ABSTRACT
BACKGROUND: There are some challenges concerning immediate implant placement in the molar region. Platelet-rich fibrin (PRF), an autologous biomaterial, has been used widely for periodontal intra-bony defects, sinus augmentation, socket preservation, and gingival recession. However, the literature remains scarce for reports on immediate implants with PRF, particularly in the case of fresh molar extraction socket. CASE SUMMARY: The patient was a 43-year-old woman with maxillary molar vertical crown-root fracture. She underwent flapless immediate implant placement into the fresh molar socket with PRF. At the follow-up visit 15 d post procedure, the vascularization of soft tissue was visible. There was no swelling or pain after the surgery. Six months postoperatively, the regeneration of bone and soft tissues was visible. Subsequently, the definitive restoration was placed. The patient was satisfied with the aesthetic outcomes. CONCLUSION: The flapless immediate implant placement into the fresh molar socket with PRF is a feasible procedure. This case report demonstrates that PRF promotes bone and soft tissue regeneration apart from having an enhanced anti-inflammatory ability. Furthermore, the procedure involves a minimally invasive technique, thus reducing the surgical complexity.
ABSTRACT
BACKGROUND: This case report discusses a modified approach for maxillary sinus augmentation, in which platelet-rich fibrin, endoscope, simultaneous implant placement, and sinus floor elevation (PESS) were applied for a maxillary sinus floor lift in a 40-year-old patient. CASE SUMMARY: A 40-year-old woman suffered missing upper right first molar. Implant stability quotient and cone-beam computed tomography (CBCT) were used to evaluate the diagnosis. CBCT showed insufficient posterior maxillary bone with a mean residual alveolar bone height of only 3.5 mm. The patient underwent a minimally invasive sinus floor elevation endoscopically. The sinus membrane was elevated in two stages, and a 12-mm implant was placed immediately. At 3 mo postoperatively, the final impressions were accomplished, and a full-ceramic crown was fit-placed. A 6-mo follow-up demonstrated satisfactory aesthetic and functional results. CONCLUSION: This is the first report to use an endoscope for maxillary sinus floor lifting in cases with severe and insufficient bone height. This case report demonstrates the advantages of the PESS technique, which include minimal invasiveness with high precision, being applicable in cases with a residual alveolar bone height < 4 mm with a promising result, and a shortened treatment period from 12 to 3 mo.
