Platelet concentrates for periodontal regeneration

  • Prabha Kadakampallil John Department of Periodontics, Pushpagiri College of Dental Sciences, Kerala
  • Thomas George Valliaveettil Department of Periodontics, Pushpagiri College of Dental Sciences, Kerala
  • Annie Kitty George Department of Periodontics, Pushpagiri College of Dental Sciences, Kerala
  • Alenya Mary Pyas Department of Periodontics, Pushpagiri College of Dental Sciences, Kerala


Platelet concentrates are derivatives of blood that aid in haemostasis and wound healing after periodontal regenerative procedures. Its ability to act as a natural scaffold of growth factors has gained significance in many surgical procedures. This review article aims to briefly describe the different platelet concentrates used in the field of periodontology.


Download data is not yet available.


1. Kanakamedala A, Ari G, Sudhakar U, Vijayalakshmi R, Ramakrishnan T, Emmad P. Treatment of a furcation defect with a combination of platelet-rich fibrin (PRF) and bone graft—A case report. ENDO (LondEngl) 2009; 3:127-35.
2. Deodhar AK, Rana RE. Surgical physiology of wound healing: a review. J Postgrad Med 1997; 43:52-6.
3. Harrison P. Platelet function analysis. Blood Rev 2005; 19:111-23.
4. Marx RE (2004) Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg 62(4): 489-496.7.
5. Marx RE (2001) Platelet-rich plasma (PRP): what is PRP and what is not PRP? Implant Dent 10(4):225-228.
6. Matras H. [Effect of various fibrin preparations on reimplantation in the rat skin]. Osterr Z Stomatol 1970; 67: 338-359.
7. Ross R, Glomset J, Kariya B, Harker L. A platelet dependent serum factor that stimulates the proliferation of arterial smooth muscle cells in vitro. Proc Natl Acad Sci USA 1974; 71:1207-10.
8. Knighton DR, Ciresi KF, Fiegel VD, Austin LL, Butler EL. Classification and treatment of chronic nonhealing wounds. Successful treatment with autologous platelet-derived wound healing factors (PDWHF). Ann Surg 1986; 204: 322-330.
9. Marx RE, Carlson ER, Eichstaedt RM, Schimmele SR, Strauss JE, Georgeff KR. Platelet-rich plasma: Growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 85: 638-646.
10. Choukroun J, Adda F, Schoeffler C, Vervelle A. An opportunity in perio-implantology: The PRF. Implantodontie 2001; 42:55-62.
11. Bielecki T, Gazdzik TS, Szczepanski T. Re: “The effects of local platelet rich plasma delivery on diabetic fracture healing”. What do we use: Platelet-rich plasma or platelet-rich gel? Bone 2006; 39: 1388; author reply 1389.
12. Cieslik-Bielecka A, Gazdzik TS, Bielecki TM, Cieslik T. Why the platelet-rich gel has antimicrobial activity? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103: 303-305; author reply 303-305.
13. Cieslik-Bielecka A, Bielecki T, Gazdzik TS, Arendt J, Król W, Szczepanski T. Autologous platelets and leukocytes can improve healing of infected high-energy soft tissue injury. Transfus Apher Sci 2009; 41: 9-12.
14. Sacco L. Lecture, International academy of implant prosthesis and osteoconnection. Lecture 2006; 12: 4.
15. Dohan Ehrenfest DM, Del Corso M, Diss A, Mouhyi J, Charrier JB. Three-dimensional architecture and cell composition of a Choukroun’s platelet-rich fibrin clot and membrane. J Periodontol 2010; 81: 546-555.
16. Sohn DS. Lecture titled with sinus and ridge augmentation with CGF and AFG, Symposium on CGF and AFG. Tokyo, June 6, 2010.
17. Choukroun J. Advanced PRF and i-PRF: Platelet concentrate or blood concentrate? J Periodontal Med Clin Pract 2014; 1: 3.
18. Tunalı M, Özdemir H, Küçükodacı Z, Akman S, Fıratlı E. In vivo evaluation of titanium-prepared platelet-rich fibrin (T-PRF): a new platelet concentrate. Br J Oral Maxillofac Surg 2013; 51: 438-443.
