Comparison of Soft Tissue Healing in Immediate Implant Placement in Fresh Extraction Socket with and without the Use of Platelet-Rich Fibrin
Keywords:
Immediate dental implant loading, Platelet-rich fibrin, Bone regeneration, Tooth extractionAbstract
Objective: To compare soft tissue healing in immediate implant placement in fresh extraction socket with and without the use of platelet-rich fibrin (PRF) by evaluating cover screw exposure on 7th post-operative day and pink esthetic score on 3rd and 6th post-operative month.
Methodology: This quasi-experimental study was conducted at the Department of Oral & Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi over 10 months from June 2022 to March 2023 after ethical approval. Total 60 patients aged 18-60 years with maxillary or mandibular teeth indicated for extraction without active infection and with adequate gingival architecture and bone volume were included. Thirty participants were included in intervention and control groups. Written informed consent and demographic details were acquired from patients and recorded. Participants were non-randomly allocated via non-probability convenience sampling to receive immediate implant placement with or without PRF based on the availability of intervention material and clinical scheduling. Follow-up evaluations were done on the 7th post-operative day for presence or absence of cover screw exposure and at 3 and 6 months for mean pink esthetic scores (PES). Data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 27.
Results: The mean age of the participants was 37.97±13.37 years. The sample consisted of 27(45%) males and 33(55%) females. Among the PRF intervention group (n=30), 4(13.3%) had cover screw exposure on the 7th post-operative day, while 26(86.7%) did not. While for the control group, the presence and absence of cover screw exposure was 15(50%). Participants who received PRF treatment demonstrated significantly higher mean PES scores at both the 3rd month (11.73±1.143) and the 6th month (10.93±0.907), compared to 9.17±0.747 and 8.90-/+0.845, respectively, in those without PRF. A statistically significant difference between the mean PES of the groups (p <0.001) was observed between study groups.
Conclusion: The mean PES of the intervention (PRF) group in post extraction immediate implant placement was significantly higher than the control group at 3rd & 6th month follow-up, indicating better soft tissue healing with PRF use. Platelet-rich fibrin-treated group also demonstrated significantly lesser occurrence of cover screw exposure on 7th post-operative day highlighting the beneficial impacts of PRF adjunct in immediate implant placement.
References
1. Gaddale R, Chowdhary R, Mishra SK, Sagar K. Soft and hard tissue changes following immediate implant placement and immediate loading in aesthetic zone-a systematic review and meta-analysis. Evid Based Dent. 2024. doi:10.1038/s41432-024-01091-7.
2. Mohammed AlMugeiren O, Salem Assari A, Abdullah Alshehri K, Abdulaziz Alsharidah M, Alotaibi AN, Hamad Alzaid A. Placement of immediate dental implants in extraction sockets exhibiting the apical pathosis. A meta-analysis. J Oral Biol Craniofac Res. 2024; 14(3):290-300. doi:10.1016/j.jobcr.2024.03.008.
3. Cosyn J, Blanco J. EAO position paper: immediate implant placement: managing hard and soft tissue stability from diagnosis to prosthetic treatment. Int J Prosthodont. 2023; 36(5):533-45. doi:10.11607/ijp.8544.
4. Jagtap A, Mangalekar SB, Kamble P. Clinical evaluation of coronally advanced flap with or without advance-platelet rich fibrin membrane in the treatment of Miller’s class-II localized gingival recession: a clinical study. Cureus. 2023; 15(2):e34919. doi:10.7759/cureus.34919.
5. Madi M, Elakel AM. The clinical implications of platelet-rich fibrin on periodontal regeneration: a systematic review. Saudi Dent J. 2021; 33(2):55-62. doi:10.1016/j.sdentj.2020.12.002.
6. Zwittnig K, Mukaddam K, Vegh D, Herber V, Jakse N, Schlenke P, et al. Platelet-rich fibrin in oral surgery and implantology: a narrative review. Transfus Med Hemother. 2022; 50(4):348-59. doi:10.1159/000527526.
7. Giammarinaro E, Baldini N, Covani U, Menini M, Pesce P, Marconcini S. Does platelet-rich fibrin enhance the outcomes of peri-implant soft tissues? A systematic review. BMC Oral Health. 2025; 25(1):615. doi:10.1186/s12903-025-05922-6.
8. Couso-Queiruga E, Stuhr S, Tattan M, Chambrone L, Avila-Ortiz G. Post-extraction dimensional changes: a systematic review and meta-analysis. J Clin Periodontol. 2021; 48(1):126-44. doi:10.1111/jcpe.13390.
