Platelet-rich plasma (PRP) in dental and oral surgery: from the wound healing to bone regeneration

TLDR

Platelet‑rich plasma (PRP), derived from a patient’s own blood, is a growth‑factor‑rich adjunct that promotes wound healing, reduces bleeding, and enhances soft‑tissue and bone regeneration in dental and oral surgery, with promising results in extractions, periodontal procedures, implant placement, and bisphosphonate‑related osteonecrosis of the jaw. This narrative review aims to catalogue the diverse applications of PRP in dental and oral surgery and evaluate its efficacy, efficiency, and risk/benefit profile, while highlighting the need for further randomized controlled trials. The authors conducted a narrative review, cataloguing PRP applications across tooth extractions, periodontal surgery, implant placement, soft‑tissue and bone‑tissue procedures, and BRONJ treatment, and critically appraising their efficacy, efficiency, and risk/benefit ratios. The review concludes that PRP enhances soft‑tissue healing and early bone regeneration after tooth extractions, improves periodontal outcomes when combined with other materials, shows promise as a coating in implant surgery, and, together with necrotic bone curettage, offers encouraging results for refractory BRONJ, all while being safe, easy to obtain, and a valuable adjunct in oral and dental procedures.

Abstract

Platelet-rich plasma (PRP) is a new approach to tissue regeneration and it is becoming a valuable adjunct to promote healing in many procedures in dental and oral surgery, especially in aging patients. PRP derives from the centrifugation of the patient's own blood and it contains growth factors that influence wound healing, thereby playing an important role in tissue repairing mechanisms. The use of PRP in surgical practice could have beneficial outcomes, reducing bleeding and enhancing soft tissue healing and bone regeneration. Studies conducted on humans have yielded promising results regarding the application of PRP to many dental and oral surgical procedures (i.e. tooth extractions, periodontal surgery, implant surgery). The use of PRP has also been proposed in the management of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with the aim of enhancing wound healing and bone maturation. The aims of this narrative review are: i) to describe the different uses of PRP in dental surgery (tooth extractions and periodontal surgery) and oral surgery (soft tissues and bone tissue surgery, implant surgery and BRONJ surgery); and ii) to discuss its efficacy, efficiency and risk/benefit ratio. This review suggests that the use of PRP in the alveolar socket after tooth extractions is certainly capable of improving soft tissue healing and positively influencing bone regeneration but the latter effect seems to decrease a few days after the extraction. PRP has produced better results in periodontal therapy in association with other materials than when it is used alone. Promising results have also been obtained in implant surgery, when PRP was used in isolation as a coating material. The combination of necrotic bone curettage and PRP application seem to be encouraging for the treatment of refractory BRONJ, as it has proven successful outcomes with minimal invasivity. Since PRP is free from potential risks for patients, not difficult to obtain and use, it can be employed as a valid adjunct in many procedures in oral and dental surgery. However, further RCTs are required to support this evidence.