Clinical and radiographic efficacy of photobiomodulation, platelet-rich fibrin, and their combination for socket preservation: a randomized clinical trial.

Abstract

The clinical and radiographic outcomes of platelet-rich fibrin (PRF), photobiomodulation treatment (PBM), and their combination for socket preservation were examined in this research. This single-blind randomized clinical trial assessed 72 individuals who had atraumatic extraction of anterior and premolar teeth. The patients were randomly allocated into four groups (n = 18): (I) PBM (660 nm, 100 mW, 2 J/cm², 10 s for soft tissue; 970 nm, 200 mW, 6 J/cm², 20 s for hard tissue in continuous-wave mode), administered once every other day for 2 weeks; (II) socket preservation with PRF; (III) PRF combined with PBM; and (IV) control (no intervention). Pain after 24, 48, and 72 h, soft tissue healing, keratinized gingiva width (KGW), and the buccolingual ridge width and height (at baseline, and 2 months post-extraction) were assessed clinically and radiographically. Data were analyzed using SPSS (alpha = 0.05). Pain scores were significantly lower in the intervention groups than in the control group at all time points (P < 0.05). The PRF-PBM group showed lower pain scores than the PBM and PRF groups, although the difference was statistically significant only compared with the PBM group (P < 0.05). In the GEE analysis of soft tissue healing, PBM and PRF-PBM showed significantly better healing scores than the control group, whereas PRF alone did not differ significantly from the control group. In the ANCOVA analysis adjusted for baseline ridge width, all intervention groups showed significantly greater follow-up buccolingual ridge width than the control group, with the largest adjusted effect observed in the PRF-PBM group. No significant intergroup differences were observed for KGW or ridge height. The results showed that PRF-PBM may provide an early biological advantage for socket healing, particularly in reducing postoperative pain, improving early soft tissue healing, and preserving buccolingual ridge width. However, KGW and vertical ridge height were not significantly affected, and longer-term studies are needed to confirm whether these early benefits are maintained. The study was registered in the clinical trial registry with the number IRCT20230222057497N1on 09.05.2023 and IRCT20230305057619N1 on 13.05.2023.