Platelet-Rich Fibrin and Its Derivatives as Adjuncts to Dental Implant Osseointegration: A Scoping Review.

Abstract

Background: Platelet-rich fibrin (PRF) is a family of autologous platelet concentrates whose solid and liquid formulations differ in cellular distribution, fibrin architecture, handling, and intended clinical use. Contemporary evidence suggests a possible influence on early peri-implant healing, but long-term osseointegration and implant-survival advantages are uncertain.

Objective: To map human clinical evidence on leukocyte- and PRF (L-PRF), advanced PRF (A-PRF), injectable or liquid PRF (i-PRF/liquid PRF), and related PRF formulations used as adjuncts to dental implant osseointegration, with attention to preparation protocols, outcome methods, healing phase, and clinical limitations.

Methods: A scoping review was conducted in accordance with JBI guidance and PRISMA-ScR. PubMed/MEDLINE, Web of Science Core Collection, and Embase were searched for English-language human clinical studies published from 2015 to 2025. Eligible studies assessed a PRF formulation during implant placement or site preparation and reported implant stability, radiographic bone outcomes, histological bone formation, or peri-implant clinical outcomes. Evidence was synthesized by PRF formulation, outcome modality, and early (within 3 months) versus later (6 months or longer) observation.

Results: Nineteen human clinical studies met the eligibility criteria. RFA/ISQ was the most common outcome and frequently suggested a transient improvement in secondary stability during the first weeks of healing. Several radiographic studies reported favorable bone-density or marginal bone findings, whereas others found no between-group differences. Histological evidence was sparse and was not interchangeable with RFA or radiographic surrogate outcomes. Studies with follow-up of 6-12 months did not establish consistent superiority in marginal bone preservation, implant survival, or other long-term clinical endpoints. Preparation reporting was incomplete: rpm and time were often stated, but relative centrifugal force (RCF), rotor geometry, tube composition, and device specifications were commonly missing.

Conclusions: PRF and its derivatives show promising potential as adjuncts that may accelerate early healing and secondary implant stability. The available evidence does not establish durable superiority for osseointegration or implant survival, nor does it identify one formulation as clinically superior. Standardized randomized trials with complete preparation reporting, validated outcome measures, long-term follow-up, patient-reported outcomes, and economic evaluation are required.