19. Mourão CF, Valiense H, Melo ER, Mourão NB, Maia MD. Obtention of injectable platelets rich-fibrin (i-PRF) and its polymerization with bone graft: technical note. Rev Col Bras Cir 2015; 42: 421-423.
20. Smith RG, Gassmann CJ, Campbell MS. Platelet‑rich plasma: Properties and clinical applications. J Lanc Gen Hosp 2007; 2:73‑7.
21. Weibrich G, Kleis WK, Hafner G, Hitzler WE, Wagner W. Comparison of platelet, leukocyte, and growth factor levels in point‑of‑care platelet‑enriched plasma, prepared using a modified Curasan kit, with preparations received from a local blood bank. Clin Oral Implants Res 2003; 14:357‑62.
22. Anitua E. Plasma rich in growth factors: Preliminary results of use in the preparation of future sites for implants. Int J Oral Maxillofac Implants 1999; 14:529‑35.
23. Lekovic V, Camargo PM, Weinlaender M, Vasilic N, Kenney EB. Comparison of platelet‑rich plasma, bovine porous bone mineral, and guided tissue regeneration versus platelet‑rich plasma and bovine porous bone mineral in the treatment of intrabony defects: A re-entry study. J Periodontol 2002; 73:198‑205.
24. Wiltfang J, Schlegel KA, Schultze-Mosgau S, et al. Sinus floor augmentation with beta-tricalciumphosphate: does platelet-rich plasma promote its osseous integration and degradation? Clin Oral Impl Res. 2003; 14:213–8.
25. Suaid, F. F., Carvalho, M. D., Santamaria, M. P., Casati, M. Z., Nociti, F. H., Sallum, A. W., & Sallum, E. A. (2008). Platelet-Rich Plasma and Connective Tissue Grafts in the Treatment of Gingival Recessions: A Histometric Study in Dogs. Journal of Periodontology, 79(5), 888–895.
26. Torres J, Tamimi F, Martinez PP, et al. Effect of platelet-rich plasma on sinus lifting: a randomized-controlled clinical trial. J Clin Periodontol. 2009; 36:677–87.
27. Riaz, R., Ravindran, C., Ramkumar, & Nandakumar. (2010). Efficacy of Platelet Rich Plasma in Sinus Lift Augmentation. Journal of Maxillofacial and Oral Surgery, 9(3), 225–230.
28. Kutkut, A., Andreana, S., Kim, H., & Monaco Jr., E. (2012). Extraction Socket Preservation Graft Before Implant Placement with Calcium Sulfate Hemihydrate and Platelet-Rich Plasma: A Clinical and Histomorphometric Study in Humans. Journal of Periodontology, 83(4), 401–409.
29. Eskan MA, Greenwell H, Hill M, et al. Platelet-rich plasma-assisted guided bone regeneration for ridge augmentation: a randomized, controlled clinical trial. J Periodontol. 2014; 85:661–8.
30. Panda, S., Doraiswamy, J., Malaiappan, S., Varghese, S. S., & Del Fabbro, M. (2014). Additive effect of autologous platelet concentrates in treatment of intrabony defects: a systematic review and meta-analysis. Journal of Investigative and Clinical Dentistry, 7(1), 13–26.
31. Dutta SR, Singh P, Passi D, Patter P. Mandibular third molar extraction wound healing with and without platelet rich plasma: a comparative prospective study. J Maxillofac Oral Surg. 2015; 14:808–15.
32. Srinivas B, Rupa N, Halini Kumari K V, Prasad S, Varalakshmi U, Sudhakar K. Root coverage using subepithelial connective tissue graft with platelet-rich plasma in the treatment of gingival recession: A clinical study. J Pharm Bioall Sci 2015;7, Suppl S2:530-8.
33. Shivashankar VY, Johns DA, Vidyanath S, Kumar MR. Platelet rich fibrin in the revitalization of tooth with necrotic pulp and open apex. J Conserv Dent 2012; 15:395‑8.
34. Dohan Ehrenfest DM, de Peppo GM, Doglioli P, Sammartino G. Slow release of growth factors and thrombospondin-1 in Choukroun’s plateletrich fibrin (PRF): a gold standard to achieve for all surgical platelet concentrates technologies. Growth Factors 2009; 27: 63-69.
35. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, et al. Platelet‑rich fibrin (PRF): A second‑generation platelet concentrate. Part I: Technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101: e37‑44.
