Phyto-fabricated gold nanoparticles and heterologous platelet-rich fibrin potentiates cutaneous wound healing dynamics in canines.

Management of isolated gingival recession defects using platelet rich fibrin and amnio-chorion membrane in coronally advanced flap: an in-vivo study.

This study aims to assess the impact of platelet-rich fibrin (PRF) on nasal mucociliary clearance (NMC) time and post-operative pain following septoplasty. This trial was conducted involving patients who underwent septoplasty. Participants were randomly assigned to either a control group or a PRF group. The control group underwent standard septoplasty, while in the PRF group, PRF membranes were placed and sutured between the Doyle splint and septal mucosa at the end of the surgery. NMC times were measured in both groups and in both nasal passages preoperatively and post-operatively using the saccharin test. Additionally, pain levels were assessed at the fourth post-operative hour. Changes in NMC times and pain scores were statistically analysed, with both intragroup and intergroup comparisons conducted. A total of 41 participants were included in the study, with PRF applied to 20 randomly selected individuals. The groups were comparable in terms of age, gender, smoking status, and deviation side and type (p > 0.05). A statistically significant reduction in median NMC duration was observed in the PRF group in the deviated nasal passage. Although a statistically significant increase in median NMC time was noted in the control group in the non-deviated passage (p < 0.05), this increase was limited in the PRF group. Furthermore, post-operative pain scores were significantly lower in the PRF group compared to the control group (p < 0.05). The application of PRF post-operatively may enhance nasal mucociliary clearance in the deviated nasal passage and alleviate post-operative pain in patients undergoing septoplasty.

Periodontitis is a multifactorial inflammatory disease driven by microbial dysbiosis and host immune dysregulation. Although conventional therapies, such as scaling and root planing or open-flap debridement, focus on biofilm control, they often fail to fully restore immune homeostasis. Consequently, platelet-rich fibrin (PRF) and its derivatives have gained increasing attention as biomaterials with both regenerative and immunomodulatory activity. This review summarizes contemporary insights into the immunopathogenesis of periodontitis, highlighting neutrophil dysfunction, Th17/Treg imbalance, and complement-mediated hyperinflammation as key drivers of tissue destruction. It also synthesizes current evidence on the biological and immunological roles of PRF, including its capacity to promote regulatory T-cell differentiation, modulate macrophage polarization toward an M2 phenotype, and regulate osteoimmunological pathways. Clinical studies show that adjunctive PRF improves probing pocket depth (PPD) reduction, clinical attachment level (CAL) gain, and patient-reported outcomes; however, heterogeneity in preparation protocols and defect characteristics limits comparability across studies. This review uniquely integrates the immunomodulatory mechanisms of platelet-derived concentrates with emerging personalized periodontics, emphasizing how biomarker-based individualization may enhance the predictability of regenerative outcomes.

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.

Introduction: Medication-related osteonecrosis of the jaw (MRONJ) is a significant challenge for clinicians with limited treatment options. In this case series, a CO2 laser (9.3µm) was utilized in conjunction with platelet-rich fibrin (PRF) mixed with allograft to create sticky Bone. Materials &amp; Methods: Four consecutive patients with MRONJ at implant sites were treated at a private practice setting. The necrotic bone was removed, and the sites were irradiated with a CO2 laser and ethelylenediaminetetraacetate (EDTA). Platelet-rich fibrin (PRF) mixed with BioOss Collagen particulate to create sticky bone to graft in the defect sites and secured with a solid-PRF membrane. Herbal-based mouthrinses in place of chlorehexidine was utilized as a post-surgical rinse. Follow-up time for the cases ranged from 6 months to 7 years. Results: All patients healed uneventfully without any post-operative complications. In one case, a new implant was placed without any post-operative complications with a 2-year follow-up. Conclusion: This case series demonstrates successful outcomes of treating MRONJ at implant sites utilizing CO2 laser to decontaminate the implant surface and sticky bone for regenerative therapy. Additional controlled clinical studies are necessary to validate this technique.

In regenerative dentistry, platelet rich fibrin (PRF) has been used as a concentrated autologous growth factors capable of encouraging tissue regeneration. Hence, ten patients requiring bilateral mandibular third molar extraction with similar difficulty index were included in the study. Following surgical extraction, A-PRF and I-PRF prepared using low-speed centrifugation protocols were placed into the extraction sockets during separate appointments conducted at a two-week interval. Following surgical extraction, A-PRF and I-PRF prepared using low-speed centrifugation protocols were placed into the extraction sockets during separate appointments conducted at a two-week interval. Thus, A-PRF and I-PRF prepared without anticoagulants using a low-speed centrifugation protocol in mandibular third molar surgery.

