three groups, each consists of ten patients for ARP procedure. group Ι, ARP was performed using L-PRF alone. group II, ARP was performed using L-PRF mixed with xenograft. group III, ARP was performed using xenograft and collagen membrane. All the patients received implant after 4 months in the ARP site.
A baseline CBCT was performed before atraumatic extraction. Radiographic alveolar ridge width was measured by selecting 3 sagittal sections at base line and measuring buccolingual ridge width at 3 points 10, 12, 14 mm from a fixed reference line at each section then the mean was calculated. The same was calculated after 4 months.
Atraumatic extraction was done. In group Ⅰ, alveolar ridge preservation was performed by L-PRF plug placed into extraction socket. In group Ⅱ, L-PRF mixed with particulate xenograft, and in group Ⅲ, xenograft is mixed with saline, placed in extraction socket to fill the socket completely, then covered by collagen membrane.
After 4 months from the grafting surgery, CBCT was performed then a re-entry procedure was performed to take bone core biopsy for histological analysis, and to place implants then primary stability of each implant was measured in ISQ units using the Ostell Mentor at four points; buccal, palatal, mesial and distal.
Regarding histomorphometric analysis, the amount of newly formed bone per area fraction, the highest mean value was recorded in L-PRF mixed xenograft group, followed by xenograft and barrier membrane group, with the least value recorded in L-PRF group. Regarding osteocyte count, the highest mean value was recorded in L-PRF mixed xenograft group followed by xenograft and barrier membrane group with the least value recorded in L-PRF group.
Radiographically, the dimensional stability at alveolar ridge width between the three groups revealed that: L-PRF mixed xenograft group showed the highest stability followed by xenograft and barrier membrane group, where L-PRF group recorded the least dimensional stability.
Regarding implant primary stability, the highest mean value was recorded in L-PRF mixed xenograft group followed by xenograft and barrier membrane group, with the least value recorded in L-PRF group.