Complications related to bone grafts can cause significant discomfort for patients, and the choice of biomaterials plays a crucial role in the success of treatments. This article presents a case study where a bovine bone graft led to complications, resolved with the use of porcine bone graft, the Fast system, PRF, and a collagen membrane. This case, led by Dr. Surmenian in France, a close collaborator of Dr. Choukroun, perfectly demonstrates the effectiveness of the PRF protocol.

The patient presented with persistent discomfort after a bovine bone graft was performed at site #22. Shortly after, the implant failed, and the bovine biomaterial remained attached to the implant. Due to this complication, the patient was referred to Dr. Surmenian’s clinic for further treatment.

The failure of this bovine graft highlights one of the risks associated with this type of material, especially in highly inflammatory sites. Excessive inflammation makes healing difficult and can compromise the success of the treatment. At this point, Dr. Surmenian decided to take a different approach.

During the removal of the failed implant, Dr. Surmenian implemented a new strategy. He opted for porcine biomaterial (Purgo), along with two screws (Fast System), PRF (Platelet Rich Fibrin), and a collagen membrane. This combination helped control the inflammation and promoted better immune integration of the graft. Additionally, the full osteo-immuno protocol was applied to ensure optimal healing.

The patient disappeared for two years before returning to the clinic. During the follow-up visit, the team was able to reopen the site, remove the screws, and place a new implant with no visible signs of inflammation. Immune integration was perfect, once again demonstrating the effectiveness of PRF and porcine bone.

This case also highlights a phenomenon observed when patients delay returning after a graft. The longer the wait, the more the graft tends to corticalize and become rigid, which can complicate implant placement. This requires careful torque management. In this case, a Biotech Kontact implant measuring 3.6x10 mm (placed 2 mm subcrestal) was used.

This clinical case demonstrates the advantages of a personalized approach using porcine graft materials and PRF to resolve inflammatory complications. With better immune integration, this approach ensures faster healing and reduces the risks associated with inflammation, contributing to the success of the implant treatment.