Clinical and imaging evaluation of platelet-rich fibrin in post-exodontic bone regeneration. A systematic review
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Published:
Jun 23, 2025
Keywords:
Platelet-Rich fibrin; bone regeneration; tooth extraction; physiological healing, imaging evaluation.
Main Article Content
Abstract
Introduction. Tooth extraction due to pulpal, periapical, and periodontal disease is one of the most common procedures in dentistry, with unpredictable scarring and volume loss leading to long-term atrophy of the alveolar bone crest. Using clinical and imaging evaluation of recent Randomized Controlled Clinical Trial (RCT) research publications, the Objective was to analyze the application of platelet-rich fibrin in the bone regeneration of post-extraction dental alveoli. Methodology, according to the protocol (PRISMA 2020), this study is a qualitative, cross-sectional, and descriptive documentary. Electronic databases such as PubMed, Scielo, Google Scholar, Embase, and Redalyc were used in this systematic review. The risk of bias was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions 6.2 (RevMan 6.2), with inclusion and exclusion criteria, including 25 randomized clinical trials published until 2022, which have investigated the use of PRF in bone and soft tissue regeneration in extraction sites. Results of this systematic review in accordance with the heterogeneous findings of clinical research, Conclusions PRF is useful to preserve the post-extraction alveolar ridge, vertical dimensional stability and promote cell proliferation which prevents the decrease of the buccal, lingual or palatal alveolar bone crest, it is worth mentioning that others have not found significant differences due to variations in design or methodology, so additional prolonged standardized research is required. General Area of Study: Dentistry Specific area of study: oral surgery Type of study: Systematic bibliographic review.
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Molina Barahona, R. M., Rosales Salcedo, G. V., Silva Erráez, C., & Morales Navarro, D. (2025). Clinical and imaging evaluation of platelet-rich fibrin in post-exodontic bone regeneration. A systematic review. Anatomía Digital, 8(2.2), 27-55. https://doi.org/10.33262/anatomiadigital.v8i2.2.3423
Section
Articulos de revisión bibliográfica
References
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2. Atamari Soncco VK, Sanga Mamani C, Huayhua Vargas KY. Fibrina rica en plaquetas en el cierre clínico de la mucosa alveolar post-exodoncia en pacientes sometidos a cirugía bucal. Evidencias en Odontología Clínica [Internet]. 2018 [citado 24 enero 2025]; 3(2):40. Disponible en: https://www.researchgate.net/publication/335478597_FIBRINA_RICA_EN_PLAQUETAS_EN_EL_CIERRE_CLINICO_DE_LA_MUCOSA_ALVEOLAR_POST-EXODONCIA_EN_PACIENTES_SOMETIDOS_A_CIRUGIA_BUCAL
3. Miron RJ, Fujioka-Kobayashi M, Hernandez M, Kandalam U, Zhang Y, Ghanaati S, et al. Injectable platelet rich fibrin (i-PRF): opportunities in regenerative dentistry? Oral Clinical Investigation [Internet]. 2017 [cited 2025 January 25]; 21(8):2619–2627. Available from: https://pubmed.ncbi.nlm.nih.gov/28154995/
4. Miron RJ, Fujioka-Kobayashi M, Bishara M, Zhang Y, Hernandez M, Choukroun J. Platelet-rich fibrin and soft tissue wound healing: a systematic review. Tissue Engineering Part B [Internet]. 2017 [cited 2025 January 25];23(1):83–99. Available from: https://pubmed.ncbi.nlm.nih.gov/27672729/
5. Liu Y, Sun X, Yu J, Wang J, Zhai P, Chen S, et al. Platelet-rich fibrin as a bone graft material in oral and maxillofacial bone regeneration: classification and summary for better application. Biomed Research International [Internet]. 2019 [cited 2025 January 25];2019. Available from: https://pubmed.ncbi.nlm.nih.gov/31886202/
