Radiographical dimension changes and wound healing evaluation of autologous dentine particles in combination with platelet-rich fibrin (PRF) and collagen plug-in human alveolar ridge preservation: a randomised controlled trial

Alveolar ridge preservation (ARP) procedures effectively reduce physiological bone resorption and accelerate bone regeneration, which may lead to better prosthetic and aesthetic outcomes for patients. Numerous grafting materials have been utilised for this procedure, including autogenous bone, xenografts, or allografts. However, these materials possess several drawbacks such as excessive harvesting methods of autogenous bone which may increase the patient's morbidity. Meanwhile, there is a risk of contamination, rejection, and infection, as well as a high cost for xenografts and alloplastic bone grafts. Dentine particles (DP) derived from the extracted tooth are an alternative grafting material mainly consisting of type I collagen and various growth factors such as bone morphogenic proteins, which can stimulate the cellular response of osteogenic lineages, enhancing the potential for bone regeneration. Platelet-rich fibrin (PRF) is a natural fibrin-based biomaterial that aids in micro-vascularisation and wound healing. Collagen plug (CP) also contains collagen type I, which may accelerate the osteogenesis, apart from stabilizing the grafting materials. Thus, combining these three has been proposed as an alternative option for ARP. This research aims to provide an overview of the usage and explore the potential of DP, PRF, and CP in bone regeneration to improve ARP treatment outcomes, which is one of the alternative options in ARP. In this study, thirty-three mandibular extraction sockets were randomised into three groups, where the first test group (A) was filled with DP, PRF, and CP, the second positive control group (B) was filled with PRF and CP only, while the third negative control (C) was left empty. Early wound healing was assessed through the Early Healing Score (EHS) at 10 ± 4 days post-ARP, evaluating three key parameters which are clinical signs of re-epithelialization (CSR), hemostasis (CSH), and inflammation (CSI). Three-dimensional radiographic evaluation was performed to measure the changes in ridge width (RW), buccal ridge height (BH), lingual ridge height (LH) and buccal bone thickness (BBT) after 6 months of ARP. The study found comparable early wound healing outcomes among all groups, with no significant differences in EHS scores for re-epithelization (Group A: 2.1 ± 0.3, Group B: 2.0 ± 0.4, Group C: 1.9 ± 0.5), hemostasis (Group A: 1.8 ± 0.4, Group B: 1.7 ± 0.5, Group C: 1.6 ± 0.6), and inflammation scores (Group A: 1.5 ± 0.5, Group B: 1.6 ± 0.6, Group C: 1.7 ± 0.7). In terms of RW, group A demonstrated the smallest reduction (0.43