Background: This study aims to evaluate whether there is a correlation between implant stability, bone density, vital bone formation and implant diameter and length. Methods: Ninety patients were enrolled in this study. They underwent a socket preservation procedure with allograft or PRF and after 4 months, a total of 90 implants were placed. CBCT scans were assigned prior to implant placement in order to assess the bone density. During the surgical re-entry, a bone biopsy was harvested with a trephine drill. Immediately after implant insertion, the primary stability was measured. The secondary stability was measured 4 months after implant placement. Results: Primary stability showed a significant positive linear correlation with bone density (r = 0.471, p < 0.001) as well as with percentage of new bone formation (r = 0.567, p < 0.001). An average significant association of secondary stability with bone density (rs = 0.498, p < 0.001) and percentage of newly formed bone (r = 0.477, p < 0.001) was revealed. The mean values of primary stability in all three implant sizes, regarding the diameter of the implants, were similar (narrow 67.75; standard 66.78; wide 71.21) with no significant difference (p = 0.262). The same tendency was observed for secondary stability (narrow 73.83; standard 75.25; wide 74.93), with no significant difference (p = 0.277). Conclusions: The study revealed a high correlation between primary and secondary implant stability, and bone density, as well as with the percentage of vital bone formation. Implant length and diameter revealed no linear correlation with the implant stability.

Background:Different barrier membranes and augmentation techniques are used in oral surgery to recover lost bone structures with varied success. Recently, a combination between bone graft materials and Platelet-Rich-Fibrin (PRF) is implemented in the periodontology and implantology.Aim: The aim of this case report was to assess the possibility for augmentation of the alveolar ridge in the frontal region of the upper jaw, utilizing a combination of bone graft material, injectable platelet-rich-fibrin (i-PRF) and advanced platelet-rich fibrin (A-PRF).Materials and methods:An 18 year-old male with expulsion of tooth 11 and partial fracture of the alveolar ridge was treated with augmentation of the alveolar ridge using bone graft material, injectable platelet–rich-fibrin(i-PRF) and advanced platelet-rich-fibrin (A-PRF). Clinical results were reviewed 4 months after the augmentation and a dental implant was placed.Results:The postoperative period was uneventful. The control CBCT scan showed good organization of new bone allowing placement of a dental implant.Conclusion:The successful clinical and radiographic results of the case suggest that using A-PRF and i-PRF can be beneficial for bone augmentation of the alveolar ridge before implant placement.

The aim of the present clinical study was to assess and compare the histomorphometric results and efficacy of freeze-dried bone allograft (FDBA) in combination with platelet-rich fibrin (PRF), and PRF as a sole grafting material for socket preservation. Ninety patients in need of tooth extraction and implant restoration were included in this study. The participants were randomly divided into three groups based on post-extraction clinical protocol: socket preservation procedure with allograft in combination with a PRF membrane (PRFm), PRF as a sole grafting material, and a control group. A total of 90 implants were placed four months post-extraction. During the surgical re-entry a bone biopsy was harvested with a trephine drill. Histological samples were prepared and analyzed for percentage vital bone and connective tissue. One-way ANOVA with Bonferroni post-hoc analysis were used to assess the results. Both test groups revealed a significantly higher percentage of vital bone formation compared to the control group. No statistically significant differences regarding vital bone formation and connective tissue quantity between the tested groups were observed (FDBA + PRFm: 3.29 ± 13.03%; and PRF: 60.79 ± 9.72%). From a clinical and histological point of view, both materials in the test groups are suitable for the filling of post-extraction sockets without bone defects. Both of the tested groups revealed a significantly higher percentage of vital bone formation compared to the control group.

Here we review the knowledge on the local biological immunological response (formation of “pseudo periosteum” of the host) to two types of nonresorbable membranes used in the horizontal and vertical alveolar ridge augmentation: the titanium-reinforced polytetrafluoroethylene membrane and the titanium mesh membrane. A literature search was conducted including available in vitro, in vivo, and clinical studies on cellular and molecular immunological response to these two types of nonresorbable membranes, in particular the formation of “pseudo periosteum”. Emerging data demonstrates that despite barrier membranes being considered as bioinert, they still elicit an immunological response from the body. The outcome of this reaction is the formation of a thin fibrous capsule referred to as “pseudo periosteum”. There are almost no biomaterials that are truly bioinert and this makes no exception for the nonresorbable membranes used in the guided bone regeneration. This iatrogenically made tissue is hypothesized to have a number of advantages and drawbacks. However, more research is needed in that area to truly understand its nature and importance to the guided bone regeneration process.

Introduction: Sufficient bone volume, as well as the bone quality characteristics are necessary prerequisites to ensure optimal mechanical stability of the implants and subsequent osseointegration. Aim: The aim of the present study was to assess the correlation between bone density values obtained by cone-beam computed tomography (CBCT), the primary stability of dental implants and the histomorphometric analysis of bone quality. Materials and methods: Following tooth extraction, socket preservation with frieze-dried bone allograft or protein-rich fibrin (PRF) was performed on 30 patients with 30 maxillary teeth in the region from second premolar to second premolar. Four months after the procedure, CBCT was used to assess the bone density (Hounsfield units) in the area of extraction. Thirty bone samples were harvested from implant sites using a trephine drill. They were analyzed with Image J software. Immediately after placing the implant, the implant stability quotient was measured using the Osstell Idx device. Results: The results revealed significant correlations between bone density and primary stability along the vestibulo-oral (r=0.392, p=0.032) and mesiodistal axes (r=0.407, p=0.026). Bone density also correlated strongly with the percentage of newly formed bone (r=0.776, p<0.001). Conclusion: Bone quality, in terms of bone density measured in CBCT and new bone formation are correlated to the primary stability of the dental implants and vice versa.