Introduction: Platelet Rich-Fibrin (PRF) is a biological matrix derived from a patient’s own blood, rich in growth factors and platelets. Its use in various periodontal and non-periodontal procedures is gaining recognition due to its potential in promoting tissue regeneration. The purpose of this review was to evaluate the benefits of using PRF in intra-bony defect regeneration, guided-bone regeneration, and sinus floor elevation. Methods: The study searched PubMed for manuscripts published between 2017 and 2022 to better understand the clinical and radiological effects of PRF. The manuscripts were divided into the following sections: intra-bony defect regeneration, guided-bone regeneration, and sinus floor elevation. Results: In intra-bony defects, PRF improved clinical and radiological parameters when compared with OFD alone, with a significant difference in wound healing at 7 days. In GBR, a CBCT evaluation shows no statistical difference between the PRF-autogenous bone complex group and the bovine bone-collagen membrane complex regarding volume change of the augmented bone with a 16% rate of bone loss following a 6-month healing period. Also, a slight increase in bone thickness has been seen when liquid PRF is used. In sinus floor elevation, results revealed no differences in graft volume between PRF group and control group at any of the evaluated time points. Although higher implant stability immediately postoperatively, higher new bone formation, the lesser amount of residual graft and earlier implant placement. Conclusion: Platelet Rich-Fibrin is widely accepted for use in periodontal surgery and dentistry due to its minimally invasive nature and low risk of adverse effects, with positive results in tissue regeneration. There is evidence that PRF leads to improved and faster healing, as well as cost-effective regenerative procedures compared to other treatments.
References
[1]
Gottlow, J., Nyman, S., Lindhe, J., Karring, T. and Wennstrom, J. (1986) New Attachment Formation in the Human Periodontium by Guided Tissue Regeneration. Case Reports. Journal of Clinical Periodontology, 13, 604-616. https://pubmed.ncbi.nlm.nih.gov/3462208/ https://doi.org/10.1111/j.1600-051X.1986.tb00854.x
[2]
Pham, T.A.V. (2021) Intrabony Defect Treatment with Platelet-Rich Fibrin, Guided Tissue Regeneration and Open-Flap Debridement: A Randomized Controlled Trial. Journal of Evidence-Based Dental Practice, 21, Article ID: 101545. https://pubmed.ncbi.nlm.nih.gov/34479673/ https://doi.org/10.1016/j.jebdp.2021.101545
[3]
Patel, G.K., Gaekwad, S.S., Gujjari, S.K. and Veerendra Kumar, S.C. (2017) Platelet-Rich Fibrin in Regeneration of Intrabony Defects: A Randomized Controlled Trial. Journal of Periodontology, 88, 1192-1199. https://pubmed.ncbi.nlm.nih.gov/28820322/ https://doi.org/10.1902/jop.2017.130710
[4]
Miron, R.J., Zucchelli, G., Pikos, M.A., Salama, M., Lee, S., Guillemette, V., et al. (2017) Use of Platelet-Rich Fibrin in Regenerative Dentistry: A Systematic Review. Clinical Oral Investigations, 21, 1913-1927. https://pubmed.ncbi.nlm.nih.gov/28551729/ https://doi.org/10.1007/s00784-017-2133-z
[5]
Csifó-Nagy, B.K., Sólyom, E., Bognár, V.L., Nevelits, A. and Dori, F. (2021) Efficacy of a New-Generation Platelet-Rich Fibrin in the Treatment of Periodontal Intrabony Defects: A Randomized Clinical Trial. BMC Oral Health, 21, Article No. 580. https://pubmed.ncbi.nlm.nih.gov/34781955/ https://doi.org/10.1186/s12903-021-01925-1