36. Naik B, Karunakar P, Jayadev M, Marshal VR. Role of Platelet rich fibrin in wound healing: A critical review. J Conserv Dent 2013; 16:284‑93.
37. Vivek G, Vivek KB, Singh GP, Ashish M, Rhythm B. Regenerative potential of platelet rich fibrin in dentistry: Literature review. Asian J Oral Health Allied Sci 2011; 1:22‑8.
38. Sunitha Raja V, Munirathnam Naidu E. Platelet‑rich fibrin: Evolution of a second‑generation platelet concentrate. Indian J Dent Res 2008; 19:42‑6.
39. Pradeep AR, Rao NS, Agarwal E, Bajaj P, Kumari M, Naik SB. Comparative evaluation of autologous platelet‑rich fibrin and platelet‑rich plasma in the treatment of 3‑wall intrabony defects in chronic periodontitis: A randomized controlled clinical trial. J Periodontol 2012; 83:1499‑507.
40. Deepa D, Jain N. Gingival fenestration defect in the maxillary anterior region treated with coronally positioned flap using platelet‑rich fibrin membrane. J Interdiscipl Dent 2015; 5:140‑4.
41. Duan X, Lin Z, Lin X, et al. Study of platelet-rich fibrin combined with rat periodontal ligament stem cells in periodontal tissue regeneration. J Cell Mol Med. 2018;22(2):1047-1055.
42. Wang, Z., Han, L., Sun, T., Wang, W., Li, X., & Wu, B. (2019). Preparation and effect of lyophilized platelet-rich fibrin on the osteogenic potential of bone marrow mesenchymal stem cells in vitro and in vivo. Heliyon, 5(10), e02739.
43. Al-Maawi, S., Herrera-Vizcaíno, C., Orlowska, A., Willershausen, I., Sader, R., Miron, R. J., … Ghanaati, S. (2019). Biologization of Collagen-Based Biomaterials Using Liquid-Platelet-Rich Fibrin: New Insights into Clinically Applicable Tissue Engineering. Materials, 12(23), 3993.
44. Atchuta A, Gooty JR, Guntakandla VR, Palakuru SK, Durvasula S, Palaparthy R. Clinical and radiographic evaluation of platelet-rich fibrin as an adjunct to bone grafting demineralized freeze-dried bone allograft in intrabony defects. J Indian Soc Periodontol. 2020;24(1):60-66.
45. Dohan Ehrenfest DM, Pinto NR, Pereda A (2018) The impact of the centrifuge characteristics and centrifugation protocols on the cells, growth factors, and fibrin architecture of a leukocyte- and platelet-rich fibrin (L-PRF) clot and membrane. Platelets 29(2): 171-184.39.
46. Corso M Del, Toffler M, Dohan Ehrenfest DM (2010) Use of an Autologous Leukocyte and Platelet-Rich Fibrin (L-PRF) Membrane in Post-avulsion Sites: An overview of Choukroun’s PRF. J Implant Adv Clin Dent 1(9): 27-35.
47. Temmerman A, Cleeren GJ, Castro AB, Teughels W, Quirynen M. L-PRF for increasing the width of keratinized mucosa around implants: A split-mouth, randomized, controlled pilot clinical trial. J Periodontal Res. 2018;53(5):793-800.
48. Eppley BL, Pietrzak WS, Blanton M. Platelet-rich plasma: a review of biology and applications in plastic surgery. Plast Reconstr Surg. 2006; 118: 147e–159e.
49. Ghanaati, S., Booms, P., Orlowska, A., Kubesch, A., Lorenz, J., Rutkowski, J., … Choukroun, J. (2014). Advanced Platelet-Rich Fibrin: A New Concept for Cell-Based Tissue Engineering by Means of Inflammatory Cells. Journal of Oral Implantology, 40(6), 679–689.
50. Pitzurra, L., Jansen, I. D. C., Vries, T. J., Hoogenkamp, M. A., & Loos, B. G. (2019). Effects of L‐PRF and A‐PRF+ on periodontal fibroblasts in in vitro wound healing experiments. Journal of Periodontal Research.
51. Sameera S, Nagasri M, Aravind Kumar P, Indeevar P, Raviraj K, Musalaiah SVVS. Comparison of two surgical techniques in the treatment of multiple gingival recessions sandwiched with a combination of A-PRF and L-PRF. Saudi Dent J. 2018;30(3):183-189.
