Title Using Platelet Rich Fibrin During Socket Preservation Prevents Alveolar Bone Loss and Leads to Faster Soft-tissue Healing Along With Decreased Post-operative Pain.
Clinical Question For a patient undergoing dental extractions, does application of platelet rich fibrin (PRF) in the extraction socket result in decreased alveolar bone loss and improved patient comfort?
Clinical Bottom Line For patients undergoing dental extractions, application of platelet rich fibrin clots or membranes is effective for maintaining alveolar ridge width and height compared to no treatment. This is supported by a systematic review of several large randomized controlled trials in which application of Leukocyte-platelet-rich fibrin (L-PRF) reduced the aforementioned bone loss by a clinically significant margin. L-PRF is becoming more accessible and affordable for the average dentist or specialist, making this treatment modality very attractive and likely to be accepted by the dental patient.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
30058532Dragonas P/2018128 patients in 6 studiesSystematic review of randomized trials
Key resultsKey Results: A statistically significant decrease in both horizontal bone loss (HBL) and vertical bone loss (VBL) was found in 3 of the 4 studies that evaluated post-operative alveolar ridge dimensions comparing PRF-application versus no treatment.
Evidence Search (“PRF”[All Fields] AND “bone grafting”[All Fields] and “extraction”[All Fields])
Comments on
The Evidence
Validity: Each of the 6 relevant studies from Dragonas’s systematic review were randomized control trials, one of which included split-mouth design. All included studies provided sufficient follow-up. Statistical significance was noted consistently across studies for ridge preservation. For interventional studies, the methodological quality of the trials was evaluated using the Cochrane Collaboration tool for assessing risk of bias, as adapted by Chambrone et al. Observed outcomes were significantly superior when compared with natural healing as noted: HBL/B: −2.9 ± 2.7 mm; HBL/L: −2.1 ± 2.5 mm; TWR: 51.92 ± 40.31%
Applicability Dental extractions are a very common procedure performed by dentists and numerous specialists. The collection and application of autologous blood products is becoming more accessible and affordable. According to current evidence, PRF is an effective modality for preserving alveolar ridge height and width. Other benefits include increased soft tissue healing, decreased post-operative pain and decreased risk of alveolar osteitis.
Specialty (Oral Medicine/Pathology/Radiology) (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics)
Keywords Socket Preservation, L-PRF, Platelet Rich Fibrin
ID# 3349
Date of submission 12/15/2018
E-mail kushnerm@livemail.uthscsa.edu
Author Matthew Kushner
Co-author(s) e-mail
Faculty mentor John Hanlon
Faculty mentor e-mail hanlonjp@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available