Platelet Concentrates in Oral Surgery: Indications and Limits. A Literature Review

Background: Platelet concentrates (PC) are blood-derived products for local application able to stimulate regeneration in soft and hard tissues, mimicking the physiological healing process. Their efficacy in oral surgical procedures is controversial and limited. Objective: The study aims to critically analyze the available evidence for the effect of autogenous PC on wound healing of different oral surgical sites reported by more recent clinical studies. Methods: Electronic and manual searches in three databases (Medline, Web of Science, Scopus) were performed to identify the clinical studies from January 2017 to December 2017 which reported the actual oral surgical indications and the benefit of local application of PC. All human studies evaluating PRP or PRF in a randomized controlled trial, case series, case report and systematic review were included. All animal, histologic and in vitro studies were excluded. Results: Fifty-two studies were selected. The use of PRF was proposed in treating many oral surgical sites. Data availability with regard to the effect of PRF on new bone formation in GBR and horizontal/ vertical bone augmentation procedures varied from abundant to absent. Positive results concerning the effect of PRF on potential post-surgical complication (pain, swelling and trismus) were reported. Conclusion: Few clinical indications could be determined: the literature on the topic was contradictory and the published data were difficult to interpret. Positive results were generally recorded for soft tissues and periodontal wound healing. No real benefit of PC application on bone regeneration was evidenced.