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Table 5 Dimensional bone alteration and bone regeneration outcomes in the evaluated studies

From: Efficacy of platelet-rich fibrin in promoting the healing of extraction sockets: a systematic review

Study n Test Control Method Results test Results control Statistical significance
Castro et al. [41] 20 L-PRF Spontaneous healing CBCT (thickness buccal bone 1 mm below the crest) after 3 months 1.1 ± 0.3 mm 1.1 ± 0.4 mm No
   A-PRF+  0.9 ± 0.3 mm No
     CBCT (horizontal resorption 1 mm below the alveolar crest) after 3 months Buccal: 1.6 ± 0.8 mm
Palatal: 0.6 ± 0.7 mm
Buccal: 1,7 ± 1.0 mm
Palatal: 0.5 ± 0.7 mm
No
    Buccal: 1.6 ± 0.7 mm
Palatal: 0.7 ± 0.8 mm
No
     CBCT (horizontal resorption 3 mm below the alveolar crest) after 3 months Buccal: 1.5 ± 0.8 mm
Palatal: 0.4 ± 0.4 mm
Buccal: 1.4 ± 0.8 mm
Palatal: 0.3 ± 0.4 mm
No
     Buccal: 1.2 ± 0.6 mm
Palatal: 0.4 ± 0.7 mm
No
     CBCT (horizontal resorption 5 mm below the alveolar crest) after 3 months Buccal: 1.0 ± 0.7 mm
Palatal: 0.2 ± 0.4 mm
Buccal: 1.0 ± 0.6 mm
Palatal: 0.1 ± 0.6 mm
No
     Buccal: 0.8 ± 0.6 mm
Palatal: 0.3 ± 0.6 mm
No
     CBCT (socket fill) after 3 months 85.2 ± 22.9% 67.9 ± 19.2% Yes: p = 0.005
     83.8 ± 18.4% Yes: p = 0.01
     Histomorphometry (percent of bone volume/ tissue volume) 47.7 ± 7.9% 34.7 ± 6.9% Yes: p < 0.05
     54.5 ± 5.6% Yes: p < 0.05
     Micro-CT (percent of bone volume/ tissue volume) 43.4 ± 8.7% 35.0 ± 8.2% No: p = 0.09
     50.7 ± 4.5% Yes: p < 0.001
Sharma et al. [54] 30 PRF Spontaneous healing Digital panoramic radiographs (grayscale value) after 16 weeks 91.980 88.689 No: 0.668
Canellas et al. [47] 45 L-PRF Spontaneous healing CBCT (bone loss 1 mm below the alveolar crest) after 3 months 0.93 ± 0.9 mm 2.27 ± 1.2 mm Yes
P < 0.0001
     CBCT (bone loss 3 mm below the alveolar crest) after 3 months 0.85 ± 0.8 mm 1.67 ± 1.1 mm Yes
p < 0.005
     CBCT (bone loss at the buccal bone wall) after 3 months 0.70 ± 0.7 mm 1.39 ± 1.2 mm Yes
P < 0.02
     CBCT (horizontal bone loss at 5 mm below the crest) after 3 months 0.67 ± 0.5 mm 1.08 ± 1.0 mm No
P = 0.094
     CBCT (vertical bone loss at the palatal/ lingual wall) after 3 months 0.67 ± 0.9 mm 1.24 ± 1.15 mm No
P = 0.064
     CBCT (new bone formation) after 3 months 190.90 ± 169.90 mm3 44.87 ± 200.20 mm3 Yes
P = 0.009
     Histomorphometry (percentage of new bone formation after 3 months) 55.96 ± 11.97% 39.69 ± 11.13% Yes
p = 0.00001
Srinivas et al. [48] 30 PRF Spontaneous healing CBCT (bone density) 24 h: 319.79 ± 95.472
3 months: 564.76 ± 94.856
24 h: 194.82 ± 78.986
3 months: 295.87 ± 87.217
24 h: Yes
P < 0.001
3 moths: Yes
P < 0.001
     CBCT (Bone hight) 24 h: 13.93 ± 3.56 mm
3 months: 12.28 ± 3.84 mm
24 h: 14.68 ± 4.32 mm
3 months: 12.78 ± 3.82 mm
24 h: No
P = 0.466
3 moths: No
P = 0.615
Ahmed et al. [53] 54 PRF Spontaneous healing Radiographic analysis (bone hight reduction, crest to tip of the root taking adjoining tooth as a guide) after 16 weeks 0.17 ± 0.44 mm 2.12 ± 0.69 mm Yes
p < 0.001
     Radiographic analysis (bone width reduction) after 16 weeks 0.47 ± 0.36 mm 1.71 ± 0.49 mm Yes
p < 0.001
     Radiographic analysis (bone density change using gray scale histogram) after 16 weeks 0.44 ± 1.21 1.45 ± 0.51 Yes
