International Journal of Science and Research (IJSR) ISSN: 2319-7064 Scientific Journal Impact Factor (2018): 7.426 Volume 8 Issue 9, September 2019 www.ijsr.net Licensed Under Creative Commons Attribution CC BY Evaluation of Two Different Biomaterials Effect on Immediate Implant Stability and Bone Changes, a Randomized Parallel Group Clinical Trial Gökhan Gürses 1 , Alparslan Esen 1 1 Necmettin Erbakan University, Dentistry Faculty, Department of Oral and Maxillofacial Surgery, Konya, Turkey Abstract: How to rehabilitate the buccal gap of immediate implants is a point that confuses dentists. In this study, we aimed to compare the effect of the plasma rich fibrin(PRF) and deproteinized bovine bone mineral(DBBM) on immediate implants which have gaps wider than 2 mm in terms of stability and crestal bone change. The total number of volunteers in our study is 15. All participants have an indication of extraction on tooth which has two adjacent teeth in the maxillar anterior or premolar region and rehabilitated with immediate implants. All individuals were divided into three groups as DBBM, PRF and Control by envelope method. Stability measurements was performed separately as mesiodistal(MD) and buccolingual(BP) at 0 and 120th day. CBCTs were taken pre-op and post-op 9th month. There was no statistically significant difference between the three groups in terms of mesial/distal and horizontal crest losses, T1-T0 MD and BP changes. The use of PRF or DBBM in the buccal gap can contribute to the stability and prevents vertical and horizontal bone losses. Keywords: buccal gap, bone loss, immediate implant, resonance frequency analysis 1. Introduction Immediate implant protocol was introduced by Schulte in 1978 to overcome the disadvantages of conventional implant protocol such as time loss and bone resorption[1]. Since then, many studies have been conducted on immediate implants which mention other advantages including protecting alveolar anatomy[2] psychosocial benefits, and cost-effectiveness[3]. Nowadays, immediate implant application is widely used. The buccal gap left after the implant placement is an important point that confuses clinicians. To increase the success rate, dentists always seek to fill the gap with a biomaterial that they think improves and accelerates the bone healing. The researchers tried various materials and techniques such as deproteinized bovine bone mineral (DBBM), demineralized freeze-dried bone allograft (DFDBA)[4] guided bone regeneration (GBR)[5] platelet- rich plasma (PRP)[6] and platelet-rich fibrin (PRF)[2]. PRF is a blood product which contains factors that associate soft and hard tissue healing[7]. There are studies reporting that the use of PRF in intra-bone defects contributes to a rapid recovery and improved bone formation [8,9]. But some long term studies indicates that PRF could not maintain its superiority to next periods and no significant differences between PRF+ and PRF- groups in terms of implant stability or crestal bone dimensional change[2,9]. GBR is a regenerative method based on the placement of a barrier membrane on the defect site. The function of membrane is to create a space for migration of guided tissue. By this way, the formation of the needed tissue could be observed. The membranes used for this purpose are typically classified as resorbable and non-resorbable membranes. Each type has its own indications, advantages and disadvantages [10]. Histological and clinical studies have reported that gaps with less than 2 mm. could fill with bone spontaneously without any extra material or guided bone regeneration (GBR) procedures[11]. In cases of buccal gap wider than 2 mm, it is not clear whether using graft/membrane alone or combination will lead the most satisfactory results [12]. The limited number of published studies and the comparison of different dental regions in the same study make it difficult to form a systematic review or meta-analysis. The aim of this study is the comparison of DBMM and PRF with the control group in terms of stability and crestal bone loss on immediate implants which has buccal gap wider than 2 mm. The null hypothesis of this study was that immediate implants which augmented with DBMM or PRF, have not enhanced osteointegration or radiographic outcomes. 2. Methods This research was designed as a prospective randomized and parallel group clinical trial and conducted on 15 volunteers. We have calculated the sample size before the study. But due to the budget allocated to our study, we could not reach this number. This study followed the Declaration of Helsinki on medical protocol and ethics and the regional Ethical Review Board of Dentistry Faculty of Necmettin Erbakan University approved the study (Document Number: 2017-01). Patients who have an extraction indication on only one single rooted tooth in maxilla anterior and premolar region which have two periodontally healthy adjacent teeth were selected for the study. Exclusion criteria were patient with any systemic disease, dehiscence or fenestration in buccal socket wall before or after extraction, smoking and buccal gap less than 2 mm after implant placement. All interventions was operated at Necmettin Erbakan University, Dentistry Faculty. Paper ID: ART20201028 10.21275/ART20201028 346