[6]
Castro, A.B., Meschi, N., Temmerman, A., Pinto, N., Lambrechts, P., Teughels, W., et al. (2017) Regenerative Potential of Leucocyte- and Platelet-Rich Fibrin. Part A: Intra-Bony Defects, Furcation Defects and Periodontal Plastic Surgery. A Systematic Review and Meta-Analysis. Journal of Clinical Periodontology, 44, 67-82. https://pubmed.ncbi.nlm.nih.gov/27783851/ https://doi.org/10.1111/jcpe.12643
[7]
Dohan Ehrenfest, D.M., Rasmusson, L. and Albrektsson, T. (2009) Classification of Platelet Concentrates: From Pure Platelet-Rich Plasma (P-PRP) to Leucocyte- and Platelet-Rich Fibrin (L-PRF). Trends in Biotechnology, 27, 158-167. https://pubmed.ncbi.nlm.nih.gov/19187989/ https://doi.org/10.1016/j.tibtech.2008.11.009
[8]
Liu, K., Huang, Z., Chen, Z., Han, B. and Ouyang, X. (2021) Treatment of Periodontal Intrabony Defects Using Bovine Porous Bone Mineral and Guided Tissue Regeneration with/without Platelet-Rich Fibrin: A Randomized Controlled Clinical Trial. Journal of Periodontology, 92, 1546-1553. https://pubmed.ncbi.nlm.nih.gov/33569807/ https://doi.org/10.1002/JPER.20-0860
[9]
Chatterjee, A., Pradeep, A.R., Garg, V., Yajamanya, S., Ali, M.M. and Priya, V.S. (2017) Treatment of Periodontal Intrabony Defects Using Autologous Platelet-Rich Fibrin and Titanium Platelet-Rich Fibrin: A Randomized, Clinical, Comparative Study. Journal of Investigative and Clinical Dentistry, 8, e12231. https://pubmed.ncbi.nlm.nih.gov/27477110/ https://doi.org/10.1111/jicd.12231
[10]
Isik, G., Ozden Yüce, M., Kocak-Topbas, N. and Günbay, T. (2021) Guided Bone Regeneration Simultaneous with Implant Placement Using Bovine-Derived Xenograft with and without Liquid Platelet-Rich Fibrin: A Randomized Controlled Clinical Trial. Clinical Oral Investigations, 25, 5563-5575. https://pubmed.ncbi.nlm.nih.gov/34047835/ https://doi.org/10.1007/s00784-021-03987-5
[11]
Hartlev, J., Spin-Neto, R., Schou, S., Isidor, F. and Norholt, S.E. (2019) Cone Beam Computed Tomography Evaluation of Staged Lateral Ridge Augmentation Using Platelet-Rich Fibrin or Resorbable Collagen Membranes in a Randomized Controlled Clinical Trial. Clinical Oral Implants Research, 30, 277-284. https://pubmed.ncbi.nlm.nih.gov/30715758/ https://doi.org/10.1111/clr.13413
[12]
Choukroun, J. and Ghanaati, S. (2018) Reduction of Relative Centrifugation Force within Injectable Platelet-Rich-Fibrin (PRF) Concentrates Advances Patients’ Own Inflammatory Cells, Platelets and Growth Factors: The First Introduction to the Low Speed Centrifugation Concept. European Journal of Trauma and Emergency Surgery, 44, 87-95. https://pubmed.ncbi.nlm.nih.gov/28283682/ https://doi.org/10.1007/s00068-017-0767-9
[13]
Andrade, C., Camino, J., Nally, M., Quirynen, M., Martínez, B. and Pinto, N. (2020) Combining Autologous Particulate Dentin, L-PRF, and Fibrinogen to Create a Matrix for Predictable Ridge Preservation: A Pilot Clinical Study. Clinical Oral Investigations, 24, 1151-1160. https://pubmed.ncbi.nlm.nih.gov/31292776/ https://doi.org/10.1007/s00784-019-02922-z
[14]
