Non-Cochrane · intervention · PM41797764
The efficacy of platelet-rich fibrin in alveolar ridge preservation: a systematic review and meta-analysis of randomized controlled trials.
Yan Jiahui, Lu Kexin · Frontiers in medicine · 2026 · PubMed · doi:10.3389/fmed.2026.1753189
Findings
Population Systemically healthy adults (18 years or older) undergoing tooth extraction
22 findings
| PRF alone placed in the extraction socket (any preparation protocol) | Spontaneous healing (blood clot) | Alveolar ridge width reduction (mm) 6 months · Follow-up time point: 6 months | MD -0.11 [-0.41, 0.18] GRADE not reported 2 studies · 110 participants |
| PRF alone placed in the extraction socket (any preparation protocol) | Spontaneous healing (blood clot) | Alveolar ridge height reduction (mm) 4 months · Follow-up time point: 4 months | MD -0.57 [-0.93, -0.20] GRADE not reported 5 studies · 122 participants |
| PRF alone placed in the extraction socket (any preparation protocol) | Spontaneous healing (blood clot) | Alveolar ridge height reduction (mm) 2 to 6 months (pooled over time points) | MD -0.60 [-0.85, -0.34] -0.60 [-0.85, -0.34] mm Moderate Downgraded: inconsistency 13 studies · 457 participants |
| PRF alone placed in the extraction socket (any preparation protocol) | Spontaneous healing (blood clot) | Alveolar ridge width reduction (mm) 2 to 6 months (pooled over time points) | MD -0.42 [-0.68, -0.16] -0.42 [-0.68, -0.16] mm Low Downgraded: imprecision, inconsistency 15 studies · 498 participants |
| PRF alone placed in the extraction socket (any preparation protocol) | Spontaneous healing (blood clot) | Percentage of new bone formation (BV/TV, histomorphometry) 2 months · Follow-up time point: 2 months | MD 22.11 [-10.27, 54.49] GRADE not reported 2 studies · 74 participants |
| PRF alone placed in the extraction socket (any preparation protocol) | Spontaneous healing (blood clot) | Percentage of new bone formation (BV/TV, histomorphometry) 3 months · Follow-up time point: 3 months | MD 11.36 [4.70, 18.02] GRADE not reported 3 studies · 83 participants |
| PRF alone placed in the extraction socket (any preparation protocol) | Spontaneous healing (blood clot) | Percentage of new bone formation (BV/TV, histomorphometry) 4 months · Follow-up time point: 4 months | MD 16.97 [4.14, 29.81] GRADE not reported 2 studies · 80 participants |
| PRF alone placed in the extraction socket (any preparation protocol) | Spontaneous healing (blood clot) | Alveolar ridge width reduction (mm) Standard plus high-speed protocols combined (low-speed A-PRF study excluded); test for subgroup differences p = 0.59 | MD -0.47 [-0.74, -0.21] GRADE not reported 14 studies · 478 participants |
| PRF alone placed in the extraction socket (any preparation protocol) | Spontaneous healing (blood clot) | Alveolar ridge width reduction (mm) 4 months · Follow-up time point: 4 months | MD -0.23 [-0.66, 0.20] GRADE not reported 5 studies · 122 participants |
| PRF alone placed in the extraction socket (any preparation protocol) | Spontaneous healing (blood clot) | Alveolar ridge width reduction (mm) 2 months · Follow-up time point: 2 months | MD -0.62 [-1.18, -0.05] GRADE not reported 2 studies · 41 participants |
| PRF alone placed in the extraction socket (any preparation protocol) | Spontaneous healing (blood clot) | Alveolar ridge height reduction (mm) 6 months · Follow-up time point: 6 months | MD -0.28 [-0.53, -0.03] GRADE not reported 2 studies · 110 participants |
| PRF alone placed in the extraction socket (any preparation protocol) | Spontaneous healing (blood clot) | Alveolar ridge width reduction (mm) 3 months · Follow-up time point: 3 months | MD -0.77 [-1.56, 0.03] GRADE not reported 6 studies · 225 participants |
| PRF alone placed in the extraction socket (any preparation protocol) | Spontaneous healing (blood clot) | Percentage of new bone formation (BV/TV, histomorphometry) 2 to 4 months (pooled over time points) | MD 15.92 [1.87, 29.97] 15.92 [1.87, 29.97] % Low Downgraded: imprecision, inconsistency 7 studies · 237 participants |
