Evaluation of Soft Tissue Changes Following Platelet-rich Fibrin in Immediate Implantation of Posterior Teeth: A Randomized Clinical Trial

Abstract

Background: Currently, immediate implant placement is favored due to its reduced number of surgical appointments and shorter overall treatment duration. However, a notable disadvantage of this protocol is the inadequate dimension of soft tissue surrounding the implant, which presents a challenge for immediate implantation in posterior teeth. As a result, patients frequently necessitate soft tissue augmentation to alleviate potential complications. In this randomized clinical trial study, a minimally invasive technique utilizing platelet-rich fibrin (PRF) was employed to enhance soft tissue thickness and keratinized tissue width during immediate implantation in the posterior region of the jaw. Methods and Materials: A total of 20 bone-level implants were utilized in 20 patients through the immediate implantation protocol. In order to augment soft tissue, 10 patients were subjected to treatment with platelet-rich fibrin (PRF) on immediate implants in the test group, while 10 patients received connective tissue graft (CTG) on immediate implants in the control group. After a period of 3 months, all implants were uncovered through surgery, and healing abutments were placed on fixtures. Keratinized tissue width was measured using a periodontal probe at baseline, 1 month, and 3 months after implant placement, while soft tissue thickness was measured at baseline and 3 months after implant placement. Results: Treatment was successful for all the patients. The average keratinized tissue width in the test and control group was 3.45 and 2.65 at baseline, 4.00 and 3.40 one month after surgery, and 4.20 and 3.85 three months after implant placement, respectively. Average keratinized tissue thickness in the test and control group was 2.45 and 2.05 at baseline and 3.20 and 3.25 at reentry (three months after implant placement), respectively. The average increase in keratinized tissue thickness from baseline to 3rd month was 0.75 in the test and 1.20 in the control group. The average increase in keratinized tissue width from baseline to 1st month was 0.55 in the test and 0.75 in the control group, and from baseline to 3rd month, it was 0.75 in the test and 1.20 in the control group, respectively. Data for both parameters in each group from baseline to 3rd month were statistically significant. Data for keratinized tissue thickness (p=0.077) and keratinized tissue width (p=0.089) between both the groups were not statistically significant. Conclusion: Platelet-rich fibrin (PRF) has the potential to serve as a minimally invasive approach for augmenting soft tissue in the posterior region of the jaw during immediate implant placement. Clinical Trial Registration Number: The clinical trial registration number for this study is IRCT20190723044313N1.