Baseline Predictors of Crestal Bone Maintenance and Implant Stability Following Immediate Implant Placement With Platelet-Rich Fibrin: A Retrospective Observational Study.

@article{rodda2026baseline,
  title = {{Baseline Predictors of Crestal Bone Maintenance and Implant Stability Following Immediate Implant Placement With Platelet-Rich Fibrin: A Retrospective Observational Study.}},
  author = {Uma Rodda and Seshu K Karri and Jhansi R Lotavath and Kandikatla C Shobhita and Viswanath Mylapoori and Korrapati Kishore},
  journal = {Cureus},
  year = {2026},
  month = sep,
  doi = {10.7759/cureus.116926},
  url = {https://europepmc.org/article/MED/42928814},
  note = {CC BY},
}

TY  - JOUR
TI  - Baseline Predictors of Crestal Bone Maintenance and Implant Stability Following Immediate Implant Placement With Platelet-Rich Fibrin: A Retrospective Observational Study.
AU  - Uma Rodda
AU  - Seshu K Karri
AU  - Jhansi R Lotavath
AU  - Kandikatla C Shobhita
AU  - Viswanath Mylapoori
AU  - Korrapati Kishore
PY  - 2026
DA  - 2026/09/25
JO  - Cureus
DO  - 10.7759/cureus.116926
UR  - https://europepmc.org/article/MED/42928814
AB  - Introduction Immediate implant placement following tooth extraction is a predictable treatment approach, although peri-implant crestal bone remodeling and implant stability may vary according to local and patient-related factors. Platelet-rich fibrin (PRF) has been used as an autologous adjunct during immediate implant placement because of its potential to support bone and soft tissue healing. However, limited evidence is available regarding the baseline factors associated with crestal bone changes in immediate PRF-treated implants. This study aimed to evaluate crestal bone changes and implant stability, and to identify baseline factors associated with crestal bone changes following immediate implant placement with adjunctive PRF. Materials and methods This retrospective observational study included 52 single-unit implants placed immediately after tooth extraction and treated with adjunctive PRF. Clinical and radiographic records obtained at three and six months after implant placement were retrospectively evaluated. Crestal bone levels were assessed radiographically using the implant shoulder as a reference point. Implant stability was assessed using resonance frequency analysis and expressed as the Implant Stability Quotient (ISQ). Baseline bone density was recorded in Hounsfield units (HU), and the final insertion torque was recorded in Ncm. Changes in crestal bone levels and ISQ were assessed using paired-sample analysis. Multiple linear regression was performed to identify independent baseline predictors of total crestal bone change from baseline to six months. Results The mean age of the study population was 48.6 ± 11.3 years, comprising 29 (55.8%) males and 23 (44.2%) females. The mean bone density was 612.4 ± 118.7 HU, mean final insertion torque was 34.8 ± 6.9 Ncm, and mean baseline ISQ was 68.4 ± 4.2. Crestal bone loss was 0.18 ± 0.09 mm from baseline to three months, 0.14 ± 0.08 mm from three to six months, and 0.32 ± 0.13 mm from baseline to 6 months (all p < 0.001). The mean ISQ increased from 68.4 ± 4.2 at implant placement to 74.1 ± 3.8 at six months (mean ΔISQ = 5.7, 95% CI: 4.8-6.6; p < 0.001). Multiple linear regression demonstrated that a higher baseline ISQ (β = -0.011, p = 0.006), higher final insertion torque (β = -0.006, p = 0.015), and greater bone density (β =-0.0003, p = 0.022) were independently associated with lower crestal bone loss at six months post-loading. Age (p = 0.240) and sex (p = 0.653) were not significant predictors. The regression model explained 44.6% of the variance in total crestal bone change (R² = 0.446; p < 0.001). Conclusion In this retrospective cohort study, higher baseline implant stability, greater final insertion torque, and greater recipient site bone density were independently associated with lower crestal bone loss over six months following immediate implant placement with adjunctive PRF. These findings suggest that baseline mechanical and radiographic characteristics may be important factors in peri-implant crestal bone maintenance. Further prospective studies with larger sample sizes and longer follow-up periods are required to validate these associations.
SN  - 2168-8184
ER  -