The use of L-PRF for increasing the volume of soft tissue around dental implants in the posterior region of the mandible – A case series

Background

The importance of soft tissue thickness and keratinized mucosa width around implant supported rehabilitations is well documented. In the areas which lack these conditions, connective tissue grafts have proven to be the gold standard. The usage of L-PRF membranes has emerged as an alternative technique.

Aim/Hypothesis

This case series is focused on determining the potential for the use of L-PRF as a sole material for- A) The increase of soft tissue thickness around implant supported rehabilitations and B) The increase of the keratinized mucosa width around implants in the posterior region of the mandible.

Material and Methods

Eleven dental implants (Biotech Dental ©, Salon de Provence, France) were placed in seven patients (five women, two men) in the premolar and molar area of the lower jaw. Digital reverse planning with CT scan analysis was performed prior to surgery in all cases, to assure that the correct rehabilitation could be performed without the need for bone augmentation procedures. All cases presented lack of soft tissue thickness and additionally required keratinized mucosa width augmentation prior to rehabilitation. L-PRF membranes were obtained and added to the healing site either at implant placement or at second stage surgery. The membranes were punched through and anchored to the implants and the surrounding tissues with the use of healing abutments and suture. Assessment of tissue volume and keratinized mucosa width changes was performed through the comparison of patronized pictures taken before surgery and after rehabilitation phases.

Results

A significant increase in the total width of soft tissue was observed in all cases. Enough keratinized mucosa width was found around all the rehabilitations in both buccal and lingual sides. None of the cases required additional surgical procedures to supply peri-implant soft tissue health. These results remained stable in follow-ups performed in a period ranging between 3 and 24 months after rehabilitation.

Conclusion and Clinical Implications

As previously stated by other authors and within the limitations of this case series, it can be suggested that the use of L-PRF membranes as a sole material has the potential for the increase of soft tissue thickness and keratinized mucosa width in the posterior mandibular area. Furthermore, these results seem to remain stable overtime, providing conditions for successful implant related treatments.