Vertical Guided Bone Regeneration: Leukocyte and PRF Bone Block vs a Mixture of Autogenous Bone with DBBM: A Split-Mouth Randomized Controlled Trial with up to 1 Year of Follow-up After Implant Loading

Int J Periodontics Restorative Dent. 2026 May 6;46(3):360-376. doi: 10.11607/prd.7338.

Abstract

Oral implants require adequate bone support, which is often facilitated by bone augmentation when bone volume is insufficient. Autogenous bone (AB) has been considered the gold standard for such procedures due to its osteogenic properties, but it necessitates a second surgical site, which increases patient morbidity. This study was a randomized, double-blind, split-mouth clinical trial comparing leukocyte-platelet-rich fibrin (L-PRF) bone block grafts against a composite graft mixture of 50% AB with 50% deproteinized bovine bone mineral for vertical guided bone regeneration (GBR). The trial included six patients needing bilateral vertical GBR before implant placement. A dense polytetrafluoroethylene membrane was used for both test and control sites. The primary outcome measure was vertical bone height (VBH) gain, assessed via CBCT at 9 and 25 months postoperative. There was no significant difference in VBH gain between the test and control sites at any time points, with a mean VBH gain at implant placement of 4.6 ± 3.0 mm for test sites and 5.2 ± 2.7 mm for control sites. One year after implant loading, the VBH gain was 3.0 ± 2.8 mm for test sites and 3.8 ± 2.6 mm for control sites (P = .96). Complications were minimal and included one implant loss due to infection in a test site. The L-PRF bone block could be a viable alternative to the composite graft, potentially reducing the need for harvesting bone from a second surgical site. Future studies with larger sample sizes are needed to confirm these findings and to explore the biologic benefits of integrating the L-PRF bone block into bone graft materials for oral implantology.

Keywords: L-PRF bone block; autogenous bone; guided bone regeneration; randomized clinical trial; vertical bone augmentation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Alveolar Ridge Augmentation* / methods
  • Bone Regeneration*
  • Bone Substitutes / therapeutic use
  • Bone Transplantation* / methods
  • Cone-Beam Computed Tomography
  • Dental Implantation, Endosseous* / methods
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Guided Tissue Regeneration, Periodontal* / methods
  • Humans
  • Leukocytes*
  • Male
  • Membranes, Artificial
  • Middle Aged
  • Platelet-Rich Fibrin*
  • Treatment Outcome

Substances

  • Membranes, Artificial
  • Bone Substitutes