Thirty Years of Autologous Platelet Concentrates: From Platelet-Rich Plasma to Platelet-Rich Fibrin.

Abstract

Nearly three decades have now passed since autologous platelet concentrates (APCs) were introduced into clinical practice. Harnessing the body's innate intrinsic capacity for healing, the concepts of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) emerged to concentrate growth factors and cells at supra-physiological levels. Nearly three decades ago, Professor Robert Marx demonstrated that PRP-obtained via centrifugation of whole blood with anti-coagulants-could accelerate healing across a wide range of indications in both dentistry and medicine. Subsequent research showed that eliminating anti-coagulants, leading to the development of PRF, resulted in an even more natural and faster healing process. In dentistry, APCs have been consistently shown to accelerate healing of both soft and hard tissues, either as standalone treatments or in combination with other biomaterials. PRF, in particular, has demonstrated benefits within several dental applications, spanning from root coverage, periodontal regeneration of intra-bony and furcation defects, ridge preservation, third molar extraction healing, sinus grafting, guided bone regeneration (GBR), and peri-implant soft tissue healing. Beyond dentistry, PRF has also proven effective in various medical indications-improving outcomes in the treatment of diabetic ulcers, managing joint pain and cartilage degradation in sports medicine, and enhancing outcomes in esthetic medicine. This review highlights the evolution of APCs, with a focus on their clinical applications and recent technological advancements. These include horizontal centrifugation techniques for PRF and more refined protocols for producing concentrated PRF (C-PRF). Lastly, the article introduces extended-PRF (e-PRF) membranes, created through heat-induced albumin denaturation, which prolong membrane degradation from the typical 2-3 weeks to up to 4 months. These innovative e-PRF membranes, composed of albumin gel and liquid PRF (Alb-PRF), are now being used as alternatives to collagen membranes in routine dental procedures.