Comparison of Histological, Clinical, and Radiographic Outcomes of Postextraction Ridge Preservation by Allogenic Bone Grafting With and Without Injectable Platelet-Rich Fibrin: A Double-Blinded Randomized Controlled Clinical Trial.

Abstract

Objectives: This randomized controlled clinical trial compared the histological, clinical, and radiographic outcomes of postextraction ridge preservation by allogenic bone grafting with and without injectable platelet-rich fibrin (I-PRF). Materials and Methods: Twenty single-rooted maxillary and mandibular teeth to be extracted and replaced by dental implants were randomly divided into two groups (n = 10). Cone-beam computed tomography (CBCT) scans were obtained preoperatively to assess bone dimensions and ridge width. The teeth were then extracted, and tooth socket preservation was performed with allograft and collagen type 1 in the control group and allograft, collagen type 1, and I-PRF in the intervention group. CBCT scans were obtained again 3 months after the first stage of surgery, and the second stage of surgery was performed for implant placement, ridge width measurement, and obtaining a biopsy sample. Radiographic bone width, clinical bone width, and radiographic bone height were measured. A histomorphometric method was applied to quantify residual graft material, new bone formation, and nonmineralized tissues. The data were analyzed with Student's t-test and Mann-Whitney U test (α = 0.05). Results: The intervention group showed a significantly smaller reduction in radiographic bone width (P=0.038) and clinical bone width (P=0.033), reduction in radiographic bone height (P=0.213) was not significant. A significantly lower percentage of residual graft particles (P=0.021) and a significantly higher mean percentage of newly formed bone (P=0.038) than the control group. However, the difference in the percentage of nonmineralized tissue (P=0.208) was not significant. Conclusion: Despite the optimal outcome of ridge preservation in both groups, the application of allograft plus I-PRF yielded superior histological, clinical, and radiographic results compared with allograft alone, and this difference was significant in most variables.