Effect of L-PRF on Implant Stability in Early Placement Sites: A Split-mouth Randomized Controlled Trial

Aim: This split-mouth study was conducted to compare implant stability between early implant placement sites treated with leukocyte- and platelet-rich fibrin (L-PRF) and delayed implant placement sites. Materials and methods: A total of 20 patients with bilateral edentulous spaces were included in the study. In each patient, one site was indicated for early implant placement (≥4 weeks after tooth extraction), while the contralateral site was indicated for delayed implant placement (≥16 weeks after tooth extraction). Each patient received 2 implants, resulting in the placement of a total of 40 implants. The early placement site with L-PRF intervention was assigned to group I, whereas the delayed placement site without L-PRF served as the control and was assigned to group II. Implant stability quotient (ISQ) was measured at buccal and lingual sides at the time of implant placement and again at 3 months postoperatively at both sites. Intergroup and intragroup comparisons were performed using the independent t-test or Mann-Whitney U test, depending on data distribution. Statistical analysis was carried out using IBM SPSS Statistics, version 23.0. Results: In the L-PRF group, the mean buccal ISQ values decreased slightly from 70.15 ± 2.43 at baseline (T_0) to 69.55 ± 2.14 at 3 months (T_3), while the lingual values changed from 68.95 ± 0.99 at T_0 to 68.85 ± 0.93 at T_3. However, these changes were not statistically significant (buccal: p = 0.083; lingual: p = 0.428). In the control group, the mean buccal ISQ values remained unchanged (68.90 ± 1.02 at T_0 and 68.90 ± 0.97 at T_3; p = 1.000), while the lingual values decreased slightly from 70.10 ± 2.47 at T_0 to 69.80 ± 2.24 at T_3, which was also not statistically significant (p = 0.230). Overall, no statistically significant intragroup differences were observed in ISQ values between baseline and 3 months postoperatively. Intergroup comparison further demonstrated broadly comparable implant stability between the L-PRF and control groups. Conclusion: Within the limitations of the present study, early placement sites treated with L-PRF achieved stability comparable to delayed placement sites, suggesting a potential supportive role of L-PRF in healing under biologically challenging conditions. Clinical significance: L-PRF may be considered a simple, autologous, and biologically active adjunct in early implant placement. Although a statistically significant advantage in implant stability was not demonstrated, the comparable stability achieved in early placement sites suggests that L-PRF may help support healing and reduce the biologic disadvantage associated with shorter healing intervals.