The use of leucocyte and platelet-rich fibrin in socket management and ridge preservation: a split-mouth, randomized, controlled clinical trial

Aim: To investigate the influence of the use L-PRF as a socket filling material and its ridge preservation properties. Materials and Methods: Twenty-two patients in need of single bilateral and closely symmetrical tooth extractions in the maxilla or mandible were included in a split-mouth RCT. Treatments were randomly assigned (L-PRF socket filling versus natural healing). CBCT scans were obtained after tooth extraction and three months. Scans were evaluated by superimposition using the original DICOM data. Mean ridge width differences between timepoints were measured at three levels below the crest on both the buccal and lingual sides (crest -1 mm (primary outcome variable), -3 mm and -5 mm). Results: Mean vertical height changes at the buccal were -1.5 mm (+/- 1.3) for control sites and 0.5 mm (+/- 2.3) for test sites (p < 0.005). At the buccal side, control sites values were, respectively, -2.1 (+/- 2.5), -0.3 mm (+/- 0.3) (p < 0.005) and -0.1 mm (+/- 0.0), and test sites values were, respectively, -0.6 mm (+/- 2.2) (p < 0.005), -0.1 mm (+/- 0.3) and 0.0 mm (+/- 0.1). Significant differences (p < 0.005) were found for total width reduction between test (-22.84%) and control sites (-51.92%) at 1 mm below crest level. Significant differences were found for socket fill (visible mineralized bone) between test (94.7%) and control sites (63.3%). Conclusion: The use of L-PRF as a socket filling material to achieve preservation of horizontal and vertical ridge dimension at three months after tooth extraction is beneficial.