Original Article

Comparison of the Efficacy of Platelet-Rich Fibrin and Bone Allograft for Alveolar Ridge Preservation after Tooth Extraction: A Clinical Trial

Abstract

Objectives: Bone remodeling after tooth extraction results in decreased ridge volume and complicates implant placement. Platelet-rich fibrin (PRF) is a rich source of autogenous cytokines and growth factors; it has been proven to effectively improve soft tissue healing and hard tissue regeneration. This study sought to compare the clinical application of freeze-dried bone allografts (FDBA) and PRF for alveolar ridge preservation after tooth extraction.
Materials and Methods: This clinical trial was conducted on 32 patients presenting for the extraction of hopeless non-molar teeth. The teeth were extracted with minimal trauma, and the samples were randomly divided into two groups (n=16). Tooth sockets were filled with either FDBA or PRF (prepared using 10cc of the patient’s blood). Bone regeneration was assessed by evaluating changes in horizontal and vertical bone dimensions after 12 weeks (the time of implant placement) using an acrylic stent fabricated before tooth extraction and a periodontal probe. The results were compared by repeated-measures analysis of variance (ANOVA; P<0.05).
Results: Ridge width showed a significant reduction compared to the baseline in both groups (P=0.001); ridge height changes were not significant (P>0.05). The evaluated groups did not show any significant difference in height/width changes (P>0.05).
Conclusion: The results showed an acceptable efficacy for PRF without graft materials in alveolar ridge preservation. This material is cost-effective and could be easily prepared. PRF application in extraction sockets yielded similar results to FDBA.

1. Tan WL, Wong TL, Wong MC, Lang NP. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clin Oral Implants Res. 2012 Feb;23 Suppl 5:1-21.
2. Irinakis T. Rationale for socket preservation after extraction of a single-rooted tooth when planning for future implant placement. J Can Dent Assoc. 2006 Dec;72(10):917-22.
3. John V, De Poi R, Blanchard S. Socket preservation as a precursor of future Implant placement: review of the literature and case reports. Compend Contin Educ Dent. 2007 Dec;28(12):646-53; quiz 654, 671.
4. Eskow AJ, Mealey BL. Evaluation of healing following tooth extraction with ridge preservation using cortical versus cancellous freeze-dried bone allograft. J Periodontol. 2014 Apr;85(4):514-24.
5. Iasella JM, Greenwell H, Miller RL, Hill M, Drisko C, Bohra AA, et al. Ridge preservation with freeze-dried bone allograft and a collagen membrane compared to extraction alone for implant site development: a clinical and histological study in human. J Periodontol. 2003 Jul;74(7):990-9.
6. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Mar;101(3):e37-44.
7. Dohan Ehrenfest DM, de Peppo GM, Doglioli P, Sammartino G. Slow release of growth factors and thrombospondin-1 in Choukroun's platelet-rich fibrin (PRF): a gold standard to achieve for all surgical platelet concentrates technologies. Growth Factors. 2009 Feb;27(1):63-9.
8. Miron RJ, Fujioka-Kobayashi M, Bishara M, Zhang Y, Hernandez M, Choukroun J. Platelet-Rich Fibrin and Soft Tissue Wound Healing: A Systematic Review. Tissue Eng Part B Rev. 2017 Feb;23(1):83-99.
9. Marenzi G, Riccitiello F, Tia M, Di Lauro A, Sammartino G. Influence of Leukocyte- and Platelet-Rich Fibrin (L-PRF) in the Healing of Simple Postextraction Sockets: A Split-Mouth Study. Biomed Res Int. 2015;2015:369273.
10. Ozgul O, Senses F, Er N, Tekin U, Tuz HH, Alkan A, et al. Efficacy of platelet rich fibrin in the reduction of the pain and swelling after impacted third molar surgery: randomized multicenter split-mouth clinical trial. Head Face Med. 2015 Nov 26;11:37.
11. Del Corso M, Vervelle A, Simonpieri A, Jimbo R, Inchingolo F, Sammartino G, et al. Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 1: Periodontal and dentoalveolar surgery. Curr Pharm Biotechnol. 2012 Jun;13(7):1207-30.
12. Gassling V, Hedderich J, Açil Y, Purcz N, Wiltfang J, Douglas T. Comparison of platelet rich fibrin and collagen as osteoblast-seeded scaffolds for bone tissue engineering applications. Clin Oral Implants Res. 2013 Mar;24(3):320-8.
13. Jeon YR, Kim MJ, Kim YO, Roh TS, Lee WJ, Kang EH, et al. Scaffold Free Bone Regeneration Using Platelet-Rich Fibrin in Calvarial Defect Model. J Craniofac Surg. 2018 Jan;29(1):251-254.
14. Van der Weijden F, Dell'Acqua F, Slot DE. Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review. J Clin Periodontol. 2009 Dec;36(12):1048-58.
15. Jambhekar S, Kernen F, Bidra AS.


Clinical and histologic outcomes of socket grafting after flapless tooth extraction: a systematic review of randomized controlled clinical trials. J Prosthet Dent. 2015 May;113(5):371-82.
16. Duan X, Lin Z, Lin X, Wang Z, Wu Y, Ji M, et al. Study of platelet-rich fibrin combined with rat periodontal ligament stem cells in periodontal tissue regeneration. J Cell Mol Med. 2018 Feb;22(2):1047-1055.
17. Kim J, Ha Y, Kang NH. Effects of Growth Factors from Platelet-Rich Fibrin on the Bone Regeneration. J Craniofac Surg. 2017 Jun;28(4):860-865.
18. Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Mar;101(3):e56-60.
19. Suttapreyasri S, Leepong N. Influence of platelet-rich fibrin on alveolar ridge preservation. J Craniofac Surg. 2013 Jul;24(4):1088-94.

20. Hauser F, Gaydarov N, Badoud I, Vazquez L, Bernard JP, Ammann P. Clinical and histological evaluation of postextraction platelet-rich fibrin socket filling: a prospective randomized controlled study. Implant Dent. 2013 Jun;22(3):295-303.
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IssueVol 17 (Continuously Published Article-Based) QRcode
SectionOriginal Article
DOI https://doi.org/10.18502/fid.v17i1.3961
Keywords
Alveolar Ridge Augmentation Allografts Bone Transplantation Platelet-Rich Fibrin
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How to Cite
1.
Azangookhiavi H, Ghodsi S, Jalil F, Dadpoor Y. Comparison of the Efficacy of Platelet-Rich Fibrin and Bone Allograft for Alveolar Ridge Preservation after Tooth Extraction: A Clinical Trial. Front Dent. 2020;17.