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Platelet-Rich Fibrin: A Versatile Purpose for Alveolar Ridge Preservation
Article · July 2019
DOI: 10.31487/j.DOBCR.2019.03.05
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Maria Alcineide Dias Araújo
Universidade Federal do Ceará
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Lana Karine Araújo
Universidade Federal do Ceará sobral
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Igor Iuco Castro-Silva
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DENTAL ORAL BIOLOGY AND CRANIOFACIAL RESEARCH | ISSN 2613-4950 
 
 
 
Available online at www.sciencerepository.org 
 
Science Repository 
 
 
 
 
*Correspondence to: Igor Iuco Castro-Silva, Ph.D, M.S., D.D.S., Adjunct Professor, Federal University of Ceara (UFC), Avenida Maurocelio Rocha Pontes 100, 
62042-280, Sobral (CE), Brazil; Tel: +55-88-36954720; E-mail: igor.iuco@sobral.ufc.br 
© 2019 Igor Iuco Castro-Silva. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted 
use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository. All rights reserved. 
http://dx.doi.org/10.31487/j.DOBCR.2019.03.05 
Short Communication 
Platelet-Rich Fibrin: A Versatile Purpose for Alveolar Ridge Preservation 
Jose Sandro Ponte1,2, Maria Alcineide Dias Araújo1, Lana Karine Araújo1, Igor Iuco Castro-Silva1,2* 
1Postgraduate Program in Biotechnology, Federal University of Ceara (UFC), Avenida Maurocelio Rocha Pontes 100, 62042-280, Sobral (CE), Brazil 
2Faculty of Dentistry, Federal University of Ceara (UFC), Rua Conselheiro José Júlio, s/n, 62010-820, Sobral (CE), Brazil 
A R T I C L E I N F O 
Article history: 
Received: 17 June, 2019 
Accepted: 1 July, 2019 
Published: 6 July, 2019 
 
 
A B S T R A C T 
Clinical use of platelet-rich fibrin (PRF) have incresead in dental procedures and represents a promising 
alternative in the regeneration of soft and hard tissues, whether associated with biomaterials or alone. PRF 
presentation forms in membrane, plug or sticky bone are discussed. Versatility, biological security of 
autologous material, simplicity, cost-effectiveness and maleability are attractive factors to the multivariate 
use of PRF in-office. However, more randomized clinical trials protocol standardization are required to 
obtain reproducible results. The choice of most indicated therapeutic modality of PRF applied to alveolar 
ridge preservation should be made based on evidence to ensure a good clinical results in-office and patient 
satisfaction. 
 
 © 2019 Igor Iuco Castro-Silva. Hosting by Science Repository. All rights reserved. 
 
Introduction 
The maintenance of the alveolar ridge after the tooth extraction is 
essential from the aesthetic and functional point of view, to ensure the 
appropriate tissue condition for implant and oral rehabilitation therapy 
[1, 2]. The local blood supply decreases with a dental and periodontal 
loss and there is more accelerated bone atrophy, especially of the thin 
buccal wall [1]. To avoid this common incident in dental practice, 
techniques of guided bone regeneration are recommended, using 
resorbable membranes and bone grafts of autogenous,allogenic, 
xenogeneic or alloplastic origin [3, 4]. The use in Brazil of bone 
substitute biomaterials in the filling of dental alveoli may exceed a 
quarter of the cases of tooth extraction in private clinics, demonstrating 
good cost-effectiveness and good professional acceptance [3]. However, 
in the brazilian public health system, there is a great demand for 
edentulism and a chronic underfunding, which motivates the search for 
regenerative strategies less dependent on commercial scaffolds to 
guarantee bone preservation [4]. 
 
Brief Literature Review 
 
Since the first use of platelet-rich fibrin (PRF) in France reported in 2001 
by Choukron, the reports in the last 18 years in the clinical use of PRF 
have increased [5]. PRF is a functional autologous fibrin matrix obtained 
by immediate centrifugation of the blood immediately collected from 
patient without the use of additives by the own dentist in-office [6, 7]. 
Although the technique of preparation, standing time, transfer process, 
temperature of centrifuge and vibration are factors for the mixed results 
reported in the literature, PRF represents a promising alternative in the 
regeneration of soft and hard tissues, whether associated with 
biomaterials or alone [2, 7, 8]. 
 
