Effect of Leukocyte‐Platelet‐Rich Fibrin on Peri‐Implant Keratinized Mucosal Width and Mucosal Thickness Following Immediate Implant Placement: A Randomized Clinical Trial

Background

Adequate keratinized peri‐implant soft tissue supports plaque control, patient comfort, and long‐term tissue stability. This study evaluated whether application of a leukocyte‐platelet‐rich fibrin (L‐PRF) plug during immediate implant placement improves keratinized mucosal width (KMW) and peri‐implant mucosal thickness (PMT).

Materials and Methods

In this parallel‐group randomized clinical trial, 60 systemically healthy patients requiring extraction and immediate implant placement were allocated to an L‐PRF group or a control group. The primary outcome was KMW at final follow‐up, whereas PMT at final follow‐up was considered a secondary clinical outcome. Both outcomes were analyzed using baseline‐adjusted ANCOVA.

Results

All randomized participants completed the study. At baseline, PMT did not differ significantly between groups ( p = 0.505), whereas KMW was greater in the L‐PRF group ( p = 0.019). At the final follow‐up, both KMW and PMT increased significantly in both groups ( p   < 0.001). The L‐PRF group demonstrated greater PMT and KMW at the final follow‐up than the control group ( p   < 0.001 for both comparisons). After adjustment, group allocation remained a significant predictor of both PMT ( p   < 0.001) and KMW ( p   < 0.001). No adverse events were reported.

Conclusion

In this trial, application of an L‐PRF plug during immediate implant placement was associated with greater KMW and PMT at final follow‐up than standard surgical closure alone. These findings should be interpreted with caution given the baseline KMW imbalance and the lack of consistently recorded surgical and site‐related variables.

Trial Registration: Iranian Registry of Clinical Trials: IRCT20221228056958N2