Preparation protocols and periodontal applications of platelet rich fibrin, a review

Blood concentrates, such as platelet rich plasma and platelet rich fibrin, have been proposed to speed up tissue healing and regeneration in many dental fields. This was based on the fact that upon platelet activation, α-granules, which are reservoirs for many growth factors, fuse with the plasma membrane and release their cargo. The released growth factors exhibit chemotactic and mitogenic properties that promote and modulate cellular functions involved in tissue healing, cell proliferation, and tissue regeneration. Platelet rich fibrin (PRF) products were introduced as a grafting biomaterial to be used in surgical periodontics, because of their regenerative qualities. PRF variants are totally autogenous, easy to prepare, fast, economic and most importantly, they do not involve a donor site, therefore PRF was suggested as a connective tissue graft (CTG) substitute, to avoid complications relating to the second surgical site to harvest the CTG. It is important to highlight that the quality and the content of the PRF matrix depends largely on the preparation conditions of the patients’ blood sample. Based on the centrifugation speed of the extracted blood, different PRF matrices can be produced, such as Leukocyte- platelet rich fibrin (L-PRF), Advanced platelet rich fibrin (A-PRF) and Advanced platelet rich fibrin plus (A-PRF+), in addition to the injectable form of platelet rich fibrin (i-PRF) and lyophilised PRF (Ly-PRF). All these variants are currently used in different dental and periodontal procedures. This article aims to provide an overview of different PRF preparations and their applications in periodontal surgery.