“A Novel Technique for Fabrication and Clinical use of an Autogenous Leukocyte-Platelet-rich Fibrin (LPRF) Membrane in Oral & Maxillofacial Implant Surgery.”
Larry D. Towning DDS, MD
Clinical Associate Professor, Oral & Maxillofacial Surgery. The Ohio State University College of Dentistry and The Ohio State University Medical Center.
Private practice OMFS East Ohio Oral and Maxillofacial Surgery Inc.
INTRODUCTION: Barrier membrane use has been proposed by many to aid in implant surgical procedures. Specifically to speed soft tissue healing, limit epithelial in-growth at grafted sites, allow diffusion of healing co-factors, contain particulate graft material and facilitate maturation of the hard and soft tissue surgical site (1,2,3 below). Leukocyte Platelet Rich Fibrin (LPRF) concentrates have been advocated for use in a wide variety of dental, medical and surgical scenarios. This is an autogenous material. Most proprietary collagen membranes are produced from allogeneic, porcine and bovine sources. This autogenous membrane technique is simple, cost effective and allows use of the patient’s cells (LPRF) to produce a clinically useful membrane.
METHODS: 10ml of venous blood is harvested via venipuncture and vacutainer. This whole blood specimen is placed in a centrifuge. The buffy coat is the fraction of the venous blood sample that contains most of the white blood cells and platelets following density gradient centrifugation of the blood. This leukocyte and platelet rich layer (“buffy coat”) is then manually separated and a portion introduced into a gravity compression mold which shapes and condenses the cells producing a membrane. This membrane can be used in a variety of ways for implant site preservation and reconstruction. Socket preservation procedures, placement over an implant after immediate extraction and implant placement, with or without simultaneous grafting. We are also utilizing the LPRF membrane as an apical barrier for sinus “push” grafts. It may be stabilized in position with sutures but does achieve stability due to natural bio-adhesion and conformation to the recipient site.
RESULTS: Although I have utilized this technique for 15 years and over 1000 cases, a single case is presented for the purposes of this e-poster: Immediate post-extraction implant placement barrier membrane with alloplastic graft material
A novel, simple and cost effective technique for fabrication of an autogenous barrier membrane is described. The clinical implementation of this membrane for oral and maxillofacial implant procedures is illustrated.
- Evaluate surgical site results with pre and post-operative Cone Beam CT and compare to no membrane or graft, compare to xenograft collagen membrane. (This human study is in process at The Ohio State University, College of Dentistry).
- Histologic examination of trephine core samples from the post-extraction grafted sites at implant placement compared to xenograft collagen membranes. (This human study is in process at The Ohio State University, College of Dentistry)
- Examine L/PRF cellular density of the fabricated membrane via light microscopy to compare varying degrees of compression and mold configuration.
1.J Periodontol. 2008 Aug;79(8):1370-7. doi: 10.1902/jop.2008.070628 .
Xenograft versus extraction alone for ridge preservation after tooth removal: a
clinical and histomorphometric study.
Barone A, Aldini NN, Fini M, Giardino R, Calvo Guirado JL, Covani U.
2. Int J Periodontics Restorative Dent. 2012 Aug;32(4):421-30.
Socket preservation using bovine bone mineral and collagen membrane: a randomized
controlled clinical trial with histologic analysis.
Cardaropoli D, Tamagnone L, Roffredo A, Gaveglio L, Cardaropoli G.
3. J Periodontol. 2012 Apr;83(4):401-9. Extraction socket preservation graft before implant placement with calcium sulfate hemihydrate and platelet-rich plasma: a clinical and histomorphometric
study in humans.
Kutkut A, Andreana S, Kim HL, Monaco E Jr.
4. Journal of Craniofacial Surg. 2015 May;26(3):729-30. Implant-supported prostheses esthetic outcomes after socket preservation technique. Perelli M(1), Abundo R, Corrente G, Saccone C, Zambelli M.
5. Clinical Implant Dent Relat Res. 2017 Sep 14. Evaluation of volumetric dimensional changes in posterior extraction sites with and without ARP using a novel imaging device. Sbordone C, Toti P, Martuscelli R,Guidetti F, Porzio M, Sbordone L.