Bone regeneration around immediate placed implant of molar teeth with autologous platelet-rich fibrin Two case reports

Rationale: There are some challenges concerning immediate implant placement in molar region. Platelet-rich fibrin (PRF), a second generation platelet concentrate, is an autologous fibrin matrix and contains platelets, growth factors, and leukocytes. It is used for tissue healing and regeneration in periodontal and oral-maxillofacial surgery. We report 2 cases of immediate placed implant of molar teeth with autologous PRF to improve and accelerate tissue healing. Patient concerns: Case 1 was a 38-year-old female patient with masticatory discomfort. Case 2 was a 43-year-old male patient with a demand for his left mandibular posterior tooth restoration. Diagnoses: Through the clinical and radiographic examination, the patient in case 1 was diagnosed with vertical root crown fracture of the maxillary right first molar. The patient in case 2 was diagnosed with residual root of the left mandibular first molar via cone-beam computer tomography and clinical examination. Interventions: The 2 patients underwent extraction of the molar teeth and immediate placed implant of molar teeth with autologous PRF was performed. In case 1, the gap between the implant surface and the socket walls of freshly extracted tooth was filled with PRF mixed with a commercial spongious bone substitute, followed by 2 PRF membranes coverage for protection. In case 2, PRF was used as a sole bone substitute material, placed between immediate implant and the socket wall of freshly extracted tooth. Outcomes: Follow-up of 2 cases revealed successful osseointegration and matured gingiva with optimal form and function. Lessons: The results suggested that PRF could solely serve as a bone scaffold in 4-wall bony defects, or can be combined with xenograft in 3-wall bony defects during immediately placed implants in molar regions, exhibiting excellent biocompatibility and good soft and hard tissue healing.