Non-Cochrane · intervention · PM42815352
Effectiveness of platelet-rich fibrin concentrates in alveolar ridge preservation after tooth extraction: A systematic review of randomized clinical trials with tomographic evaluation.
Meneses-Santos Daniela, Marçal Anderson Carlos, Mesquita Caio Melo, et al. · Clinics (Sao Paulo, Brazil) · 2026 · PubMed · doi:10.1016/j.clinsp.2026.101172
Findings
17 findings
| Population | ||||
|---|---|---|---|---|
| Patients undergoing tooth extraction | Platelet-rich fibrin concentrates | Blood clot, no intervention or placebo | Buccal alveolar bone height change Some concerns | SMD 0.39 [-0.07, 0.85] GRADE not reported 6 studies |
| Patients undergoing tooth extraction | Platelet-rich fibrin concentrates | Blood clot, no intervention or placebo | Alveolar ridge width change 3 mm below crest High risk of bias | SMD 1.14 [-5.5, 7.78] GRADE not reported 2 studies |
| Patients undergoing tooth extraction | Platelet-rich fibrin concentrates | Blood clot, no intervention or placebo | Alveolar ridge width change 1 mm below crest Some concerns | SMD 0.08 [-0.39, 0.55] Very low Downgraded: imprecision 7 studies · 269 participants |
| Patients undergoing tooth extraction | Platelet-rich fibrin concentrates | Blood clot, no intervention or placebo | Alveolar ridge width change 5 mm below crest | SMD 0.12 [-0.17, 0.4] Very low Downgraded: imprecision 6 studies |
| Patients undergoing tooth extraction | Platelet-rich fibrin concentrates | Blood clot, no intervention or placebo | Buccal alveolar bone height change High risk of bias | SMD 0.27 [-2.08, 2.61] GRADE not reported 4 studies |
| Adults undergoing atraumatic non-third-molar tooth extraction (extraction sockets) | Platelet-rich fibrin concentrates alone as socket filling (PRF, L-PRF, A-PRF, CGF) | Spontaneous healing (blood clot) / no socket filling | Alveolar ridge width loss at 5 mm below the crest (CBCT) 56 to 150 days after extraction (study-specific follow-up) · Clinical oral surgery; trials from Asia, South America, Europe and Africa · Risk of bias: some concerns | SMD 0.10 [-0.26, 0.45] GRADE not reported 5 studies · 215 participants |
| Patients undergoing tooth extraction | Platelet-rich fibrin concentrates | Blood clot, no intervention or placebo | Alveolar ridge width change 1 mm below crest High risk of bias | SMD 1.19 [-3.6, 5.98] GRADE not reported 2 studies |
| Patients undergoing tooth extraction | Platelet-rich fibrin concentrates | Blood clot, no intervention or placebo | Final bone density | no estimate extracted GRADE not reported Studies not reported |
| Adults undergoing atraumatic non-third-molar tooth extraction (extraction sockets) | Platelet-rich fibrin concentrates alone as socket filling (PRF, L-PRF, A-PRF, CGF) | Spontaneous healing (blood clot) / no socket filling | Buccal bone plate height loss (CBCT) 56 to 150 days after extraction (study-specific follow-up) · Clinical oral surgery; trials from Asia, South America, Europe and Africa | SMD 0.43 [-0.10, 0.97] Very low Downgraded: imprecision 10 studies · 359 participants |
| Patients undergoing tooth extraction | Platelet-rich fibrin concentrates | Blood clot, no intervention or placebo | Alveolar ridge width change 3 mm below crest | SMD 0.36 [-0.31, 1.03] Very low Downgraded: imprecision 6 studies |
| Patients undergoing tooth extraction | Platelet-rich fibrin concentrates | Blood clot, no intervention or placebo | Alveolar ridge width change 1 mm below crest | SMD 0.3 [-0.21, 0.81] Very low Downgraded: imprecision 9 studies |
| Patients undergoing tooth extraction | Platelet-rich fibrin concentrates | Blood clot, no intervention or placebo | Percentage of repaired alveoli | no estimate extracted GRADE not reported Studies not reported |
| Patients undergoing tooth extraction | Platelet-rich fibrin concentrates | Blood clot, no intervention or placebo | Alveolar ridge width change 5 mm below crest Table 5 estimate | SMD 0.12 [-0.26, 0.45] Very low Downgraded: imprecision 5 studies · 215 participants |
| Patients undergoing tooth extraction | Platelet-rich fibrin concentrates | Blood clot, no intervention or placebo | Palatal alveolar bone height change Some concerns | SMD 0.19 [-0.14, 0.51] GRADE not reported 6 studies |
| Patients undergoing tooth extraction | Platelet-rich fibrin concentrates | Blood clot, no intervention or placebo | Palatal alveolar bone height change High risk of bias | SMD 0.64 [-0.94, 2.21] GRADE not reported 4 studies |
| Patients undergoing tooth extraction | Platelet-rich fibrin concentrates | Blood clot, no intervention or placebo | Alveolar ridge width change 3 mm below crest Some concerns | SMD 0.07 [-0.54, 0.67] Very low Downgraded: imprecision 4 studies · 191 participants |
