Leucocyte- and platelet-rich fibrin has positive impact on bone regeneration and implant procedures

Leucocyte- and platelet-rich fibrin (L-PRF) has been tested for enhancing alveolar ridge preservation (ARP), but little is known about the local release profile of growth factors (GF) and the clinical equipoise related to its efficacy remains. This study compared the patterns of GF release, early soft tissue healing and alveolar ridge resorption following unassisted healing and L-PRF application in non-molar extraction sockets.

Atraumatic tooth extraction of two hopeless teeth per patient was followed by unassisted healing or L-PRF placement to fill the socket in 18 systemically healthy, nonsmoking subjects. This intraindividual trial was powered to assess changes in horizontal alveolar ridge dimensions 1 mm below the crest of alveolar bone. GF concentrations in wound fluid were assessed with a multiplex assay at 6, 24, 72 and 168 hours. Early healing was evaluated with the wound-healing index and changes in soft tissue volumes on serial digital scans. Hard tissue changes were measured on superimposed CBCT images after 5 months of healing.

Results:

• L-PRF resulted in higher GF concentrations in WF as compared to the control, but no differences in release patterns or time of peak were observed.
• No intergroup differences in early healing parameters were observed.
• Alveolar bone resorption was observed in both groups.
• No significant intergroup differences were observed in hard tissue healing 1, 3 or 5 mm apical to the original bone crest, or inability to digitally plan a prosthetically guided implant with or without bone augmentation.

Thus, Leucocyte- and platelet-rich fibrin increased the GF concentrations in wound fluid of extraction sockets without shifting the pattern observed in unassisted healing, while the increased delivery did not translate into clinical benefits in early wound healing or ARP. The current findings question the assumption that increased local concentrations of GF by L-PRF translate into improved clinical outcomes. Additional definitive studies are needed to establish the benefits of Leucocyte- and platelet-rich fibrin in alveolar ridge preservation.

Reference:

Castro AB, Meschi N, Temmerman A, Pinto N, Lambrechts P, Teughels W, Quirynen M. Regenerative potential of leucocyte- and platelet-rich fibrin. Part B: sinus floor elevation, alveolar ridge preservation and implant therapy. A systematic review. J Clin Periodontol. 2017 Feb;44(2):225-234. doi: 10.1111/jcpe.12658. Epub 2017 Jan 10. PMID: 27891638; PMCID: PMC5347939.