CC BY-NC-ND 4.0 · Eur J Dent 2019; 13(02): 280-286
DOI: 10.1055/s-0039-1696585
Review Article
Dental Investigation Society

From Platelet-Rich Plasma to Advanced Platelet-Rich Fibrin: Biological Achievements and Clinical Advances in Modern Surgery

Andrea Caruana
1   Faculty of Health Sciences, School of Dentistry, Fernando Pessoa University, Porto, Portugal
Daniele Savina
1   Faculty of Health Sciences, School of Dentistry, Fernando Pessoa University, Porto, Portugal
José Paulo Macedo
1   Faculty of Health Sciences, School of Dentistry, Fernando Pessoa University, Porto, Portugal
Sandra Clara Soares
2   Biomedical Research Center, Fernando Pessoa Energy, Environment and Health Research Unit, Faculty of Health Sciences, Fernando Pessoa University, Porto, Portugal
› Author Affiliations
Funding None.
Further Information

Publication History

Publication Date:
11 September 2019 (online)


In the past 20 years, the platelet concentrates have evolved from first-generation products, i.e., platelet-rich plasma (PRP) and plasma rich in growth factors to the second-generation products such as leukocyte-platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF). These autologous products with a higher leukocyte inclusion and flexible fibrin mesh act as a scaffold to increase cellular migration in the angiogenic, osteogenic, and antimicrobial potential of these biomaterials in tissue regeneration. In the second-generation platelet concentrates, the protocols are easier, cheaper, and faster with an entire physiological fibrin matrix, resulting in a tridimensional mesh, not as rigid as one of the first generations. This allows the slow release of molecules over a longer period of time and triggers the healing and regenerative process at the site of injury. The potential of A-PRF to mimic the physiology and immunology of wound healing is also due to the high concentration of growth factors released as follows: vascular endothelial growth factor, platelet-derived growth factor, transforming growth factor-β, and anti-inflammatory cytokines that stimulate tissue cicatrization, vessels formation, and bone cell proliferation and differentiation. Furthermore, the number of neutrophils and monocytes/macrophages is higher releasing important chemotactic molecules such as chemokine ligand-5 and eotaxin. Thus, L-PRF and A-PRF have been used, especially in implantology, periodontology, and maxillofacial surgery. Future clinical applications include tissue regeneration/grafts, ulcers/skin necrosis in the diabetic patient and others, plastic surgery, and even musculoskeletal lesions.

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