Implant Tribune Italian Edition

Fig.9 e 10.Riempimento della cavità sinusale con biomateriale e succes- siva applicazione di PRF sulla finestra Fig.11 e 12.OPT post-operatoria e aspetto del tessuto a 7 giorni dall’in- tervento Fig.13 e 14.Tac a 6 mesi dall’intervento.OPT della protesizzazione a 9 mesi dall’intervento Fig.15 e 16.Tac a 12 mesi e OPT a 2 anni dal carico protesizo CASO CLINICO n. 5 Fig.1,2 e 3. OPT e Foto iniziali Fig.4 e 5. Movimento della membrana dopo scollamento con atti respi- ratori e inserimento del PRF. Fig.6. Inserimento dell’impianto CT Blossom Fig.7 e 8 Impianti inseriti e riempimento finale con aggiunta di biomate- riale e PRF a chiusura Fig.9.OPT post-operatoria Fig.10 e 11.OPT di controllo a 6 mesi dall’intervento e protesizzazione finale Discussioni e conclusioni Dalle osservazioni descritte fino ad ora e dai dati presenti in let- teratura, possiamo affermare che le ricerche attuali, evidenziano numerose possibilità d’impiego e sostanziali differenze tra il PRF ed i concentrati piastrinici utilizzati in precedenza, evidenziando come il PRF sia un materiale versatile in ambito chirurgico: è già oggi possibile osservarne un suo positivo utilizzo in diversi ambiti clinici,dalla chirurgia plastica a quella maxillo-ortopedica,derma- tologica ed altre (utilizzo nella riparazione della cuffia dei rotatori, nella chirurgia del tendine d’Achille,nel trattamento delle protesi d’anca,nella guarigione chirurgica di ernia inguinale con Mesh,in trattamenti cosmetici del viso, nella riparazione e rigenerazione tissutale in ulcere da decubito e croniche,etc.). In base a quanto sovraesposto i vantaggi sarebbero legati • al metodo di preparazione,senz’altro più semplice rispetto a PRP PRGF senza aggiunta di sostanze ausiliare ed estranee; • alla formazione di una matrice fibrinica con struttura simi- lare a quella naturale, flessibile e di buona qualità, capace di incorporare citochine e di sostenere la migrazione cellulare, unitamentealpotentestimoloneoangiogeneticocaratteristi- co del biomateriale insieme ad un’azione osteogenetica sulle cellule osteoprogenitrici; • allaconcentrazioneel’attivazionelentadeileucocitiaumenta le capacità della PRF contro le infezioni dimostrandosi un im- portante nodo immunologico prolungato nel tempo; • sottoformadimembrana,ilPRFpermetteunprotezionedel sito chirurgico favorendo dai margini della ferita una accele- razione dei processi cicatriziali. Infine gli aspetti medico linguali prevedono un utilizzo del PRF come materiale di autotrasfusione senza incorrere in divieti co- stituzionali,con la speranza in un breve futuro di un adeguamento della legislazione italiana per gli atti di prelievo e di centrifugazione da parte dell’odontoiatra. Per concludere si può affermare che il PRF rappresenta sicura- mente un nuovo approccio alla chirurgia rigenerativa ed implan- tare. Dovranno però essere ancora eseguiti ulteriori studi per poter meglio comprendere la versatilità,i meccanismi d’azione,e le po- tenziali applicazioni cliniche di questo protocollo. BIBLIOGRAFIA 1. Gibble JW,Ness PM.Fibrin glue:the perfect operative sealant?Transfusion 1990;30:741-7. 2. SaltzR,SierraD,FeldmanD,SaltzMB,DimickA,VasconezLO.Experimentalandclinicalapplicationsoffibringlue. Plast Reconstr Surg 1991;88:1005-15,discussion 1016-7. 3. 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