A 14 Weeks Longitudinal Study to Investigate the Effect of Leukocyte- Platelet Rich Fibrin Plug on the Quality of the Newly Formed Bone in Ridge Preservation Procedure Following a Tooth Extraction. It is a Clinical, Radiographic and Histomorphometric Study.

Study Overview
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Brief Summary
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This 14 weeks longitudinal study will be conducted from March 2018 to June 2020, with a 40 participants. No subjects has received placebo medication at any point in the research procedures. Null hypothesis: The use of L-PRF plug, in combination with non-resorbable, open barrier membrane technique to fill the extraction sockets will have no effect on the quality of the newly formed bone nor on the dimensional changes of the ridge, compared to non-resorbable, open barrier membrane technique with natural blood clot.

Detailed Description
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This 14 weeks longitudinal study was conducted from March 2018 to June 2020, with a 27 participants. No subjects has received placebo medication at any point in the research procedures. The proposed sample population has been recruited from the patient population of the University of Kentucky College of Dentistry clinics and the patient must have had an unsalvageable tooth that was planned for extraction and delayed implant placement and was assigned into a control group and a test group by chance. Fifteen extraction socket sites of the test group were filled with autogenous L-PRF Plug (Intralock) and d-PTFE membrane (Cytoplast) was laid on the top to seal the extraction socket. In the control group, d-PTFE membrane (Cytoplast) was laid on the top of twelve extraction sockets to allow natural blood clot formation in the extraction socket. The primary aim is to assess the quality of the newly formed bone at 14 weeks the time of implant placement by comparing the percentage of new vital bone in the histomorphometric analysis. The second aim was to assess the horizontal and vertical changes of the residual bony ridge using Cone Bean Computerized Tomography (CBCT) analysis at baseline immediately after tooth extraction at 12 weeks of healing. Null hypothesis: The use of L-PRF plug, in combination with non-resorbable, open barrier membrane technique to fill the extraction sockets will have no effect on the quality of the newly formed bone nor on the dimensional changes of the ridge, compared to non-resorbable, open barrier membrane technique with natural blood clot.

Official Title
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Ridge Preservation With Leukocyte Platelet Rich Fibrin: A Clinical, Radiographic, and Histomorphometric Study.

Conditions
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Alveolar Ridge Preservation, Tooth Extraction

Intervention / Treatment
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* Biological: Leukocyte platelet rich fibrin plug + d-PTFE membrane
* Device: d-PTFE membrane


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The subject must have an unsalvageable tooth that is planned for extraction and delayed implant placement. The tooth should be free of acute odontogenic infections. Extraction sockets with minimal to moderate bony defect. Exclusion Criteria: Any patient who is planned for full mouth extraction. Heavy smoker (more than 10 cigarettes a day). History of malignancy, chemotherapy, radiation therapy. Immunosuppressive disease. Uncontrolled systemic disease. Any contraindications to surgical procedures. Females who are pregnant or breastfeeding. For multi-rooted teeth, if the most coronal part of the interradicular septum is less than 5 mm below the crest of the bone.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control group<br>Under the effect of local anesthetic tooth will be extracted then a d-PTFE membrane will be used to cover the socket without any bone graft material to preserve the ridge. | Device: d-PTFE membrane<br>* Following tooth extraction, the socket will be covered with a d-PTFE membrane<br>* Other names: Cytoplast;|
| Experimental: Test group<br>Under the effect of local anesthetic tooth extraction will be followed by the collection of about 50 ml of the patient's venous blood, then without adding any anticougulant the blood will be spun to make a plug. The Leukocyte platelet rich fibrin plug + d-PTFE membrane will be used to preserve the ridge. | Biological: Leukocyte platelet rich fibrin plug + d-PTFE membrane<br>* Following tooth extraction, an autologous leukocyte platelet rich fibrin plug will be placed in the socket and covered with a d-PTFE membrane<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of the Newly Formed Bone | Histomorphometric analysis will be performed on a bone core sample harvested at the time of implant placement. | The bone sample was harvested at 14 weeks from the baseline visit (extraction of tooth). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dimensional Changes of the Alveolar Ridge (Ridge Width) | Two Cone Bean Computerized Tomography (CBCT) measurements were compared to perform the analysis. | The baseline CBCT after tooth extraction and 12 weeks CBCT after extraction. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Platelet-Rich Fibrin, high-density polytetrafluoroethylene membrane