Soft-Tissue Healing Assessment after Extraction and Socket Preservation Using Platelet-Rich Fibrin (PRF) in Smokers: A Single-Blinded, Randomized, Controlled Clinical Trial

Abstract

Background: Wound healing is essential in any surgical procedure, and multiple factors, such as smoking, can impair it. The aim of this clinical trial was to evaluate the ability of platelet-rich fibrin to enhance socket wound healing in smokers. Methods: A total of 18 smoker participants with forty non-restorable upper molars indicated for extraction were recruited to the study and were randomly allocated to four different groups for the assessment of four techniques: advanced platelet-rich fibrin (A-PRF), factor-enriched bone graft matrix with advanced platelet-rich fibrin (A/S-PRF), freeze-dried bone allograft and crosslinked collagen membrane (FDBA/CM), and resorbable collagen plug (RCP). One examiner clinically measured soft-tissue closure and the healing pattern using a periodontal probe and a healing index. Each subject was given a questionnaire after each follow-up visit to record several patient-reported experience measures (PREMs). This was conducted at baseline and 10, 21, and 28 days after the extraction procedure. Results: Both A-PRF and A/S-PRF showed significant results in terms of soft-tissue closure bucco-palatally (p = 0.270) and mesio-distally (p = 0.012), and healing pattern parameters (p < 0.0001), while RCP showed the least favorable outcome. Conclusions: Different forms of PRF exhibited enhanced wound closure and healing patterns, as well as reduced post-operative complications among smokers.

Healing of Extraction Sites after Alveolar Ridge Preservation Using Advanced Platelet-Rich Fibrin: A Retrospective Study

“…There was a statistically significant difference only for width at 3 mm. The significance of this phenomenon resides in a healing/resorption process similar to the maxilla/mandible when A-PRF is used post-extraction [ 16 , 28 ].…”

“…However, there are several factors that can influence these four phases [ 10 ]. These include systemic health, such as diabetes [ 11 ], smoking [ 12 , 13 , 14 ], radiation, antiresorptive drugs, and chemotherapy [ 15 , 16 ]. Any disruption of wound healing can lead to excessive bleeding or the absence of blood clots [ 17 , 18 ].…”

“…Platelet concentrates were used to enhance post-extraction healing [ 39 , 40 ]. Platelet- rich fibrin (PRF), the most studied type of platelet concentrates for accelerating wound healing, especially for soft-tissue migration [ 16 , 41 , 42 , 43 ] is a platelet product rich in slow-release autogenous growth factors that improve healing. PRF is a completely autologous product prepared exclusively from the patient’s blood, with a rich network of fibrin, platelets, leukocytes, and cytokines [ 41 , 43 ].…”

Methods of socket preservation: literature review

“…Articles [17,21,[28][29][30][31][32][33]45,47] describe studies aimed at determining the effectiveness of platelet-rich fibrin in the healing process and bone genesis.…”

“…However, the effectiveness in the synthesis of new bone is controversial, since not all studies have followed this dynamics. The article [28] describes the effectiveness of the regenerative ability of soft tissues by platelet-rich fibrin in smokers. Participants in this study had to meet the following criteria:…”