The biological bases of PRF reside in the high concentration of fibrin, 
platelets and leukocytes, which stimulates cell agglutination and growth 
factors involved with angiogenesis, the repair mechanisms, the 
immunological and antibacterial action, reducing surgical sequelae of 
pain and infection [8]. PRF may be present as a covering membrane of 
the dental alveolus, plug of filling the tooth socket or in the hybrid form 
of fibrin gel with fragments of bone graft or sticky bone (Figure 1) [9-
11]. 
 
PRF membrane exhibits clinical and radiographic findings that are like 
the collagen membrane when used as a coating of freeze-dried bone 
allograft in grade II furcation defects in molars in up to 6 months of 
follow-up, reinforcing their contributive role in guided bone 
regeneration and representing an alternative to other expensive 
membranes [9]. 
 
https://www.sciencerepository.org/dental-oral-biology-and-craniofacial-research
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mailto:igor.iuco@sobral.ufc.br
Platelet-Rich Fibrin: A Versatile Purpose for Alveolar Ridge Preservation 2 
 
Dental Oral Biology and Craniofacial Research doi: 10.31487/j.DOBCR.2019.03.05 Volume 2(3): 2-3 
Socket plug technique with or without the use of plaster of Paris as bone 
substitute in alveolar ridge preservation contributes to better post-
operative healing and minimal loss of alveolar width and height for long 
term [10]. As for the autologous concentrated growth factors (CGF), they 
enriched bone graft matrix (sticky bone) and CGF-enriched fibrin 
membrane provides stabilization of bone graft in the defect, and 
therefore, accelerates tissue healing, bone maturation and minimizes 
bone loss during healing period [11]. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Figure 1: After centrifugation (A) human PRF can be isolated (B). PRF in the form of a membrane (C), plug (D) or sticky bone (PRF+biphasic calcium 
phosphate, E). Histological images of fibrin-like material and intense cellularity (F, 100x, HE) compound by platelets, leukocytes and erythrocytes (G, 400x, 
HE). Images kindly provided by Ponte JS and Castro-Silva II in reference to own research registered in Brazil using PRF (CEP-UVA, CAAE n. 
91602218.0.0000.5053, protocol n. 2.806.761). 
 
A bibliographic survey of nine selected articles in the last 10 years 
showed that PRF presents effective and safe use when used in 
combination with biomaterials or isolated to accelerate the healing of 
soft and hard tissues, in addition to presenting low risk associated with 
satisfactory clinical results. Disadvantages in the use of PRF were 
associated to its protocol for obtention including handling, blood 
collection time and its transference for the centrifuge. A minimal 
experience of clinician for PRF manipulation can reduce all 
disadvantages listed before [5]. 
 
A systematic review (SR) about efficacy of PRF in bone regeneration of 
the jaws demonstred which its use appears to improve the local 
conditions of the grafts and soft tissues, reducing the healing times and 
symptoms. Four randomized clinical trials (RCT) in maxillary sinus lift 
surgery have not shown any difference using PRF in comparison to the 
traditional technique, 2 RCTs indicated that PRF in combination with 
autogenous bone improves bone volume and 3 articles evaluated alveolar 
preservation (1 RCT and 2 SRs) demonstrating that there may be an 
increase in the density of neoformed bone in the long term with a lower 
rate of buccal/lingual reabsorption [12]. 
A SR and meta-analysis of regenerative potential of PRF in intra-bony 
defects and furcation defects was carried out based on 24 RCTs. 
Significant pocket depth reduction, clinical attachment level gain and 
bone fill (mean value of 1.7 ± 0.7 mm) was achieved when comparing 
PRF to open flap debridement in intra-bony defects and furcation defects 
[13]. Simplicity, cost-effectiveness, and user-friendliness/malleability 
are attractive factors to the multivariate use of PRF [7]. However, more 
randomized clinical trials protocol standardization are required to obtain 
reproducible results [12, 13]. 
 
Conclusion 
 
The choice of most indicated therapeutic modality of PRF applied to 
alveolar ridge preservation should be made based on evidence to ensure 
a good clinical results in-office and patient satisfaction. 
 
