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CC BY 4.0 · Eur J Dent
DOI: 10.1055/s-0045-1812061
Original Article

Analysis of Soft Tissue Healing Over Socket Orifice Sealed with Platelet-Rich Fibrin Membrane

Authors

  • Rann Manlerd 

    1   Faculty of Dentistry, Mahidol University, Bangkok, Thailand

  • Bundhit Jirajariyavej 

    1   Faculty of Dentistry, Mahidol University, Bangkok, Thailand

  • Nisarat Ruangsawasdi 

    2   Department of Pharmacology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand

  • Prakan Thanasrisuebwong 

    3   Dental Implant Center, Faculty of Dentistry, Mahidol University, Bangkok, Thailand

Funding This study was supported by the Master of Science (Dentistry), Faculty of Graduate Studies, Mahidol University.
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Abstract

Objective

Socket sealing is a technique for alveolar ridge preservation following tooth extraction. Leukocyte and platelet-rich fibrin (L-PRF), an autologous platelet-derived material rich in growth factors, is used to support healing. However, its benefits for soft tissue healing compared with collagen sponge or spontaneous healing remain unclear. This study evaluated soft tissue healing outcomes, wound margin distance, inflammation, postoperative pain, and wound closure area, among sockets treated with L-PRF membrane, collagen sponge, or spontaneous healing.

Materials and Methods

A randomized controlled clinical trial was conducted on 45 extraction sites at the Faculty of Dentistry, Mahidol University, Bangkok, Thailand. Sockets were randomly assigned to L-PRF sealing, collagen sponge sealing, or spontaneous healing. Primary outcomes included wound margin distance reduction percentage, soft tissue healing index, and postoperative pain. The secondary outcome was wound closure area reduction percentage between the L-PRF and collagen sponge groups. Measurements were recorded postoperatively and on days 7, 14, and 21. Pain scores were recorded daily for 1 week. Age, sex, tooth position, and arch were evaluated as covariates.

Statistical Analysis

One-way ANOVA with least significant difference post-hoc test was used for primary outcomes, and an independent t-test was used for secondary outcomes (p < 0.05).

Results

Forty-five teeth were enrolled. Three teeth from the collagen sponge group were excluded due to infection and loss to follow-up; three additional teeth were recruited using the original allocation and randomization protocol. On day 7, L-PRF showed a significantly superior soft tissue healing index than collagen sponge (p = 0.002, 95% CI: [0.28, 1.18]) and spontaneous healing (p = 0.002, 95% CI: [0.28, 1.18]). On day 5, L-PRF reduced pain more than collagen sponge (p = 0.036, 95% CI: [0.04, 1.03]) and spontaneous healing (p = 0.026, 95% CI: [0.07, 1.06]). No significant differences in wound closure distance reduction percentage or wound area reduction percentage were observed among the groups.

Conclusion

L-PRF improved soft tissue healing and reduced postoperative pain within the first week, but showed no added benefit in wound closure compared with collagen sponge or spontaneous healing. L-PRF may support short-term symptom relief but not enhanced post-extraction soft tissue regeneration at the clinical relevance level.

Keywords

alveolar ridge preservation - L-PRF - leukocyte and platelet-rich fibrin - collagen sponge - socket sealing surgery

Availability of Data and Materials

The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request.


Ethical Approval

All procedures were approved by the Institutional Review Board of the Faculty of Dentistry and Faculty of Pharmacy, Mahidol University (COA.No.MU-DT/PY-IRB 2022/036.0508).


Clinical Trial Number

The study was registered at the Thai Clinical Trials Registry (TCTR20250812006) (https://www.thaiclinicaltrials.org/show/TCTR20250812006).


Supplementary Material



Publication History

Article published online:
22 October 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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