The efficacy of platelet-rich fibrin (PRF) in post-extraction hard and soft tissue healing and associated complications: a systematic review and meta-analysis of split-mouth randomized clinical trials.

BACKGROUND

Tooth loss is often followed by potential complications, including restricted mouth opening, edema, regional pain, and alveolar osteitis (AO), all of which can impair socket healing and quality of life, compromising the ability to socialize and speak post-extraction. One of the approaches currently used to minimize adverse effects is to use platelet-rich fibrin (PRF) immediately following tooth extraction to reduce these complications. This study aims to evaluate the effectiveness of platelet-rich fibrin in promoting soft and hard tissue healing, and its effects on post-extraction complications.

METHOD

A systematic review and meta-analysis were conducted, following an electronic and manual search of PubMed, EMBASE, Web of Science, and Scopus databases. A total of 455 articles were screened, of which 41 articles underwent systematic review, and 21 studies (701 patients) were included for meta-analysis. Statistical analyses were performed using Comprehensive Meta-Analysis software. The risk of bias was evaluated by three assessors based on five domains. To evaluate PRF effectiveness, the focus was on split-mouth designs to minimize inter-patient variability.

RESULT

PRF significantly improved soft tissue healing (eight studies, p < 0.05), reduced AO incidence (four studies, p < 0.05), and lowered post-operative pain (eleven studies, p < 0.05). However, PRF did not demonstrate statistically significant improvement in bone healing (three studies, p > 0.05).

CONCLUSION

The analysis showed that PRF significantly improved soft tissue healing and reduced the incidence of AO. While PRF helped reduce pain, the results were inconsistent and influenced by the timing of post-operative assessments. The impact on hard tissue healing was controversial, and future research should explore alternative methods to evaluate PRF's effects on bone regeneration.