Clinico-radiological evaluation of dentinal graft versus platelet-rich fibrin matrix in extraction sockets with immediate implant placement: a randomized controlled trial

Abstract

Background Immediate implant placement is a pivotal approach for single-tooth replacement, offering reduced treatment duration and enhanced patient satisfaction. However, postextraction bone resorption remains a challenge. Dentinal grafts and platelet-rich fibrin matrix (PRFM) are promising augmentation materials, yet direct comparative evaluations are limited. Objective To compare the clinico-radiological outcomes of dentinal grafts versus PRFM in maintaining crestal bone morphology and density during immediate implant placement. Patients and methods This randomized controlled trial enrolled 30 participants, divided equally into two groups. Group 1 received dentinal grafts, while group 2 underwent PRFM augmentation. Primary outcomes included vertical and horizontal crestal bone changes and bone density, assessed via cone beam computed tomography at baseline and 6 months postsurgery. Secondary outcomes encompassed implant stability, complications, and marginal bone loss. Results At 6 months, both groups demonstrated favorable bone preservation. The dentinal graft group showed comparatively greater dimensional stability in vertical and horizontal crestal bone, whereas the PRFM group exhibited enhanced soft tissue healing. Bone density values improved in both groups with no statistically significant intergroup difference. Implant stability was maintained throughout, and no major biological or technical complications were reported. Conclusion Both dentinal grafts and PRFM proved effective in preserving crestal bone morphology and supporting implant stability during immediate implant placement. Dentinal grafts offered superior dimensional bone preservation, while PRFM enhanced soft tissue healing. These findings suggest that both materials are viable, cost-effective augmentation options, with the choice guided by clinical priorities.