Evaluation of Alveolar Ridge Dimensions by Socket Preservation Therapy Using a Bone Graft and Platelet-Rich Fibrin: A Randomized Controlled Trial.

Abstract

Following the loss of a tooth, the new edentulous area of the ridge will undergo several adaptive modifications due to changes in function within and surrounding the socket. This bone resorption explains the need for socket preservation techniques in areas of esthetic concerns and functional demands. Demineralized freeze-dried bone allograft (DFDBA) possesses greater osteoinductive potential due to the exposure of bone morphogenetic protein (BMP-3​​​​​​)​and collagen fibrils and can be used efficiently in socket preservation techniques. DFDBA yields better results when combined with an autologous platelet concentrate, such as platelet-rich fibrin. Therefore, we formulated this randomized controlled clinical trial to assess the clinical and radiovisiographical outcomes of platelet-rich fibrin (PRF) and DFDBAs for extraction socket preservation in humans at different time intervals. This was a randomized controlled trial with 100 people as study subjects, and they wererandomly divided into two groups: the test group (DFDBA and PRF placed in the extraction socket) and the control group (natural healing of the extraction socket). Clinical and radiographic evaluation using radiovisiography (RVG) was done at baseline, three-month, and six-month intervals. Cone-beam computed tomography (CBCT) was used at six months to determine the bone density in the test and control groups. When compared from baseline to six months, the percentage change in clinical and RVG measurements for the test group was 15.96% (11.9064 mm) and 16.77% (12.1840 mm), respectively, whereas for the control group, it was 46.09% (14.0396 mm) and 47.61% (14.5716 mm), thus indicating lesser bone resorption in the test group as opposed to the control group. CBCT values also showed greater bone density for the test group (682.3120 HU) than the control group (503.8336 HU). This study demonstrates the advantages of DFDBA bone graft with PRF compared to natural healing in achieving socket preservation by maintaining the marginal and buccolingual bone levels.