PRF (platelet-rich fibrin) has become an integral part of my surgical practice, and the change in patient outcomes has been striking. Reduced postoperative morbidity, faster healing, and improved patient engagement are all results I now observe routinely. Understanding why PRF produces these outcomes — and communicating that clearly to patients — has deepened both my clinical approach and my team’s confidence in delivering it.
PRF is an autologous material that carries no risk of immune reaction and no concerns around biocompatibility. Prepared through a straightforward centrifugation process, it enhances and supports the body’s natural healing cascade. It contains a fibrin matrix, platelets, leukocytes, and even circulating stem cells, all working together to support tissue regeneration, reduce inflammation, and improve the predictability of treatment outcomes.
The evidence so far
A growing body of literature supports the use of PRF in oral surgery. Improved soft tissue healing following tooth extraction has been demonstrated in systematic review evidence,[i] while positive outcomes have also been reported in the peri-implant environment, including increased width of keratinised tissue and enhanced soft tissue thickness.[ii] PRF has also been associated with improved secondary implant stability.[iii]
A key reason PRF is so valuable is the fibrin itself. Fibrin acts as a provisional extracellular matrix and three-dimensional scaffold, providing the structural environment that guides early healing. Fibroblasts, endothelial cells, and osteogenic cells all use this network as their initial framework for tissue organisation and repair.
Within this fibrin matrix, platelets act as one of the main biological drivers of regeneration. They contain growth factors and signalling molecules that promote angiogenesis, stimulate cell proliferation, collagen production, and cell differentiation.[iv] These growth factors are gradually released from the fibrin scaffold, supporting a sustained and organised healing response. Crucially, an analgesic effect has also been documented: a recent systematic review published in Periodontology 2000 reported that up to 72% of patients experienced reduced postoperative pain when PRF was used.[v]
Leukocytes add another important dimension. They assist with wound debridement and immune control in the early phase — particularly relevant in oral surgery — and contribute key growth factors, including vascular endothelial growth factor (VEGF), which plays a central role in driving angiogenesis and supporting tissue repair.iv Evidence specifically examining leucocyte- and platelet-rich fibrin (L-PRF) demonstrates improved bone formation and socket width, further supporting the value of the leucocyte component.[vi]
Observed real-world benefits
In my hands, PRF creates the biological conditions required for effective and predictable tissue regeneration. I use it in all my bone grafting cases and have consistently found it optimises healing post-surgery.
One of the most practically useful benefits is what happens when PRF is combined with particulate grafts. The result is what clinicians often call “sticky bone”: the biomaterial becomes cohesive and far easier to handle. Rather than chasing loose granules around the surgical site, the graft can be stabilised, shaped, and precisely adapted to the defect. This improves surgical control and graft stability simultaneously, reducing operative time and supporting more predictable outcomes — a combination that is difficult to achieve through any other single means.
There are also meaningful patient advantages beyond the clinical ones. The consultation conversations required before PRF treatment provide a genuine opportunity to discuss patients’ broader health in detail. Many patients respond with considerable engagement — reading the literature we provide, asking thoughtful questions, and taking a real interest in how their treatment is being optimised. This kind of informed involvement tends to support better long-term oral health behaviours and strengthens the therapeutic relationship.
I have also observed a positive impact on the wider team. Five dental nurses at the practice are now trained to use the equipment and facilitate the procedure, managing everything from stock ordering to appointment preparation and centrifuge operation. This level of involvement gives team members a more meaningful role in treatment delivery, promoting a genuinely collaborative culture — and the effect on team morale has been tangible.
Application in practice
A potential challenge for clinicians introducing PRF into their routine is phlebotomy competence. This is straightforwardly resolved through a high-quality phlebotomy course. There is also the matter of equipment: the centrifuge and a stock of test tubes represent an upfront cost that must be factored in, both for the practice and in terms of transparent communication with patients about any associated fees. Like most new procedures, however, once the workflow is established it becomes second nature, and the investment — in training, equipment, and time — is clearly worthwhile.
PRF is not without its limitations. Case selection matters, and it should be used as part of a considered surgical approach rather than applied universally. The evidence base, while increasingly robust, continues to evolve, and clinicians should remain engaged with the literature as it develops. That said, in the right cases, the combination of structural support, biological signalling, immune regulation, and improved graft handling that PRF provides makes it a genuinely valuable addition to the surgical armamentarium.
For those looking to develop their knowledge further, the Association of Implantology (ADI) offers high-quality professional education and the opportunity to connect with like-minded peers. Colleagues at all stages of their implant career are very welcome.
For more information about the ADI, visit www.adi.org.uk
Author: Dr Zubair Sacranie ADI president-elect
[i] Al-Maawi S, Becker K, Schwarz F, Sader R, Ghanaati S. Efficacy of platelet-rich fibrin in promoting the healing of extraction sockets: a systematic review. Int J Implant Dent. 2021 Dec 19;7(1):117. doi: 10.1186/s40729-021-00393-0.
[ii] Giammarinaro E, Baldini N, Covani U, Menini M, Pesce P, Marconcini S. Does platelet-rich fibrin enhance the outcomes of peri-implant soft tissues? A systematic review. BMC Oral Health. 2025 Apr 22;25(1):615. doi: 10.1186/s12903-025-05922-6.
[iii] Tabassum S, Raj SC, Rath H, Mishra AK, Mohapatra A, Patnaik K. Effect of platelet rich fibrin on stability of dental implants: A systematic review and meta-analysis. Int J Health Sci (Qassim). 2022 Sep-Oct;16(5):58-68.
[iv] Strauss FJ, Nasirzade J, Kargarpoor Z, Stähli A, Gruber R. Effect of platelet-rich fibrin on cell proliferation, migration, differentiation, inflammation, and osteoclastogenesis: a systematic review of in vitro studies. Clin Oral Investig. 2020 Feb;24(2):569-584. doi: 10.1007/s00784-019-03156-9.
[v] Estrin NE, Tran TB, Ahmad P, Farshidfar N, Romanos GE, Sculean A, Miron RJ. Analgesic effects of platelet-rich fibrin (PRF): A systematic review. Periodontology 2000. 2025 Oct 13. doi: 10.1111/prd.70014. Epub ahead of print.
[vi] Wang X, Xin F, Zhou S. A systematic review and meta-analysis of effect of leucocyte- and platelet-rich fibrin on dental extraction. Med Oral Patol Oral Cir Bucal. 2024 Nov 1;29(6):e775-e781. doi: 10.4317/medoral.26724.