Acknowledgments 
 
Our special thanks to Coordination for the Improvement of Higher 
Education Personnel (CAPES-DS and PROAP-UFC-PPGB grants, 
Platelet-Rich Fibrin: A Versatile Purpose for Alveolar Ridge Preservation 3 
 
Dental Oral Biology and Craniofacial Research doi: 10.31487/j.DOBCR.2019.03.05 Volume 2(3): 3-3 
Brazil) and Ceara State Foundation of Support for Scientific and 
Technological Development (FUNCAP, process #BP3-0139-
00270.01.00/18, Brazil) for the financial support. 
REFERENCES 
 
1. Du Toit J, Siebold A, Dreyer A, Gluckman H (2016) Choukroun 
Platelet-Rich Fibrin as an Autogenous Graft Biomaterial in Preimplant 
Surgery: Results of a Preliminary Randomized, Human 
Histomorphometric, Split-Mouth Study. Int J Periodontics Restorative 
Dent 36: S75-S86. [Crossref] 
2. Amit Arvind Agrawal (2017) Evolution, current status and advances in 
application of platelet concentrate in periodontics and implantology. 
World J Clin Cases 5: 159-171. [Crossref] 
3. Castro-Silva II, Coutinho LACR (2013) Use of bone grafts in Dentistry: 
profile of dentists from Niteroi/RJ. Rev bras odontol 69: 154-158. 
4. Castro-Silva II, Lima FMS, Granjeiro JM (2013) Bone grafts in 
Brazilian Dentistry: overview, challenges and prospects on the vision 
of Health Management. Rev flum odontol 39: 63-71. 
5. Andrade LS, Leite LP, Melo-Silva FB, Brito-Resende RF, Guedes-de-
Uzeda MJ (2018) The use of platelet-rich fibrin concentrate in tissue 
healing and regeneration in dentistry. Int J Growth Factors Stem Cells 
Dent 1: 23-26. 
6. Castro-Silva II (2018) Platelet-rich fibrin for bone tissue regeneration. 
Otorhinolaryngol Head Neck Surg 3: 1-1. 
7. Zumarán CC, Parra MV, Olate SA, Fernández EG, Muñoz FT et al. 
(2018) The 3 R's for Platelet-Rich Fibrin: A "Super" Tri-Dimensional 
Biomaterial for Contemporary Naturally-Guided Oro-Maxillo-Facial 
Soft and Hard Tissue Repair, Reconstruction and Regeneration. 
Materials (Basel) 11: E1293. [Crossref] 
8. Choukroun J, Diss A, Simonpieri A, Girard MO, SChoeffler C et al. 
(2006) Platelet-rich fibrin (PRF): a second-generation platelet 
concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral 
Med Oral Pathol Oral Radiol Endod 101: 56-60. [Crossref] 
9.Mehta DB, Deshpande NC, Dandekar SA (2018) Comparative 
evaluation of platelet-rich fibrin membrane and collagen membrane 
along with demineralized freeze-dried bone allograft in Grade II 
furcation defects: A randomized controlled study. J Indian Soc 
Periodontol 22: 322-327. [Crossref] 
10. Girish-Kumar N, Chaudhary R, Kumar I, Arora SS, Kumar N et al. 
(2018) To assess the efficacy of socket plug technique using platelet 
rich fibrin with or without the use of bone substitute in alveolar ridge 
preservation: a prospective randomised controlled study. Oral 
Maxillofac Surg 22: 135-142. [Crossref] 
11. Sohn D-S, Huang B, Kim J, Park WE, Park CC (2015) Utilization of 
Autologous Concentrated Growth Factors (CGF) Enriched Bone Graft 
Matrix (Sticky Bone) and CGF-Enriched Fibrin Membrane in Implant 
Dentistry. JIACD 7: 11-29. 
12. Millard JL, Apablaza EM, Sirandoni RF, Carmona AV, Diaz DP (2018) 
Efficacy of Platelet-Rich Fibrin in Bone Regeneration of the Jaws: A 
Systematic Review. Res Rep Oral Maxillofac Surg 2: 007. 
13. Castro AB, Meschi N, Temmerman A, Pinto N, Lambrechts P et al. 
(2017) Regenerative potential of leucocyte- and platelet-rich fibrin. 
Part A: intrabony defects, furcation defects and periodontal plastic 
surgery. A systematic review and meta-analysis. J Clin Periodontol 44: 
67-82. [Crossref] 
 
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