A scoping review on platelet-rich fibrin-driven bone regeneration: biological mechanisms and clinical applications in oral and maxillofacial surgery

Platelet-rich fibrin (PRF), a second-generation platelet concentrate, has emerged as a promising autologous biomaterial in regenerative medicine. Unlike platelet-rich plasma (PRP), PRF is prepared without anticoagulants or biochemical additives, allowing natural platelet activation and fibrin polymerization. This process generates a three-dimensional fibrin matrix containing concentrated platelets, leukocytes, cytokines, and growth factors that collectively support tissue regeneration. Owing to these regenerative properties, PRF has been increasingly applied in oral and maxillofacial surgery. Despite its widespread clinical use, the precise biological mechanisms underlying PRF-mediated bone regeneration remain incompletely understood. PRF functions not only as a reservoir for growth factors, but also as a dynamic immunomodulatory scaffold that regulates inflammation, angiogenesis, cellular migration, and osteogenic differentiation. Recent evidence further suggests that leukocytes, fibrin architecture, cytokine networks, and osteoimmunological interactions within PRF play critical roles in coordinating tissue regeneration. This scoping review aims to summarize the current understanding of the biological mechanisms and regenerative potential of PRF in bone healing and oral and maxillofacial reconstruction. Particular emphasis is placed on the interplay between growth factor release, fibrin matrix structure, immune modulation, and cellular signaling pathways involved in osteogenesis. Furthermore, recent advances, limitations, and future perspectives regarding PRF optimization and clinical applications are discussed.