Platelet concentrates a new renaissance in tissue regeneration

Main Article Content

Shaymaa S. Hassan
Emad F. Alkhalidi
Rayan S. Hamed

Keywords

platelets, autologous platelet concentrates, tissue regeneration, growth factors

Abstract

Background: Platelet concentrates inevitably open novel options in regenerative medicine and are commonly used in a variety of medical fields, including medicinal dentistry, thanks to the ability of platelets as key regenerating factors as well as other blood components to enhance tissue regeneration. Various types of autologous platelet concentrate that are typically prepared from patients’ blood have been discovered according to their preparation method and centrifugation protocol, type of tubes, and whether they require biochemical additives such as anticoagulants with different structural and regenerative properties. This review article aimed to clarify the generations and forms of platelet concentrates their preparation methods, biological action, composition, and application in dentistry.

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References

1. Khiste SV, Naik Tari R. Platelet-Rich Fibrin as a Biofuel for Tissue Regeneration. ISRN Biomaterials. 2013;1-6.
2. Ribatti D, Crivellato E. Giulio Bizzozero and the discovery of platelets. Leukemia Research. 2007;31(10):1339-41. https://doi.org/10.1016/j.leukres.2007.02.008
3. Chaudhary PK, Kim S, Kim S. An Insight into Recent Advances on Platelet Function in Health and Disease. IJMS. 2022;23(11):6022.https://doi.org/10.3390/ijms23116022
4. Scridon A. Platelets and Their Role in Hemostasis and Thrombosis—From Physiology to Pathophysiology and Therapeutic Implications. IJMS. 2022;23(21):12772. https://doi.org/10.3390/ijms232112772
5. Woods VMA, et al. Targeting transgenic proteins to alpha granules for platelet-directed gene therapy. Molecular Therapy-Nucleic Acids. 2022;27:774-86. https://doi.org/10.1016/j.omtn.2021.12.038
6. Mathew J, Sankar P, Varacallo M. Physiology, Blood Plasma. in StatPearls (StatPearls Publishing, Treasure Island (FL). 2024.
7. Miron RJ, et al. Platelet-Rich Fibrin and Soft Tissue Wound Healing: A Systematic Review. Tissue Engineering Part B: Reviews.2017;23(1):83-99. https://doi.org/10.1089/ten.teb.2016.0233
8. Giannotti L, et al. Progress in Regenerative Medicine: Exploring Autologous Platelet Concentrates and Their Clinical Applications.
Genes. 2023;14(9):1669. https://doi.org/10.3390/genes14091669
9. Ding ZY, Tan Y, Peng Q, Zuo J, Li N. Novel applications of platelet concentrates in tissue regeneration (Review). Exp Ther Med.
2021;21(3):226. https://doi.org/10.3892/etm.2021.9657
10. Soudi A, et al. Role and application of stem cells in dental regeneration: A comprehensive overview. EXCLI Journal; 20:Doc454;
ISSN. 2021:20:454-89. https://doi.org/10.17179/excli2021-3335
11. Jasmine S, Thangavelu A, Krishnamoorthy R, Alshatwi AA. Platelet Concentrates as Biomaterials in Tissue Engineering: a
Review. Regen. Eng. Transl. Med.2021;7:419-31.
12. Hussein FF, Elmarssafy LH. Platelet concentrates in periodontal tissue engineering: An updated review. mat
express.2023;13:731-52.
13. Ezzatt OM. Autologous Platelet Concentrate Preparations in Dentistry. BJSTR.2018;8
14. Alshujaa B, Talmaç AC, Alsafadi A. Autologous Platelet Concentrates: Their Generations, Forms, Preparation Protocols and
Roles in Periodontal Regeneration. Eastern J Med.2023;28:369-77.
15. Ra Hara G, Basu T. Platelet-rich plasma in regenerative medicine. Biomed Res Ther. 2014;1:5.
16. Miron RJ, et al. Use of platelet-rich fibrin in regenerative dentistry: a systematic review. Clin Oral Invest. 2017;21(6):1913-1927.
https://doi.org/10.1007/s00784-017-2133-z
17. Marx RE,et al. Platelet-rich plasma. Oral Surgery,Oral Medicine,Oral Pathology,Oral Radiology,and Endodontology.1998;85:638-46.
