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Management of the Post-Extraction Socket with Buccal Dehiscence in the Esthetic Zone Associated with Immediate Implant Placement Using L-PRF and CTG for Periosteal Inhibition: A Case Report

Year: 2026

Type: article

Abstract: Background: Management of post-extraction sockets with buccal dehiscence in the esthetic zone remains clinically challenging, particularly when immediate implant placement is indicated. Conventional approaches often rely on guided bone regeneration (GBR) with biomaterials, which may increase surgical complexity and morbidity. This case report evaluates the clinical and radiographic outcomes of a fully autologous approach combining leukocyte- and platelet-rich fibrin (L-PRF) and connective tissue graft (CTG) in conjunction with immediate implant placement. Methods: A 50-year-old healthy patient presenting with a fractured maxillary lateral incisor and buccal bone dehiscence underwent atraumatic extraction, immediate implant placement, and simultaneous site management using L-PRF membranes and CTG. Clinical and radiographic evaluations were performed at baseline (T0) and after 12 months (T1). Cone-beam computed tomography (CBCT) was used to assess horizontal bone thickness (HBT) at multiple apico-coronal levels and vertical evaluation parameters, including nasal floor–crest distance (NF–AC) and buccal dehiscence height (BDH). Clinical outcomes included keratinized tissue width (KT), gingival thickness (GT), and patient-reported outcome measures (PROMs). Results: Radiographic analysis demonstrated increased HBT at all levels (+1,4 mm at 12 mm, +3,1 mm at 15 mm, +3,2 mm at 18 mm, and +2,6 mm at 21 mm). NF-AC showed a marked increase (+2,7 mm) and substantial reduction of the buccal dehiscence defect. Clinically, KT increased by +2,0 mm and GT by +1,8 mm. Healing was uneventful, with minimal postoperative discomfort and high patient satisfaction. Conclusions: Within the limitations of a single case, the combined use of L-PRF and CTG with immediate implant placement resulted in favorable clinical and radiographic outcomes, suggesting that a fully autologous, biologically driven approach may represent a viable alternative to conventional GBR in selected cases. Further controlled studies are required to confirm these findings.

Source: Dentistry Journal

DOI: 10.3390/dj14070445