Platelet-rich fibrin versus acellular dermal matrix for vertical soft tissue augmentation simultaneously with dental implantation: a 3-month randomized pilot clinical trial

Abstract

Background: Vertical soft tissue thickness is critical for peri-implant health and aesthetics. Platelet-rich fibrin (PRF) and acellular dermal matrix (ADM) are increasingly used for soft tissue augmentation during dental implantation, but direct comparisons of their efficacy are limited. This study aimed to compare the efficacy of PRF and ADM for vertical soft tissue augmentation, simultaneously with dental implantation. Methods: This pilot randomized controlled clinical trial included 20 patients with thin soft tissue phenotypes (≤ 2 mm) in the posterior mandible. Patients were randomly assigned to the PRF (n = 10) or ADM (n = 10) groups. The primary outcome was gingival thickness measured at baseline and three months postoperatively via a #15 endodontic file and a digital caliper. The Shapiro-Wilk test was used to assess data normality. Data were analyzed via independent and paired t-tests for normally distributed data and Mann-Whitney and Wilcoxon tests for non-normally distributed data. Chi-square tests and Fisher’s exact tests used to compare sex distribution between groups. Between-group comparisons at baseline and three months were performed, with significance set at P < 0.05. Results: The baseline gingival thickness did not differ significantly between the groups (P = 0.19). At three months, gingival thickness significantly increased in both the PRF (from 1.66 ± 0.23 mm to 3.30 ± 0.75 mm) and ADM (from 1.52 ± 0.22 mm to 2.58 ± 0.47 mm) groups (P < 0.001 for both). Although the gingival thickness at three months was significantly greater in the PRF group (p = 0.02), the mean soft tissue gain was not significantly different between the groups (P = 0.081). Conclusions: Both PRF and ADM significantly increased gingival thickness three months post-surgery, with PRF resulting in greater overall thickness. These preliminary findings support using PRF and ADM as effective options for vertical soft tissue augmentation during dental implantation. However, given the pilot nature of this study, further research with larger sample sizes and longer follow-up periods is needed to validate these results. Trial registration: This project was registered in the Iranian Registry of Clinical Trials under the ID (IRCT20200914048713N1) and registration date 30/11/2021.