Use of Platelet-Rich Fibrin (PRF) on Palatal Wound Healing: A Narrative Review With Clinical Recommendations.

Abstract

This clinical narrative review aimed to comprehensively evaluate the effects of platelet-rich fibrin (PRF) on clinically related and patient-reported outcomes during palatal wound healing following autologous palatal graft harvesting. To gather all available evidence, a comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar, along with a manual search of reference lists from eligible studies, up to November 22, 2024. A total of 28 clinical comparative studies were identified, including 21 randomized clinical trials (RCTs), two non-RCTs, and five case series. Most studies investigated the application of PRF following free gingival grafts (FGG) rather than subepithelial connective tissue grafts (SCTG), with the majority also using solid PRF as opposed to liquid PRF. For FGG harvesting sites, PRF demonstrated positive outcomes in enhancing wound healing-related outcomes, reducing postoperative pain and other complications, lowering analgesic consumption, and improving quality of life (QoL). For SCTG harvesting sites, PRF also showed beneficial effects in promoting wound healing, reducing postoperative pain, and eliminating the need for analgesics. Based on the current findings, PRF application following either FGG and SCTG harvesting appears to be a promising approach for enhancing wound healing, minimizing postoperative complications, reducing analgesic consumption, and improving patient satisfaction. Clinical recommendations, along with step-by-step protocols, are also provided in this review article to guide clinicians in optimized efficiency for use of PRF for palatal wound healing following FGG and SCTG harvesting. A recommended simplified use of solid PRF prepared using horizontal centrifugation, in combination with a palatal stent, is suggested. The addition of sutures alongside the stent may provide enhanced stabilization of PRF in place for larger graft sites. Nevertheless, further well-designed RCTs with standardized methods and larger sample sizes are needed to strengthen the evidence base and confirm the therapeutic advantages of PRF in palatal wound healing.