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

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).