Comparison of Soft Tissue Healing in Immediate Implant Placement in Fresh Extraction Socket with and without the Use of Platelet-Rich Fibrin

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.