What question did this study set out to answer?

The aim is to evaluate the effectiveness of platelet-rich fibrin combined with different grafts in bone regeneration.

March 2, 2026Open Access

The impact of platelet rich fibrin on bone regeneration in critical-sized calvarial defects of rat model: A micro-computed tomographic analysis

RARayan Bakur AlkurdiKing Saud University AAAli Awad AlrahlahKing Saud University MAMontaser Nazmi AlqutubKing Saud University

Key Points

The aim is to evaluate the effectiveness of platelet-rich fibrin combined with different grafts in bone regeneration.
Seventy male Wistar rats were assigned to seven treatment groups.
Standardized critical-sized calvarial defects were created and treated with various grafts and PRF.
Bone regeneration was assessed after 12 weeks using micro-computed tomography.
All groups exhibited new bone formation, with PRF-treated groups showing significantly better outcomes.
The PRF + autograft group had the highest bone volume and bone mineral density, indicating superior regeneration.
PRF + mixed graft improved percentage bone volume compared to graft-only groups.

Abstract

Objectives: Tooth loss can lead to alveolar bone resorption, complicating implant placement and requiring bone augmentation. While guided bone regeneration using autogenous or xenogenic grafts is standard, limitations such as donor site morbidity and variable outcomes persist. Platelet-rich fibrin (PRF), an autologous, growth factor-rich biomaterial, may enhance bone regeneration. To the best of our knowledge, this study provides a comparative evaluation of PRF combined with autograft, xenograft, and mixed grafts within the same critical-sized defect on a rat model (CSDs) using comprehensive micro-computed tomography (mCT) analysis, providing a novel, standardized assessment of PRF’s effects on bone regeneration. Methods: Seventy male Wistar rats were randomly assigned to seven groups: negative control, bovine xenograft, autograft, mixed autograft + xenograft, and each of these combined with PRF. Standardized 5 mm CSDs were created and treated accordingly. PRF was prepared from autologous blood and applied with grafts when applicable. After 12 weeks, calvarial samples were analyzed using mCT to assess new tissue and bone volume, percentage bone volume, trabecular structure, porosity, surface density, and bone mineral density (BMD). Data were analyzed using the Kruskal–Wallis nonparametric test with pairwise comparisons (a ≤ 0.05). Results: All groups showed new bone formation. PRF-treated groups significantly outperformed graft-only groups. The PRF + autograft group showed the highest bone volume (12.976 ± 2.179 mm 3 ), trabecular thickness (0.575 ± 0.045 mm), and BMD (0.541 ± 0.061 g/cm 3 ) ( P < 0.001), reflecting enhanced bone microarchitecture and mineral density based on mCT analysis, with parameters trending toward those observed in native calvarial bone. The PRF + mixed graft group demonstrated superior percentage bone volume (46.514 ± 8.347%) compared to graft-only groups. The PRF + xenograft group similarly enhanced bone formation relative to graft-only controls; however, its regenerative effect remained lower than that achieved with PRF + autograft. PRF-treated defects exhibited more plate-like trabeculae and reduced trabecular separation. Conclusion: Within the limitations of an animal model and a 12-week follow-up, PRF significantly enhanced bone regeneration based on quantitative mCT parameters, particularly when combined with autograft. These findings provide experimental imaging evidence supporting the potential translational relevance of PRF, while highlighting the need for further biomechanical and clinical investigations.

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