Effect of different platelet‐rich fibrin matrices for ridge preservation in multiple tooth extractions: A split‐mouth randomized controlled clinical trial

Abstract

Aim To evaluate dimensional changes in the alveolar ridge and bone structure after tooth extraction when L‐PRF or A‐PRF+ was used in comparison to unassisted socket healing. Materials and methods Twenty patients in need of at least three tooth extractions in the aesthetic zone were included. L‐PRF, A‐PRF+ or control was randomly assigned, leaving one empty socket/edentulous site between conditions. CBCT scans were obtained immediately after tooth extraction and after 3 months of healing. Horizontal and vertical dimensional changes of the ridge and socket fill were calculated. Histological and micro‐CT analysis of bone biopsies were used to evaluate post‐surgical bone structural healing. Results Mean horizontal and vertical changes at 1‐mm below the crest (buccal and palatal side) were similar for the three sites (p > 0.05). For the socket fill, L‐PRF (85.2%) and A‐PRF+ (83.8%) showed superior values than the control (67.9%). The histological and radiological analysis reported more newly formed bone for the PRF groups, without any significant differences between both. Conclusions PRF matrices failed to reduce the dimensional changes after multiple tooth extractions in the premaxilla. After 3‐month healing, both PRF matrices showed radiographically a significant superiority for the socket fill. Histologically, they seemed to accelerate new bone formation.

Efficacy of platelet-rich fibrin in promoting the healing of extraction sockets: a systematic review

“…The percent socket fill was significantly higher in the PRF group compared to the control group. Castro et al [ 41 ] also demonstrated a significantly higher socket fill after 3 months using CBCT measurement in the PRF treated group compared to the untreated control (Table 5 ).…”

“…Most of the included studies evaluated the L-PRF protocol. Additionally, Giudice et al [ 40 ] and Castro et al [ 41 ] evaluated A-PRF + in comparison to L-PRF, Clark et al [ 39 ] evaluated A-PRF and Ustaoglu et al [ 42 ] analyzed T-PRF in comparison to L-PRF. Most of the studies reported solely the used rounds per minutes (rpm) and centrifugation time without referring to the centrifuge design or the applied relative centrifugal force (Table 4 ).…”

“…Focus was placed on the evaluation of the percent of new bone formation by histomorphometry. Canellas et al [ 47 ]; Zhang et al [ 49 ] and Castro et al [ 41 ] showed significantly higher percent of new bone formation in the PRF group after 3 months compared to the control group. Areewong et al [ 55 ] (healing time: 8 weeks) and Clark et al [ 39 ] (healing time 15 weeks) did not show statistical significant differences in the ratio of new bone formation (Table 5 ).…”

“…Similarly, the bone density measurement after 15 weeks did not show statistically significant differences. Castro et al [ 41 ] showed a statistically significantly higher percent of bone volume/tissue volume when comparing the group of A-PRF + to the untreated control. However, no statistical significant differences were documented for the L-PRF group (Table 5 ).…”

Platelet-Rich Fibrin Decreases the Inflammatory Response of Mesenchymal Cells

“…Platelet-rich fibrin (PRF), a concentrate of cells and growth factors generated from the centrifugation of whole blood, is one local technique aimed at assisting in alveolar ridge preservation [ 12 , 13 , 14 ], increasing the width of the keratinized mucosa [ 15 ], treatment of periodontal intrabony defects [ 16 ], and treating gingival recessions [ 17 ]. Moreover, PRF is effective in the treatment of ulcers [ 9 ] and is used in other fields such as facial esthetics [ 18 , 19 ] and sports medicine [ 19 ], including meniscal repair [ 20 ].…”