18. Alves R, Grimalt R. A Review of Platelet-Rich Plasma: History, Biology, Mechanism of Action, and Classification. Skin Appendage
Disord. 2018;4(1):18-24. https://doi.org/10.1159/000477353
19. Pavlovic V, Ciric M, Jovanovic V, Trandafilovic M, Stojanovic P. Platelet-rich fibrin: Basics of biological actions and protocol
modifications. Open Medicine.2021;16:446-54. https://doi.org/10.1515/med-2021-0259
20. Zhang W, et al. Platelet-Rich Plasma for the Treatment of Tissue Infection: Preparation and Clinical Evaluation. Tissue Engineering
Part B: Reviews.2019;25:225-36. https://doi.org/10.1089/ten.teb.2018.0309
21. Lana JF, et al. Platelet-Rich Plasma Power-Mix Gel (ppm)—An Orthobiologic Optimization Protocol Rich in Growth Factors and
Fibrin. Gels. 2023;9(7):553. https://doi.org/10.3390/gels9070553
22. Yun SH, Sim EH, Goh RY, Park JI, Han JY. Platelet Activation: The Mechanisms and Potential Biomarkers. BioMed Research
International. 2016:2016:9060143. https://doi.org/10.1155/2016/9060143
23. Jones IA, Togashi RC, Thomas Vangsness C. The Economics and Regulation of PRP in the Evolving Field of Orthopedic Biologics.
Curr Rev Musculoskelet Med. 2018;11(4):558-65. https://doi.org/10.1007/s12178-018-9514-z
24. Lin Y, Qi J, Sun Y. Platelet-Rich Plasma as a Potential New Strategy in the Endometrium Treatment in Assisted Reproductive
Technology. Front. Endocrinol. 2021:12:707584. https://doi.org/10.3389/fendo.2021.707584
25. Xu J, Gou L, Zhang P, Li H, Qiu, S. Platelet-rich plasma and regenerative dentistry. Australian Dental Journal. 2020;65(2):131-
142. https://doi.org/10.1111/adj.12754
26. Narayanaswamy R, et al. Evolution and Clinical Advances of Platelet-Rich Fibrin in Musculoskeletal Regeneration. Bioengineering.
2023;10(1):58. https://doi.org/10.3390/bioengineering10010058
27. Bhangdiya K, Wankhede A, Madhu PP, Reche A. An overview on platelet concentrates in tissue regeneration in periodontology.
AIMSBOA.2023;10:53-61.
28. Miron RJ, Zhang Y. Autologous liquid platelet rich fibrin: A novel drug delivery system. Acta Biomaterialia. 2018:75:35-51.
https://doi.org/10.1016/j.actbio.2018.05.021
29. Anegundi RV, Shenoy SB, Kaukab SF, Talwar A. Platelet concentrates in periodontics: review of in vitro studies and systematic
reviews. J Oral Med Oral Surg. 2022;28:42.
30. Davis VL, et al. Platelet-Rich Preparations to Improve Healing. Part II: Platelet Activation and Enrichment, Leukocyte Inclusion,
and Other Selection Criteria. Journal of Oral Implantology. 2014;40:511-21. https://doi.org/10.1563/aaid-joi-d-12-00106
31. Fukuda K, Kuroda T, Tamura N, Mita H, Kasashima Y. Optimal activation methods for maximizing the concentrations of plateletderived
growth factor-BB and transforming growth factor-β1 in equine platelet-rich plasma. J. Vet. Med. Sci. 2020;82(10):1472-
9. https://doi.org/10.1292/jvms.20-0167
32. Ünlü A, et al. A Cycle of Freezing and Thawing as a Modified Method for Activating Platelets in Platelet-rich Plasma to Use in
Regenerative Medicine. Panamerican Journal of Trauma, Critical Care & Emergency Surgery.2020;9:101-4.
