Evaluation of Stem Cell Exosomes Versus Platelet-Rich Fibrin in Tooth Extraction Socket Healing

This is a randomized, single-blind, controlled clinical trial designed to compare the regenerative potential of Mesenchymal Stem Cell (MSC)-derived exosomes versus Autologous Platelet-Rich Fibrin (PRF) in alveolar ridge preservation.

A total of 40 patients requiring a single non-infected tooth extraction in the aesthetic zone or premolar area are enrolled and randomized into two equal groups (n=20).

Group A (Intervention): Following atraumatic extraction, MSC-derived exosomes are applied to the extraction socket.

Group B (Control): Following atraumatic extraction, autologous PRF (prepared via centrifugation) is placed in the socket.

The primary outcome measure is the change in alveolar bone density (measured in Hounsfield Units) and ridge dimensions (width and height) using Cone Beam Computed Tomography (CBCT) at baseline and 3 months post-operatively. Secondary outcomes include the assessment of soft tissue healing using the Landry Index, and patient-reported outcomes including postoperative pain (Visual Analog Scale) and swelling. The study aims to determine if the cell-free approach of exosome therapy provides a more standardized and effective alternative to traditional PRF for ridge preservation.

Inclusion criteria

• Patients aged between 20 and 45 years.
• Patients requiring a single tooth extraction of a non-infected tooth in the aesthetic zone (incisors, canines) or premolar area.
• Presence of adjacent teeth to the extraction site.
• Adequate oral hygiene (Plaque Index < 20%).
• Patients willing and able to comply with the follow-up schedule and 3-month CBCT scan.
• Signed informed consent provided by the participant.

Exclusion criteria

• Patients with systemic diseases that contraindicate oral surgery or interfere with bone healing (e.g., uncontrolled diabetes, osteoporosis, hyperparathyroidism).
• History of head and neck radiation therapy or bisphosphonate medication use.
• Active infection or acute abscess at the extraction site.
• Heavy smokers (more than 10 cigarettes per day).
• Pregnant or lactating women.
• Patients with poor oral hygiene or active periodontal disease in the rest of the mouth.
• Use of any medications known to affect bone metabolism (e.g., long-term corticosteroids).