UCSF

Objective: Platelet-Rich Fibrin (PRF) is an autogenous blood product with clinical applications in dento-alveolar surgery. However, there is minimal information regarding its clinical efficacy. This randomized controlled clinical trial aims to evaluate the efficacy of PRF alone or with freeze-dried bone allograft (FDBA) as compared to FDBA alone or no graft (blood clot) in improving de novo bone formation during ridge preservation as determined by Micro X-ray computed tomography (Micro-CT) analysis.

Methods: Forty patients requiring extraction of non-molar teeth and replacement with dental implants were enrolled and randomized into one of four ridge preservation approaches: 1:PRF, 2:PRF+FDBA, 3:FDBA, or 4:blood clot. Non-traumatic extractions were performed without the elevation of a mucoperiosteal flap and the ridge preservation procedure was performed. After three months healing, bone core samples were harvested at the time of implant placement for micro-CT analysis.

Results: Analysis was performed for thirty three subjects that completed the study to date. The attrition rate was 12%. Implant success rate was 97%. All treatment groups allowed for the successful placement of implants after three months of healing. All treatment groups demonstrated evidence of new bone formation as measured by micro-CT analysis. Trabecular formation was noted in the blood clot, PRF, and PRF+FDBA groups, while minimal trabecular structure could be noted in the FDBA group. NO significant differences were noted between groups for bone volume fraction or bone mineral density. There was a trend for highest bone volume fraction with the PRF group and highest bone mineral density for the PRF+FDBA group.

Conclusion: This study demonstrates the use of PRF with or without FDBA for ridge preservation. A trend for increased bone formation at extraction sockets supports its application where de novo bone formation is desired. This study represents the first randomized controlled clinical trial evaluating the efficacy of PRF for ridge preservation by histological, micro-CT, and clinical measures.