Quantitative Changes Following Ridge Preservation Procedures with PRFM Grafts

Objectives: Platelet-Rich Fibrin Matrix (PRFM) is an autologous biologic material created by centrifugation of whole blood. A previous histologic canine study demonstrated that PRFM used for ridge preservation grafting results in less surgical time and faster healing compared to Guided Bone Regeneration (GBR) procedures employing bioabsorbable membranes and non-vital allografts. PRFM grafted sites also seemed to exhibit less bone resorption during healing. The current human investigation quantified ridge dimensional changes associated with the healing of extraction sites using PRFM alone as a graft material.

Methods: 21 extraction sites, in 21 patients requiring ridge preservation procedures, were treated with PRFM alone as the graft material. Using stents, standardized measurements of ridge width, at 3mm and 5 mm apical to the crest, and ridge height were recorded at the time of extraction, after graft placement and after 4 months of healing. PRFM was prepared as per the manufacturer's instructions. Primary closure of flaps was achieved.

Results: A small, statistically significant loss of alveolar ridge width and height occurred during the 4 months of healing following extraction. Alveolar width resorption 3 mm and 5 mm apical to the crest was a mean of 0.32 mm,( 4.71% loss), and 0.57 mm, (7.38% loss) respectively. Alveolar height resorption was a mean of 0.67 mm (7.13% loss) during healing.

Conclusion: Extraction sites grafted with PRFM alone displayed rapid clinical healing, minimal flap re-opening and material exposure, and excellent bone density after 4 months of healing. Alveolar resorptive changes during healing were less than those of other reported investigations using membranes with and without non-vital graft materials. Advantages of the PRFM alone graft are: less surgical time, elimination of technique and potential healing difficulties associated with barrier membranes, and less resorption during healing as compared to other GBR treatment modalities.