Effect of Titanium-Prepared Platelet-Rich Fibrin on Extraction Socket Preservation: A CBCT-Based Volumetric Analysis
Objective: Alveolar ridge remodeling following tooth extraction may compromise subsequent implant placement. Titanium-prepared platelet-rich fibrin (T-PRF) has been proposed as an autologous biomaterial that may enhance socket healing and minimize post-extraction dimensional changes. This study aimed to compare the radiographic healing of extraction sockets treated with T-PRF and those left to heal spontaneously using cone-beam computed tomography (CBCT)-based volumetric analysis. Methods: A total of 30 systemically healthy patients (18 males and 12 females) requiring tooth extraction followed by implant placement were enrolled in this randomized clinical trial. A total of 58 extraction sockets were included, with 27 sockets allocated to the T-PRF group and 31 sockets assigned to spontaneous healing (control group). The initial CBCT examination (baseline assessment) was performed 7–10 days after tooth extraction, and a follow-up CBCT examination was performed 3 months after extraction. Baseline socket volume, residual non-ossified socket volume, and the estimated percentage of socket fill were assessed using dedicated volumetric analysis software. Because some participants contributed more than one extraction socket, generalized estimating equations (GEE) were used to account for within-patient clustering. Results: Baseline socket volumes were comparable between the groups (p = 0.752). At 3 months, the residual non-ossified socket volume was significantly lower in the T-PRF group than in the control group (0.043 cm³ vs. 0.087 cm³; p = 0.013). Both groups demonstrated progressive socket healing over time; however, the estimated percentage of socket fill was significantly higher in the T-PRF group than in the control group (80.1% vs. 57.3%). Conclusion: Within the limitations of this randomized clinical trial, T-PRF was associated with improved radiographic healing of extraction sockets, as reflected by a lower residual non-ossified socket volume after 3 months compared with spontaneous healing. T-PRF may represent a simple, autologous, and clinically useful adjunct for socket preservation prior to implant placement.