The effect of recurrent application of concentrated platelet-rich fibrin inside the extraction socket on the hard and soft tissues. a randomized controlled trial

Abstract

Background Platelet-rich fibrin (PRF) is commonly used for ridge preservation following tooth extraction. However, its effectiveness diminishes over a period of two weeks as it is resorbed and loses its biological activities. Therefore, this clinical study aims to evaluate the effect of recurrent application of concentrated PRF (C-PRF) inside the extraction socket on the hard and soft tissue alterations. Methods Twenty patients requiring single tooth extraction and replacement with a dental implant were randomized into one of two ridge preservation approaches: Advanced PRF plus alone (Control group) or advanced PRF plus with the recurrent application of a C-PRF inside the socket every two weeks for 2 months (four times). The ridge width, the ridge height, and the soft tissue thickness were assessed clinically at the baseline and reassessed after 3 months from tooth extraction during implant surgery. Then the amount of hard tissue loss and soft tissue alterations were calculated. Results There was a statistically significant difference in the amount of hard tissue loss between groups in the third month. The amount of horizontal ridge loss for the control and test groups were 2.9 ± 0.7 mm and 1.9 ± 0.5 mm, respectively (p-value < 0.05). The vertical bone loss for control and test groups were 1.8 ± 0.5 mm and 1.0 ± 0.3 mm, respectively (p-value < 0.05). Additionally, for the soft tissue thickness, there was no statistical difference between the groups (p-value > 0.05). Conclusion Within the limitations of this study, the recurrent application of C-PRF in the extraction socket could decrease the amount of ridge alteration following tooth extraction and may play a role in the bone regeneration procedures. Trial registration Registered on ClinicalTrials.gov (ID: NCT05492357, on 08/08/2022).

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

“…al., the results showed a reduction in bone volume of 25% in the group with spontaneous healing and only 3% for the group in which the alveolar ridge was preserved [ 1 ]. Also, in other studies in which the same comparisons were made, the results were favorable for the preservation of the alveolar ridge [ 8 , 18 , 22 , 35 , 46 , 47 , 56 , 57 ]. The studies that analyzed the results of implant therapy had better outcomes for the preserved ridges than spontaneously healed alveoli [ 27 , 36 , 58 ].…”

“…By modifying the centrifugation process, different types of platelet concentrates can be obtained [ 40 , 44 ]. The advantages of using platelet-rich fibrin in post-extraction wounds are as follows: an improvement in soft tissue healing, reduction in inflammation and pain, as well as acceleration of bone formation [ 41 , 45 , 46 , 47 , 48 , 49 , 50 ].…”

“…Unlike other platelet products, A-PRF has a more homogeneous distribution of the amount of platelets and leukocytes present [ 39 ] and it has a thicker, more reticulate network [ 40 , 52 ]. Most studies have reported improved soft- and hard-tissue regeneration when using A-PRF alone or with other grafting material [ 42 , 46 , 47 , 48 ]. The use of A-PRF ensures success in obtaining larger height dimensions and in maintaining favorable ridge profile, probing depth, and gingival margin level of adjacent teeth after extraction.…”

Advancements in alveolar bone grafting and ridge preservation: a narrative review on materials, techniques, and clinical outcomes

“…In a recent exploration, Lahham et al [ 17 ] investigated the repercussions of recurrent applications of concentrated PRF (C-PRF) within extraction sockets. The study unveiled notable reductions in hard tissue loss within the test group over a span of 3 months, thereby hinting at C-PRF’s potential in alleviating ridge alterations post-extraction and fostering bone regeneration endeavors [ 17 ]. The enriched content of growth factors and bioactive components within PRF notably amplifies socket healing and tissue regeneration.…”

Management of a severely atrophic maxilla using concentrated platelet-rich fibrin block. A case report

“…Fibrin networks are formed during coagulation and synergize with cytokines released by platelets to create a biocompatible matrix that is proficient in retaining tissue growth factors [ 7 ]. Osteoblasts, endothelial cells, chondrocytes, and fibroblasts can be stimulated and differentiated by these factors, which can assist in the formation of bones and the healing of soft tissues [ 8 , 9 ]. Recently, a novel formulation called concentrated platelet-rich fibrin (C-PRF) has emerged as an extension of the traditional PRF.…”