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ePaper created 2016-05-19, 12:42:25 | version 1.38.0
case report | 212 2016 implants ishelpfultolookatapaperpublishedbyPalmaand colleagues: in an animal study, they discovered that although there was not bone over the apex of the implants, the apex was covered by the Schnei derian membrane.12 A-PRF has been well intro ducedintheliteratureoverthelastyearsbyDohan and colleagues.13–16 Cases Two patients were treated in Godt Smil Odense over16months.Bothofthesepatientshadonething in common, they did not want any animal products to be used in the treatment and therefore choose to use A-PRF as their sole grafting material. Both pa tientswereingoodgeneralhealthanddonotsmoke. Venousbloodwassampledwithaso-calledbutterfly (Vacuette® Greiner bio-one) and the rule is 10 ml of venousbloodforeverydentalimplant,plus10 mlfor each mm of planned bone height. The blood is col lectedin10mltubes(A-PRF®+)andarecentrifuged according to Choukroun’s protocol. Operation Premedication is 2,000 mg Imadrax (Amoxicilin), 1,000 mgPinex(Paracetamol)and400 mgIbumetin (Ibuprofen) 60 minutes before treatment. The oral cavity was rinsed with 0,2 % Chlorhexidin for one minute. Local anaesthesia was administered buc cally and palatally (Xyloplyin® dental adrenalin 20 mg/ml + 12.5 microgram/ml lidocaine hydrochlo ride+adrenalin,DENTSPLY).Themucoperiostealtrapi zoid flap was raised and osteotomy was performed using the Summers technique. A-PRF membranes wereplacedintothesinusunderneaththeSchneide rian membrane. Valsalva tests were negative for both patients. The dental implant (K3Pro Sure) was inserted and the last A-PRF membrane was placed over the area, underneath the incision line. Both dental implants had good primary stability. Sutures were Glycolon 6–0 (Resorba). No further boneaugmentationsweredone.Postoperativemed ication was Imadrax (Amoxicillin), 500 mg 4 times a day for three days, Ibumetin (Ibuprofen, 400 mg) in combination with 1,000 mg Pinex (Paracetamol) as needed. Both patients were instructed to remain on soft diet for the next two days, no physical activity for seven days. Abutment operation was performed aftertwelveweeksandbothdentalimplantsreceived a screw-retained Prettau® full-ceramic crown. Discussion It is not possible to have valuable results from a small case presentation like this, but it is clear that a considerableamountofbonehasformedaroundthe implants, both dental implants were stable six months after loading. There was no BOP at control threemonthsafterloading.Previouspublicationson this matter confirm that it is safe to use A-PRF to in crease the bone height in sinus maxillaris using the Summers technique when the primary stability of the implant is good.3, 4, 10, 11, 17 Further research in this area is much needed._ Editorial note: A different documentation of the same cases has been published in The Icelandic Den- tal Journal. A list of references is available from the author. contact Dadi Hrafnkelsson, Cand Odont Overtandlæge Godt Smil Odense/Godt Smil Hørsholm Hovedgaden 55 C, 2. sal 2970 Hørsholm, Denmark Tel.: +45 70294020 Fig. 8 Fig. 9 Fig. 10 Fig. 8: Case 2, pre-operative. Fig. 9 & 10: Case 2, six months after operation. 2122016 Tel.: +4570294020