This pilot retrospective case series aimed to evaluate the 6-month clinical outcomes and safety of a combined regenerative protocol utilizing exosomes specifically designed for periodontal regeneration (Periosomes), with 90% anorganic bovine bone/10% collagen (ABBMC), and horizontal platelet-rich fibrin (H-PRF) for the treatment of advanced periodontal osseous defects. This study analyzed stage-III (severe) periodontitis patients (from poor to hopeless prognosis) who underwent periodontal surgery using Periosomes with an ABBC/H-PRF scaffold with a 6-month follow-up. Complete periodontal charting, including probing depth (PD), gingival margin (GM), bleeding on probing (BOP), clinical attachment loss (CAL), gingival index (GI), plaque index (PI), and tooth mobility, was assessed at baseline and the follow-up. The study included 13 patients (8 females and 5 males) aged 29 to 73 years, with 23 periodontal defects of one-walled (60.9%) and two-walled (39.1%) defect morphology. The sites treated with Periosomes showed statistically significant reductions in PD from baseline to six months in one-walled defects (8.50 ± 2.41 mm to 3.14 ± 0.77; p 0.0001) and two-walled defects (7.56 ± 1.13 mm to 3.22 ± 0.44; p 0.0001) as well as in CAL from 9.14 ± 3.01 mm to 4.79 ± 2.17 (p 0.0001) in one-walled defects and from 7.22 ± 1.56 mm to 3.56 ± 1.01 (p 0.0001) in and two-walled defects. Furthermore, frequency distribution analysis found that 96% of sites attained residual PD 5 mm and 92% showed CAL gains ≥3 mm at the 6-month follow-up. The combined use of Periosomes, ABBMC, and H-PRF was associated with favorable short-term clinical improvements in advanced periodontal osseous defects with no reported adverse events. To our knowledge, this is the first human clinical study assessing the use of exosomes in periodontal regenerative therapy. However, controlled clinical trials with comparator groups and longer follow-up are necessary to evaluate the independent contribution of exosomes in periodontal regeneration.

Osteoporosis is a systemic skeletal disorder characterized by impaired bone microarchitecture and reduced bone strength arising from dysregulated coupling between osteoclast-mediated resorption and osteoblast-driven formation. Estrogen deficiency, chronic inflammation, oxidative stress, and altered RANKL/OPG signaling amplify osteoclastogenesis while suppressing Wnt/β-catenin-dependent osteoblast differentiation, resulting in progressive trabecular thinning and cortical porosity. Although antiresorptive agents and anabolic therapies reduce fracture risk, they do not fully restore bone quality, microvascular integrity, or osteoimmune balance. Platelet-derived biomaterials (PDBs), including platelet-rich plasma, platelet-rich fibrin, platelet lysates, and platelet-based hydrogels, represent autologous bioactive systems enriched with platelet-derived growth factor, transforming growth factor-β, vascular endothelial growth factor, insulin-like growth factor-1, and bioactive lipid mediators. Upon activation, PDBs provide an early burst and sustained release of growth factors within a fibrin matrix that supports mesenchymal stem cell recruitment, RUNX2- and Osterix-mediated osteogenic differentiation, extracellular matrix deposition, and angiogenic coupling through VEGF-driven neovascularization. Concurrently, PDBs modulate osteoclast activity by influencing the RANKL/OPG axis, promoting macrophage polarization toward an M2 reparative phenotype, and attenuating inflammatory cytokine signaling. Integration of PDBs with osteoconductive scaffolds and nanostructured delivery platforms further enhances mechanical stability, local retention, and spatiotemporal biofactor presentation in osteoporotic bone defects. Preclinical evidence demonstrates improvements in bone mineral density, trabecular architecture, and fracture repair; emerging clinical applications in spinal fusion and fracture management suggest translational promise. However, variability in platelet concentration, activation protocols, and dosing standardization remains a barrier to widespread clinical adoption. PDB-based regenerative strategies therefore offer a mechanistically targeted and clinically adaptable approach to restoring skeletal integrity in osteoporosis.