| PRF alone placed in the extraction socket (any preparation protocol) | Spontaneous healing (blood clot) | Percentage of new bone formation (BV/TV, histomorphometry) Standard plus high-speed protocols combined (low-speed A-PRF study excluded); test for subgroup differences p = 0.02 | MD 17.07 [1.96, 32.19] GRADE not reported 6 studies · 217 participants |
| PRF alone placed in the extraction socket (any preparation protocol) | Spontaneous healing (blood clot) | Alveolar ridge height reduction (mm) 3 months · Follow-up time point: 3 months | MD -0.95 [-1.59, -0.31] GRADE not reported 6 studies · 225 participants |
| PRF alone placed in the extraction socket (any preparation protocol) | Spontaneous healing (blood clot) | Alveolar ridge height reduction (mm) Standard plus high-speed protocols combined (low-speed A-PRF study excluded); test for subgroup differences p = 0.24 | MD -0.57 [-0.82, -0.32] GRADE not reported 12 studies · 437 participants |
| PRF alone, standard L-PRF protocol (2700 rpm, 12 min) | Spontaneous healing (blood clot) | Alveolar ridge height reduction (mm) PRF preparation protocol subgroup | MD -0.68 [-1.05, -0.31] GRADE not reported 10 studies · 342 participants |
| PRF alone, standard L-PRF protocol (2700 rpm, 12 min) | Spontaneous healing (blood clot) | Percentage of new bone formation (BV/TV, histomorphometry) PRF preparation protocol subgroup | MD 10.31 [4.81, 15.82] GRADE not reported 4 studies · 119 participants |
| PRF alone, standard L-PRF protocol (2700 rpm, 12 min) | Spontaneous healing (blood clot) | Alveolar ridge width reduction (mm) PRF preparation protocol subgroup | MD -0.42 [-0.71, -0.13] GRADE not reported 11 studies · 359 participants |
| PRF alone, high-speed protocol (3000 rpm, 10 min) | Spontaneous healing (blood clot) | Alveolar ridge width reduction (mm) PRF preparation protocol subgroup | MD -0.60 [-1.20, -0.01] GRADE not reported 3 studies · 119 participants |
| PRF alone, high-speed protocol (3000 rpm, 10 min) | Spontaneous healing (blood clot) | Alveolar ridge height reduction (mm) PRF preparation protocol subgroup | MD -0.45 [-0.57, -0.33] GRADE not reported 2 studies · 95 participants |
| PRF alone, high-speed protocol (3000 rpm, 10 min) | Spontaneous healing (blood clot) | Percentage of new bone formation (BV/TV, histomorphometry) PRF preparation protocol subgroup | MD 30.09 [14.11, 46.07] GRADE not reported 2 studies · 98 participants |
Included primary studies 32
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Canellas 2020 Tomographic and histomorphometric evaluation of socket healing after tooth extraction using leukocyte- and platelet-rich fibrin: A… PMID:31810848 | 2020 | 3 other reviews | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm); Percentage of new bone formation (BV/TV, histomorphometry) | not extracted yet |
| Castro 2021 Effect of different platelet-rich fibrin matrices for ridge preservation in multiple tooth extractions: A split-mouth randomized… PMID:33847018 | 2021 | 3 other reviews | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm); Percentage of new bone formation (BV/TV, histomorphometry) | not extracted yet |
| Abad 2023 Efficacy of the application of leukocyte and platelet-rich fibrin (L-PRF) on alveolar ridge preservation. A randomized controlled clinical… PMID:37088697 | 2023 | 2 other reviews | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm) | not extracted yet |
| Areewong 2019 Platelet-rich fibrin to preserve alveolar bone sockets following tooth extraction: A randomized controlled trial. PMID:31647177 | 2019 | 2 other reviews | Percentage of new bone formation (BV/TV, histomorphometry) | not extracted yet |
| Clark 2018 Advanced platelet-rich fibrin and freeze-dried bone allograft for ridge preservation: A randomized controlled clinical trial. PMID:29683498 | 2018 | 2 other reviews | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm); Percentage of new bone formation (BV/TV, histomorphometry) | not extracted yet |
| Girish Kumar 2018 To assess the efficacy of socket plug technique using platelet rich fibrin with or without the use of bone substitute in alveolar ridge… PMID:29411166 | 2018 | 2 other reviews | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm) | not extracted yet |