33. Brokhman I, Galea AM. A novel method for the preparation and frozen storage of growth factors and cytokines obtained from
platelet-rich plasma. Journal of Cartilage & Joint Preservation. 2024:27:200-6. https://doi.org/10.1016/j.reth.2024.03.021
34. Harrison S, et al. Platelet Activation by Collagen Provides Sustained Release of Anabolic Cytokines. Am J Sports
Med.2011;39(4):729-34. https://doi.org/10.1177/0363546511401576
35. Dhurat R, Sukesh M. Principles and methods of preparation of platelet-rich plasma: A review and author′s perspective. J Cutan
Aesthet Surg. 2014;7(4):189-97. https://doi.org/10.4103/0974-2077.150734
36. Neculaes B, et al. Activation of platelet-rich plasma by pulse electric fields: Voltage, pulse width and calcium concentration
can be used to control and tune the release of growth factors, serotonin and hemoglobin. PLoS ONE. 2021;16(4):e0249209.
https://doi.org/10.1371/journal.pone.0249209
37. Al-Hamed FS, et al. Regenerative Effect of Platelet Concentrates in Oral and Craniofacial Regeneration. Front. Cardiovasc. Med.
2019:6:126. https://doi.org/10.3389/fcvm.2019.00126
38. Mussbacher M, et al. Optimized plasma preparation is essential to monitor platelet-stored molecules in humans. PLoS
ONE.2017;12(12):e0188921. https://doi.org/10.1371/journal.pone.0188921
39. Mannuß S. Influence of different methods and anticoagulants on platelet parameter measurement. Journal of Laboratory
Medicine.2020;44:255-72.
40. Ramsook RR, Danesh H. Timing of Platelet Rich Plasma Injections During Antithrombotic Therapy. Pain Physician.
2016;19(7):E1055-61.
41. Chang Chien GC, Panchal R. Anti-Platelet and Anticoagulation Medications. in Regenerative Medicine (eds. Hunter, C. W.,
Davis, T. T. & DePalma, M. J.) 201-208 (Springer International Publishing, Cham, 2023). https://doi.org/10.1007/978-3-030-
75517-1_20
42. Aizawa H, et al. A Comparative Study of the Effects of Anticoagulants on Pure Platelet-Rich Plasma Quality and Potency.
Biomedicines. 2020;8(3):42 https://doi.org/10.3390/biomedicines8030042
43. Sachs L, et al. Ex vivo anticoagulants affect human blood platelet biomechanics with implications for high-throughput functional
mechanophenotyping. Commun Biol. 2022;5(1):86. https://doi.org/10.1038/s42003-021-02982-6
44. Marx RE. Platelet-Rich Plasma (PRP): What Is PRP and What Is Not PRP? Implant Dentistry. 2001;10(4):225-8. https://doi.
org/10.1097/00008505-200110000-00002
45. Arora S, Agnihotri N. Platelet Derived Biomaterials for Therapeutic Use: Review of Technical Aspects. Indian J Hematol Blood
Transfus. 2017;33(2):159-167. https://doi.org/10.1007/s12288-016-0669-8
46. Do Amaral RJFC, et al. Platelet-Rich Plasma Obtained with Different Anticoagulants and Their Effect on Platelet
Numbers and Mesenchymal Stromal Cells Behavior In Vitro. Stem Cells International. 2016:2016:7414036. https://doi.
org/10.1155/2016/7414036
47. Rachmi U, Esa T, Bahrun U, Muhadi D. The comparison of platelet parameters in Platelet Rich Plasma (PRP) using
Ethylenediaminetetraacetic Acid (EDTA) and Acid Citrate Dextrose (ACD) anticoagulants at Dr. Wahidin Sudirohusodo Hospital,
Makassar, Indonesia. IJBS.2021;15:87-91.
48. Rodella LF. Platelet preparations in dentistry: How? Why? Where? When? WJS.2015;4:39.
49. Saqlain N, Mazher N, Fateen T, Siddique A. Comparison of single and double centrifugation methods for preparation of Platelet-
Rich Plasma (PRP). Pak J Med Sci. 2023;39(3):634-7. https://doi.org/10.12669/pjms.39.3.7264
50. Dashore S, Chouhan K, Nanda S, Sharma A. Preparation of platelet-rich plasma: National IADVL PRP taskforce recommendations.
