# The efficacy of platelet-rich fibrin in alveolar ridge preservation: a systematic review and meta-analysis of randomized controlled trials

## TL;DR

This study finds that platelet-rich fibrin helps preserve alveolar bone after tooth extraction and promotes new bone growth better than natural healing.

## Contribution

This is the first systematic review and meta-analysis evaluating PRF as a standalone grafting material for alveolar ridge preservation.

## Key findings

- PRF significantly reduced alveolar bone height loss at 3, 4, and 6 months post-extraction.
- PRF promoted greater new bone formation compared to spontaneous healing at 3 and 4 months.
- High-speed centrifugation protocols enhanced new bone formation more than standard protocols.

## Abstract

The aim of this study was to systematically evaluate the independent efficacy of platelet-rich fibrin (PRF) as a sole grafting material in alveolar ridge preservation and to dynamically delineate the trajectory of PRF’s effects on alveolar ridge morphology and new bone formation across various healing stages.

A comprehensive search was conducted across four databases (PubMed, Embase, the Cochrane Library, and Web of Science) for pertinent records from their establishment until November 2025. The study encompassed randomized controlled trials (RCTs) that evaluated alveolar ridge preservation utilizing PRF alone in comparison to spontaneous healing. Two investigators independently conducted literature screening, data extraction, and methodological quality evaluation, employing the Cochrane Risk of Bias instrument (ROB-2) for the latter. The certainty of the evidence for each outcome was assessed using the GRADE framework. The meta-analysis utilized RevMan version 5.3, while publication bias was evaluated by Egger’s test in Stata 18.

A total of eighteen studies were incorporated into the analysis. Compared to the spontaneous healing group, the PRF group showed significantly smaller losses in alveolar bone height at 3 months (p = 0.004; 95% CI = −1.59 to −0.31), 4 months (p = 0.002; 95% CI = −0.93 to −0.20), and 6 months (p = 0.03; 95% CI = −0.53 to −0.03). The use of PRF resulted in a significantly lower reduction in alveolar bone width at 2 months (p = 0.03; 95% CI = −1.18 to −0.05) and 3 months. The percentage of new bone formation in the PRF group was significantly greater than that in the spontaneous healing group at both 3 months (p = 0.0008; 95% CI: 4.70–18.02) and 4 months (p = 0.010; 95% CI: 4.14–29.81). High-speed centrifugation was associated with significantly greater new bone formation than standard protocols (p = 0.02), while effects on dimensional preservation did not differ significantly between protocols.

PRF appears to mitigate alveolar bone resorption following tooth extraction and may enhance new bone formation during the healing process. The osteogenic effect of PRF may be optimized by high-speed centrifugation protocols. As a secure autologous biomaterial, it is a promising option for preserving alveolar bone and enhancing circumstances for eventual implant restoration.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251183872, identifier PROSPERO (CRD420251183872).