| Adults undergoing atraumatic non-third-molar tooth extraction (extraction sockets) | Platelet-rich fibrin concentrates alone as socket filling (PRF, L-PRF, A-PRF, CGF) | Spontaneous healing (blood clot) / no socket filling | Palatal/lingual bone plate height loss (CBCT) 56 to 150 days after extraction (study-specific follow-up) · Clinical oral surgery; trials from Asia, South America, Europe and Africa | SMD 0.36 [-0.06, 0.79] Very low Downgraded: imprecision 10 studies · 359 participants |
Included primary studies 21
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 | not stated | 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 | not stated | 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 | not stated | 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 | not stated | 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 | not stated | not extracted yet |
| Abad et al., 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 | not stated | not extracted yet |
| Badakhshan 2020 Clinical and Radiographic Assessments of Tooth Socket Preservation Using Leukocyte Platelet-Rich Fibrin. PMID:33389912 | 2020 | 1 other review | not stated | not extracted yet |
| Badakhshan et al., 2020 Clinical and Radiographic Assessments of Tooth Socket Preservation Using Leukocyte Platelet-Rich Fibrin DOI:10.1615/jlongtermeffmedimplants.2020034794 | 2020 | 1 other review | not stated | not extracted yet |
| Canellas et al., 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 | not stated | not extracted yet |
| Castro et al., 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 | not stated | not extracted yet |
| Mousavi et al., 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 | not stated | not extracted yet |
| Temmerman et al., 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 | not stated | not extracted yet |
| Wang 2022 Increased local concentrations of growth factors from leucocyte- and platelet-rich fibrin do not translate into improved alveolar ridge… PMID:35734895 | 2022 | 1 other review | not stated | 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 | not stated | not extracted yet |
| Alasqah 2024 Efficacy of Platelet-Rich Fibrin in Preserving Alveolar Ridge Volume and Reducing Postoperative Pain in Site Preservation of… PMID:39064496 | 2024 | this review only | not stated | not extracted yet |
| Assadi 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Kassar & Heshmeh, 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Kassar 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Srinivas 2018 Wound Healing and Bone Regeneration in Postextraction Sockets with and without Platelet-rich Fibrin. PMID:29963421 | 2018 | this review only | not stated | not extracted yet |
| Taha 2019 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Wang et al., 2022 Increased local concentrations of growth factors from leucocyte‐ and platelet‐rich fibrin do not translate into improved alveolar ridge… DOI:10.1111/jcpe.13688 | 2022 | this review only | not stated | 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 | Patients undergoing tooth extraction (third molar extractions excluded) | 362 participants and 599 extraction sockets, aged 18 to 64 years, 13 trials from Asia (n=8), South America (n=2), Europe (n=2), Africa (n=1) |
| Intervention | PRF concentrates used alone for alveolar ridge preservation after extraction (no associated bone grafts) | L-PRF (n=9), PRF (n=3), A-PRF (n=1, alongside L-PRF), CGF (n=1) |
| Comparison | Blood clot (spontaneous healing) control or placebo/no intervention | Spontaneous healing / blood clot (n=13) |
| Outcomes | Dimensional changes of the alveolar ridge on CBCT: width (horizontal) at 1, 3 and 5 mm below the crest and height (vertical) at buccal and palatal plates; percentage of repaired alveoli and final bone density described | Ridge width loss at 1 mm (n=9), 3 mm (n=6), 5 mm (n=6); buccal height loss (n=10); palatal height loss (n=10); repaired alveoli and bone density reported narratively |
| Study designs | Randomized clinical trials | RCTs (n=13): split-mouth (n=9), parallel-group (n=4) |
| Timing | Not specified | 56 to 180 days after extraction |
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 | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Yes | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Partial Yes | no |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | Yes | Yes | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: No | no |
| 12Impact of risk of bias on the pooled results | Yes | Yes | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Critically Low | no |