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

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          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.

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          Most cited references20

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          A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans.

          Clover Wong, Sabrina T. Wong, W Tan … (2012)
          Removal of teeth results in both horizontal and vertical changes of hard and soft tissue dimensions. The magnitude of these changes is important for decision-making and comprehensive treatment planning, with provisions for possible solutions to expected complications during prosthetic rehabilitation. To review all English dental literature to assess the magnitude of dimensional changes of both the hard and soft tissues of the alveolar ridge up to 12 months following tooth extraction in humans. An electronic MEDLINE and CENTRAL search complemented by manual searching was conducted to identify randomized controlled clinical trials and prospective cohort studies on hard and soft tissue dimensional changes after tooth extraction. Only studies reporting on undisturbed post-extraction dimensional changes relative to a fixed reference point over a clearly stated time period were included. Assessment of the identified studies and data extraction was performed independently by two reviewers. Data collected were reported by descriptive methods. Weighted means and percentages of the dimensional changes over time were calculated where appropriate. The search provided 3954 titles and 238 abstracts. Full text analysis was performed for 104 articles resulting in 20 studies that met the inclusion criteria. In human hard tissue, horizontal dimensional reduction (3.79 ± 0.23 mm) was more than vertical reduction (1.24 ± 0.11 mm on buccal, 0.84 ± 0.62 mm on mesial and 0.80 ± 0.71 mm on distal sites) at 6 months. Percentage vertical dimensional change was 11-22% at 6 months. Percentage horizontal dimensional change was 32% at 3 months, and 29-63% at 6-7 months. Soft tissue changes demonstrated 0.4-0.5 mm gain of thickness at 6 months on the buccal and lingual aspects. Horizontal dimensional changes of hard and soft tissue (loss of 0.1-6.1 mm) was more substantial than vertical change (loss 0.9 mm to gain 0.4 mm) during observation periods of up to 12 months, when study casts were utilized as a means of documenting the changes. Human re-entry studies showed horizontal bone loss of 29-63% and vertical bone loss of 11-22% after 6 months following tooth extraction. These studies demonstrated rapid reductions in the first 3-6 months that was followed by gradual reductions in dimensions thereafter. © 2011 John Wiley & Sons A/S.
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            Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution.

            David Dohan, Joseph Choukroun, Antoine Diss … (2006)
            Platelet-rich fibrin (PRF) belongs to a new generation of platelet concentrates geared to simplified preparation without biochemical blood handling. In this initial article, we describe the conceptual and technical evolution from fibrin glues to platelet concentrates. This retrospective analysis is necessary for the understanding of fibrin technologies and the evaluation of the biochemical properties of 3 generations of surgical additives, respectively fibrin adhesives, concentrated platelet-rich plasma (cPRP) and PRF. Indeed, the 3-dimensional fibrin architecture is deeply dependent on artificial clinical polymerization processes, such as massive bovine thrombin addition. Currently, the slow polymerization during PRF preparation seems to generate a fibrin network very similar to the natural one. Such a network leads to a more efficient cell migration and proliferation and thus cicatrization.
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              Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review.

              F. Dell‘Acqua, Fridus van der Weijden, Dagmar Slot (2009)
              To review the literature to assess the amount of change in height and width of the residual ridge after tooth extraction. MEDLINE-PubMed and the Cochrane Central register of controlled trials (CENTRAL) were searched through up to March 2009. Appropriate studies which data reported concerning the dimensional changes in alveolar height and width after tooth extraction were included. Approximal height change, mid-buccal change, mid-crestal change, mid-lingual change, Alveolar width change and socket fill were selected as outcome variables. Mean values and if available standard deviations were extracted. Weighted mean changes were calculated. Independent screening of the titles and abstracts of 1244 MEDLINE-PubMed and 106 Cochrane papers resulted in 12 publications that met the eligibility criteria. The reduction in width of the alveolar ridges was 3.87 mm. The mean clinical mid-buccal height loss was 1.67 mm. The mean crestal height change as assessed on the radiographs was 1.53 mm. Socket fill in height as measured relative to the original socket floor was on an average 2.57 mm. During the post-extraction healing period, the weighted mean changes as based on the data derived from the individual selected studies show the clinical loss in width to be greater than the loss in height, assessed both clinically as well as radiographically.
              Article 0 comments Cited 166 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Front Dent
                Journal ID (iso-abbrev): Front Dent
                Journal ID (publisher-id): FID
                Journal ID (pmc): FID
                Title: Frontiers in Dentistry
                Publisher: Tehran University of Medical Sciences
                ISSN (Electronic): 2676-296X
                Publication date (Print): January 2020
                Publication date (Electronic): 18 January 2020
                Volume: 17
                Issue: 1
                Pages: 1-6
                Affiliations
                [1. ]Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran
                [2. ]Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
                [3. ]Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
                [4. ]Dentist, Private Practice, Tehran, Iran
                [5. ]Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran
                Author notes
                [* ] Corresponding author: Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran Email: ydadpour@ 123456gmail.com
                Article
                Publisher ID: FID-17-1
                DOI: 10.18502/fid.v17i1.3961
                PMC ID: 7882193
                PubMed ID: 26564430
                SO-VID: f77dde8f-1905-4f8a-90a3-81ca77557656
                Copyright © © 2020 The Authors. Published by Tehran University of Medical Sciences
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license, ( https://creativecommons.org/licenses/by-nc/4.0/) Non-commercial uses of the work are permitted, provided the original work is properly cited.

                History
                Date received : 20 August 2019
                Date accepted : 02 December 2019
                Categories
                Subject: Original Article

                Keywords: alveolar ridge augmentation,allografts,bone transplantation,platelet-rich fibrin
                Data availability:
                Keywords: alveolar ridge augmentation, allografts, bone transplantation, platelet-rich fibrin

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