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Regenerative Potential of Platelet Rich Fibrin (PRF) in Socket Preservation in Comparison with Conventional Treatment Modalities: A Systematic Review and Meta-Analysis



Platelet rich fibrin (PRF) has shown great potential in osteogenesis; however, some studies still question utilizing it as a grafting material. Thus, the aim of this review is to evaluate the effect of PRF when used in socket and ridge preservation procedures.


Electronic searches through MEDLINE, EMBASE, and Cochrane, Science Citation Index Expanded databases and manual searches of unpublished data, academic theses, and journals were conducted up until July 2021. The outcomes were to assess the ability of PRF as a graft material to preserve bone width, height, and density after tooth extraction.


Twelve studies were included in the review, using PRF showed significant results in all three outcomes when compared to no grafting at all, however when compared to other commonly used grafting materials it showed a lesser effect. On the other hand, most studies included reported mixing PRF with a graft material showed the best result. The meta-analysis also revealed the significant results in using PRF on the three outcomes.


The meta-analysis of the studies included proved the beneficial effect of PRF in socket preservation surgeries alone or in combination with other graft materials, but further individual multi-centre randomized controlled studies with appropriate sample size are still needed to further confirm our findings.

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  1. Annunziata M, Guida L, Nastri L, Piccirillo A, Sommese L, Napoli C. The role of autologous platelet concentrates in alveolar socket preservation: a systematic review. Transfus Med Hemother. 2018;45:195–203.

  2. 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. Exp Ther Med. 2018;5:2277–86.

    Google Scholar 

  3. Grecu AF, Reclaru L, Ardelean LC, Nica O, Ciucă EM, Ciurea ME. Platelet rich fibrin and its emerging therapeutic benefits for musculoskeletal. injury treatment. Medicina (Kaunas). 2019;55:141.

  4. Wang X, Zhang Y, Choukroun J, Ghanaati S, Miron RJ. Effects of an injectable platelet-rich fibrin on osteoblast behavior and bone tissue formation in comparison to platelet-rich plasma. Platelets. 2018;9:48–55.

    Article  Google Scholar 

  5. Magalhães VS, Ribeiro RA, Leite do Amaral JMB, Pimentel AC, Paulim LA. The use platelet rich fibrin in dental implants: a literature review. Trends in Transplant. 2018;11:2–3.

  6. Neiva RF, Gil LF, Tovar N, Janal MN, Marao HF, Bonfante EA, et al. The synergistic effect of leukocyte platelet-rich fibrin and micrometer/nanometer surface texturing on bone healing around immediately placed implants: an experimental study in dogs. Biomed Res Int. 2016;2016:9507342.

    Article  Google Scholar 

  7. Zhao JH, Tsai CH, Chang YC. Clinical application of platelet rich fibrin as the sole grafting material in maxillary sinus augmentation. J Formosan Med Assoc. 2015;114:779–80.

    CAS  Article  Google Scholar 

  8. Meshram VS, Lambade PN, Meshram PV, Kadu A, Tiwari MS. The autologous platelet rich fibrin: a novel approach in osseous regeneration after cystic enucleation: a pilot study. Indian J Dent Res. 2015;26:560–4.

  9. 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. BMJ. 2021;372:n71.

  10. Schardt C, Adams MB, Owens T, Keitz S, Fontelo P. Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decis Mak. 2007;7:16.

    Article  Google Scholar 

  11. McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb). 2012;22:276–82.

    Article  Google Scholar 

  12. Higgins JPT, Green S, Cochrane handbook for systematic reviews of interventions. Version 5.1.0. The Cochrane Collaboration. 2011.

  13. McGuinness LA. Robvis: An R Package and Web Application for Visualising Risk-of-Bias Assessments. 2019.

  14. Yewale M, Bhat S, Kamath A, Tamrakar A, Patil V, Algal AS. Advanced platelet-rich fibrin plus and osseous bone graft for socket preservation and ridge augmentation: a randomized control clinical trial. J Oral Biol Craniofac Res. 2021;11:225–33.

    Article  Google Scholar 

  15. Azangookhiavi H, Ghodsi S, Jalil F, Dadpour Y. Comparison of the efficacy of platelet-rich fibrin and bone allograft for alveolar ridge preservation after tooth extraction: a clinical trial. Front Dent. 2020;17:1–6.

    PubMed  PubMed Central  Google Scholar 

  16. Dhamija R, Shetty V, Vineeth K, Nagaraju R, Rao RS. Socket preservation with demineralized freeze-dried bone allograft and platelet-rich fibrin for implant site development: A randomized controlled trial. J Indian Prosthodont Soc. 2020;20:304–11.

