Radiographic Evaluation in Alveolar Preservation Using Platelet-Rich Fibrin: A Randomized Controlled Trial

Background: Tooth extractions commonly result in dimensional changes of the alveolar ridge. Platelet-rich fibrin (PRF) has emerged as a promising autologous biomaterial for alveolar preservation. This randomized controlled trial aimed to evaluate, through cone beam computed tomography (CBCT), the effect of PRF in maintaining alveolar dimensions post-extraction. Methods: A single-blind, randomized controlled clinical trial was conducted in 10 systemically healthy patients requiring premolar extractions for orthodontic reasons. A total of 36 alveoli were analyzed: 19 with PRF (experimental group) and 17 without PRF (control group). CBCT scans were performed at baseline, 30 days, and 120 days post-extraction to measure alveolar height, vestibulo-palatal/lingual depth at 1, 3, and 5 mm, and bone tissue density using Hounsfield Units (HU). Results: Baseline cephalocaudal alveolar height was similar in both groups (~10.5 mm, p = 0.399). At 30 days, height preservation was significantly greater in the PRF group (10.61 mm vs. 8.82 mm, p < 0.001). At 120 days, the PRF group maintained greater height (10.30 mm vs. 9.31 mm), although this difference was not statistically significant (p = 0.059). No significant differences were observed in alveolar depth at 1, 3, or 5 mm (p > 0.05). The PRF group showed a trend toward better preservation and higher mean bone density values (190–282 HU), although no formal statistical comparison of HU values was performed. Repeated measures ANOVA revealed a significant interaction effect of time and group on alveolar height (p = 0.010, η2 = 0.046) and at 1 mm depth (p = 0.035, η2 = 0.020). Conclusions: PRF significantly improved short-term alveolar height preservation. Trends toward better depth preservation and higher bone density values were observed in the PRF group, although these findings were not statistically significant. PRF appears to be a safe biomaterial with potential to support alveolar ridge maintenance post-extraction.