Platelet-Derived Growth Factors to Enhance Healing and Reduce Post-Extraction Complications in Smokers

Summary

This study is a randomized controlled clinical trial with a split-mouth design to evaluate the effect of Advanced Platelet-Rich Fibrin (A-PRF) application on socket healing following dental extractions in smokers. In the split-mouth design, each participant serves as their own control, minimizing inter-subject variability and controlling for potential confounders such as smoking habits, oral hygiene, and systemic health conditions. Bilateral tooth extractions will be performed for each participant, with one extraction site randomly assigned to receive socket preservation using an A-PRF plug, while the contralateral site will be left to heal naturally without intervention. The study will be conducted at the Faculty of Dentistry and the University Dental Hospital, King Abdulaziz University, Jeddah, Saudi Arabia. Recruitment began in December 2025 and will continue until the targeted sample size is achieved.

Timeline

Start

2026-01-31

Primary completion

2026-05-31

Completion

2026-06-30

Publications

• Background Yerke LM, Jamjoom A, Zahid TM, Cohen RE. The Effect of Platelet-Rich Fibrin, Calcium Sulfate Hemihydrate, Platelet-Rich Plasma and Resorbable Collagen on Soft Tissue Closure of Extraction Sites. J Funct Biomater. 2017 May 25;8(2):17. doi: 10.3390/jfb8020017.
• Background Pan J, Xu Q, Hou J, Wu Y, Liu Y, Li R, Pan Y, Zhang D. Effect of platelet-rich fibrin on alveolar ridge preservation: A systematic review. J Am Dent Assoc. 2019 Sep;150(9):766-778. doi: 10.1016/j.adaj.2019.04.025.
• Background Malcangi G, Patano A, Palmieri G, Di Pede C, Latini G, Inchingolo AD, Hazballa D, de Ruvo E, Garofoli G, Inchingolo F, Dipalma G, Minetti E, Inchingolo AM. Maxillary Sinus Augmentation Using Autologous Platelet Concentrates (Platelet-Rich Plasma, Platelet-Rich Fibrin, and Concentrated Growth Factor) Combined with Bone Graft: A Systematic Review. Cells. 2023 Jul 6;12(13):1797. doi: 10.3390/cells12131797.
• Background El Bagdadi K, Kubesch A, Yu X, Al-Maawi S, Orlowska A, Dias A, Booms P, Dohle E, Sader R, Kirkpatrick CJ, Choukroun J, Ghanaati S. Reduction of relative centrifugal forces increases growth factor release within solid platelet-rich-fibrin (PRF)-based matrices: a proof of concept of LSCC (low speed centrifugation concept). Eur J Trauma Emerg Surg. 2019 Jun;45(3):467-479. doi: 10.1007/s00068-017-0785-7. Epub 2017 Mar 21.
• Background Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, Dohan AJ, Mouhyi J, Dohan DM. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Mar;101(3):e56-60. doi: 10.1016/j.tripleo.2005.07.011.
• Background Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Mar;101(3):e45-50. doi: 10.1016/j.tripleo.2005.07.009. Epub 2006 Jan 10.
• Background Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol. 2009 Mar;27(3):158-67. doi: 10.1016/j.tibtech.2008.11.009. Epub 2009 Jan 31.
• Background Dohan Ehrenfest DM, Del Corso M, Diss A, Mouhyi J, Charrier JB. Three-dimensional architecture and cell composition of a Choukroun's platelet-rich fibrin clot and membrane. J Periodontol. 2010 Apr;81(4):546-55. doi: 10.1902/jop.2009.090531.
• Background Alshehri, A., et al., Assessment of the low-speed centrifugation concept modified in the release of fibroblast growth factor-2 in Saudi healthy patient. Saudi Journal of Oral Sciences, 2020. 7(3): p. 169-173.
• Background Fujioka-Kobayashi M, Miron RJ, Hernandez M, Kandalam U, Zhang Y, Choukroun J. Optimized Platelet-Rich Fibrin With the Low-Speed Concept: Growth Factor Release, Biocompatibility, and Cellular Response. J Periodontol. 2017 Jan;88(1):112-121. doi: 10.1902/jop.2016.160443. Epub 2016 Sep 2.
• Background Lalla E, Papapanou PN. Diabetes mellitus and periodontitis: a tale of two common interrelated diseases. Nat Rev Endocrinol. 2011 Jun 28;7(12):738-48. doi: 10.1038/nrendo.2011.106.
• Background Souto-Maior JR, Pellizzer EP, de Luna Gomes JM, Dds CAAL, Dds JFSJ, Vasconcelos BCDE, de Moraes SLD. Influence of Diabetes on the Survival Rate and Marginal Bone Loss of Dental Implants: An Overview of Systematic Reviews. J Oral Implantol. 2019 Aug;45(4):334-340. doi: 10.1563/aaid-joi-D-19-00087. Epub 2019 May 1.