52. Chellathurai BNK, Ganesh B, Rajaram V. Advanced Platelet-Rich Fibrin in Periosteal Inversion Technique for Root Coverage-A Case Report [published online ahead of print, 2020 Aug 4]. Clin Adv Periodontics.
53. Miron RJ, Fujioka Kobayashi M, Hernandez M (2017) Injectable platelet rich fibrin (i-PRF): opportunities in regenerative dentistry? Clin Oral Investig 21(8): 2619-2627.
54. Ozsagir, Z. B., Saglam, E., Sen Yılmaz, B., Choukroun, J., & Tunali, M. (2020). Injectable platelet‐rich fibrin and microneedling for gingival augmentation in thin periodontal phenotype: A randomized controlled clinical trial. Journal of Clinical Periodontology.
55. O’Connell, S. M. (2007). Safety Issues Associated With Platelet-Rich Fibrin Method. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 103(5), 587.
56. Tunalı, M., Özdemir, H., Küçükodacı, Z., Akman, S., Yaprak, E., Toker, H., & Fıratlı, E. (2014). A Novel Platelet Concentrate: Titanium-Prepared Platelet-Rich Fibrin. BioMed Research International, 2014, 1–7.
57. S. Takemoto, T. Yamamoto, K. Tsuru, S. Hayakawa, A. Osaka, and S. Takashima, “Platelet adhesion on titanium oxide gels: effect of surface oxidation,” Biomaterials, vol. 25, no. 17, pp. 3485–3492, 2004.
58. Tunalı M, Özdemir H, Küçükodacı Z, Akman S, Fıratlı E. In vivo evaluation of titanium-prepared platelet-rich fibrin (T-PRF): a new platelet concentrate. Br J Oral Maxillofac Surg. 2013;51(5):438-443.
59. Chatterjee, A., Pradeep, A. R., Garg, V., Yajamanya, S., Ali, M. M., & Priya, V. S. (2016). Treatment of periodontal intrabony defects using autologous platelet-rich fibrin and titanium platelet-rich fibrin: a randomized, clinical, comparative study. Journal of Investigative and Clinical Dentistry, 8(3), e12231.
60. Arabaci, T., & Albayrak, M. (2018). Titanium-prepared platelet-rich fibrin provides advantages on periodontal healing: A randomized split-mouth clinical study. Journal of Periodontology, 89(3), 255–264.
61. Ustaoğlu G, Uğur Aydın Z, Özelçi F. Comparison of GTR, T-PRF and open-flap debridement in the treatment of intrabony defects with endo-perio lesions: a randomized controlled trial. Med Oral Patol Oral Cir Bucal. 2020 Jan 1;25 (1): e117-23.
62. Borsani E, Bonazza V, Buffoli B (2015) Biological Characterization and In Vitro Effects of Human Concentrated Growth Factor Preparation: An Innovative Approach to Tissue Regeneration. Biol Med 7(5).
63. Nityasri, Aromal S, Pradeep KY, et al. Role of CGF (Concentrated Growth Factor) in periodontal regeneration. J Dent Health Oral Disord Ther. 2018;9(2):350‒352.
64. Sohn DS, Heo JU, Kwak DH et al. Bone regeneration in the maxillary sinus using an autologous fibrin-rich block with concentrated growth factors alone. Implant Dent. 2011; 20(5):389-395.
65. Bozkurt Doğan Ş, Öngöz Dede F, Ballı U, Atalay EN, Durmuşlar MC. Concentrated growth factor in the treatment of adjacent multiple gingival recessions: a split-mouth randomized clinical trial. J Clin Periodontol. 2015;42(9):868-875.
66. Dong-Seok Sohn DDS, PhD1 Bingzhen Huang MD, PhD2 Jin Kim DDS, MS3 W, Eric Park DDS4, Charles C Park DDS5. Utilization of Autologous Concentrated Growth Factors (CGF) Enriched Bone Graft Matrix (Sticky Bone) and CGF-Enriched Fibrin Membrane in Implant Dentistry. The Journal of Implant & Advanced Clinical Dentistry. 2015; 7:10
67. Gökmenoğlu C, Yavuz MC, Sadik E, Çanakçi V, Kara C. Treatment of Different Types of Bone Defects with Concentrated Growth Factor: Four Case Reports. Int J Oral Dent Health. 2016; 2:029(2):2.