The objective of this meta-analysis was to systematically assess the effectiveness of Platelet-Rich Fibrin (PRF) in combination with Hydroxyapatite (HA) for the regenerative treatment of periodontal intrabony defects METHODS: A systematic search was conducted across multiple databases, including PubMed, Web of Science, Cochrane Library, EMBASE, CNKI, and Wanfang, to identify Randomized Controlled Trials (RCTs) examining the combined use of PRF and HA for periodontal intrabony defects. Two independent researchers screened the literature according to inclusion and exclusion criteria, extracted data, and assessed the quality of the studies. Data analysis was performed using Stata 17.0 software. A total of 11 RCTs were included in the final meta-analysis. The meta-analysis indicated that the combination of PRF and HA significantly improved probing depth (MD = 0.74, 95% CI 0.32‒1.17, p < 0.001), clinical attachment loss (MD = 0.75, 95% CI 0.32‒1.19, p < 0.001), plaque index (MD = 0.05, 95% CI 0.00‒0.10, p = 0.03), and gingival index (MD = 0.13, 95% CI 0.01‒0.25, p = 0.04) in the treatment of periodontal intrabony defects. The combination of platelet-rich fibrin and hydroxyapatite appears to be an effective approach for treating periodontal intrabony defects. However, due to the limited number and quality of the included studies, further research with high-quality, large-scale trials is necessary to validate these findings.

Immediate implant has been one of the solutions to decrease bone resorption after tooth extraction. Gap distance between the dental implant and adjacent bone has undergone much research to enhance bone formation in this area. This is small exploratory study that aimed to compare the efficacy of extended platelet rich fibrin (e-PRF) a regenerative biomaterial produced by heating platelet-poor plasma (PPP) to denature albumin, extending the resorption time of standard PRF from 2 to 3 weeks to 4-6 months, as well as allograft as a space filling material in immediate dental implant placement. Twenty-eight implants were placed for the prosthetic replacement of non-restorable single-rooted maxillary teeth using immediate implant placement. Patients were randomly allocated into two equal groups (n = 14 each). In Group I, allograft was placed in the peri-implant gap, whereas in Group II, e-PRF was used. Implant stability was assessed using resonance frequency analysis (RFA). Buccal bone thickness and marginal bone loss were evaluated using CBCT throughout the follow-up period. Statistical analysis was performed on all clinical and radiographic data. A total of 28 patients received 28 immediate implants in the maxillary esthetic zone. During the 12-month follow-up period, all implants were successful with no complications. No statistically significant differences were observed between the groups regarding implant stability, marginal bone loss, or buccal bone thickness. Within this small exploratory trial, no statistically significant intergroup differences were detected between e-PRF and allograft as space-filling materials around immediate implants regarding stability, marginal bone loss, and buccal bone thickness. Clinical-Trials.gov PRS ( https://register. gov ) has this study registered under the identifier number. NCT07445776 on 03/02/2026.

This split-mouth randomized clinical trial aimed to assess whether incorporating platelet-rich fibrin (PRF) into a volume-stable collagen matrix results in superior reduction of recession depth after 6 months of healing in the treatment of multiple gingival recessions using the coronally advanced flap. Patients with bilateral maxillary RT1 recessions at non-molar sites were recruited. Each side received either a PRF-impregnated matrix or a non-impregnated matrix. Clinical parameters, including recession depth, keratinized tissue width, bleeding on probing, probing depth, clinical attachment level, and gingival thickness, were measured at baseline and 6 months, as well as the Root Coverage Esthetic Score (RES) and patient-reported outcome measures (PROMs). The percentage of complete root coverage was calculated 6 months after treatment. Twenty-five patients were enrolled. However, one patient was excluded due to incomplete follow-up. Both groups significantly improved over time, but no intergroup differences were observed for any of the clinical parameters (p > 0.05). No statistically significant differences were found between test and control groups in evaluations of RES and PROMs, showing similar postoperative experiences of patients. Within the limitations of this study, adding PRF to a volume-stable collagen matrix did not result in superior recession depth reduction or improved clinical, esthetic, or patient-reported outcomes after 6 months. Brazilian Register of Clinical Trials (ensaiosclinicos.gov.br) identifier: RBR-3hqrvrr (20/10/2021).

To summarize current evidence on Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) applications and outcomes in facial plastic surgery. PRP and PRF are autologous platelet concentrates with regenerative potential. They release growth factors that promote tissue repair, angiogenesis, extracellular matrix remodeling, graft integration, and scar remodeling, making them increasingly relevant in facial plastic surgery. A narrative review of clinical studies, meta-analyses, and systematic reviews was conducted. Key outcomes included wound healing, graft retention, postoperative edema and ecchymosis, scar improvement, and patient satisfaction. PRP improved wound healing, reduced crusting, and enhanced patient satisfaction in rhinoplasty, while PRF decreased cartilage resorption and improved graft stability. In rhytidectomy, PRP offered modest reductions in edema and ecchymosis. Both agents enhanced scar revision and fat graft outcomes, with PRF showing superior remodeling and long-term graft retention. In periorbital rejuvenation, PRP improved pigmentation and satisfaction, whereas PRF improved skin texture and wrinkles. Both were safe with minimal adverse events. PRP and PRF are effective biologic adjuncts in facial plastic surgery, supporting tissue regeneration, graft integration, and aesthetic outcomes. Efficacy is influenced by patient factors and technique. High-quality, procedure-specific trials are needed to optimize protocols.