9. Fang J, Xin XR, Li W, Wang HC, Lv HX, Zhou YM. Immediate implant placement in combination with platelet rich-fibrin into extraction sites with periapical infection in the esthetic zone: a case report and review of literature. World J Clin Cases. 2021; 9(4):960-9. doi:10.12998/wjcc. v9.i4.960.
10. Sharma A, Ingole S, Deshpande M, Ranadive P, Sharma S, Kazi N, et al. Influence of platelet-rich fibrin on wound healing and bone regeneration after tooth extraction: A clinical and radiographic study. J Oral Biol Craniofac Res. 2020; 10(4):385-90. doi:10.1016/j.jobcr.2020.06.012.
11. Kamal MA, Elbattawy W, Eid S, Shoeib M. Clinical evaluation of platelet-rich fibrin versus subepithelial connective tissue graft, for soft tissue augmentation around implant in the aesthetic zone: a randomized control clinical trial. Egypt Dent J. 2022; 66(4):2187-95. doi:10.21608/edj.2020.42015.1249.
12. Maghaireh H. Pink aesthetics in implant dentistry: a three dimensional objective assessment a clinical review. Smile Dent J. 2021; 16(2):8-17. Available from: https://www. smiledentaljournal.me/files/smiledentaljournal_files_20220114124758.pdf.
13. Al-Maawi S, Becker K, Schwarz F, Sader R, Ghanaati S. Efficacy of platelet-rich fibrin in promoting the healing of extraction sockets: a systematic review. Int J Implant Dent. 2021; 7(1):117. doi:10.1186/s40729-021-00393-0.
14. Zaidi SAA, Arain B, Khawar N, Islam SA, Shaikh AA, Zaidi SAA. Platelet-rich plasma PRP in dental and oral surgery: wound healing to bone regeneration. PJMHS. 2023; 17(03):287-9. doi:10.53350/pjmhs2023173287.
15. Ali S, Pathak S, Dhirawani, Asrani S, Irfan. Evaluation of treatment outcome after immediate implant placement with and without autologous leukocyte platelet-rich fibrin. J Adv Med Dent Scie Res. 2021; 9(7):105-11. doi:10.21276/jamdsr.
16. Guney Z, Karacaoglu F, Baris E, Gezer KG, Akkaya MM. The relationship of peri-implant soft tissue wound healing with implant cover screw design: cross-sectional study. Clin Implant Dent Relat Res. 2024; 26(2):299-308. doi:10.1111/cid.13272.
17. Sharma K, Roy S, Kumari A, Bhargavi M, Patel S, Ingale P, et al. A comparative evaluation of soft and hard tissue changes around dental implants placed with and without platelet-rich fibrin. Cureus. 2023; 15(3):e36908. doi:10. 7759/cureus.36908.
18. Guan S, Xiao T, Bai J, Ning C, Zhang X, Yang L, et al. Clinical application of platelet-rich fibrin to enhance dental implant stability: a systematic review and meta-analysis. Heliyon. 2023; 9(2):e13196. doi:10.1016/j.heliyon.2023.e13196.
19. Aldosari MT, Jomah AA, Mohamed Alsultan AA, Alaskar LA, Salem Alamri AS, Alshahrani MA, et al. Aesthetic outcomes of single-tooth implant-supported crowns in the anterior region: a retrospective evaluation using the pink and white esthetic scores. Metall Mater Eng. 2025; 31(1):120-33. doi:10.63278/10.63278/mme.v31.1.
20. Sharafuddin AH, Nasr SS, Abd El-Rahman AR, Elarab AE. The effect of connective tissue graft and platelet-rich fibrin around immediately placed dental implants in the esthetic zone: a randomized clinical trial. J Osseointegr. 2022; 14(1):38-48. doi:10.23805/JO.2022.14.4.
21. Ahmed El Komi HAK, Bayomi MM, Eldestawy MT. Clinical outcome of an inject able platelet-rich fibrin and platelet-rich plasma on immediate dental implant. AJDS. 2021; 24(4):417-24. doi:10.21608/AJDSM.2020.39073. 1096.
22. Chandana K, Kumar SR, Krishna CS, Mekala S, Durga Chowdary ML, Mounika B. Evaluation of effect of PRF on rebound of soft tissue in immediate placement of implants-a randomized control study. ASDS. 2022; 6(8):101-12. doi:10.31080/ASDS.2022.06.1440.
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