Platelet Rich Fibrin (PRF) in Implantology
17.2.2026 · 6 min
Importance on Healing
- PRF accelerates tissue regeneration by providing a high concentration of growth factors at the surgical site, leading to faster healing after dental implant placement.
- It enhances bone integration (osseointegration), creates a stable foundation for implants, and reduces the risk of complications, such as infection or delayed healing.
- PRF also helps to minimize swelling and postoperative discomfort, resulting in smoother recovery.
Definition and Use in Implantology
Definition: PRF is an autologous platelet concentrate derived from the patient’s own blood and processed without anticoagulants or additives, resulting in a fibrin-rich matrix containing platelets, leukocytes, and growth factors.
Use: In implantology, PRF is applied to surgical sites such as extraction sockets, bone grafts, or around implants to promote soft and hard tissue healing, enhance bone regeneration, and reduce complications in both simple and complex cases.
Biologic Mechanisms
PRF releases growth factors (e.g., TGF-β, PDGF, and VEGF) that stimulate:
- Collagen production
- Angiogenesis (formation of new blood vessels)
- Osteoblast activity (bone formation)
- Its fibrin matrix acts as a bioactive scaffold, supporting cell migration, proliferation, and differentiation while also providing a sustained release of growth factors for prolonged healing.
- PRF contains white blood cells, which contribute to its antimicrobial and anti-inflammatory properties.
Advantages
- Autologous and biocompatible: No risk of allergic reactions or disease transmission.
- Cost-effectiveness: Prepared chairside from the patient’s own blood without the need for expensive external materials.
- Reduces infection risk: Contains white blood cells and natural antimicrobial properties.
- Minimally invasive and easy to prepare.
- Improves both soft and hard tissue healing and reduces postoperative pain and swelling.
Indications
- Enhancing bone regeneration at implant sites, especially where bone density is low or bone grafting is required.
- Acceleration of soft tissue healing after extraction, implant placement, or grafting procedures.
- Sinus lift procedures and guided bone regeneration.
- Patients with compromised healing, such as those with systemic conditions or poor bone quality.
Clinical Studies
Multiple randomized controlled trials and meta-analyses have shown that PRF:
- Increases the implant stability quotient (ISQ) during early healing.
- Promotes faster osseointegration and bone formation around implants.
- Reduces healing time and improves the width of keratinized mucosa.
- However, some studies note that while PRF improves early healing and stability, its impact on long-term implant survival compared to other biomaterials remains under investigation.
How to Generate PRF: Low-Speed Centrifuge Method (Ghanaati, Choukroun Protocol)
- Blood collection: Blood was drawn from the patient into sterile tubes without anticoagulant.
- Centrifugation:Choukroun Protocol (L-PRF): Centrifuge at ~2700–3000 rpm for 10–12 min (approximately 700 g RCF).Ghanaati Low-Speed Concept (A-PRF): Centrifuge at ~200 g for 8 minutes (lower speed and force), which increases the concentration of cells and growth factors in the PRF matrix.
- Harvesting: Collect the middle PRF layer (between the red blood cells and plasma) and use it as a membrane or clot directly at the surgical site.
Limitations
- Technique-sensitive: Delays in processing can reduce quality, and preparation must be quick and precise.
- Variability: Differences in centrifuge protocols and devices can affect PRF consistency and efficacy.
- Limited space maintenance: PRF membranes do not provide structural support for large defects and often require a combination with other graft materials.
- Long-term outcomes: More research is required to confirm its superiority over other augmentation materials.
Conclusions
PRF is a natural autologous biomaterial that significantly enhances healing in implantology by accelerating bone and soft tissue regeneration. The ease of preparation, safety profile, and ability to improve early implant stability make it a valuable adjunct in many clinical scenarios. However, its effectiveness depends on the proper technique used, and it is best used in combination with other materials for larger augmentations.
