Evaluating the efficacy of platelet-rich fibrin in accelerating canine retraction following upper first premolar extraction: a split-mouth randomized controlled trial.

Background: While recent studies have explored the use of blood-derived materials to expedite orthodontic tooth movement, their efficacy remains a subject of debate, with conflicting results reported in the literature. Objective: The objective of this randomized controlled clinical trial is to assess the efficacy of platelet-rich fibrin (PRF) in accelerating the distal movement of maxillary canines subsequent to the extraction of the first premolars and to determine patient satisfaction with the treatment. Materials and methods: A randomized controlled clinical trial using a split-mouth design was conducted on 20 patients (12 female, 8 male). One side of each patient's mouth received an immediate post-extraction application of PRF, while the contralateral side served as a control. Canine retraction velocity and anchorage loss were evaluated using gypsum models; speed of movement was measured at monthly intervals. Patient-reported outcomes were collected using Visual Analog Scales at 1-, 3-, and 7-days post-extraction. A t-test (with 95% confidence level) was used for statistical analysis. Results: A statistically significant difference was observed between the control side and the study side (where PRF was applied) regarding the speed of upper canine movement during the first and second months, as well as over the entire evaluation period (T0-T3). The probability value was less than 0.001 for each of these periods. However, no significant difference was noted between the two sides during the third month. By analyzing the algebraic sign of the differences between the averages, it was concluded that the speed of upper canine movement was greater on the side where PRF was applied compared to the control side. Regarding the mesial movement of the upper first molar (anchorage loss), the loss of anchorage was slower on the PRF application side compared to the control side across all evaluation periods, though the differences were not statistically significant, as the probability value exceeded 0.05 at the 95% confidence level. Additionally, a statistically significant difference was observed between the control and PRF application sides for the variable of pain. This difference was noted 1 day after the application of PRF within the socket during orthodontic treatment, as well as on the third day, with probability values of 0.0052 and 0.0066, respectively. However, no significant difference in pain levels was observed between the two sides on the seventh day after fibrin application compared to the control side, as the probability value was greater than 0.05 at the 95% confidence level. Conclusions: The use of PRF in the extraction socket was found to accelerate the movement of the upper canines during the first and second months compared to traditional extraction methods. Additionally, the application of PRF significantly reduced pain levels following the extraction procedure.