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Randomized Controlled Trial
. 2025 Jul 29;29(8):393.
doi: 10.1007/s00784-025-06470-7.

Effect of platelet-rich fibrin on microperfusion during early socket healing: a randomized controlled clinical trial

Marie Sophie Katz  1 , Mark Ooms  2 , Marius Heitzer  2 , Maurice Klein  2 , Philipp Winnand  2 , Timm Steiner  2 , Frank Hölzle  2 , Ali Modabber  2
Affiliations
Randomized Controlled Trial

Effect of platelet-rich fibrin on microperfusion during early socket healing: a randomized controlled clinical trial

Marie Sophie Katz et al. Clin Oral Investig. .

Abstract

Objectives: This study aimed to evaluate and compare the early healing of fresh alveolar sockets treated with or without platelet-rich fibrin (PRF) using laser Doppler flowmetry and tissue spectrophotometry (LDF-TS). The primary outcome was gingival perfusion; secondary outcomes included clinical wound healing (based on the Landry Wound Healing Index) and patient-reported postoperative pain.

Materials and methods: Sixty-two patients requiring single tooth extraction were randomized into two groups. In the PRF group, an advanced PRF (A-PRF+) plug was placed in the socket before suturing; in the control group, only suturing was performed. Gingival perfusion was measured at four sites preoperatively and on postoperative days 3 and 10 using LDF-TS. Patients rated pain, and wound healing was clinically assessed. Twelve patients were lost to follow-up, leaving 50 for analysis.

Results: No significant differences were found between the PRF and control group regarding pain (day 3: p = 0.654; day 10: p = 0.329) or wound healing (day 3: p = 0.178; day 10: p = 0.595). Perfusion parameters also showed no significant group differences between baseline and day 10: oxygen saturation (SO₂: p = 0.884), relative hemoglobin (rHb: p = 0.387), and blood flow (p = 0.072).

Conclusions: Gingival perfusion showed no significant group differences over 10 days. PRF did not significantly reduce pain or improve wound healing.

Clinical relevance: PRF does not appear to significantly enhance healing, pain reduction, or perfusion in simple extractions. Future studies should use split-mouth designs and focus on more complex surgeries to better evaluate PRF's effects.

Trial registration: All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was performed according to the Consolidated Standards of Registered Trial (CONSORT) guidelines. The study was approved by the institutional Clinical Research Ethics Committee (Decision Number 23-105) and by the German Clinical Trials Register (File Number DRKS00032344, registered on October 11, 2023).

Keywords: Laser-Doppler flowmetry; Platelet-rich fibrin; Ridge preservation; Tooth extraction; Wound healing.

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Conflict of interest statement

Declarations. Consent for publication: The patients signed informed consent regarding publication of their data and photographs. Competing interests: The authors declare no competing interests. Ethical approval: All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was performed according to the Consolidated Standards of Registered Trial (CONSORT) guidelines. The study was approved by the institutional Clinical Research Ethics Committee (Decision Number 23–105) and by the German Clinical Trials Register (File Number DRKS00032344, registered on October 11, 2023). Consent to participate: Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Perfusion measurements before and after ridge preservation with an A-PRF + plug. (a) Oxygen to see (O2C) device; (b) gingival probe, arrow indicating the measuring point; (c) measurement points adjacent to the non-restorable tooth (X); (d) gingival measurement preoperatively; (e) the socket was filled with an A-PRF + plug after extraction and sutured; (f) clinical assessment and gingival measurement on postoperative day 3; (g) clinical assessment, gingival measurement, and removal of the sutures on postoperative day 10
Fig. 2
Fig. 2
Differences in pain on the visual analogue scale (VAS) between the control and platelet-rich fibrin (PRF) groups on postoperative day 3 (a) and on postoperative day 10 (b). Each bar represents the interquartile range (IQR), with the top of the bar indicating the upper quartile. The horizontal lines correspond to the medians of the respective groups (Control group: day 3 and day 10 = 0; PRF group: day 3 = 1, day 10 = 0). The whiskers indicate lower and upper extremes, excluding outliers
Fig. 3
Fig. 3
Differences in the Landry Wound Healing Index (WHI) between the control and platelet-rich fibrin (PRF) groups on postoperative day 3 (a) and on postoperative day 10 (b). Each bar represents the interquartile range (IQR), with the top indicating the upper quartile and the bottom the lower quartile. The horizontal lines indicate the medians for each group (Control group: day 3 = 3, day 10 = 5; PRF group: day 3 = 3, day 10 = 5). The whiskers indicate lower and upper extremes, excluding outliers
Fig. 4
Fig. 4
Differences in perfusion values between postoperative day 3 and preoperative (baseline) values (a, d, g); between postoperative day 10 and postoperative day 3 (b, e, h); and postoperative day 10 and preoperative (baseline) values (c, f, i). Bars show the median values (SO2, rHb, and blood flow); top and bottom of the boxes show the lower and upper quartiles; whiskers show lower and upper extremes, excluding outliers
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