Effectiveness of pure platelet-rich fibrin (PRF) in alveolar ridge preservation after tooth extraction: a systematic review of randomized controlled trials

This systematic review evaluated the effectiveness of pure platelet rich fibrin (PRF) in alveolar ridge preservation (ARP) following tooth extraction.

The review was conducted according to PRISMA 2020 guidelines and registered in PROSPERO (CRD420261282818). A structured search of the databases (PubMed, Scopus, ScienceDirect, and the Cochrane Central Trials) identified randomized controlled trials (RCTs) investigating pure PRF formulations (L-PRF, A-PRF, T-PRF, i-PRF) used alone in extraction sockets with a minimum follow-up of 3 months. Primary outcomes included horizontal and vertical ridge dimensional changes assessed radiographically. Secondary outcomes comprised histomorphometric findings, bone density, soft tissue healing, and patient-reported outcomes.

Ten RCTs met the inclusion criteria. Considerable heterogeneity was observed in study design, PRF preparation protocols, follow-up duration, and measurement methods. Overall, pure PRF demonstrated inconsistent effects on horizontal and vertical ridge preservation compared with spontaneous healing and did not show superiority over xenograft based approaches. However, histomorphometric analyses consistently reported greater newly formed or vital bone in PRF-treated sites. Reduced postoperative pain and improved early soft tissue healing were among the most reproducible findings. Evidence regarding bone density outcomes was limited and variable.