Indian Dermatol Online J. 2021;12(Suppl 1):S12-S23.https://doi.org/10.4103/idoj.idoj_269_21
51. Pachito DV, Bagattini ÂM, De Almeida AM, Mendrone-Júnior A, Riera R. Technical Procedures for Preparation and Administration
of Platelet-Rich Plasma and Related Products: A Scoping Review. Front. Cell Dev. Biol. 2020:8:598816 https://doi.org/10.3389/
fcell.2020.598816
52. Apakupakul J, Sattasathuchana P, Chanloinapha P, Thengchaisri N. Optimization of a rapid one-step platelet-rich plasma
preparation method using syringe centrifugation with and without carprofen. BMC Vet Res. 2020;16(1):124. https://doi.
org/10.1186/s12917-020-02350-2
53. Degen RM, Bernard JA, Oliver KS, Dines JS. Commercial Separation Systems Designed for Preparation of Platelet-Rich Plasma
Yield Differences in Cellular Composition. HSS Jrnl. 2017;13(1):75-80. https://doi.org/10.1007/s11420-016-9519-3
54. Tambella AM, Martin S, Cantalamessa A, Serri E, Attili AR. Platelet-rich Plasma and Other Hemocomponents in Veterinary
Regenerative Medicine. Wounds. 2018;30(11):329-36.
55. Dashore S, Chouhan K, Nanda S, Sharma A. Platelet-rich fibrin, preparation and use in dermatology. Indian Dermatol Online J.
2021;12(Suppl 1):S55-S65. https://doi.org/10.4103/idoj.idoj_282_21
56. Arshad S. et al. Platelet-Rich Fibrin Used in Regenerative Endodontics and Dentistry: Current Uses, Limitations,
and Future Recommendations for Application. International Journal of Dentistry. 2021;2021:4514598. https://doi.
org/10.1155/2021/4514598
57. Kardos D, et al. Biological and Mechanical Properties of Platelet-Rich Fibrin Membranes after Thermal Manipulation and
Preparation in a Single-Syringe Closed System. IJMS. 2018;19(11):3433. https://doi.org/10.3390/ijms19113433
58. Bai MY, et al. Current Progress of Platelet-Rich Derivatives in Cartilage and Joint Repairs. IJMS. 2023;24(16):12608. https://doi.
org/10.3390/ijms241612608
59. De Lima Barbosa R, et al. The Effects of Platelet-Rich Fibrin in the Behavior of Mineralizing Cells Related to Bone Tissue
Regeneration—A Scoping Review of In Vitro Evidence. JFB. 2023;14(10):503. https://doi.org/10.3390/jfb14100503
60. Dohan DM, et al. Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part I: Technological concepts and
evolution. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2006;101(3):e37-44. https://doi.
org/10.1016/j.tripleo.2005.07.008
61. Saluja H, Dehane V, Mahindra U. Platelet-Rich fibrin: A second generation platelet concentrate and a new friend of oral and
maxillofacial surgeons. Ann Maxillofac Surg. 2011;1(1):53-7. https://doi.org/10.4103/2231-0746.83158
62. Wu QY, Zhang Q, Fang F, Bu WB. Clinical Application of Platelet-Rich Fibrin in Dermatology. International Journal of Dermatology
and Venereology.2022;5:160-5.
63. Kobayashi E, et al. Comparative release of growth factors from PRP, PRF, and advanced-PRF. Clin Oral Invest. 2016;20(9):2353-
2360. https://doi.org/10.1007/s00784-016-1719-1
64. Strauss FJ, Nasirzade J, Kargarpoor Z, Stähli A, Gruber R. Effect of platelet-rich fibrin on cell proliferation, migration,
differentiation, inflammation, and osteoclastogenesis: a systematic review of in vitro studies. Clin Oral Invest. 2020;24(2):569-
84. https://doi.org/10.1007/s00784-019-03156-9
65. Deeb MA. Role of Platelet-Rich Fibrin (PRF) and Platelet-Rich Plasma (PRP) in Oro-Facial Tissue Regeneration: A Narrative
Review. Journal of Advanced Oral Research.2020;11:5-11.
