Platelet-Rich Fibrin in Oral Surgery and Implantology: A Narrative Review

Katharina Zwittnig; Khaled Mukaddam; Daniel Vegh; Valentin Herber; Norbert Jakse; Peter Schlenke; Tomislav Ante Zrnc; Michael Payer

doi:10.1159/000527526

Platelet-Rich Fibrin in Oral Surgery and Implantology: A Narrative Review

Transfus Med Hemother. 2022 Dec 22;50(4):348-359. doi: 10.1159/000527526. eCollection 2023 Aug.

Authors

Katharina Zwittnig¹, Khaled Mukaddam², Daniel Vegh^{1

3}, Valentin Herber¹, Norbert Jakse¹, Peter Schlenke⁴, Tomislav Ante Zrnc⁵, Michael Payer¹

Affiliations

¹ Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria.
² Department of Oral Surgery, University Center for Dental Medicine Basel, University of Basel, Mattenstrasse, Basel, Switzerland.
³ Department of Prosthodontics, Semmelweis University Faculty of Dentistry, Budapest, Hungary.
⁴ Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria.
⁵ Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria.

Abstract

Background: The application of blood concentrates has gained popularity in dentistry in recent years. Platelet-rich fibrin (PRF) has been discussed frequently due to a high content of growth factors and the option of chair-side manufacturing in a simple centrifugation process. PRF is free from adjuvants and inexpensive to produce. The number of studies reporting beneficial effects of PRF in various clinical applications such as alveolar ridge preservation, sinus floor elevation, management and prevention of medical-related osteonecrosis of the jaw, third molar extractions, and guided bone regeneration in dentistry has increased recently. However, to date, neither clinical recommendations nor guidelines are available. The present narrative review aims to summarize the level of evidence on the clinical application of PRF within the field of oral surgery and implantology.

Summary: A literature search in Pubmed and Medline has identified 34 articles as a basis for this narrative review. The effectiveness of the clinical application of PRF has been analyzed for five indications within dentistry: medical-related osteonecrosis of the jaw, wisdom tooth extraction, guided bone regeneration, sinus floor elevation, and alveolar ridge preservation. The amount of data for third molar extractions, socket preservation, and guided bone regeneration is extensive. Less data were available for the use of PRF in combination with sinus floor elevations. There is a lack of studies with scientific evidence on PRF and medical-related osteonecrosis of the jaw; however, studies positively impact patient-related outcome measures. Most studies report on beneficial effects when PRF is additionally applied in intrabony defects. There is no evidence of the positive effects of PRF combined with bone graft materials during sinus floor elevation. However, some benefits are reported with PRF as a sole filling material.

Key messages: Many recently published studies show the positive clinical impact of PRF. Yet, further research is needed to ensure the validity of the evidence.

Keywords: Bone augmentation; MRONJ; Oral surgery; PRF; Third molar extraction.

Publication types

Review

Grants and funding

There were no funding sources.