Postgraduate program in Periodontology, Faculty of Odontology, Complutense University of Madrid (UCM), Madrid, Spain.
ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Complutense University of Madrid (UCM), Madrid, Spain.
Clin Implant Dent Relat Res. 2023 Jun;25(3):592-604. doi: 10.1111/cid.13208. Epub 2023 Apr 23.
Alveolar ridge preservation (ARP) is a well-defined treatment performed to reduce bone dimensional changes occurring during the healing of post-extraction sockets to allow for adequate implant placement. Leukocyte and platelet-rich fibrin (L-PRF) has been showing to potentially promote bone and tissue regeneration during wound healing. Therefore, the aim of this study is to evaluate its efficacy for ARP when applied to fresh extraction sockets, in comparison with spontaneous healing.
Twenty-seven patients with hopeless non-molar teeth were treated. After randomization, fresh extraction sockets were either filled with L-PRF or allowed to heal spontaneously. CBCTs and intraoral scans were obtained immediately after extraction and at 4 months. Through superimposition of the obtained images, changes in the horizontal ridge width, height, buccal volume, and ridge contour changes were measured, as well as patient-reported outcome measures (PROM's).
The ridge dimensions changed similarly in both groups. Although less reduction occurred in the test group at 1 mm from the bone crest, differences were not statistically significant (p > 0.05). Application of L-PRF did not prevent reductions of ridge contours, neither in the linear vertical aspect nor in volumetric changes. There were no differences between groups in the need for bone regeneration when placing implants. Patients in both groups reported similar outcomes in terms of bleeding, pain, inflammation, and function at 1 and 4 weeks postoperatively.
Alveolar preservation with L-PRF neither minimized bone resorption occurring after tooth extraction in non-molar sites nor reduced the need for bone regeneration when placing implants. Furthermore, its use did not improve PROM's.
牙槽嵴保存（ARP）是一种明确的治疗方法，用于减少拔牙后愈合过程中发生的骨尺寸变化，以允许足够的植入物放置。富含白细胞和血小板的纤维蛋白（L-PRF）已显示在伤口愈合过程中可能促进骨和组织再生。因此，本研究旨在评估其在新鲜拔牙窝中的 ARP 效果，与自发愈合相比。
对 27 名患有无望非磨牙的患者进行了治疗。随机分组后，新鲜拔牙窝分别用 L-PRF 填充或自然愈合。拔牙后立即和 4 个月时获得 CBCT 和口腔内扫描。通过对获得的图像进行叠加，测量水平牙槽嵴宽度、高度、颊侧体积和嵴轮廓变化的变化，以及患者报告的结果测量（PROM）。
两组的牙槽嵴尺寸变化相似。尽管在骨嵴 1mm 处实验组的减少较小，但差异无统计学意义（p>0.05）。L-PRF 的应用并不能防止嵴轮廓的减少，无论是线性垂直方面还是体积变化方面。在植入物放置时，两组在需要骨再生方面没有差异。两组患者在术后 1 周和 4 周时在出血、疼痛、炎症和功能方面报告的结果相似。
富含白细胞和血小板的纤维蛋白在非磨牙部位拔牙后不能最小化骨吸收，也不能减少植入物放置时的骨再生需求。此外，其使用并未改善 PROM。