Impacted mandibular third molars present a common challenge in oral surgery, often associated with postoperative complications such as delayed healing and periodontal defects; therefore, optimizing adjunctive therapies is clinically important. In this study, we aimed to evaluate the efficacy of platelet-rich fibrin (PRF) and preoperative azithromycin in modulating inflammation and enhancing wound healing following surgical extraction of impacted mandibular third molars. In this prospective clinical study, healthy subjects aged 18-50 years were randomly assigned to three groups: a control group receiving standard postoperative amoxicillin therapy, a PRF group receiving PRF with standard therapy, and a PRF-plus-azithromycin group receiving PRF, standard therapy, and a single preoperative dose of azithromycin. Clinical parameters were assessed and cytomorphometric analysis was performed preoperatively and postoperatively. Clinical parameters generally improved over time in all groups (p < 0.001). Differences between groups were observed for interincisal distance, Landry Index, and pain scores, with a trend toward more favorable outcomes in the combined-therapy group. Cytomorphometric analysis revealed cellular alterations in the control group, relative stability in the PRF group, and intermediate changes in the combined-therapy group. Within the limitations of this study, the combination of PRF and preoperative azithromycin showed potential benefits in several postoperative outcomes. However, given the study design and sample characteristics, these findings should be considered preliminary and require confirmation in larger prospective studies before definitive clinical recommendations can be made.

Platelet-rich plasma (PRP) has emerged as a major focus in soft-tissue repair in recent years, with its diverse biological functions supported by extensive experimental and clinical evidence. The biological activity of PRP extends beyond simple growth-factor delivery and is shaped by preparation heterogeneity. This review synthesized English-language evidence from PubMed/MEDLINE, Web of Science, and Google Scholar on PRP, platelet-rich fibrin, platelet-derived extracellular vesicles, soft-tissue repair, scarring, fibrosis, angiogenesis, macrophage polarization, mitochondrial transfer, stem/progenitor cells, adipose grafting, facial rejuvenation, and aesthetic soft-tissue remodeling, with literature considered up to March 2026. Current evidence indicates that PRP may influence several stages of soft-tissue remodeling, including inflammatory and immune regulation, angiogenesis and redox balance, extracellular matrix deposition and degradation, and endogenous tissue regeneration. Mechanistic findings link these effects to macrophage phenotypic modulation, TGF-β/Smad signaling, vascular reconstruction, matrix metalloproteinase activity, mitochondrial transfer, and regulation of tissue-resident stem or progenitor cells. However, PRP is not a single standardized biological product; platelet concentration, leukocyte content, activation method, fibrin architecture, release kinetics, delivery route, and distinctions among conventional PRP, PRF, and PRP-derived extracellular vesicles may substantially affect biological behavior and clinical interpretation. PRP may be best understood as a context-dependent, platelet-derived bioregulatory system that modifies the local tissue microenvironment rather than as a simple volumizing or growth-factor supplement. Its potential relevance to scar revision, fat-graft retention, wound-related contour irregularity, post-inflammatory stiffness, and facial rejuvenation supports further standardized clinical studies with clearly reported formulations and outcomes. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

ObjectiveNo studies have examined the effectiveness of platelet-rich plasma (PRP) alone and platelet-rich fibrin (PRF) without alveolar bone grafting or other bone substitutes for alveolar cleft repair during infancy. This study evaluated the effectiveness of autologous PRP/PRF on alveolar regeneration in infantile unilateral cleft lip and alveolus.DesignRetrospective study.SettingPatients, Participants: A total of 56 patients with alveolar clefts were classified into the no PRP/PRF (which received gingivoperiosteoplasty [GPP] without PRP/PRF), PRP (which received GPP with PRP), and PRF (which received GPP with PRF) groups.InterventionsRegarding preparation, 5 mL of blood was withdrawn, and 1 mL each of PRP and PRF was prepared via centrifugal separation. PRP was implanted in the alveolar cleft after loading it into a commercially available gelatin sponge, while PRF was implanted directly.Main Outcome MeasuresPostoperative bone formation was assessed using computed tomography and radiography for qualitative analysis.ResultsThe new alveolar bone volume was higher in the PRF group than in the other groups; however, no differences were observed between the PRP, PRF, and control groups.ConclusionThis study was performed without complication. However, no significant difference in bone formation was found between the PRP, PRF, and control groups.

