A 6-Month Clinical Pilot Study of Guided Bone Regeneration with or without Platelet-Rich Fibrin: A Randomized Controlled Trial

Main Article Content

Nuanthip Tapaneeyakorn
Subin Puasiri
Saengsome Prajaneh
Waraporn Suwannarong


The purpose of study was to compare clinical wound healing and alveolar ridge gain in horizontal and vertical bone defects by guided bone regeneration (GBR) with or without platelet-rich fibrin (PRF). A randomized controlled clinical trial (split-mouth) in 10 healthy patients (7 females, 3 males) with bilateral localized alveolar ridge defects was selected. GBR was performed by using allograft and collagen membrane in both control and test groups, but PRF membrane was used only in the test group.  PRF membrane was obtained from venous blood sample of 10 cc mixed with allograft and to cover the collagen membrane before flap closure in the test group. Outcomes were assessed by Visual Analog Scale (VAS), Healing Index (HI) score and alveolar ridge gain in both horizontal and vertical bone defects by Cone Beam Computed Tomography (CBCTs). The result of mean VAS showed no significant difference in both groups. Mean HI score in the test group was higher than the control group at day 3, 7 and 14, but statistical significance (p=0.046) was found at day 14.  Buccal alveolar ridge width was gained in both groups with no significant difference. Increasing of soft tissue thickness was also found in both groups. In conclusion, using PRF membrane as biomaterial in conjunction with GBR can promote early wound healing process. Furthermore, larger sample size and long-term studies are needed to confirm the positive effect of PRF in enhancing the bone regeneration.


Download data is not yet available.

Article Details

How to Cite
Tapaneeyakorn N, Puasiri S, Prajaneh S, Suwannarong W. A 6-Month Clinical Pilot Study of Guided Bone Regeneration with or without Platelet-Rich Fibrin: A Randomized Controlled Trial. Khon Kaen Dent J [Internet]. 2020 Aug. 25 [cited 2023 Jan. 29];23(2):74-89. Available from: https://he01.tci-thaijo.org/index.php/KDJ/article/view/230555
Research Articles
Share |


Jung RE, Fenner N, Hämmerle CHF, Zitzmann NU. Long-term outcome of implants placed with guided bone regeneration (GBR) using resorbable and non-resorbable membranes after 12-14 years. Clin Oral Implants Res 2013;24(10):1065-73.

Schenk R, Buser D, Hardwick W, Dahlin C. Healing pattern of bone regeneration in membrane-protected defects: a histologic study in the canine mandible. Int J Oral Maxillofac Implant 1994;9(1):13-29.

Wang H, Carroll M. Guided bone regeneration using bone grafts and collagen membranes. Quintessence Int 2001; 32(7):504-15.

Wang HL, Boyapati L. “PASS” principles for predictable bone regeneration. Implant Dent 2006;15(1):8-17.

Chen FM, Jin Y. Periodontal tissue engineering and regeneration: current approaches and expanding opportunities. Tissue Eng Part B Rev 2010;16(2):219-55.

Dohan DM, Choukroun J, Diss A, Dohan AJJ, Mouhyi J, Gogly B. Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101(3):e37-44.

Dohan DM, Choukroun J, Diss A, Dohan AJ, Mouhyi J, Gogly B. Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101(3):e45-50.

Gassling V, Douglas T, Warnke PH, Açil Y, Wiltfang J, Becker ST. Platelet-rich fibrin membranes as scaffolds for periosteal tissue engineering. Clin Oral Implants Res 2010;21(5):543-549.

Mazor Z, Horowitz RA, Del Corso M, Prasad HS, Rohrer MD, Dohan Ehrenfest DM. Sinus floor augmentation with simultaneous implant placement using choukroun’s platelet-rich fibrin as the sole grafting material: a radiologic and histologic study at 6 months. J Periodontol 2009;80(12):2056-64.

Choukroun J, Diss A, Simonpieri A, et al. Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part V: Histologic evaluations of PRF effects on bone allograft maturation in sinus lift. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101(3):299-303.

Moraschini V, Barboza ESP. Effect of autologous platelet concentrates for alveolar socket preservation: a systematic review. Int J Oral Maxillofac Surg 2015;44(5):632-41.

Aroca S, Keglevich T, Barbieri B, Gera I, Etienne D. Clinical evaluation of a modified coronally advanced flap alone or in combination with a platelet-rich fibrin membrane for the treatment of adjacent multiple gingival recessions: a 6-month study. J Periodontol 2009;80(2): 244-52.

Sharma A, Pradeep AR. Autologous platelet-rich fibrin in the treatment of mandibular degree II furcation defects: a randomized clinical trial. J Periodontol 2011;82(10): 1396-1403.

Sharma A, Pradeep AR. Treatment of 3-wall intrabony defects in patients with chronic periodontitis with autologous platelet-rich fibrin: a randomized controlled clinical trial. J Periodontol 2011;82(12): 1705-12.

Zhou J, Li X, Sun X, Qi M, Chi M, Yin L, et al. Bone regeneration around immediate placed implant of molar teeth with autologous platelet-rich fibrin: two case reports. Medicine (Baltimore) 2018;97(44):e13058.

