Platelet concentrates

Clinical questions

What is the current evidence to support the use of platelet concentrates (PC) in implant therapy? Is the use of PCs worthwhile?
There is currently limited evidence to support possible recommendations. However, no negative side effects associated with the use of PC have been reported.

Do all PCs have similar effects or should they be recommended differently?
There are several different classifications for PCs. A distinction must be made between platelet-rich plasma (PRP), preparation rich in growth factors (PRGF) and platelet-rich fibrin (PRF), as these have been tested and found to have different results. Additionally, the possible recommendations for each depend on the specific clinical indications.

Do PCs improve implant success rates?
Neither PRP nor PRGF have been shown to improve implant stability or reduce marginal bone loss (MBL) following implant placement. A randomised clinical trial (RCT) was carried out to determine whether the use of PRF can lead to better ISQ values and lower levels of MBL, but there is currently insufficient evidence to support a clinical recommendation on this basis.

Do PCs improve the results of alveolar ridge preservation (ARP)?
PRP and PRGF have not been shown to improve the outcome of ARP procedures, whether used alone or in conjunction with graft materials. PRF, however, has been found to limit post-extraction bone resorption and therefore can be recommended.

Can PCs improve the outcome of ridge augmentation procedures?
PRP has been shown to improve the clinical results of augmentation procedures and may be recommended. However, PRGF and PRF have not been evaluated for this indication.

Are PCs beneficial in sinus-lift procedures when used in combination with autogenous bone and/or bone substitutes?
None of the PC variants have been found to be superior to conventional sinus-lift techniques; they are therefore not recommended

Are there any other possible recommendations for PCs?
It has been shown that the use of PRF in open-flap debridement of peri-implantitis can lead to improved results, but the data supporting this is limited and cannot support a clinical recommendation.

Key points
  • 1. Generally speaking, there is insufficient evidence supporting the use of PCs
  • 2. PRP, PRGF and PRF have been proven to have different effects depending on the clinical indication
  • 3. PRF can be used in alveolar ridge preservation, but PRP and PRGF have shown no additional benefits for this indication
  • 4. The use of PRP may be recommended in augmentation procedures, but limited evidence is available on this matter
  • 5. None of the PCs are recommended for sinus-lift procedures as they have not been proven to have any additional benefits to the conventional procedure