Dentine-derived barrier membrane versus extended platelet-rich fibrin for guided bone regeneration: a 2-year randomized clinical trial.

backgroundAn autogenous dentine-derived barrier membrane (DDBM), primarily consisting of type I collagen, is a recognized as an osteo-conductive material in implant dentistry. A recently developed method is used to prolong the functional properties of PRF to 4 to 6 months. This newly prepared material is called Albumin-platelet rich fibrin (Alb-PRF) or extended platelet-rich fibrin (e-PRF). The aim of this study was to compare clinical and radiographic results of autogenous demineralized dentine-derived barrier membrane versus extended platelet-rich fibrin membrane for guided bone regeneration (GBR) with immediate implant placement in the posterior mandible. MATERIALS AND

methodsForty patients with non-restorable mandibular molars indicated for immediate implant placement and GBR were selected and randomly divided into two equal groups (n = 20 per group). In Group 1, implants were placed using a dentine-derived barrier membrane, while in Group 2, implants were placed using an extended platelet-rich fibrin membrane. All patients underwent clinical and radiographic assessments immediately after placement and at 3, 6, 12, and 24 months to evaluate implant stability, peri-implant probing depth (PPD), marginal bone loss (MBL), and relative bone density.

resultsAll implants achieved a 100% survival rate over the 24-month period. Implant stability increased significantly over time in both groups (P < 0.001), with no significant intergroup differences at any point; at 12 months, the median (IQR) was 78.0 (77.0-79) for Dentine Group and 79 (75.0-81.0) for e-PRF Group (P = 0.201, r = 0.207). PPD also increased significantly within both groups (P < 0.001), but remained within healthy limits, with no significant differences between groups at any points; at 24 months, the median (IQR) was 3.25 mm (3.13-3.50 mm) for Dentine Group vs. 3.25 mm (3.0-3.31 mm) for e-PRF Group; (P = 0.142, r = 0.241). MBL increased significantly over time in both groups (P < 0.001). At 24 months, no significant intergroup differences were found for buccal MBL, the median (IQR) was 1.22 mm (1.20-1.30 mm) for Dentine Group vs. 1.30 mm (1.25-1.39 mm) for e-PRF Group; P = 0.060, r = 0.300) or lingual MBL, the median (IQR) was 1.27 mm (1.20-1.37 mm) for Dentine Group vs. 1.27 mm (1.19-1.37 mm) for e-PRF Group; (P = 0.678, r = 0.069). Similarly, relative bone density showed a significant intragroup increase (P < 0.001) with no significant intergroup differences at 24 months for buccal density the median (IQR) was 1204.5 (1150.0-1261.0) for Dentine Group vs. 1266.0 (1119.0-1311.0) for e-PRF Group; (P = 0.183, r = 0.214) or lingual density the median (IQR) was 1180.0 (1156.0-1210) for Dentine Group vs. 1212.50 (1112.0-1233.0) for e-PRF Group; (P = 0.314, r = 0.163).

conclusionBoth autogenous DDBM and e-PRF membrane demonstrated favorable clinical and radiographic outcomes over 24 months when used for GBR in conjunction with immediate implant placement in the posterior mandible. Both materials represent cost-effective, biological alternatives for GBR, maintaining stable peri-implant tissues over a 2-year period.

trial registrationThe study was retrospectively registered at ClinicalTrials.gov PRS ( https://register. CLINICALTRIALS: gov ) under the identifier number NCT07396350 on 02/02/2026.