Simonpieri A, Del Corso M, Vervelle A, Jimbo R, Inchingolo F, Sammartino G, et al. Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 2: bone graft, implant and reconstructive surgery. Curr Pharm Biotechnol 2012; 13(7):1231-56.

Seibert J. Reconstruction of deformed, partially edentulous ridges, using full thickness onlay grafts. Part II. prosthetic/periodontal interrelationships. Compend Contin Educ Dent 1983;4(6):549-62.

Allen EP, Gainza CS, Farthing GG, Newbold DA. Improved technique for localized ridge augmentation: a report of 21 cases. J Periodontol 1985;56(4):195-9.

Sclar A. Surgical technique for management of peri-implant soft tissue. in: Soft tissue and esthtic considerations on implant therapy. 1st ed. Chicago: Quintessence Publishing; 2003. 48.

Campbell W, Lewis S. Visual analogue measurement of pain. Ulster Med J 1990;59(2):149–54.

Landry R, Turnbull R, Howley T. Effectiveness of benzydamyne HCl in the treatment of periodontal post-surgical patients 10:105-18.

Singh A, Kohli M, Gupta N. Platelet rich fibrin: a novel approach for osseous regeneration. J Maxillofac Oral Surg 2012;11(4):430-4.

Daugela P, Grimuta V, Sakavicius D, Jonaitis J, Juodzbalys G. Influence of leukocyte- and platelet-rich fibrin (L-PRF) on the outcomes of impacted mandibular third molar removal surgery: A split-mouth randomized clinical trial. Quintessence Int 2018;49(5):377-88.

Su CY, Kuo YP, Tseng YH, Su CH, Burnouf T. In vitro release of growth factors from platelet-rich fibrin (PRF): a proposal to optimize the clinical applications of PRF. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108(1):56-61.

Wu CL, Lee SS, Tsai CH, Lu KH, Zhao JH, Chang YC. Platelet-rich fibrin increases cell attachment, proliferation and collagen-related protein expression of human osteoblasts. Aust Dent J 2012;57(2):207-12.

Strauss FJ, Stähli A, Gruber R. The use of platelet-rich fibrin to enhance the outcomes of implant therapy: A systematic review. Clin Oral Implants Res 2018;29(Suppl 18):6-19.

Cortellini S, Castro AB, Temmerman A, Dessel JV, Pinto N, Jacobs R, et al. Leucocyte- and platelet-rich fibrin block for bone augmentation procedure: A proof-of-concept study. J Clin Periodontol 2018;45(5):624-34.

Chavda S, Levin L. Human studies of vertical and horizontal alveolar ridge augmentation comparing different types of bone graft materials: A systematic review. J Oral Implantol 2018;44(1):74-84.

Papageorgiou SN, Papageorgiou PN, Deschner J, Götz W. Comparative effectiveness of natural and synthetic bone grafts in oral and maxillofacial surgery prior to insertion of dental implants: Systematic review and network meta-analysis of parallel and cluster randomized controlled trials. J Dent 2016;48:1-8.

Zhang Y, Tangl S, Huber CD, Lin Y, Qiu L, Rausch-Fan X. Effects of Choukroun’s platelet-rich fibrin on bone regeneration in combination with deproteinized bovine bone mineral in maxillary sinus augmentation: A histological and histomorphometric study. J Cranio-Maxillofacial Surg 2012;40(4):321-8.

Sbricoli L, Guazzo R, Annunziata M, Gobbato L, Bressan E, Nastri L. Selection of collagen membranes for bone regeneration: A literature review. Materials (Basel) 2020; 13(3):786.

Urban IA, Monje A. Guided bone regeneration in alveolar bone reconstruction. Oral Maxillofac Surg Clin North Am 2019;31(2):331-8.

Sterio TW, Katancik JA, Blanchard SB, Xenoudi P, Mealey BL. A prospective, multicenter study of bovine pericardium membrane with cancellous particulate allograft for localized alveolar ridge augmentation. Int J Periodontics Restor Dent 2013;33(4):499-507.

Mordenfeld A, Johansson CB, Albrektsson T, Hallman M. A randomized and controlled clinical trial of two different compositions of deproteinized bovine bone and autogenous bone used for lateral ridge augmentation. Clin Oral Implants Res 2014;25(3):310-20.

Gultekin BA, Cansiz E, Borahan MO. Clinical and 3-dimensional radiographic evaluation of autogenous iliac block bone grafting and guided bone regeneration in patients with atrophic maxilla. J Oral Maxillofac Surg 2017;75(4):709-22.

Wessing B, Lettner S, Zechner W. Guided bone regeneration with collagen membranes and particulate graft materials: A systematic review and meta-analysis. Int J Oral Maxillofac Implants 2018;33(1): 87-100.

Thamaraiselvan M, Elavarasu S, Thangakumaran S, Gadagi JS, Arthie T. Comparative clinical evaluation of coronally advanced flap with or without platelet rich fibrin membrane in the treatment of isolated gingival recession. J Indian Soc Periodontol 2015;19(1):66-71.

Buser D, von Arx T. Surgical procedures in partially edentulous patients with ITI implants. Clin Oral Implants Res 2000;11(Suppl 1):83-100.

Machtei EE. The Effect of membrane exposure on the outcome of regenerative procedures in humans: a meta-analysis. J Periodontol 2001;72(4):512-6.