6. Arce González MA, Días Suárez AM, Díaz Hernández M, Hernández Moreno VJ. Fibrina rica en plaquetas y leucocitos: biomaterial autólogo excelente para la regeneración tisular. Medicentro Electrónica Revista Científica Villa Clara [Internet]. 2018 [citado 25 de enero de 2025]; 22(1):19–26. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30432018000100003&lng=es&nrm=iso&tlng=es
7. Sharma R, Sharma P, Sharma SD, Chhabra N, Gupta A, Shukla D. Platelet-Rich Fibrin as an-aid to soft- and hard-tissue healing. Journal of Maxillofacial Oral Surgery [Internet]. 2021 [cited 2025 March 23]; 20(3):496–501. Available from: https://pubmed.ncbi.nlm.nih.gov/34408379/
8. Dutta SR, Passi D, Singh P, Sharma S, Singh M, Srivastava D. A randomized comparative prospective study of platelet-rich plasma, platelet-rich fibrin, and hydroxyapatite as graft material for mandibular third molar extraction socket healing. National Journal of Maxillofacial Surgery [Internet]. 2016 [cited 2025 January 25];7(1):45-51. Available from: https://pubmed.ncbi.nlm.nih.gov/28163478/
9. Gülşen U, Şentürk MF. Effect of platelet rich fibrin on edema and pain following third molar surgery: a split mouth control study. BMC Oral Health [Internet]. 2017 [cited 2025 January 25];17(79). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5404677/
10. Yuan Y, Xu B, Yang J, Wu M. Effects of platelet‐rich fibrin on post‐extraction wound healing and wound pain: a meta‐analysis. International Wound Journal [Internet]. 2024 [citado 25 de enero de 2025]; 21(2): e14654. Disponible en: https://doi.org/10.1111/iwj.14654
11. Gutiérrez Ramírez DA, Hinojosa Sarria JP, Restrepo Dorado AI, Muñoz Ramírez AL, Velarde Trochez NF, Bastidas Daza FE. Análisis estructural de la fibrina rica en plaquetas y sus aplicaciones en odontología regenerativa. Universitas Odontológica [Internet]. 2018 [citado 25 de enero de 2025];37(79). Disponible en: https://www.redalyc.org/journal/2312/231267124005/html/
12. Trybek G, Rydlińska J, Aniko-Włodarczyk M, Jaroń A. Effect of platelet-rich fibrin application on non-infectious complications after surgical extraction of impacted mandibular third molars. International Journal of Environmental Research and Public Health [Internet]. 2021 [cited 2025 January 25]; 18(16): 8249. Available from: https://pubmed.ncbi.nlm.nih.gov/34443998/
13. Kotsakis GA, Boufidou F, Hinrichs JE, Prasad HS, Rohrer M, Tosios KI. Extraction socket management utilizing platelet rich fibrin: a proof-of-principle study of the “accelerated-early implant placement” concept. Journal Oral Implantology [Internet]. 2016 [cited 2025 January 25];42(2):164–168. Available from: https://pubmed.ncbi.nlm.nih.gov/26389580/
14. Zhang Y, Ruan Z, Shen M, Tan L, Huang W, Wang L, et al. Clinical effect of platelet-rich fibrin on the preservation of the alveolar ridge following tooth extraction. Experimental and Therapeutic Medicine [Internet]. 2018 [cited 2025 January 25]; 15(3):2277–2286. Available from: https://pubmed.ncbi.nlm.nih.gov/29456635/
15. Nemtoi A, Sirghe A, Nemtoi A, Haba D. The effect of plasma with platelet-rich fibrin in bone regeneration and on rate of orthodontic tooth movement in adolescents. Revista de Chimie [Internet]. 2018 [cited 2025 January 25]; 69(12):3727–3730. Available from: https://www.researchgate.net/publication/331972173
16. Alzahrani AA, Murriky A, Shafik S. Influence of platelet rich fibrin on post-extraction socket healing: a clinical and radiographic study. Saudi Dental Journal [Internet]. 2017 [cited 2025 January 25]; 29(4):149–155. Available from: https://pubmed.ncbi.nlm.nih.gov/29033524/
17. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Systematic Reviews BMC [Internet]. 2021 [cited 2025 Jan 28]; 10(1): 89. Available from: https://pubmed.ncbi.nlm.nih.gov/33781348/
18. Santos CMDC, Pimenta CADM, Nobre MRC. The PICO strategy for the research question construction and evidence search. Revista Latino Am Enfermagem [Internet]. 2007 [cited 2025 Jan 28];15(3):508–11. Available from: https://pubmed.ncbi.nlm.nih.gov/17653438/
