The Effect of Advanced Platelet-Rich Fibrin on the Healing of Post-Extraction Sockets in Patients with Diabetes: Preliminary Findings from a Randomized Controlled Clinical Trial

PURPOSE: Diabetes Mellitus (DM) represents a significant public health challenge globally, with a particularly high prevalence in Saudi Arabia. The rising incidence of DM has increased concerns about effective management strategies, especially in contexts involving surgical interventions such as dental extractions. Diabetic individuals frequently experience complications during postoperative healing, characterized by impaired tissue repair and increased susceptibility to infections. This study aimed to evaluate the effect of A-PRF on early post-extraction soft-tissue healing in patients with type 2 diabetes mellitus. MATERIALS AND METHODS: A randomized, split-mouth clinical trial with participant and outcome-assessor blinding was conducted at King Abdulaziz University Dental Hospital. Eight patients with type 2 diabetes mellitus undergoing dental extractions contributed 31 extraction sockets/sites for site-level analysis. Sites were allocated to A-PRF treatment or control, and socket area was digitally measured at baseline, 1 week, and 3 weeks after extraction. Linear mixed-effects models were used to account for repeated measurements within sockets and clustering of sockets within patients. Fixed effects included treatment group, time, and group-by-time interaction. Marginal mean contrasts were used to estimate within-group changes from baseline and between-group differences, with false discovery rate adjustment applied where appropriate. RESULTS: At baseline, mean socket area was similar between Control/No PRF and A-PRF sites. By 3 weeks, socket area decreased by -17.10 mm2 in Control/No PRF sites and -21.97 mm2 in A-PRF sites, with both reductions remaining statistically significant after FDR adjustment. However, between-group differences were not statistically significant at 1 week (-3.82 mm2; 95% CI -12.55 to 4.92; p=0.392) or 3 weeks (-4.78 mm2; 95% CI -13.51 to 3.96; p=0.284). The group-by-time interaction was also non-significant (p=0.532), and the average treatment effect was -2.84 mm2 (95% CI -10.30 to 4.62; p=0.456). CONCLUSION: A-PRF-treated sockets showed numerically greater reductions in residual socket area compared with control sites; however, the between-group differences were not statistically significant. These findings suggest that A-PRF may have a favorable healing trend in diabetic patients, but the results should be interpreted as preliminary and require confirmation in larger, adequately powered randomized trials.