Platelet-rich fibrin (PRF) has gained prominence in dentistry as an autologous biomaterial with high regenerative potential, widely used as an adjuvant in post-surgical healing. This study aimed to analyze, from a physiological perspective, the mechanisms of action of PRF and its effectiveness in the tissue repair process. This is a qualitative research with a descriptive and exploratory approach, developed through a literature review based on scientific articles, dissertations, and recent studies on the subject. The results show that PRF acts directly on the different phases of healing, promoting the gradual release of growth factors, stimulating angiogenesis, cell proliferation, and extracellular matrix organization. In addition, its contribution to the modulation of the inflammatory response was observed, resulting in reduced pain, edema, and post-operative complications. The critical analysis of the studies also revealed that, despite its benefits, the effectiveness of PRF may vary according to individual patient factors and the technique used, highlighting the need for standardization of clinical protocols. In this sense, PRF should not be considered an isolated solution, but rather a complementary tool integrated into therapeutic planning. The relevance of this study lies in expanding scientific knowledge about autologous biomaterials and contributing to safer and more effective clinical practices. It is concluded that PRF has great potential in optimizing post-surgical healing, representing a promising alternative in contemporary dentistry, provided it is used judiciously and based on scientific evidence.

Objective This study investigated the impact of physical activity levels on growth factor concentrations within leukocyte- and platelet-rich fibrin (L-PRF).Methodology In total, 120 participants were categorized into sedentary (n=60) and physically active (n=60) groups via the International Physical Activity Questionnaire. Venous blood was collected to analyze platelet count, mean platelet volume, white blood cell count, red blood cell count, plateletcrit, platelet distribution width, and platelet-large cell ratio, and to prepare the L-PRF. Concentrations of vascular endothelial growth factor (VEGF), transforming growth factor-beta (TGF-β), and platelet-derived growth factor (PDGF) were determined using ELISA.Results Metabolic equivalent of task (MET) values were significantly higher in the active group (p<0.001). Conversely, VEGF, TGF-β, and PDGF levels were significantly higher in the sedentary group (p<0.001). Hemoglobin and hematocrit values were also significantly higher in active individuals (p=0.025 and p=0.040, respectively). A significant moderate negative correlation was found between MET values and concentrations of VEGF, TGF-β, and PDGF (r=−0.33, r=−0.33, and r=−0.31, respectively; p<0.01). Multivariable linear regression analyses, adjusted for sex, periodontal parameters, and hematological variables, confirmed that Total MET constituted an independent negative predictor of all growth factors (all p<0.001), whereas periodontal indices showed no significant independent associations. Sex-stratified analyses and interaction models showed that the association between physical activity and growth factor levels was significantly sex dependent (MET × sex interaction: all p<0.05), with stronger effects in women.Conclusions Physical activity seems to be associated with variations in growth factor levels in L-PRF, suggesting that individual physiological status may influence the biological composition of autologous platelet concentrates.

The potential of eggshell membrane in bone regeneration: a scoping review of applications and advances.

Reconstruction of keratinized mucosa (KM) with sufficient dimensions is critical for long-term periodontal and peri-implant health. However, existing biomaterials struggle to recapitulate the complex biophysical and biochemical microenvironment of KM while achieving stable adhesion and integration in the wet and mechanically dynamic oral cavity. Here, we design a photocrosslinkable double-network hydrogel composed of methacrylated platelet-rich fibrin (iPRF-MA), N-hydroxysuccinimide-functionalized alginate (Alg-NHS), and luteolin-loaded epigallocatechin gallate microspheres (Lut@EGCG) to enable KM regeneration in the challenging oral environment through dual microenvironmental modulation. At the material level, the covalent network from iPRF-MA and the supramolecular network based on Alg-NHS work synergistically, resulting in strong wet tissue adhesion and high fatigue resistance, which collectively prevent hydrogel dislodgement under oral dynamic stresses. Biochemically, the hydrogel enables sustained release of growth factors and EGCG, synergistically enhancing angiogenesis and immune regulation, while also redirecting neutrophil phenotype toward a phagocytic state for specific antibacterial activity. Biophysically, the hydrogel provides gingival fibroblasts with a mechanically instructive microenvironment that activates mechanotransduction signaling and accelerates extracellular matrix remodeling. In vivo experiments confirm outstanding KM regeneration following treatment with the double-network hydrogel. This study demonstrates a microenvironment-targeting strategy for KM reconstruction through rational hydrogel design, offering a therapeutic platform for functional KM regeneration.