PRF and Other Techniques for Augmentation & Healing in Implantology
| Technique | Purpose | Biological Support | Augmentation Potential | Healing Enhancement | Common Use Cases |
|---|---|---|---|---|---|
| PRF (Platelet-Rich Fibrin) | Enhances healing, regeneration, and graft stability | Autologous growth factors, fibrin matrix | Mild (used as an adjunct, not volumetric) | High – accelerates soft and hard tissue healing | Socket preservation, graft mixing, sinus lift, peri-implant defects |
| Collagen Membranes (Resorbable) | Barrier for GBR, guides bone growth | None (acts as passive barrier) | Indirect via GBR | Moderate – stabilizes site, protects graft | GBR, socket preservation, minor ridge defects |
| Bone Grafts (Autograft / Allograft / Xenograft) | Volume augmentation | Depends on type (autograft = osteogenic) | High (major volume gain possible) | Moderate – acts as scaffold, not bioactive | Ridge augmentation, sinus lift, ridge preservation |
| BMPs (Bone Morphogenetic Proteins) | Stimulate bone formation | Strong osteoinductive growth factors | High – induces new bone formation | High – accelerates bone regeneration | Large vertical defects, compromised healing cases |
| L-PRF / A-PRF / i-PRF (Advanced PRF types) | Variants of PRF with tailored release kinetics | Enriched in specific growth factors | Mild to moderate (depending on application) | Very high – extended release of factors | Advanced GBR, sinus lifts, ridge preservation, peri-implantitis |
| Sticky Bone (PRF + Particulate Graft) | Graft stability and cohesion | PRF matrix acts as a natural "glue" | Moderate to high (due to graft content) | High – promotes vascularization & healing | Sinus lifts, ridge augmentation, large defects |
| Amnion-Chorion Membranes | Barrier membrane with natural growth factors | Contains cytokines and regenerative proteins | Moderate | High – anti-inflammatory and bioactive | Soft tissue defects, GBR, peri-implant defects |
| Soft Tissue Grafting (CTG/FGG) | Soft tissue volume and keratinization improvement | Patient-derived tissue | No hard tissue gain | High – improves mucosal healing | Thin biotype, aesthetic zones, peri-implant mucosa defects |
FAQ – PRF in Implantology
1. What is PRF?
PRF (Platelet-Rich Fibrin) is an autologous biomaterial derived from a patient’s blood, rich in platelets, leukocytes, and growth factors, used to enhance healing in dental procedures.
2. How does PRF function biologically?
PRF releases growth factors that stimulate cell proliferation, angiogenesis, and extracellular matrix formation, promoting both soft and hard tissue regeneration.
3. Does PRF accelerate healing?
Yes, PRF accelerates healing of both soft and hard tissues, reducing recovery time and postoperative complications.
4. Does PRF help in bone formation?
PRF stimulates osteoblast activity and angiogenesis, supporting bone formation and regeneration around implants.
5. Does PRF reduce bone loss around the implants?
Studies indicate that PRF can reduce crestal bone loss around implants, enhancing bone stability.
6. How does PRF improve osseointegration?
PRF creates a growth factor-rich environment that enhances the integration of the implant with surrounding bone.
7. Is PRF suitable for immediate implantation and loading?
Yes, PRF can be used in immediate implant placement and loading protocols to improve healing and initial stability.
8. How is PRF produced?
PRF is produced by collecting the patient’s blood and centrifuging it without anticoagulants to separate fibrin-rich clots.
9. Is PRF biocompatible and safe?
Yes, PRF is autologous and free of chemical additives, making it highly biocompatible and safe.
10. Which procedures is PRF used for?
PRF is used in dental implant placement, bone grafting, sinus lifts, tooth extraction, and periodontal surgeries to enhance healing.
11. Does PRF accelerate healing following tooth extraction?
Yes, PRF reduces healing time and lowers the risk of complications following tooth extraction.
12. Is PRF a form of autologous blood therapy?
Yes, PRF is an autologous therapy prepared from and applied using the patient’s own blood.
13. Are there any PRF contraindications?
PRF is contraindicated in patients with severe blood disorders, systemic infections, or inability to provide adequate blood samples.
14. What are the alternatives to PRF?
Alternatives include Platelet-Rich Plasma (PRP), collagen membranes, and autogenous, allogeneic, or xenogenic bone grafts.
15. Are there any disadvantages of PRF?
Disadvantages include mild regenerative effect and variable results depending on patient health and blood quality.
16. When is PRF not suitable?
PRF is not suitable for patients with blood disorders, severe systemic illnesses, or large bone defects.
17. What if a patient’s blood is not suitable for PRF?
Alternatives include PRP, growth factor membranes, or autogenous/allogeneic/xenogenic bone grafts.
18. What are the advantages of PRF compared to common alternatives?
PRF is fully autologous, promotes faster healing, reduces inflammation, and improves graft stability.