68. Sohn DS. Lecture titled with sinus and ridge augmentation with CGF and AFG, Symposium on CGF and AFG. Tokyo, June 6, 2010.
69. Sohn DS, Huang B, Kim J, Park WE PC (2015) Utilization of autologous concentrated growth factors (CGF) enriched bone graft matrix (sticky bone) and CGF-enriched fibrin membrane in implant dentistry. J Implant Adv Clin Dent 7: 11-18.45.
70. Sushma Naag, Abhishek Savirmath, Butchi Babu Kalakonda, Uday Kiran Uppada, Shekar Kamisetty, et al. (2015) Platelet concentrates: Bioengineering dentistry’s regenerative dreams. J Dent Res Rev 2(2): 23-29.
71. Agrawal AA (2017) Evolution, current status and advances in application of platelet concentrate in periodontics and implantology. World J Clin cases 5(5): 159-171.47.
72. Mustafa Özay Uslu, Mehmet Kızıltoprak, Ömer Alperen Kırmızıgül. Autologous Fibrin Glue as a Novel Platelet Concentration in Palatal Wound Healing. Dental Research and Oral Health 2 (2019): 040-046.
73. U.T. Seyfert, W. Hauck, H. Berger, D. Bohm, H. Zankl, F.W. Albert Platelet-tumor cell interaction Folia Haematol Int Mag Klin Morphol Blutforsch, 117 (5) (1990), pp. 685-697.
74. S. Wang, Z. Li, R. Xu Human Cancer and platelet interaction, a potential therapeutic target Int J Mol Sci, 19 (4) (2018).
75. P. Xu, H. Zuo, B. Chen, R. Wang, A. Ahmed, Y. Hu, et al. Doxorubicin-loaded platelets as a smart drug delivery system: an improved therapy for lymphoma Sci Rep, 7 (2017), p. 42632.
76. X. Zhang, J. Wang, Z. Chen, Q. Hu, C. Wang, J. Yan, et al. Engineering PD-1-Presenting platelets for Cancer immunotherapy Nano Lett, 18 (9) (2018), pp. 5716-5725.
77. M. Dovizio, A. Bruno, A. Contursi, R. Grande, P. Patrignani. Platelets and extracellular vesicles in cancer: diagnostic and therapeutic implications Cancer Metastasis Rev, 37 (2–3) (2018), pp. 455-467.
78. J.E. Italiano Jr., A.T. Mairuhu, R. Flaumenhaft. Clinical relevance of microparticles from platelets and megakaryocytes. Curr Opin Hematol, 17 (6) (2010), pp. 578-584.
79. G. Castaman, L. Yu-Feng, F. Rodeghiero. A bleeding disorder characterised by isolated deficiency of platelet microvesicle generation. Lancet, 347 (9002) (1996), pp. 700-701.
80. H.J. Weiss. Scott syndrome: a disorder of platelet coagulant activity. Hematol, 31 (4) (1994), pp. 312-319.
81. C.M. Boulanger, N. Amabile, A. Tedgui. Circulating microparticles: a potential prognostic marker for atherosclerotic vascular disease. Hypertension, 48 (2) (2006), pp. 180-186.
82. E.A. Knijff-Dutmer, J. Koerts, R. Nieuwland, E.M. Kalsbeek-Batenburg, M.A. van de Laar. Elevated levels of platelet microparticles are associated with disease activity in rheumatoid arthritis. Arthritis Rheum, 46 (6) (2002), pp. 1498-1503.
83. S.R. Son, S.K. Sarkar, B.L. Nguyen-Thuy, A.R. Padalhin, B.R. Kim, H.I. Jung, et al. Platelet-rich plasma encapsulation in hyaluronic acid/gelatin-BCP hydrogel for growth factor delivery in BCP sponge scaffold for bone regeneration. J Biomater Appl, 29 (7) (2015), pp. 988-1002.
How to Cite
JOHN, Prabha Kadakampallil et al. Platelet concentrates for periodontal regeneration. Annals of Dentistry University of Malaya, [S.l.], v. 27, p. 55-65, dec. 2020. ISSN 2462-2060. Available at: <>. Date accessed: 26 feb. 2021.
Review Article

Most read articles by the same author(s)