| Mousavi 2024 Comparison of histologic and radiographic changes of sockets grafted with LPRF and sockets without intervention after tooth extraction. PMID:37940776 | 2024 | 2 other reviews | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm) | not extracted yet |
| Temmerman 2016 The use of leucocyte and platelet-rich fibrin in socket management and ridge preservation: a split-mouth, randomized, controlled clinical… PMID:27509214 | 2016 | 2 other reviews | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm) | not extracted yet |
| Abad 2023 Efficacy of the application of leukocyte and platelet‐rich fibrin ( <scp>L‐PRF</scp> ) on alveolar ridge preservation. A randomized… DOI:10.1111/cid.13208 | 2023 | 1 other review | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm) | not extracted yet |
| Alzahrani 2017 Influence of platelet rich fibrin on post-extraction socket healing: A clinical and radiographic study. PMID:29033524 | 2017 | 1 other review | Alveolar ridge width reduction (mm) | not extracted yet |
| Badakhshan 2020 Clinical and Radiographic Assessments of Tooth Socket Preservation Using Leukocyte Platelet-Rich Fibrin DOI:10.1615/jlongtermeffmedimplants.2020034794 | 2020 | 1 other review | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm) | not extracted yet |
| Badakhshan 2020 Clinical and Radiographic Assessments of Tooth Socket Preservation Using Leukocyte Platelet-Rich Fibrin. PMID:33389912 | 2020 | 1 other review | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm) | not extracted yet |
| Canellas 2020 Tomographic and histomorphometric evaluation of socket healing after tooth extraction using leukocyte- and platelet-rich fibrin: A… DOI:10.1016/j.jcms.2019.11.006 | 2020 | 1 other review | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm); Percentage of new bone formation (BV/TV, histomorphometry) | not extracted yet |
| Castro 2021 Effect of different platelet‐rich fibrin matrices for ridge preservation in multiple tooth extractions: A split‐mouth randomized… DOI:10.1111/jcpe.13463 | 2021 | 1 other review | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm); Percentage of new bone formation (BV/TV, histomorphometry) | not extracted yet |
| Hauser 2012 Clinical and histological evaluation of postextraction platelet-rich fibrin socket filling: a prospective randomized controlled study. PMID:23644909 | 2013 | 1 other review | Alveolar ridge width reduction (mm) | not extracted yet |
| Ivanova 2021 Comparison Study of the Histomorphometric Results after Socket Preservation with PRF and Allograft Used for Socket Preservation-Randomized… PMID:34299902 | 2021 | 1 other review | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm); Percentage of new bone formation (BV/TV, histomorphometry) | not extracted yet |
| Mousavi 2024 Comparison of histologic and radiographic changes of sockets grafted with LPRF and sockets without intervention after tooth extraction DOI:10.1007/s10006-023-01190-2 | 2023 | 1 other review | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm) | not extracted yet |
| Temmerman 2016 The use of leucocyte and platelet‐rich fibrin in socket management and ridge preservation: a split‐mouth, randomized, controlled clinical… DOI:10.1111/jcpe.12612 | 2016 | 1 other review | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm) | not extracted yet |
| Zhang 2018 Clinical effect of platelet-rich fibrin on the preservation of the alveolar ridge following tooth extraction. PMID:29456635 | 2018 | 1 other review | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm); Percentage of new bone formation (BV/TV, histomorphometry) | not extracted yet |
| Aldommari 2025 Titanium-prepared platelet-rich fibrin enhances alveolar ridge preservation: a randomized controlled clinical and radiographic study DOI:10.1038/s41598-025-09528-4 | 2025 | this review only | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm) | not extracted yet |
| Aldommari 2025 Titanium-prepared platelet-rich fibrin enhances alveolar ridge preservation: a randomized controlled clinical and radiographic study. PMID:40617944 | 2025 | this review only | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm) | not extracted yet |
