Assessment of the Effect of Platelet Rich Fibrin with and without Leukocytes on the Dental Implant Stability: A Randomized Clinical Trial

Abstract

This study aimed to evaluate and compare the effects of platelet-rich fibrin (PRF) and leukocyte-and platelet-rich fibrin (L-PRF) on dental implant stability over a four-month follow-up period using resonance frequency analysis. A prospective randomized split-mouth clinical trial was conducted at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Science and Technology, Sana’a, Yemen. The final sample included 32 implant sites in 8 patients aged 30 –60 years, with 16 sites treated with PRF and 16 sites treated with L-PRF. Implant stability was measured using an Osstell ISQ device and compatible SmartPegs, and Implant Stability Quotient (ISQ) values were recorded immediately after implant placement, at one month, and at four months. Data were analyzed using the Shapiro–Wilk test, paired-samples t-test, Pearson’s correlation, and one-way analysis of variance (ANOVA). Both groups showed increased mean ISQ values during follow-up. In the PRF group, the mean ISQ increased from 64.56 ± 7.51 at baseline to 68.61 ± 5.02 at one month and 70.19 ± 3.51 at four months. In the L-PRF group, the mean ISQ increased from 68.47 ± 5.97 to 74.14 ± 4.25 and 76.22 ± 3.55, respectively. L-PRF sites showed significantly higher ISQ values than PRF sites at baseline (p = 0.019), one month (p < 0.001), and four months (p < 0.001). Within the limitations of this study, both PRF and L-PRF were associated with improved implant stability during the early healing period. L-PRF was associated with higher ISQ values and may support a more favorable peri-implant healing environment. However, because baseline ISQ values were already higher in the L-PRF group, the apparent advantage of L-PRF should be interpreted cautiously and should not be considered definitive evidence of causation.