66. Verma U, Yadav R, Dixit M, Gupta A. Platelet-rich fibrin: A paradigm in periodontal therapy - A systematic review. J Int Soc
Prevent Communit Dent. 2017;7(5):227-33. https://doi.org/10.4103/jispcd.jispcd_429_16
67. Chen Y, Zhong H, Zhao Y, Luo X, Gao W. Role of platelet biomarkers in inflammatory response. Biomark Res. 2020:8:28. https://
doi.org/10.1186/s40364-020-00207-2
68. Pepelassi E, Deligianni M. The Adjunctive Use of Leucocyte- and Platelet-Rich Fibrin in Periodontal Endosseous and Furcation
Defects: A Systematic Review and Meta-Analysis. Materials. 2022;15(6):2088. 15, 2088 (2022). https://doi.org/10.3390/
ma15062088
69. Fiorillo L. et al. Growth Factors in Oral Tissue Engineering: New Perspectives and Current Therapeutic Options. BioMed
Research International. 2021:2021:8840598. https://doi.org/10.1155/2021/8840598
70. Herrera-Vizcaino C. Systematic review of platelet-rich fibrin (PRF) centrifugation protocols in oral and maxillofacial surgery and
the introduction of AR2T3: an easy to remember acronym to correctly report vertical and horizontal PRF centrifugation. Front
Oral Maxillofac Med. 2023;5:5-5.
71. Ghanaati S, et al. Advanced Platelet-Rich Fibrin: A New Concept for Cell-Based Tissue Engineering by Means of Inflammatory
Cells. Journal of Oral Implantology. 2014;40(6):679-89. https://doi.org/10.1563/aaid-joi-d-14-00138
72. Bielecki T, M Dohan Ehrenfest D, A. Everts P, Wiczkowski A. The Role of Leukocytes from L-PRP/L-PRF in Wound Healing and
Immune Defense: New Perspectives. 2012;13(7):1153-62. https://doi.org/10.2174/138920112800624373
73. Fan Y, Perez K, Dym H. Clinical Uses of Platelet-Rich Fibrin in Oral and Maxillofacial Surgery. Dental Clinics of North America.
2020;64(2):291-303. https://doi.org/10.1016/j.cden.2019.12.012
74. Mosesson MW, Siebenlist KR, Meh DA. The Structure and Biological Features of Fibrinogen and Fibrin. Annals of the New York
Academy of Sciences. 2001:936:11-30. https://doi.org/10.1111/j.1749-6632.2001.tb03491.x
75. Kumar M, et al. Omega-3 Fatty Acids and Their Interaction with the Gut Microbiome in the Prevention and Amelioration of
Type-2 Diabetes. Nutrients. 2022;14(9):1723. https://doi.org/10.3390/nu14091723
76. Choukroun J, et al. Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part IV: Clinical effects on tissue
healing. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2006;101(3):e56-60. https://doi.
org/10.1016/j.tripleo.2005.07.011
77. Kawase T. Platelet-rich plasma and its derivatives as promising bioactive materials for regenerative medicine: basic principles
and concepts underlying recent advances. Odontology. 2015;103(2):126-35. https://doi.org/10.1007/s10266-015-0209-2
78. Merkhan MM, Shephard MT, Forsyth NR. Physoxia alters human mesenchymal stem cell secretome. J Tissue Eng.
2021:12:20417314211056132. https://doi.org/10.1177/20417314211056132
79. Shephard MT, Merkhan MM, Forsyth NR. Human Mesenchymal Stem Cell Secretome Driven T Cell Immunomodulation Is IL-10
Dependent. IJMS. 2022;23(21):13596. https://doi.org/10.3390/ijms232113596
80. Chen L, Merkhan MM, Forsyth NR, Wu P. Chorionic and amniotic membrane-derived stem cells have distinct, and gestational
diabetes mellitus independent, proliferative, differentiation, and immunomodulatory capacities. Stem Cell Research.
2019:40:101537. https://doi.org/10.1016/j.scr.2019.101537
81. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma
(P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends in Biotechnology. 2009;27(3):158-67. https://doi.org/10.1016/j.
tibtech.2008.11.009
82. Tunalı M, et al. A Novel Platelet Concentrate: Titanium-Prepared Platelet-Rich Fibrin. BioMed Research International.
