Titanium-Prepared Platelet-Rich Fibrin for Extraction Socket Healing

Tooth extraction is commonly followed by physiological alveolar bone resorption, which may compromise subsequent implant placement. Alveolar ridge preservation techniques have been developed to minimize post-extraction dimensional changes. Titanium-prepared platelet-rich fibrin (T-PRF) is an autologous platelet concentrate prepared in titanium tubes without anticoagulants and has been proposed to enhance wound healing and bone regeneration through the sustained release of growth factors.

This prospective randomized controlled clinical trial was conducted at the Department of Periodontology, Eskişehir Osmangazi University. Patients requiring tooth extraction followed by implant placement were screened according to predefined inclusion and exclusion criteria and provided written informed consent before participation.

Participants were randomly allocated to either the T-PRF group or the spontaneous healing (control) group. In the intervention group, T-PRF was prepared from autologous venous blood using titanium tubes and placed into the extraction socket immediately after atraumatic tooth extraction. In the control group, extraction sockets were allowed to heal spontaneously without the use of any socket preservation material. All surgical procedures were performed by the same experienced operator, and postoperative care was standardized for all participants.

Cone-beam computed tomography (CBCT) scans were obtained approximately 10 days after extraction (baseline) and again at 3 months before implant placement. Volumetric measurements were performed using dedicated imaging software by a blinded examiner. The primary outcome was the percentage of socket fill and residual non-ossified socket volume after 3 months. Secondary outcomes included baseline socket volume and clinical healing during the postoperative period.

The results of this study will contribute to the clinical evidence regarding the effectiveness of T-PRF as a minimally invasive autologous biomaterial for enhancing extraction socket healing prior to implant placement.

Inclusion criteria

• Adults aged 18 to 65 years.
• Systemically healthy individuals.
• Indication for tooth extraction followed by implant placement.
• Adequate bone volume for future implant placement without the need for advanced augmentation procedures.
• Good oral hygiene (Plaque Index ≤1.5)
• Ability and willingness to provide written informed consent.

Exclusion criteria

• Current smokers.
• Pregnant or breastfeeding women.
• Uncontrolled systemic disease or diabetes mellitus.
• Use of medications known to affect bone metabolism.
• History of head and neck radiotherapy or chemotherapy.
• Acute infection, periapical lesions, alveolar bone pathology, or socket defects at the extraction site.
• Severe periodontal destruction requiring extensive augmentation procedures.
• Inability or unwillingness to attend scheduled follow-up visits.