PURPOSE: The objective of this study is to evaluate the efficacy of Plasma rich in growth factors (PRGF) compared to spontaneous healing in alveolar ridge preservation of the aesthetic zone. METHODS: This randomized and controlled clinical trial included 46 patients requiring simple-tooth extraction in the aesthetic zone and subsequent implant placement. The extraction sockets were treated either with PRGF or allowed to heal spontaneously. Postoperative healing was assessed by pain, Landry's soft tissue healing index, and inflammation index at 3, 7, and 15 days after tooth extraction. Histomorphometric bone regeneration was evaluated in biopsies harvested after 12 weeks of healing. Dimensional alveolar ridge measurements were performed at baseline and 12 weeks. Any postoperative complications and adverse effects were registered. Statistical analysis was performed to assess the differences between the study groups. RESULTS: PRGF significantly enhanced postoperative healing, as evidenced by statistically significant reductions in pain on day 3 (p = 0.036) and improved soft tissue healing on days 3 (p = 0.047), 5 (p = 0.012), and 7 (p = 0.027). No significant differences were observed between groups regarding postoperative inflammation. The new bone formation was significantly improved with PRGF treatment (p = 0.024), with a median of 36.1% (range: 15.8% to 58.9%) in the control group compared to 48.7% (range: 31.9% to 92.3%) in the PRGF group. PRGF contributed to improved dimensional stability of the alveolar ridge at 12 weeks. CONCLUSION: PRGF improved healing following tooth extraction by promoting soft tissue healing and reducing postoperative pain. Additionally, it enhanced bone regeneration and contributed to better preservation of the alveolar ridge.