19. Froeks Kamminga. Release of version 6.2 of the Cochrane Handbook and updated MECIR version February 2021. Cochrane Methods [Internet]. [cited 2025 Feb 5]. Available from: https://methods.cochrane.org/news/release-version-62-cochrane-handbook-and-updated-mecir-version-february-2021
20. Anwandter A, Bohmann S, Nally M, Castro AB, Quirynen M, Pinto N. Dimensional changes of the post extraction alveolar ridge, preserved with leukocyte- and platelet rich fibrin: a clinical pilot study. Journal of Dentistry [Internet]. 2016 [cited 2025 March 23]; 52:23-29. Available from: https://pubmed.ncbi.nlm.nih.gov/27338946/
21. Areewong K, Chantaramungkorn M, Khongkhunthian P. Platelet-rich fibrin to preserve alveolar bone sockets following tooth extraction: A randomized controlled trial. Clinical Implantology Dental Relat Research. 2019 [cited 2025 January 25]; 21(6):1156–1163. Available from: https://pubmed.ncbi.nlm.nih.gov/31647177/
22. Baslarli O, Tumer C, Ugur O, Vatankulu B. Evaluation of osteoblastic activity in extraction sockets treated with platelet-rich fibrin. Medicine Oral Pathology Oral Surgical. 2015 [cited 2025 January 25]; 20(1): e111–6. Available from: https://pubmed.ncbi.nlm.nih.gov/25475771/
23. Brazdeikyte V, Baliutavičiute D, Rokicki JP. Influence of PRGF and PRF on postextractive alveolus regeneration: a randomised controlled trial. Quintessence International [Internet]. 2021 [cited 2025 January 30];53(1):58–67. Available from: https://pubmed.ncbi.nlm.nih.gov/34076381/
24. Doiphode AM, Hegde P, Mahindra U, Kumar SMS, Tenglikar PD, Tripathi V. Evaluation of the efficacy of platelet-rich plasma and platelet-rich fibrin in alveolar defects after removal of impacted bilateral mandibular third molars. Journal International Society of Preventive and Community Dentistry [Internet]. 2016 [cited 2025 January 25]; 6: S47–52. Available from: https://pubmed.ncbi.nlm.nih.gov/27195227/
25. El Bagoury EZF, Hassan M, Thabet HH. Evaluation of platelet-rich fibrin on alveolar bone height after removal of impacted lower third molar. Egyptian Journal of Oral & Maxillofacial Surgery [Internet]. 2015 [cited 2025 March 23];6(2):50–54. Available from: https://www.researchgate.net/publication/279244034
26. Fontes Martins LC, Sousa Campos de Oliveira AL, Aloise AC, Scavone de Macedo LG, Teixeira ML, Moy PK, et al. Bone marrow aspirate concentrates and platelet-rich fibrin in fresh extraction sockets: a histomorphometric and immunohistochemical study in humans. Journal of Cranio-Maxillofacial Surgery [Internet]. 2021 [cited 2025 January 25]; 49(2):104–109. Available from: https://pubmed.ncbi.nlm.nih.gov/33349509/
27. Gasparro R, Sammartino G, Mariniello M, di Lauro AE, Spagnuolo G, Marenzi G. Treatment of periodontal pockets at the distal aspect of mandibular second molar after surgical removal of impacted third molar and application of L-PRF: a split-mouth randomized clinical trial. Quintessence International [Internet]. 2020 [cited 2025 January 30]; 51(3):204–211. Available from: https://pubmed.ncbi.nlm.nih.gov/32020130/
28. Guzmán Castillo FG, Paltas Miranda ME, Benenaula Bojorque JA, Núñez Barragán KI, Simbaña García DV. Cicatrización de tejido óseo y gingival en cirugías de terceros molares inferiores. Estudio comparativo entre el uso de fibrina rica en plaquetas versus cicatrización fisiológica. Revista Odontológica Mexicana [Internet]. 2017 [citado 30 de enero de 2025] 21(2): 114-120. Disponible en: https://www.scielo.org.mx/pdf/rom/v21n2/1870-199X-rom-21-02-00114.pdf
29. Jeyaraj PE, Chakranarayan A. Soft tissue healing and bony regeneration of impacted mandibular third molar extraction sockets, following postoperative incorporation of platelet-rich fibrin. Annals of Maxillofacial Surgery [Internet]. 2018 [cited 2025 January 30]; 8(1):10–18. Available from: https://pubmed.ncbi.nlm.nih.gov/29963419/
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