Effectiveness of Platelet-Rich Fibrin or Platelet-Rich Plasma in Mandibular Fracture Management: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to critically evaluate and synthesize the available evidence on the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in the management of mandibular and non-mandibular maxillofacial fractures. A comprehensive search of electronic databases was conducted up to February 2025 based on predefined inclusion criteria. The risk of bias in randomized controlled trials was assessed using the Cochrane Risk of Bias (ROB) tool, while the Newcastle-Ottawa Scale was applied to observational studies. A random-effects meta-analysis was performed to evaluate bone mineral density (BMD) at fracture sites, with mean differences and 95% confidence intervals (CI) as the effect estimate. Heterogeneity was assessed using the I² statistic, and the certainty of evidence was rated using the GRADE approach. For clinical outcomes not suitable for meta-analysis, a qualitative synthesis was conducted. Fourteen studies met the inclusion criteria. The pooled analysis revealed significantly higher mean BMD values in mandibular fractures treated with PRP/PRF at 3 months (127.33 [95% CI: 49.40 to 205.26]) and 6 months (41.47 [95% CI: 17.79 to 65.15]) follow-up compared to controls. Additionally, improved clinical outcomes-such as reduced inflammation, faster soft tissue healing, greater pain relief, and enhanced jaw mobility-were consistently reported in mandibular fracture cases treated with PRP/PRF. These findings suggest that PRP and PRF may have a beneficial role in the healing of mandibular fractures. However, the overall evidence remains limited, and studies assessing their use in non-mandibular maxillofacial fractures are scarce. Further high-quality research is needed to confirm these findings and assess their broader applicability.