Plasma Rich in Growth Factors (PRGF-Endoret) versus Platelet Rich in Fibrin (PRF) Around Immediate Dental Implant in Esthetic Zone

Abstract

In early years of modern implantology, the chief concern was tissue health and implant survival. But now there has been an increasing appreciation that esthetic is just as important to success of the final restoration as health. Replacement of lost teeth by implants has revolutionized rehabilitation while significantly advancing restoration dentistry.( El Askary et al 2001) Consequently, many recent studies have focused on treatment outcome of implant therapy performed in the esthetic zone. Placement of dental implant in the esthetic zone is a technique sensitive procedure with a little room for error (Al-Sabbagh et al 2006). Yet challenges remain in many cases. Inadequate bone availability for implant placement and optimal esthetic outcomes are common issues facing clinicians. However, certain cases have undergone such extensive bone and soft tissue destruction that implants cannot be placed immediately and hard and/or soft tissue augmentation is required prior to implant placement (Jivraj et al 2006). Successful implant therapy still can be attained in a resorbed ridge through a wide range treatment options, including Block grafts, guided bone regeneration, and placement of narrower width or shorter length implants (Cyril et al 2011) . In the process of tissue repair and restoration, the osseointegration of dental implant can be improved and accelerated by increasing the regenerative capacity of surrounding tissues with the appropriate stimuli (DuRaine et al 2011). Because growth factors are expressed during different phases of tissue healing, it has been thought that they could serve as therapeutic agents to promote tissue regeneration. (Anitua, E. 2006). Platelet-rich plasma (PRP), platelet-rich concentrate, autologous platelet gel or platelet releasate, all refer to one concept (1) which is an autologous concentration of human platelets contained in a small volume of plasma. It is known for a long time that fibrin clot and platelets have haemostatic and tissue repairing effect. In 1975, an article was published with the concept of platelet gel under the title of: ‘use of platelet-fibrinogen-thrombin mixture as a corneal adhesive'(Marx et al 1998). An exciting report was published in 1979 about the usage of gel foam in sutureless nerve anastomosis. After a few years an animal model showed that platelets and fibrin initiate a process consist of cell migration, collagen synthesis, fibroplasia and angiogensis which helps the lesion healing. The real application of platelet releases in treating wounds has begun in the mid-1980s after publication of (Kingthon et al. in 1986). In 1997 another important report was published about the maxillofacial surgery and platelet gels. The usages of platelet gel became more popular in late 1990s, after the publication (1998) of a paper about the effectiveness of the platelet-rich plasma (PRP) in bone regeneration in the field of dental care. (Banihashemi, 2014).