2014;2014:209548. https://doi.org/10.1155/2014/209548
83. Fujioka-Kobayashi M. et al. Optimized Platelet-Rich Fibrin With the Low-Speed Concept: Growth Factor Release, Biocompatibility,
and Cellular Response. Journal of Periodontology. 2017;88(1):112-21. https://doi.org/10.1902/jop.2016.160443
84. Choukroun J, Ghanaati S. Reduction of relative centrifugation force within injectable platelet-rich-fibrin (PRF) concentrates
advances patients’ own inflammatory cells, platelets and growth factors: the first introduction to the low speed centrifugation
concept. Eur J Trauma Emerg Surg. 2018;44(1):87-95. https://doi.org/10.1007/s00068-017-0767-9
85. Moens S, Goveia J, Stapor PC, Cantelmo AR, Carmeliet P. The multifaceted activity of VEGF in angiogenesis - Implications for
therapy responses. Cytokine & Growth Factor Reviews. 2014;25(4):473-82. https://doi.org/10.1016/j.cytogfr.2014.07.009
86. Lichtman MK, Otero-Vinas M, Falanga V. Transforming growth factor beta (TGF-β) isoforms in wound healing and fibrosis.
Wound Repair Regeneration. 2016;24(2):215-22. https://doi.org/10.1111/wrr.12398
87. Miron RJ, Gruber R, Farshidfar N, Sculean A, Zhang Y. Ten years of injectable platelet-rich fibrin. Periodontology. 2024;94(1):92-
113. https://doi.org/10.1111/prd.12538
88. Thanasrisuebwong P, Surarit R, Bencharit S, Ruangsawasdi N. Influence of Fractionation Methods on Physical and Biological
Properties of Injectable Platelet-Rich Fibrin: An Exploratory Study. IJMS. 2019;20(7):1657. https://doi.org/10.3390/
ijms20071657
89. Wang X, Zhang Y, Choukroun J, Ghanaati S, Miron R. Behavior of Gingival Fibroblasts on Titanium Implant Surfaces in
Combination with either Injectable-PRF or PRP. IJMS. 2017;18(2):331. https://doi.org/10.3390/ijms18020331
90. Wend S, et al. Reduction of the relative centrifugal force influences cell number and growth factor release within injectable
PRF-based matrices. J Mater Sci: Mater Med. 2017;28(12):188. https://doi.org/10.1007/s10856-017-5992-6
91. Bowen RAR, Remaley AT. Interferences from blood collection tube components on clinical chemistry assays. Biochem
Med.2014;24(1):31-44.https://doi.org/10.11613/BM.2014.006.
92. Miron RJ, et al. A novel method for harvesting concentrated platelet-rich fibrin (C-PRF) with a 10-fold increase in platelet and
leukocyte yields. Clin Oral Invest. 2020;24(8):2819-28. https://doi.org/10.1007/s00784-019-03147-w
93. Zeitounlouian TS, Zeno KG, Brad BA, Haddad RA. Effect of injectable platelet-rich fibrin (i-PRF) in accelerating orthodontic
tooth movement: A randomized split-mouth-controlled trial. J Orofac Orthop. 2021;82(4):268-277. https://doi.org/10.1007/
s00056-020-00275-x
94. Karakasli K, Erdur EA. The effect of platelet-rich fibrin (PRF) on maxillary incisor retraction rate. The Angle Orthodontist.
2021;91(2):213-219. https://doi.org/10.2319/050820-412.1
95. Çağlı Karcı İ, Baka ZM. Assessment of the effects of local platelet-rich fibrin injection and piezocision on orthodontic tooth
movement during canine distalization. American Journal of Orthodontics and Dentofacial Orthopedics. 2021;160(1):29-40.
https://doi.org/10.1016/j.ajodo.2020.03.029
96. Erdur EA, Karakaslı K, Oncu E, Ozturk B, Hakkı S. Effect of injectable platelet-rich fibrin (i-PRF) on the rate of tooth movement:
The Angle Orthodontist. 2021;91(3):285-92. https://doi.org/10.2319/060320-508.1
97. Chai J, et al. Effect of Liquid Platelet-rich Fibrin and Platelet-rich Plasma on the Regenerative Potential of Dental Pulp Cells
Cultured under Inflammatory Conditions: A Comparative Analysis. Journal of Endodontics. 2019;45(8):1000-8. https://doi.
org/10.1016/j.joen.2019.04.002
98. Zheng S, Zhang X, Zhao Q, Chai J, Zhang Y. Liquid platelet-rich fibrin promotes the regenerative potential of human periodontal
ligament cells. Oral Diseases. 2020;26(8):1755-63. https://doi.org/10.1111/odi.13501
99. Uner D, Izol B. Evaluation of the effect of oxidized gelatin sponge on pain level in the donor area in free gingival graft operations.
