All surgical procedures were performed under local anesthesia by the same surgeon. A full-thickness mucoperiosteal flap was removed by incision on the alveolar crest. Implant cavities were prepared according to the surgical protocol of the Bego Semados implant system (BEGO Implant Systems GmbH & Co. KG, Bremen, Germany). The final osteotomy diameters were the same as the placed implants. In the study group, the implant cavity walls were laid with CGF membranes all around (Fig. 2). The implants in the study group were irrigated with CGF fluid on their surface and placed in the corresponding socket (Fig. 3). The implants representing the control group were placed in the corresponding socket without any additional procedure. The implant surgery was completed in one session by attaching gingival formers to the implants in both groups. Gingival formers were not covered with soft tissue and mucoperiosteal flaps were sutured with 3/0 silk suture material.

The patients were recommended to apply cold compresses after the surgery. Patients were prescribed antibiotic (amoxicillin + clavulanic acid combination 1000 mg 2 × 1), analgesic (arveles tablet, 25 mg 2 × 1), and antiseptic mouthwash (0.2% chlorhexidine gluconate mouthwash, 3 × 1) for 1 week. The patients were controlled at the 1st week, 4th week and 12th week.

The stability of implants by RFA was done using Osstell instrument (Integration Diagnostics, Goteborg, Sweden) with Smartpeg™ (Integration Diagnostics, Goteborg, Sweden), a transducer suitable for implants. The measurement result is obtained from the resonance frequency values by an arithmetic algorithm and given as the ISQ (implant stability quotient) value. At measurement time, the transducer, Smartpeg™, was placed in the region where the prosthetic part is located in the implants.

For measurements, the Osstell™ probe was approximated to the Smartpeg™ from the buccal, palatal, mesial, and distal sides. For each implant, resonance frequency values were obtained in four different directions. The ISQ values were averaged to determine the mean ISQ value for each implant. The ISQ values of the implants were measured during the operation, at the first week and at the fourth week after the operation.