    Article  Google Scholar 

  17. Ahmed N, Gopalakrishna V, Shetty A, Nagraj V, Imran M, Kumar P. Efficacy of PRF vs PRF + biodegradable collagen plug in post-extraction preservation of socket. J Contemp Dent Pract. 2019;20:1323–8.

    Article  Google Scholar 

  18. Kollati P, Koneru S, Dwarakanath CD, Gottumukkala SNVS. Effectiveness of naturally derived bovine hydroxyapatite (Cerabone™) combined with platelet-rich fibrin matrix in socket preservation: A randomized controlled clinical trial. J Indian Soc Periodontol. 2019;23:145–51.

    Article  Google Scholar 

  19. Clark D, Rajendran Y, Paydar S, Ho S, Cox D, Ryder M, et al. Advanced platelet-rich fibrin and freeze-dried bone allograft for ridge preservation: a randomized controlled clinical trial. J Periodontol. 2018;89:379–87.

    CAS  Article  Google Scholar 

  20. Girish Kumar N, Chaudhary R, Kumar I, Arora SS, Kumar N, Singh H. 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. 2018;22:135–42.

    CAS  Article  Google Scholar 

  21. Hauser F, Gaydarov N, Badoud I, Vazquez L, Bernard JP, Ammann P. Clinical and histological evaluation of postextraction platelet-rich fibrin socket filling: a prospective randomized controlled study. Implant Dent. 2013;22:295–303.

    Article  Google Scholar 

  22. Thakkar DJ, Deshpande NC, Dave DH, Narayankar SD. A comparative evaluation of extraction socket preservation with demineralized freeze-dried bone allograft alone and along with platelet-rich fibrin: a clinical and radiographic study. Contemp Clin Dent. 2016;7:371–6.

    Article  Google Scholar 

  23. De Angelis P, De Angelis S, Passarelli PC, Liguori MG, Manicone PF, D’Addona A. Hard and soft tissue evaluation of different socket preservation procedures using leukocyte and platelet-rich fibrin: a retrospective clinical and volumetric analysis. J Oral Maxillofac Surg. 2019;77:1807–15.

    Article  Google Scholar 

  24. Mendoza-Azpur G, Olaechea A, Padial-Molina M, Gutiérrez-Garrido L, Ovalle F, Mesa F, et al. Composite alloplastic biomaterial vs. autologous platelet-rich fibrin in ridge preservation. J Clin Med. 2019;8:223.

    CAS  Article  Google Scholar 

  25. 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. Exp Ther Med. 2018;15:2277–86.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:e37–44.

    Article  Google Scholar 

  27. Fujioka-Kobayashi M, Miron RJ, Hernandez M, Kandalam U, Zhang Y, Choukroun J. Optimized platelet-rich fibrin with the low-speed concept: growth factor release, biocompatibility, and cellular response. J Periodontol. 2017;88:112–21.

    CAS  Article  Google Scholar 

  28. Pan J, Xu Q, Hou J, Wu Y, Liu Y, Li R, et al. Effect of platelet-rich fibrin on alveolar ridge preservation: a systematic review. J Am Dent Assoc. 2019;150:766–78.

    Article  Google Scholar 

  29. Bastami F, Khojasteh A. Use of leukocyte- and platelet-rich fibrin for bone regeneration: a systematic review. RRR. 2016;1:47–68.

    Google Scholar 

  30. Moraschini V, Barboza ES. Effect of autologous platelet concentrates for alveolar socket preservation: a systematic review. Int J Oral Maxillofac Surg. 2015;44:632–41.

    CAS  Article  Google Scholar 

  31. Najeeb S, Khurshid Z, Agwan MAS, Ansari SA, Zafar MS, Matinlinna JP. Regenerative potential of platelet rich fibrin (PRF) for curing intrabony periodontal defects: a systematic review of clinical studies. Tissue Eng Regen Med. 2017;14:735–42.

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The authors would like to thank Deanship of scientific research in King Saud University for funding and supporting this research through the initiative of DSR Graduate Students Research Support (GSR).

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Correspondence to Yasser Alrayyes.

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The review was registered on PROSPERO under Registration Number: CRD42021261939 on 27th of July 2021.

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Alrayyes, Y., Al-Jasser, R. Regenerative Potential of Platelet Rich Fibrin (PRF) in Socket Preservation in Comparison with Conventional Treatment Modalities: A Systematic Review and Meta-Analysis. Tissue Eng Regen Med 19, 463–475 (2022).

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  • Fibrin
  • Regeneration
  • Socket preservation
  • Bone graft
  • Platelet rich fibrin