Immediate implant and simultaneous buccal bone reconstruction with a composite graft of calcium sulfate and leukocyte-platelet-rich fibrin. A one-year case report

Abstract

The placement of immediate implants in compromised sockets often requires adjunctive reconstructive measures. In particular, the loss of integrity of the buccal wall may preclude implant placement or, at least, it requires contextual, guided bone regeneration. There is no uniform consensus regarding the best biomaterial or strategy to reconstruct buccal bone defects.

In this clinical case, two immediate transgingival implants were placed in the extractive socket of the upper right first molar and in the second premolar position. The buccal bone defect was managed with sticky bone made out of calcium sulfate blended with patient-derived leukocyte- and platelet-rich fibrin (L-PRF).

After 4 months, the implants were connected to definitive abutments and crowns. The comparison between pre- 1-year—post-treatment computed tomography scans revealed exceptional bone reconstruction at the buccal level, where the initial lesion was present.

The use of a composite graft made out of calcium sulfate blended with L-PRF ensured bone reconstruction of the buccal defect around two immediate implants without the use of heterologous bone particulate and/or overlying collagen membranes. Further clinical studies are needed to explore the potential and limits of this technique.