Diagnostic and Clinical Outcomes of Three Regenerative Strategies for Alveolar Bone Defects: A Comparative Study Using CBCT and ISQ

<b>Background</b>: This prospective clinical study aimed to evaluate the effectiveness of platelet-rich fibrin (PRF) in guided bone regeneration (GBR) prior to dental implant placement. <b>Material and methods</b>: Sixty-five patients with alveolar bone defects were randomly assigned to three groups. All groups received a composite graft consisting of 70% allograft and 30% xenograft. Group A received the graft combined with PRF. Group B received the graft with PRF and a resorbable collagen membrane. Group C (control) received the same graft and membrane without PRF. Cone-beam computed tomography (CBCT) was used to assess bone regeneration at baseline and 6 months postoperatively. Implant stability was evaluated using ISQ values at the time of implant placement (6 months after grafting) and again at 3 to 4 months during the second-stage uncovering procedure. Soft tissue healing, postoperative complications, and pain scores were also recorded. <b>Results</b>: Group B showed the best outcomes, with the highest mean vertical bone gain (3.0 ± 0.4 mm), greatest implant stability (ISQ: 74.2 ± 1.8), and no complications. Group A achieved moderate bone gain (2.3 ± 0.4 mm) and good ISQ values (71.5 ± 2.3), with favorable soft tissue healing. In contrast, Group C had the lowest bone gain (2.1 ± 0.5 mm), reduced ISQ values (68.9 ± 2.9), and the highest incidence of complications, including dehiscence and minor infections. <b>Conclusions</b>: These results suggest that PRF enhances both hard and soft tissue regeneration, particularly when used with grafts and membranes. PRF may reduce healing time and postoperative discomfort, improving the overall success of regenerative implant procedures.