Activated platelets-rich plasma (A-PRP) was used extensively in various experimental and clinical models. However, the use of anticoagulant in A-PRP preparation may interfere with healing process. Second generation of A-PRP were developed without adding anticoagulants or activators which where know as platelet rich fibrin (PRF). The PRF was improved during preparation and were known as advanced-PRF (A-PRF). In vitro studies, A-PRF showed releasing of significantly higher growth factors over time than PRF however, limited studies document its efficiency in vivo. Stony coral was used as a bone substitute for its osteo-conductivity. It can be used either alone or a part of a composite with reported success and low complication rates. The aim of the present study to evaluate the efficacy of A-PRF alone or with combination. Twelve adult mongrel dogs (15-25 kg body weight) of both sexes were used in this experiment. A 3 drill hole defects of 10 mm diameter were made in the tibial tuberosity 1 cm apart. The upper hole was filled with A-PRF alone, the middle hole was left empty as control and the lower hole was filled with mixture of A-PRF & coral powder. Sequential radiographs were obtained every week for the first month and every two weeks until completion of the study at 12 weeks. Radiographic opacity score of the defect compared to adjacent bone range from -3 to +3 and radiopacity score of host-implant interface which ranged from 0 to +3. Dogs were euthanized at the end of respective observation period at 2nd, 4th, 8th and 12th week post-operative for histological evaluation using Emery scoring system. By the end of the study, using A-PRF and with or without combination of coral powder was significantly improved and accelerate bone healing. Addition of coral powder scientifically improves the quality of remodeled bone histologically however, there was no significant radiographic differences.