Clinical and radiographic evaluation of autologous albumin-rich platelet-rich fibrin membrane versus synthetic collagen membrane for immediate dental implant placement in the maxillary esthetic zone: a preliminary randomized clinical trial

BACKGROUND: Long-term aesthetic stability following immediate implant placement depends on achieving predictable bone regeneration within the peri-implant “jumping gap” and existing labial bone defects. Despite using a beta-tricalcium phosphate/calcium sulfate putty bone graft (β-TCP + CS), regenerative membranes are essential adjuncts to ensure superior healing. Therefore, this preliminary study aimed to determine whether autologous Albumin-Platelet-Rich Fibrin (Alb-PRF) provides superior aesthetic and osseous outcomes compared with the standard synthetic collagen membrane. PATIENTS AND METHODS: This single-blind, preliminary randomized clinical trial involved 20 participants with a non-restorable maxillary aesthetic tooth and a labial bone defect who received immediate implants. Participants were allocated into two groups (n=10 each): Group I received a β-TCP + CS putty combined with a synthetic collagen membrane, while Group II received the same bone graft combined with an Alb-PRF membrane placed in the labial jumping gap. Primary outcome variables, including marginal bone loss (MBL) and labial bone thickness (LBT), were assessed via CBCT at baseline, 6 months, and 12 months. Secondary outcomes included the Pink Esthetic Score (PES) and clinical parameters (Plaque Index, Bleeding on Probing, and Peri-implant Probing Depth), which were measured at baseline, 4, 6, and 12 months post-surgery. RESULTS: Clinical parameters showed no significant inter-group differences. However, Group II demonstrated significantly higher PES scores at 4 months (p=0.027) and 12 months (p=0.018). While Group I exhibited significantly better preservation of LBT at 6 months (p=0.005) and 12 months (p=0.001), Group II showed significantly less MBL at 6 months (P ≤ 0.001) and 12 months (p=0.023). CONCLUSION: Both membranes effectively treat peri-implant defects. While the collagen membrane better preserves labial bone thickness, Alb-PRF yields superior aesthetic scores and reduces marginal bone loss. TRIAL REGISTRATION: This preliminary randomized clinical trial was registered on ClinicalTrials.gov and approved on 15/10/2024 with trial number (NCT06643468).