Advanced Platelet-Rich Fibrin Plus Improves Marginal Bone Preservation in Immediate Dental Implant Placement

Introduction: Immediate dental implant placement in fresh extraction sockets has become a widely accepted treatment modality, yet marginal bone loss remains a significant clinical concern. Advanced Platelet-Rich Fibrin Plus (A-PRF+) represents a novel autolo-gous biomaterial with enhanced regenerative properties. This prospective clinical study aimed to evaluate the effect of A-PRF+ on Marginal Bone Level (MBL) preservation in immediate dental implant placement. Materials and Methods: Sixteen patients (3 males, 13 females; mean age 44.25 years) re-quiring immediate implant placement in fresh extraction sockets were enrolled. Fifty dental implants (Dentium, USA) were randomly allocated into two groups: study group (n = 26) receiving A-PRF+ as graft material for jumping distance augmentation, and control group (n = 24) without augmentation material. Randomization was performed using computer-generated random sequences with allocation concealment via sealed opaque envelopes. Im-plants were placed 1mm subcrestal following atraumatic extraction. A-PRF+ was prepared using a standardized centrifugation protocol (1300 rpm, 8 minutes). Marginal bone levels were measured using calibrated periodontal probes at baseline and 24 weeks post-surgery, with implant length serving as the reference for calibration. Results: At baseline, mean MBL was 14.11mm (study group) and 14.25mm (control group). After 24 weeks, the study group demonstrated superior bone preservation with a mean MBL of 12.36mm compared to 11.50mm in the control group (p < 0.05). The overall survival rate was 96% with 4% failure rate. Maxillary sites showed significantly better outcomes in the study group compared to controls (p < 0.01), while mandibular sites showed no significant difference between groups. Discussion: The superior marginal bone preservation observed in the A-PRF+ group high-lights its potential as a valuable adjunct in immediate implant therapy. The statistically sig-nificant difference, particularly in maxillary sites, suggests that A-PRF+ may effectively counteract the physiological bone remodeling that typically follows tooth extraction. This autologous biomaterial likely enhances healing by concentrating growth factors and provid-ing a stable fibrin scaffold, both of which are critical for bone regeneration in the jumping distance. Conclusion: A-PRF+ application significantly enhances marginal bone level preservation in immediate dental implant placement. The autologous biomaterial demonstrates particular efficacy in maxillary sites, supporting its clinical application as an adjunctive treatment for immediate implant protocols.