Narrow Ridge Expansion for Implant Placement Using Ultrasonic Bone Surgery and Platelet Rich Fibrin With and Without Silk Fibroin.

Abstract

ABSTRACT Object: To evaluate the effect of combined split-crest technique using ultrasonic bone surgery with platelet rich fibrin alone and in combination with silk fibroin for dental implant placement in narrow ridge. Subject and Methods: A total of 24 implants inserted in 18 patients with narrow ridge. Patients were assigned into one of the following 2 groups based on the graft material used. For group I, the peri implant gap was filled with silk fibroin mixed with PRF while for group 2 was filled with PRF only. All patients undergone a ridge splitting technique using piezoelectrical device and immediate implant placment. Assessments included measurements of the ridge width, implant stability and bone density. Results: The differences in implant stability measurements were non- significant in both groups at baseline however, at 6 months was statistically significant (P=0.001) in favor of silk fibroin group. Additionally, the differences in mean crest width measurements between both studied groups, were statistically non- significant at base line and immediately after surgery while silk fibroin group exhibited a statistically significant (P=0.010) increase in mean crest width measurements at 6 months. Moreover, silk fibroin group also showed higher and statistically significant (P=0.001) mean bone density measurements, at 6 months compared to PRF group. Conclusions: Compared to PRF alone, adding silk fibroin might provide a better reconstruction of ridge width, implant stability and bone density in the narrow ridge augmented with crest splitting and immediate implants.