Clinical, Histomorphometric, and Digital Evaluation of Plasma Rich in Growth Factors for Alveolar Ridge Preservation: A Randomized Controlled Clinical Trial

OBJECTIVES: To evaluate the clinical, digital and histological outcomes of bone regeneration using autologous plasma rich in growth factors (PRGF®) for alveolar ridge preservation (ARP), compared to an anorganic bovine bone (ABB) graft. MATERIALS AND METHODS: A randomized clinical trial was conducted in adult subjects requiring tooth extraction and subsequent implant placement. The effect of the therapy was assessed by clinical, intraoral and CBCT scans, and patient-reported outcomes at post-extraction, before implant placement and 1 year after implant loading. Bone core biopsies were also collected four months post-extraction for histological and immunohistochemical analysis. RESULTS: A total of 26 patients were included in this study. IOS and CBCTs demonstrated a reduction of the bone crest over time, with statistically significant differences within but not between groups. The PRGF® group exhibited improved early soft tissue healing, lower inflammation index, and reduced patient-reported discomfort. PRGF® group showed a trend toward higher mineralized tissue and fewer TRAP-positive cells, indicating reduced osteoclastic activity. In addition, soft tissue measurements increased from extraction to implant placement in the PRGF® group, while ABB prevented early bucco-lingual collapse regardless of the thickness of the facial bone. CONCLUSIONS: Both ABB and PRGF® yielded similar clinical, digital dimensions, histomorphometric results, and patient-reported outcomes in ARP therapy. PRGF® histology demonstrated no residual material in the grafted area. CLINICAL IMPLICATIONS: These findings support the use of PRGF as a biologically active, autologous material for ARP in addition to other options such as xenografts. According to our results, PRGF seems to offer advantages in soft tissue healing and patient-centered outcomes.