Giannelli Andrea, Forte Marta, D'Albis Giuseppe, Cianciotta Giulia, Limongelli Luisa, Stef Laura, Feier Ramona, Alrashadah Abdulrahman Omar, Corsalini Massimo, Capodiferro Saverio
Private Practitioner, 73046 Matino, Italy.
Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, 70124 Bari, Italy.
J Clin Med. 2025 Apr 20;14(8):2844. doi: 10.3390/jcm14082844.
The physiological process of wound healing is a complex and dynamic series of events that aims to restore damaged tissues to their original structure and function. Platelet-rich plasma (PRP), an autologous blood-derived product, is characterized by a high concentration of platelets suspended in a small volume of plasma, along with a complete array of coagulation factors at physiological concentrations. Beyond platelets, PRP contains a significant quantity of bioactive growth factors, such as platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and transforming growth factor-beta (TGF-β), all of which are crucial mediators of tissue repair and osteogenesis. Due to these properties, PRP has garnered considerable attention in oral surgery, where the efficient regeneration of both hard and soft tissues is critical for the optimal therapeutic outcomes. This systematic review aimed to critically evaluate the efficacy of PRP in oral surgical procedures, with particular emphasis on its role in the regeneration of both soft and hard tissues, as well as its clinical outcomes. Furthermore, the review sought to identify the diverse surgical applications of PRP and assess the impact of its use in conjunction with grafting materials on regenerative outcomes. A comprehensive systematic review was conducted, analyzing articles published within the last decade regarding the application of PRP in oral surgery, specifically focusing on periodontal, regenerative, and implant-related procedures. Studies were selected based on rigorous inclusion criteria, assessing the utilization of PRP across different clinical settings. Thirteen relevant studies were included, which were categorized as follows: three studies involving implant surgery, three studies focusing on third molar extractions, two studies on regenerative surgery, two studies addressing periodontal surgery, one study examining intrabony periodontal defects, and two studies on ridge augmentation procedures. The majority of studies reported modest improvements in clinical parameters such as periodontal probing depth and clinical attachment level (CAL). Furthermore, significant positive outcomes were observed in soft tissue healing, with notable enhancements in bone density. These results suggest that PRP may facilitate the healing process, particularly in soft tissues, while also promoting bone regeneration to a degree. The findings of this systematic review underscore the potential of PRP as a valuable adjunct in oral surgery, demonstrating significant benefits in the regeneration of soft tissues and, to a lesser extent, hard tissues. Notably, the standalone application of PRP did not yield substantial improvements in regenerative outcomes. However, when PRP was used in combination with grafting materials, more pronounced benefits were observed, indicating a synergistic effect that enhances both soft and hard tissue regeneration. These findings support the rationale for incorporating PRP into clinical practice, particularly in conjunction with grafting materials, to optimize patient outcomes in oral surgery. Further research, particularly involving larger sample sizes and long-term follow-ups, is necessary to fully elucidate the optimal clinical applications and mechanistic pathways of PRP in oral regenerative procedures.
伤口愈合的生理过程是一系列复杂且动态的事件,旨在将受损组织恢复到其原始结构和功能。富血小板血浆(PRP)是一种自体血液衍生产品,其特点是在少量血浆中悬浮着高浓度的血小板,以及生理浓度的全套凝血因子。除血小板外,PRP还含有大量生物活性生长因子,如血小板衍生生长因子(PDGF)、血管内皮生长因子(VEGF)和转化生长因子-β(TGF-β),所有这些都是组织修复和成骨的关键介质。由于这些特性,PRP在口腔外科中受到了相当大的关注,在口腔外科中,软硬组织的有效再生对于实现最佳治疗效果至关重要。本系统评价旨在严格评估PRP在口腔外科手术中的疗效,特别强调其在软硬组织再生中的作用及其临床结果。此外,该评价旨在确定PRP的各种外科应用,并评估其与移植材料联合使用对再生结果的影响。进行了一项全面的系统评价,分析了过去十年内发表的关于PRP在口腔外科中的应用的文章,特别关注牙周、再生和种植相关手术。根据严格的纳入标准选择研究,评估PRP在不同临床环境中的使用情况。纳入了13项相关研究,分类如下:三项涉及种植手术的研究,三项关注第三磨牙拔除的研究,两项关于再生手术的研究,两项涉及牙周手术的研究,一项检查骨内牙周缺损的研究,以及两项关于牙槽嵴增高手术的研究。大多数研究报告了临床参数如牙周探诊深度和临床附着水平(CAL)的适度改善。此外,在软组织愈合方面观察到显著的积极结果,骨密度有明显提高。这些结果表明,PRP可能促进愈合过程,特别是在软组织中,同时也在一定程度上促进骨再生。本系统评价的结果强调了PRP作为口腔外科中有价值辅助手段的潜力,证明了其在软组织再生以及在较小程度上在硬组织再生中的显著益处。值得注意的是,PRP的单独应用在再生结果方面并未产生实质性改善。然而,当PRP与移植材料联合使用时,观察到了更明显的益处,表明存在增强软硬组织再生的协同效应。这些发现支持了将PRP纳入临床实践的理论依据,特别是与移植材料联合使用,以优化口腔外科手术的患者预后。需要进一步的研究,特别是涉及更大样本量和长期随访的研究,以充分阐明PRP在口腔再生手术中的最佳临床应用和作用机制途径。