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• Background De Angelis P, Manicone PF, Gasparini G, De Filippis I, Liguori MG, De Angelis S, Cannata F, D'Addona A. The Effect of Controlled Diabetes and Hyperglycemia on Implant Placement with Simultaneous Horizontal Guided Bone Regeneration: A Clinical Retrospective Analysis. Biomed Res Int. 2021 Jun 14;2021:9931505. doi: 10.1155/2021/9931505. eCollection 2021.
• Background Power DJ, Sambrook PJ, Goss AN. The healing of dental extraction sockets in insulin-dependent diabetic patients: a prospective controlled observational study. Aust Dent J. 2019 Mar;64(1):111-116. doi: 10.1111/adj.12669. Epub 2019 Jan 2.
• Background Huang S, Dang H, Huynh W, Sambrook PJ, Goss AN. The healing of dental extraction sockets in patients with Type 2 diabetes on oral hypoglycaemics: a prospective cohort. Aust Dent J. 2013 Mar;58(1):89-93. doi: 10.1111/adj.12029. Epub 2013 Jan 28.
• Background Aronovich S, Skope LW, Kelly JP, Kyriakides TC. The relationship of glycemic control to the outcomes of dental extractions. J Oral Maxillofac Surg. 2010 Dec;68(12):2955-61. doi: 10.1016/j.joms.2010.05.006. Epub 2010 Oct 14.
• Background Gadicherla S, Smriti K, Roy S, Pentapati KC, Rajan J, Walia A. Comparison of Extraction Socket Healing in Non-Diabetic, Prediabetic, and Type 2 Diabetic Patients. Clin Cosmet Investig Dent. 2020 Jul 20;12:291-296. doi: 10.2147/CCIDE.S264196. eCollection 2020.
• Background Shen X, Shen X, Li B, Zhu W, Fu Y, Xu R, Du Y, Cheng J, Jiang H. Abnormal macrophage polarization impedes the healing of diabetes-associated tooth sockets. Bone. 2021 Feb;143:115618. doi: 10.1016/j.bone.2020.115618. Epub 2020 Aug 26.
• Background Devlin H, Sloan P. Early bone healing events in the human extraction socket. Int J Oral Maxillofac Surg. 2002 Dec;31(6):641-5. doi: 10.1054/ijom.2002.0292.
• Background de Sousa Gomes P, Daugela P, Poskevicius L, Mariano L, Fernandes MH. Molecular and Cellular Aspects of Socket Healing in the Absence and Presence of Graft Materials and Autologous Platelet Concentrates: a Focused Review. J Oral Maxillofac Res. 2019 Sep 5;10(3):e2. doi: 10.5037/jomr.2019.10302. eCollection 2019 Jul-Sep.
• Background Zhou S, Li G, Zhou T, Zhang S, Xue H, Geng J, Liu W, Sun Y. The role of IFT140 in early bone healing of tooth extraction sockets. Oral Dis. 2022 May;28(4):1188-1197. doi: 10.1111/odi.13833. Epub 2021 Mar 16.
• Background Wang Q, Liu J, Qi S, Liao X, Liu D, Pan J. Clinical analysis of medication related osteonecrosis of the jaws: A growing severe complication in China. J Dent Sci. 2018 Sep;13(3):190-197. doi: 10.1016/j.jds.2017.12.003. Epub 2018 Feb 6.
• Background Yoo JJ, Kim DW, Kim MY, Kim YT, Yoon JH. The effect of diabetes on tooth loss caused by periodontal disease: A nationwide population-based cohort study in South Korea. J Periodontol. 2019 Jun;90(6):576-583. doi: 10.1002/JPER.18-0480. Epub 2019 Mar 12.
• Background Al-Rubeaan K, Al Derwish M, Ouizi S, Youssef AM, Subhani SN, Ibrahim HM, Alamri BN. Diabetic foot complications and their risk factors from a large retrospective cohort study. PLoS One. 2015 May 6;10(5):e0124446. doi: 10.1371/journal.pone.0124446. eCollection 2015.
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• Background Davis VL, Abukabda AB, Radio NM, Witt-Enderby PA, Clafshenkel WP, Cairone JV, Rutkowski JL. Platelet-rich preparations to improve healing. Part I: workable options for every size practice. J Oral Implantol. 2014 Aug;40(4):500-10. doi: 10.1563/AAID-JOI-D-12-00104.
• Background Mohseni Homagarani Y, Adlparvar K, Teimuri S, Tarrahi MJ, Nilchian F. The effect of diabetes mellitus on oral health-related quality of life: A systematic review and meta-analysis study. Front Public Health. 2023 Feb 24;11:1112008. doi: 10.3389/fpubh.2023.1112008. eCollection 2023.
• Background Kudiyirickal MG, Pappachan JM. Diabetes mellitus and oral health. Endocrine. 2015 May;49(1):27-34. doi: 10.1007/s12020-014-0496-3. Epub 2014 Dec 9.
• Background Alwin Robert A, Al Dawish MA. Microvascular complications among patients with diabetes: An emerging health problem in Saudi Arabia. Diab Vasc Dis Res. 2019 May;16(3):227-235. doi: 10.1177/1479164118820714. Epub 2019 Jan 1.

Drugs

Indications