Ann Med Res.2020;27:334.
100.Ozsagir ZB, Saglam E, Sen Yilmaz B, Choukroun J, Tunali M. Injectable platelet-rich fibrin and microneedling for gingival
augmentation in thin periodontal phenotype: A randomized controlled clinical trial. J Clinic Periodontology. 2020;47(4):489-
99. https://doi.org/10.1111/jcpe.13247
101.Manasa B, Baiju KV, Ambili R. Efficacy of injectable platelet-rich fibrin (i-PRF) for gingival phenotype modification: a split-mouth
randomized controlled clinical trial. Clin Oral Invest. 2023;27(6):3275-83. https://doi.org/10.1007/s00784-023-04943-1
102.Bahar ŞÇ, Karakan NC, Vurmaz A. The effects of injectable platelet-rich fibrin application on wound healing following
gingivectomy and gingivoplasty operations: single-blind, randomized controlled, prospective clinical study. Clin Oral Invest.
2024;28(1):85. https://doi.org/10.1007/s00784-023-05477-2
103.Yuce E, Komerik N. Comparison of the Efficiacy of Intra-Articular Injection of Liquid Platelet-Rich Fibrin and Hyaluronic Acid
After in Conjunction With Arthrocentesis for the Treatment of Internal Temporomandibular Joint Derangements. Journal of
Craniofacial Surgery. 2020;31(7):1870-4. https://doi.org/10.1097/scs.0000000000006545
104.Ghoneim NI, Mansour NA, Elmaghraby SA, Abdelsameaa SE. Treatment of temporomandibular joint disc displacement
using arthrocentesis combined with injectable platelet rich fibrin versus arthrocentesis alone. Journal of Dental Sciences.
2022;17(1):468-75. https://doi.org/10.1016/j.jds.2021.07.027
105.Torul D, Cezairli B, Kahveci K. The efficacy of intra-articular injectable platelet-rich fibrin application in the management of
Wilkes stage III temporomandibular joint internal derangement. International Journal of Oral and Maxillofacial Surgery.
2021;50(11):1485-90. https://doi.org/10.1016/j.ijom.2021.03.004
106.Fernandes J, Priyalochana G, Thiyaneswaran N. Efficacy of application of i-PRF to the surface of implants to improve
osseointegration during the healing period: A split-mouth pilot study. Journal of Osseointegration. 2021. https://doi.
org/10.23805/JO.2022.14.6
107.Sunil R, et al. Influence of I-PRF on Implant Stability and Marginal Bone Loss in the Posterior Mandible: A Split-Mouth
Randomized Controlled Trial. Act Scie Dental. 2022;131-7. https://doi.org/10.31080/ASDS.2022.06.1444
108.Mu Z, et al. Effects of injectable platelet rich fibrin on bone remodeling in combination with DBBM in maxillary sinus elevation: a
randomized preclinical study. Am J Transl Res. 2020;12(11):7312-25. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc7724338/
109.Xie H, Xie YF, Liu Q, Shang LY, Chen MZ. Bone regeneration effect of injectable-platelet rich fibrin (I-PRF) in lateral sinus lift: a
pilot study. Shanghai Kou Qiang Yi Xue. 2019;28(1):71-5.
110.Gollapudi M, Bajaj P, Oza RR. Injectable Platelet-Rich Fibrin - A Revolution in Periodontal Regeneration. Cureus.
2022;14(8):e28647. https://doi.org/10.7759/cureus.28647
111.Kabir Md A, et al. Mechanical Properties of Human Concentrated Growth Factor (CGF) Membrane and the CGF Graft with
Bone Morphogenetic Protein-2 (BMP-2) onto Periosteum of the Skull of Nude Mice. IJMS. 2021;22(21):11331. https://doi.
org/10.3390/ijms222111331
112.Chen L, et al. Efficacy of concentrated growth factor (CGF) in the surgical treatment of oral diseases: a systematic review and
meta-analysis. BMC Oral Health.2023;23(1):712. https://doi.org/10.1186/s12903-023-03357-5