P = 0.006
Areewong et al. [55] 38 PRF Spontaneous healing Histomorphometric: new bone formation ratio after 8 weeks 31.33 ± 18% 26.33 ± 19.63% No
P = 0.431
Zhang et al. [49] 28 PRF Spontaneous healing CBCT after 3 months (reduction of the buccal alveolar) 1.6000 ± 1.46416 mm 2.8000 ± 1.81487 mm No
     CBCT after 3 months (reduction of the height of the lingual/palatal alveolar crest) 1.0000 ± 0.70711 mm 2.0500 ± 1.29180 mm No
     CBCT after 3 months (reduction of the width of the alveolar crest) 1.0500 ± 0.77862 mm 2.0760 ± 1.67149 mm No
     Histomorphometric analysis after 3 months (osteoid) area/tissue area) 9.7624 ± 4.0121% 2.8056 ± 1.2094% Yes
P < 0.01
Kumar et al. [43] 48 PRF Spontaneous healing Clinical measurement using measured using metal callipers (average loss of alveolar width) after 6 months 3 ± 0.8 mm 3.3 ± 0.61 mm No
     Clinical measurement using measured using metal callipers (average loss of alveolar height) after 6 months 3 ± 0.64 mm 3 ± 0.83 mm No
     Radiological measurement (degree of alveolar fill) after 6 months 73.76 ± 0.14% 74.3 ± 0.13% No
Clark et al. [39] 45 Test 1: A-PRF
Test 2: A-PRF + FDBA
Control1: spontaneous healing
Control 2: FDBA
Clinical measurement using alginate impression and a periodontal probe (loss ridge height reduction) after 15 weeks Test 1: A-PRF: 1.8 ± 2.1 mm
Test 2: A-PRF + FDBA: 1.0 ± 2.3 mm
Control 1: 3.8 ± 2.0 mm
Control 2: 2.2 ± 1.8 mm
Test 1 vs. control 1: Yes
P < 0.05
Test 2 vs. control 2: No
     Clinical measurement using alginate impression and a metal callipers (Loss of ridge width (coronal)) after 15 weeks Test 1: A-PRF: 2.8 ± 1.2 mm
Test 2: A-PRF + FDBA: 1.9 ± 1.1 mm
Control 1: 2.9 ± 1.7 mm
Control 2: 2.5 ± 1.1 mm
Test 1 vs. control 1: No
Test 2 vs. control 2: No
     Clinical measurement using alginate impression and a metal callipers (Loss of ridge width (middle)) after 15 weeks Test 1: A-PRF: 1.8 ± 1.8 mm
Test 2: A-PRF + FDBA: 1.7 ± 1.2 mm
Control 1: 1.8 ± 1.3 mm
Control 2: 1.5 ± 1.2 mm
Test 1 vs. control 1: No
Test 2 vs. control 2: No
     Clinical measurement using alginate impression and a metal callipers (Loss of ridge width (apical)) after 15 weeks Test 1: A-PRF: 1.8 ± 1.5 mm
Test 2: A-PRF + FDBA: 1.6 ± 1.5 mm
Control 1: 1.5 ± 1.6 mm
Control 2: 1.2 ± 1.3 mm
Test 1 vs. control 1: No
Test 2 vs. control 2: No
     Micro-CT analysis of bone cores (bone mineral density) after 15 weeks Test 1: A-PRF: 493 ± 70 mg/cm3
Test 2: A-PRF + FDBA: 521 ± 58 mg/cm3
Control 1:487 ± 64 mg/cm3
Control 2: 551 ± 58 mg/cm3
Test 1 vs. control 1: No
Test 2 vs. control 2: No
     Histomorphometric analysis (percentage of vital bone) after 15 weeks Test 1: A-PRF:46% ± 18%
Test 2: A-PRF + FDBA: 29% ± 14%
Not reported Test 1 vs. control 1: No
Test 2 vs. control 2: No
Alzahrani et al. [44] 24 PRF Spontaneous healing Clinical Cast analysis (reduction of alveolar ridge width) Week 1: 2.09 ± 0.84 mm
Week 4: 5.22 ± 0.80 mm
Week 8: 8.58 ± 1.73 mm
Week 1: 3.26 ± 2.21 mm
Week 4: 9.79 ± 6.02 mm
Week 8: 13.54 ± 6.57 mm
Week 1:No
P = 0.141
Week 4:Yes
P = 0.012
Week 8:Yes
P = 0.036
     Radiolographic analysis (mean radiographic bone fill) Week 1: 74.05 ± 1.66%
Week 4: 81.54 ± 3.33%
Week 8: 88.81 ± 1.53%
Week 1: 68.82 ± 1.07%
Week 4: 74.03 ± 1.22%
