Autologous Blood Concentrates: Platelet-Rich Plasma (PRP) and Platelet-Rich Fibrin (PRF) in Oral Implantology – Clinical Rationale, Protocols, and Evidence with an Emphasis on Immediate Placement

Background: Immediate implant placement in fresh extraction sockets offers advantages in treatment time, esthetics, and patient comfort, but also poses biological and technical challenges that can affect osseointegration and soft tissue stability. Autologous platelet concentrates, especially platelet-rich fibrin (PRF), have been introduced as adjunctive tools to support soft- and hard-tissue healing in this context. Aim: This article reviews the clinical rationale, preparation protocols, and current evidence for using PRF as an adjunct in immediate implant placement, with a focus on its validated role in socket healing and ridge preservation, with an emphasis on biological mechanisms, preparation variants, and the potential impact on early healing phases. Methods: The article summarizes current clinical handling protocols, discusses differences in preparation and release kinetics between PRP and PRF, and illustrates the integration of PRF in immediate-implant workflows using representative cases. The role of PRF in clot stabilization, graft handling, and early wound healing is described based on the available evidence and guideline recommendations. Results: Available evidence supports that PRF provides a sustained release of growth factors within a fibrin scaffold, supporting early wound stabilization and soft tissue healing. Meta-analyses indicate PRF shows a clear benefit for socket closure and ridge preservation, while evidence for PRF as an adjunct in immediate implant placement remains limited and inconclusive. Reported outcomes suggest PRF may help reduce marginal bone loss and support early soft tissue healing, but results across studies remain heterogeneous and sometimes inconclusive. Conclusion: PRF is a useful adjunctive tool for clinicians to support biologic wound conditions, primarily for socket closure and ridge preservation, particularly for stabilizing the wound environment and supporting early healing. However, its routine use should be guided by sound surgical principles and appropriate biomaterials. For immediate implant placement, its role remains adjunctive and should not replace sound surgical principles or biomaterials. Further high-quality, long-term randomized controlled trials are recommended to further clarify the clinical relevance and long-term effects of PRF in immediate implantology.