Impact of Recurrent Application of C-PRF Inside the Extraction Socket on the Hard & Soft Tissues
Introduction
The biological process of bone resorption post-tooth extraction cannot be arrested, but; alveolar ridge preservation (ARP) modalities significantly reduce the rate of physiologic bone resorption occurring due to tooth extraction, thus facilitating dental replacement therapy. Platelet-rich fibrin (PRF) is commonly used for ridge preservation after tooth extraction. Concentrated PRF (C-PRF) is the last generation of liquid-form PRF, that is mainly used in dermatology and bone augmentation procedures. The effectiveness of PRF however diminishes over a period of two weeks due to resorption and loss of its biological activities.
Aim
To determine the effect of recurrent application of C-PRF inside the extraction socket on the hard and soft tissue alterations.
Patient Profile
- Patient requiring single maxillary or mandibular non-molar tooth extraction and replacement with a dental implant.
- The study participants had alveolar bone level >67% of the root length (pre-assessed using periapical radiographs and ensured clinically following tooth extraction and small flap elevation) (age; 20 to 65 years, n=20)
Methods
Study Design
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A randomized clinical trial
Treatment Strategy
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Patients were randomized into one of the two ridge preservation approaches: advanced PRF plus alone (Control group; n=10) or advanced PRF plus the recurrent application of a C-PRF inside the socket every two weeks for 2 months (four times, test group, n=10).
Outcomes
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Hard tissue loss and soft tissue alterations at 3 months
Assessments
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The ridge width, the ridge height, and the soft tissue thickness were assessed clinically at the baseline and after 3 months from tooth extraction during implant surgery.
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The amount of hard tissue loss and soft tissue alterations were calculated.
Results
- The amount of hard tissue loss differed statistically between the study groups in the third month. Patients in the test group had a significantly lower amount of horizontal ridge loss (2.9 ± 0.7 mm vs. 1.9 ± 0.5 mm, p value <0.05), and vertical bone loss compared to the control group (1.8 ± 0.5 mm and 1.0 ± 0.3 mm), respectively (p-value < 0.05).
Fig. 1: Changes in the study parameters at 3 months
*p-value <0.05
- The soft tissue thickness did not differ significantly between the groups (p-value > 0.05).
- No complications occurred in any of the 20 cases included in the study.
Conclusions
- The recurrent application of C-PRF in the extraction socket decreased the amount of ridge alteration following tooth extraction and may play a role in the bone regeneration procedures.
BMC Oral Health. 2023 Sep 19;23(1):677. Doi: 10.1186/s12903-023-03400-5.
