Clinical Evaluation of Peri-Implant Mucosal Enhancement Using Leukocyte and Titanium Platelet-Rich Fibrin with Sohn's Poncho Technique: A Randomized Clinical Trial

ABSTRACT Establishing stable peri-implant soft tissue is crucial for long-term implant success. Autologous platelet concentrates, such as Leukocyte-Platelet Rich Fibrin (L-PRF) and Titanium-Prepared Platelet Rich Fibrin (T-PRF), have shown promise in soft tissue regeneration. Yet, comparative evidence remains limited, especially when combined with minimally invasive techniques such as Sohn’s Poncho method. Platform-switching implants are known to preserve crestal bone and soft tissue better than platform-matching designs, though their impact on mucosal thickness and keratinized mucosa is not well studied. This prospective, randomized clinical trial aimed to evaluate and compare the clinical efficacy of L-PRF and T-PRF in augmenting peri-implant mucosal thickness and keratinized tissue width using Sohn’s Poncho technique. Systemically healthy patients receiving bilateral posterior mandibular implants were randomly assigned to either the L-PRF or T-PRF group. Platelet concentrates were applied using the Poncho technique. Mucosal thickness and keratinized tissue width were measured at baseline and four months using an endodontic spreader with a rubber stopper and a UNC-15 probe, respectively. Data were analyzed using appropriate statistical tests with significance set at p < 0.05. Both groups showed statistically significant improvement from baseline in soft tissue parameters (p < 0.05), with the T-PRF group demonstrating significantly greater gains than the L-PRF group (p < 0.05). Healing was uneventful with minimal discomfort. These results suggest that T-PRF is more effective than L-PRF for enhancing the peri-implant mucosal phenotype and keratinized tissue when used with Sohn’s Poncho technique, supporting its potential as a superior biomaterial for soft-tissue augmentation to promote long-term peri-implant health and aesthetics.