Week 8: 80.35 ± 2.61%
Week 1: Yes
P = 0.012
Week 4:Yes
P = 0.00
Week 8: Yes
P = 0.017
Temmerman et al. [50] 22 PRF Spontaneous healing CBCT after 3 months (Vertical resorption, lingual) 0.4 ± 1.1 mm 0.7 ± 0.8 mm No
     CBCT 3 months (Vertical resorption, buccal) 0.5 ± 2.3 mm 1.5 ± 1.3 mm Yes
P = 0.0002)
     CBCT 3 months (Horizontal width reduction 1 mm below the crest) 22.84 ± 24.28% 51.92 ± 40.31% Yes
P = 0.0004
     CBCT 3 months (Horizontal width reduction 3 mm below the crest) 6.16 ± 6.16% 14.51 ± 19.6% Yes
p = 0.007
     CBCT 3 months (Horizontal width reduction 5 mm below the crest) 2.91 ± 4.54% 4.4 ± 4.89% Yes
P = 0.02
     CBCT 3 months (socket fill) 8.1 ± 3.1 mm
94.7 ± 26.9%
6.2 ± 3.9 mm
63.3 ± 31.9%
Yes, P = 0.005
Yes, P = 0.0004
Suttapreyasri et al. [45] 8 PRF Spontaneous healing Clinical socket dimension measurements after 8 weeks (mesial-distal [M-D] and buccal-lingual [B-L]) were measured from the inner socket orifice at the midpoint of the extraction site, a UNC-15 periodontal probe (Hu-Friedy, Chicago, IL) M-D: 1.76 ± 1.36 mm
B-L: 3.31 ± 0.09 mm
M-D 2.17 ± 1.65 mm
B-L: 3.92 ± 0.64 mm
M-D: no
B-L: no
     Cast analysis buccal contour change after 8 weeks Upper part: 1.96 ± 1.10 mm
Middle part: 1.79 ± 0.90 mm
Lower part: 0.5 ± 0.72 mm
Upper part: 2.59 ± 0.7 mm
Middle part: 1.61 ± 0.43 mm Lower part: 0.56 ± 0.38 mm
Upper part: no
Middle part: no
Lower part: no
     Cast analysis lingual contour change after 8 weeks Upper part:
1.59 ± 0.64 mm
Middle part:
0.42 ± 0.39 mm
Lower part:
1.78 ± 0.57 mm
Upper part:
1.03 ± 0.57 mm
Middle part:
1.78 ± 0.47 mm
Lower part:
0.39 ± 0.35 mm
Upper part: no
Middle part: no
Lower part: no
     Radiographic Resorption of Marginal Bone Levels at Mesial of the Extraction Site after 8 weeks 2.22 ± 0.51 mm 2.86 ± 0.65 mm No
     Radiographic Resorption of Marginal Bone Levels at distal of the Extraction Site after 8 weeks 2.08 ± 0.09 mm 2.10 ± 0.50 mm No
Hauser et al. [46] 23 PRF Spontaneous healing Clinical measurements of the alveolar crest
Width loss after 8 weeks
0.48% 3.68% Yes
P < 0.05
     Radiographical analysis of the vertical linear Measurements on Superimposable Radiographs after 8 weeks Mesial: 1.21 ± 0.4 mm
Distal: 0.76 ± 0.25 mm
Mesial: 0.77 ± 0.17 mm
Distal: 2.07 ± 0.81 mm
Mesial: yes
Distal: no
     Micro CT (bone volume/Tissue Volume) after 8 weeks 0.281 ± 0.037 0.249 ± 0.037 No
Thakkar et al. [52] 36 sites demineralized freeze‑dried bone allograft (DFDBA) mixed with PRF, covered by a collagen membrane Demineralized freeze‑dried bone allograft (DFDBA), covered by a collagen membrane calibrated radiographs (Ridge width reduction from baseline to 180 days) 0.75 ± 0.49 mm 1.3611 ± 0.70 mm Yes (p = 0.005)
    Ridge height reduction (from baseline to 180 days)   1.38 ± 0.50 mm 1.08 ± 0.428 mm No
Yewale et al. [51]   Sybograf plus (70% HA and 30% βTCP) mixed with A-PRF + , covered by a Collagen sponge (Collasponge ™) Sybograf plus (70% HA and 30% βTCP), covered by a Collagen sponge (Collasponge ™) CBCT after 6 months: horizontal width at 1 mm 2.123 ± 0.76 mm 1.83 ± 0.8 mm No
     CBCT after 6 months: horizontal width at 3 mm 1.689 ± 0.84 mm 0.596 ± 1.08 mm Yes (p = 0.041)
     CBCT after 6 months: horizontal width at 5 mm 0.97 ± 1.28 mm 0.59 ± 1.59 mm No