| Aliyev 2025 Does Varying Platelet-Rich Fibrin Centri̇fugati̇on Protocols Enhance New Bone Formati̇on in Extracti̇on Site? DOI:10.1016/j.joms.2024.08.005 | 2025 | this review only | Percentage of new bone formation (BV/TV, histomorphometry) | not extracted yet |
| Aliyev 2025 Does Varying Platelet-Rich Fibrin Centri̇fugati̇on Protocols Enhance New Bone Formati̇on in Extracti̇on Site? PMID:39214149 | 2025 | this review only | Percentage of new bone formation (BV/TV, histomorphometry) | not extracted yet |
| Alzahrani 2017 Influence of platelet rich fibrin on post-extraction socket healing: A clinical and radiographic study DOI:10.1016/j.sdentj.2017.07.003 | 2017 | this review only | Alveolar ridge width reduction (mm) | not extracted yet |
| Areewong 2019 Platelet‐rich fibrin to preserve alveolar bone sockets following tooth extraction: A randomized controlled trial DOI:10.1111/cid.12846 | 2019 | this review only | Percentage of new bone formation (BV/TV, histomorphometry) | not extracted yet |
| Clark 2018 Advanced platelet‐rich fibrin and freeze‐dried bone allograft for ridge preservation: A randomized controlled clinical trial DOI:10.1002/jper.17-0466 | 2018 | this review only | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm); Percentage of new bone formation (BV/TV, histomorphometry) | not extracted yet |
| Girish 2018 To assess the efficacy of socket plug technique using platelet rich fibrin with or without the use of bone substitute in alveolar ridge… DOI:10.1007/s10006-018-0680-3 | 2018 | this review only | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm) | not extracted yet |
| Hauser 2012 Clinical and Histological Evaluation of Postextraction Platelet-rich Fibrin Socket Filling DOI:10.1097/id.0b013e3182906eb3 | 2013 | this review only | Alveolar ridge width reduction (mm) | not extracted yet |
| Ivanova 2021 Comparison Study of the Histomorphometric Results after Socket Preservation with PRF and Allograft Used for Socket Preservation—Randomized… DOI:10.3390/ijerph18147451 | 2021 | this review only | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm); Percentage of new bone formation (BV/TV, histomorphometry) | not extracted yet |
| Niedzielska 2022 The Assessment of the Usefulness of Platelet-Rich Fibrin in the Healing Process Bone Resorption DOI:10.3390/coatings12020247 | 2022 | this review only | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm) | not extracted yet |
| Rodrigues 2023 Comparative Effects of Different Materials on Alveolar Preservation DOI:10.1016/j.joms.2022.10.008 | 2023 | this review only | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm) | not extracted yet |
| Rodrigues 2023 Comparative Effects of Different Materials on Alveolar Preservation. PMID:36400157 | 2023 | this review only | Alveolar ridge height reduction (mm); Alveolar ridge width reduction (mm) | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Systemically healthy adults aged 18 years and older requiring tooth extraction | Healthy adults undergoing tooth extraction (n=17 RCTs; sample sizes 10 to 90 patients) |
| Intervention | Post-extraction placement of PRF alone in the socket | PRF alone: standard L-PRF 2700 rpm 12 min (12 studies), high-speed 3000 rpm 10 min (4), A-PRF 1300 rpm (1) |
| Comparison | Spontaneous healing with blood clot | Spontaneous healing |
| Outcomes | Alveolar ridge height, alveolar ridge width, percentage of new bone formation (BV/TV) | Ridge height (13 RCTs, 457); ridge width (15 RCTs, 498); new bone formation (7 RCTs, 237) |
| Study designs | Randomized controlled trials | 17 RCTs |
| Timing | Follow-up of at least 1 month | 2, 3, 4 and 6 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | Yes | Yes | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Yes | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Partial Yes | no |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes | RCT: Yes | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No | RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Low | no |