Evaluation of Efficacy of Advanced Platelet-rich Fibrin in Premolar Extraction Sockets as an Aid to Accelerate Orthodontic Tooth Movement and Wound Healing: A Split-mouth In Vivo Study.
Divya Mareddy, T R Marimallappa, Mahesh Kumar Ranghnath, Kr Ashok Kumar, B Jambukeshwar Kumar, Supriyo Pal
Abstract
Open AccessAims and background: Surgical extraction of premolars is a routine orthodontic procedure for correcting malocclusion, but is often associated with postoperative challenges. Advanced platelet-rich fibrin (A-PRF), a second-generation platelet concentrate rich in growth factors, offers promise as an adjunct to improve healing outcomes. This study aimed to evaluate the impact of A-PRF on clinical outcomes following surgical premolar extraction. Materials and methods: A prospective split-mouth, in vivo study was conducted on 13 patients requiring bilateral premolar extractions for orthodontic treatment. A-PRF was applied to the extraction site on one side (study group), while the contralateral side served as a control. Mini screws were placed bilaterally to facilitate canine distalization using NiTi closed-coil springs with 150 gm of force. Clinical wound healing was evaluated on days 3 and 7 postextraction, while orthodontic tooth movement was measured monthly using digital calipers over a four-month period. Data were analyzed using Mann-Whitney U and Chi-square tests. Results: The study group demonstrated significantly better wound healing (mean score: 2.53) compared to the control group (mean score: 1.08) (p < 0.05). Orthodontic tooth movement was significantly higher in the A-PRF group (mean displacement: 5.89 mm) than in the control group (mean displacement: 3.71 mm) (p < 0.05). Conclusion: A-PRF application in orthodontic extraction sockets accelerates wound healing and tooth movement by promoting osteoclastic activity and bone remodeling through a sustained release of growth factors such as platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and transforming growth factor beta (TGF-β). Its minimally invasive autologous nature positions A-PRF as a promising adjunct to orthodontic treatment, reducing treatment duration and enhancing patient outcomes. Clinical significance: A-PRF improves post-extraction healing, reducing discomfort and complications in children. It supports bone remodeling, optimizing alignment and shortening treatment during growth phases. A-PRF is autologous, biocompatible, and minimally invasive, ensuring safety and better cooperation. How to cite this article: Mareddy D, Marimallappa TR, Ranghnath MK, et al. Evaluation of Efficacy of Advanced Platelet-rich Fibrin in Premolar Extraction Sockets as an Aid to Accelerate Orthodontic Tooth Movement and Wound Healing: A Split-mouth In Vivo Study. Int J Clin Pediatr Dent 2025;18(7):838-842.