Qualitative and Quantitative Assessment of Bone Formation Following Socket Preservation with Deproteinized Bovine Bone Mineral, Advanced Platelet-rich Fibrin and a Combination of Both: A Randomised Controlled Clinical Trial

Evaluation of the Impact of Platelet Concentrates in Bone Regeneration

Aim Although several biomaterials have been tried for alveolar ridge preservation post tooth extraction. There is still no ideal biomaterial suggested for socket preservation. Among the various bone grafts used, xenografts such as De-proteinized bovine bone mineral (DBBM) have been widely used. It has a slow substitution rate and takes several months to years to resorb which could be detrimental to bone-to-implant contact (BIC). In this scenario, platelet concentrates, especially third generation such as advanced platelet-rich fibrin (A-PRF) have been used for regenerative therapy. It has a unique advantage of sustained release of growth factors, apart from the presence of elevated levels of leucocytes which not only reduces the inflammatory reaction but also helps in the recruitment of osteoprogenitor cells, thereby facilitating new bone formation.The present study aimed to evaluate the effectiveness of the combination of DBBM and A-PRF in alveolar ridge preservation.

Materials and Methods Thirty-nine patients requiring extraction of teeth and replacement with dental implants were randomized into one of the three ridge preservation approaches: DBBM, A-PRF, and DBBM+A-PRF. Four months post socket preservation, bone cores were harvested before implant placement. The bone samples were then subjected to histological and histomorphometric analysis. 

Results Significantly more vital bone was present in the DBBM+A-PRF group compared to the A-PRF group and DBBM group (P =0.00). However, the connective tissue formed was more in the DBBM group and A-PRF group compared to the DBBM+A-PRF group (P =0.00), which was statistically significant.

Conclusion New bone formation was qualitatively superior in the DBBM+A-PRF group compared to when DBBM and A-PRF were individually used which could be detrimental to the bone to BIC thereby providing better osseointegration.