Associação de membrana de colágeno e fibrina rica em plaquetas (PRF) em cirurgia de regeneração óssea guiada na região posterior de mandíbula

RESUMO

A regeneração óssea guiada (ROG) é o método mais utilizado para aumento ósseo antes da cirurgia de implante dentário. Uma paciente do sexo feminino, com 55 anos de idade, apresentou dor e inchaço na mandíbula posterior. Após análise clínica e tomográfica de feixe cônico, indicou-se a extração dos dentes 37 e 38. Foi realizada a colocação de implantes dentários nas posições dos dentes 36, 37 e 38, associada à regeneração da parede óssea lingual. A combinação da regeneração óssea guiada realizada simultaneamente com a colocação de implantes na mandíbula posterior, utilizando uma membrana de colágeno em conjunto com fibrina rica em plaquetas, proporcionou resultados satisfatórios em termos de reconstrução óssea e reabilitação com implantes, conforme evidenciado por um período de acompanhamento de 36 meses.

Palavras-chave – Regeneração óssea guiada; Implante dentário imediato; Fibrina rica em plaquetas.

ABSTRACT

Guided bone regeneration (GBR) is a widely employed technique for bone augmentation preceding dental implant surgery. A 55-years-old female patient presented pain and swelling in the posterior mandible. Following a clinical and tomographic assessment, the extraction of teeth 37 and 38 was deemed necessary. Dental implant placement in the position of teeth 36, 37, and 38 was carried out, associated by the regeneration of the lingual bone wall. The combination of guided bone regeneration performed simultaneously with implant placement in the posterior mandible, employing a collagen membrane in conjunction with platelet-rich fibrin, showed favorable outcomes in terms of bone reconstruction and implant-supported rehabilitation, as evidenced by a 36-month follow-up period.

Key words – Guided bone regeneration; Immediate dental implant; Platelet-rich fibrin.

Referências

Anjos LM, Rocha AO, Magrin GL, Kammer PV, Benfatti CAM, Souza JCM et al. Bibliometric analysis of the 100 most cited articles on bone grafting in dentistry. Clin Oral Implants Res 2023;34(11):1198-1216.

Magrin GL, Ruales-Carrera E, Apaza-Bedoya K, Escobar-Ramos M, Parma-Benfenati S, Benfatti CAM. Polydioxanone dome technique for guided bone regeneration: surgical technique and results up to 72 months of follow-up. Int J Periodontics Restorative Dent 2023;43(2):222-30.

Urban IA, Monje A. Guided bone regeneration in alveolar bone reconstruction. Oral Maxillofac Surg Clin North Am 2019;31(2):331-8.

Wang HL, Boyapati L. “PASS” principles for predictable bone regeneration. Implant Dent 2006;15(1):8-17.

Panahipour L, Kargarpour Z, Luza B, Lee J-S, Gruber R. TGF-β activity related to the use of collagen membranes: in vitro bioassays. Int J Mol Sci 2020;21(18):6636.

Sbricoli L, Guazzo R, Annunziata M, Gobbato L, Bressan E, Nastri L. Selection of collagen membranes for bone regeneration: a literature review. Materials 2020;13(3):786.

Bunyaratavej P, Wang HL. Collagen membranes: a review. J Periodontol 2001;72(2):215-29.

Nyman S, Gottlow J, Lindhe J, Karring T, Wennstrom J. New attachment formation by guided tissue regeneration. J Periodontal Res 1987;22(3):252-4.

Amaral Valladão CA, Freitas Monteiro M, Joly JC. Guided bone regeneration in staged vertical and horizontal bone augmentation using platelet-rich fibrin associated with bone grafts: a retrospective clinical study. Int J Implant Dent 2020;6(1):72.

Al-Maawi S, Herrera-Vizcaíno C, Orlowska A, Willershausen I, Sader R, Miron RJ et al. Biologization of collagen-based biomaterials using liquid-platelet-rich fibrin: new insights into clinically applicable tissue engineering. Materials 2019;12(23):3993.

Ghanaati S, Herrera-Vizcaino C, Al-Maawi S, Lorenz J, Miron RJ, Nelson K et al. Fifteen years of platelet rich fibrin in dentistry and oromaxillofacial surgery: how high is the level of scientific evidence? J Oral Implantol 2018;44(6):471-92.

Anderegg CR, Metzler DG. Tooth mobility revisited. J Periodontol 2001;72(7):963-7.

Miron RJ, Fujioka-Kobayashi M, Hernandez M, Kandalam U, Zhang Y, Ghanaati S et al. Injectable platelet rich fibrin (i-PRF): opportunities in regenerative dentistry? Clin Oral Investig 2017;21(8):2619-27.

Fujioka-Kobayashi M, Katagiri H, Kono M, Schaller B, Zhang Y, Sculean A et al. Improved growth factor delivery and cellular activity using concentrated platelet-rich fibrin (C-PRF) when compared with traditional injectable (i-PRF) protocols. Clin Oral Investig 2020;24(12):4373-83.

Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol 2009;27(3):158-67.

Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1986;1(1):11-25.

Liñares A, Dopico J, Magrin G, Blanco J. Critical review on bone grafting during immediate implant placement. Periodontol 2000 2023 Sep 1. Online ahead of print.

Wessing B, Lettner S, Zechner W. Guided bone regeneration with collagen membranes and particulate graft materials: a systematic review and meta-analysis. Int J Oral Maxillofac Implants 2018;33(1):87-100.

Asmarz HY, Magrin GL, Prado AM, Passoni BB, Benfatti CAM. Evaluation of removal torque and internal surface alterations in frictional morse taper connections after mechanical loading associated or not with oral biofilm. Int J Oral Maxillofac Implants 2021;36(3):492-501.

Di Summa F, Kargarpour Z, Nasirzade J, Stähli A, Mitulović G, Panić-Janković T et al. TGFβ activity released from platelet-rich fibrin adsorbs to titanium surface and collagen membranes. Sci Rep 2020;10(1):10203.

Panahipour L, Kargarpour Z, Luza B, Lee JS, Gruber R. TGF-β activity related to the use of collagen membranes: in vitro bioassays. Int J Mol Sci 2020;21(18):6636.

Michels R, Magrin GL, Cruz ACC, Magini RS, Benfatti CAM. Functionalization of a volume-stable collagen matrix using liquid platelet-rich fibrin: a case report presenting a new approach for root coverage. Case Rep Dent 2023;2023:3929269.

Papi P, Pranno N, Di Murro B, Pompa G. Early implant placement and peri-implant augmentation with a porcine-derived acellular dermal matrix and synthetic bone in the aesthetic area: a 2-year follow-up prospective cohort study. Int J Oral Maxillofac Surg 2021;50(2):258-66.