Titanium-prepared platelet-rich fibrin enhances alveolar ridge preservation: a randomized controlled clinical and radiographic study

This randomized controlled trial evaluated the efficacy of titanium-prepared platelet-rich fibrin (T-PRF) for alveolar ridge preservation (ARP) compared with leukocyte and platelet rich fibrin (L-PRF) and spontaneous healing. Thirty single-rooted teeth requiring extraction were randomly assigned to one of three groups (ARP with T-PRF, ARP with L-PRF, and spontaneous healing) using a flapless, atraumatic extraction approach. Radiographic measurements (bone width, height, and density) were obtained pre-operatively and at four months via OnDemand3D software, and clinical parameters-including post-operative pain, analgesic consumption, soft-tissue healing, periodontal probing depth, gingival recession, and keratinized tissue width-were assessed. At four months, the T-PRF group demonstrated substantially greater preservation of ridge dimensions (P = 0.000), and higher bone density (P = 0.000), along with improved soft-tissue healing (P < 0.05), lower pain scores (P = 0.000), and reduced analgesic use (P < 0.05). Periodontal parameters remained stable across the groups, except for keratinized tissue width (KTW), which was substantially greater in the T-PRF group (P = 0.020). There were substantial differences among the groups in the need for bone regeneration when implants were placed (P < 0.05). These findings support the clinical advantage of T-PRF in optimizing post-extraction outcomes for implant site development.This trial was registered in the UK's Clinical Study Registry ISRCTN (ISRCTN60191547).