Karagah, A., Tabrizi, R., Mohammadhosseinzade, P., Mirzadeh, M., Tofangchiha, M., Lajolo, C., et al. (2022) Effect of Sinus Floor Augmentation with Platelet-Rich Fibrin Versus Allogeneic Bone Graft on Stability of One-Stage Dental Implants: A Split-Mouth Randomized Clinical Trial. International Journal of Environmental Research and Public Health, 19, Article 9569. https://pubmed.ncbi.nlm.nih.gov/35954926/ https://doi.org/10.3390/ijerph19159569
[15]
Pichotano, E.C., de Molon, R.S., de Souza, R.V., Austin, R.S., Marcantonio, E. and Zandim-Barcelos, D.L. (2019) Evaluation of L-PRF Combined with Deproteinized Bovine Bone Mineral for Early Implant Placement after Maxillary Sinus Augmentation: A Randomized Clinical Trial. Clinical Implant Dentistry and Related Research, 21, 253-262. https://pubmed.ncbi.nlm.nih.gov/30690860/ https://doi.org/10.1111/cid.12713
[16]
Nizam, N., Eren, G., Akcali, A. and Donos, N. (2018) Maxillary Sinus Augmentation with Leukocyte and Platelet-Rich Fibrin and Deproteinized Bovine Bone Mineral: A Split-Mouth Histological and Histomorphometric Study. Clinical Oral Implants Research, 29, 67-75. https://pubmed.ncbi.nlm.nih.gov/28786494/ https://doi.org/10.1111/clr.13044
[17]
Cho, Y.S., Hwang, K.G., Jun, S.H., Tallarico, M., Kwon, A.M. and Park, C.J. (2020) Radiologic Comparative Analysis between Saline and Platelet-Rich Fibrin Filling after Hydraulic Transcrestal Sinus Lifting without Adjunctive Bone Graft: A Randomized Controlled Trial. Clinical Oral Implants Research, 31, 1087-1093. https://pubmed.ncbi.nlm.nih.gov/32871620/ https://doi.org/10.1111/clr.13655
[18]
Olgun, E., Ozkan, S.Y., Atmaca, H.T., Yalim, M. and Hendek, M.K. (2018) Comparison of the Clinical, Radiographic, and Histological Effects of Titanium-Prepared Platelet Rich Fibrin to Allograft Materials in Sinus-Lifting Procedures. Journal of Investigative and Clinical Dentistry, 9, e12347. https://pubmed.ncbi.nlm.nih.gov/29893477/ https://doi.org/10.1111/jicd.12347
[19]
COmert Kilic, S., Güngormüs, M. and Parlak, S.N. (2017) Histologic and Histomorphometric Assessment of Sinus-Floor Augmentation with Beta-Tricalcium Phosphate Alone or in Combination with Pure-Platelet-Rich Plasma or Platelet-Rich Fibrin: A Randomized Clinical Trial. Clinical Implant Dentistry and Related Research, 19, 959-967. https://pubmed.ncbi.nlm.nih.gov/28745027/ https://doi.org/10.1111/cid.12522
[20]
Harlos, M.M., da Silva, T.B., Montagner, P.G., Teixeira, L.N., Gomes, A.V. and Martinez, E.F. (2022) Histomorphometric Evaluation of Different Graft Associations for Maxillary Sinus Elevation in Wide Antral Cavities: A Randomized Controlled Clinical Trial. Clinical Oral Investigations, 26, 1-9. https://pubmed.ncbi.nlm.nih.gov/35511290/ https://doi.org/10.1007/s00784-022-04515-9
[21]
Chandradas, N., Ravindra, S., Rangaraju, V., Jain, S. and Dasappa, S. (2016) Efficacy of Platelet Rich Fibrin in the Treatment of Human Intrabony Defects with or without Bone Graft: A Randomized Controlled Trial. Journal of International Society of Preventive and Community Dentistry, 6, S153-S159. https://pubmed.ncbi.nlm.nih.gov/27652249/ https://doi.org/10.4103/2231-0762.189753
[22]
Kanayama, T., Horii, K., Senga, Y. and Shibuya, Y. (2016) Crestal Approach to Sinus Floor Elevation for Atrophic Maxilla Using Platelet-Rich Fibrin as the Only Grafting Material: A 1-Year Prospective Study. Implant Dentistry, 25, 32-38. https://pubmed.ncbi.nlm.nih.gov/26384097/ https://doi.org/10.1097/ID.0000000000000327
