PMC3335652_01
Initial presentation.
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Upon clinical examination, it was noted that several posterior teeth were missing from the first quadrant and that the only remaining multirooted tooth (the upper right first molar) was severely periodontally compromised (Figure 1).
Radiograph shows hopeless upper molar with retained roots both mesial and distal to the tooth.
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The radiographic examination revealed the presence of unextracted roots in the areas immediately mesial and distal to the remaining molar (Figure 2).
Extraction site immediately after tooth removal.
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The remaining tooth sockets were curetted and all granulation tissue and socket debris were removed (Figure 3).
Formation of L-PRF.
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Using this method, the blood in the tubes separated into three visible layers, that is, a red blood cell layer (RBC) that occupied the lower most part of the tube, a cell-free layer that occupied the uppermost part of the tube, and an L-PRF layer that was located between the two (Figure 4).
L-PRF membrane.
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For each tube, the L-PRF layer was removed, and compressed between saline soaked sterile gauze to form an "L-PRF membrane" (Figure 5).
Extraction site healing 1 week after tooth removal (note the visibility of the L-PRF membrane).
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The site was free of infection and the L-PRF membrane was still clearly visible (Figure 6).
Radiograph showing new bone formation.
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A radiograph taken prior to implant placement confirmed new bone formation in the extraction area (Figure 7).
Flap reflection.
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The ridge had retained its morphology with no signs of bone resorption or of the residual socket (Figure 8).
Radiograph showing stable peri-implant bone 3 months after restoration.
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