Platelet-rich fibrin (PRF) in dentistry: what it is, how it is prepared and what research shows

What is platelet-rich fibrin (PRF)?

Platelet-rich fibrin (PRF) is a concentrate of platelets embedded in a network of fibrin, the protein that forms a natural blood clot. It is prepared from the patient’s own blood, without anticoagulants or other additives (Castro et al., 2017).

The PRF clot traps platelets and white blood cells, and reviews describe the gradual release of factors involved in healing. The classification by Dohan Ehrenfest et al. (2009) divides platelet concentrates into four groups according to their leucocyte and fibrin content. The leucocyte-containing form most often used in dentistry is called L-PRF.

Because it is made from the patient’s own blood, PRF is prepared in the practice immediately before use, during the same appointment. Platelet-rich fibrin is an addition to a procedure, rather than a requirement: a wound also heals without it, using the natural clot.

How is PRF prepared?

Preparing platelet-rich fibrin takes around a quarter of an hour and is done in the practice, usually just before or during the procedure. Castro et al. (2017) describe the protocol in several steps.

A liquid form called i-PRF (injectable PRF) is obtained by shorter, slower centrifugation. In a laboratory study by Miron et al. (2017), blood was centrifuged for 3 minutes at 700 revolutions per minute. The authors noted that further research was needed to confirm the usefulness of i-PRF.

• Blood is taken from a vein, about 9 to 10 ml into each tube, without anticoagulants.
• Centrifugation starts immediately, for 10 to 12 minutes at a force of about 400 g in the protocols described.
• The blood separates into three layers: red blood cells at the bottom, platelet-poor plasma at the top and a fibrin clot in the middle.
• The fibrin clot is removed and placed in the wound or combined with a bone substitute by the dentist.

How does PRF differ from platelet-rich plasma (PRP)?

Platelet-rich plasma (PRP) is the older, first generation of platelet concentrates, while platelet-rich fibrin belongs to the second generation. PRP is prepared with an anticoagulant, and thrombin, including bovine thrombin, has been used to make it set. PRF, by contrast, is produced without biochemical processing of the blood (Dohan et al., 2006).

Castro et al. (2017) list the drawbacks of the first generation: cost, dependence on the operator and longer preparation time. The names are sometimes confused, although platelet-rich plasma and platelet-rich fibrin are different preparations, even though both come from the patient’s blood.

Does PRF after tooth extraction reduce pain and dry socket risk?

After lower wisdom tooth extraction, platelet-rich fibrin reduced dry socket risk and pain in most studies. An umbrella review by Monsalves Morales et al. (2026), covering 19 systematic reviews, reported a relative risk or odds ratio for alveolar osteitis, or dry socket, of 0.22 to 0.43, meaning that this complication occurred considerably less often.

The same authors cautioned that only 1 of the 19 reviews was of high methodological quality. In the highest-rated review, the pain-relieving effect of L-PRF was smaller than the threshold for a difference noticeable to patients. A review of 59 randomised studies (Siawasch et al., 2025) described less pain, swelling and restricted mouth opening, and faster soft tissue healing, in most studies, but judged the risk of bias to be high.

A broader review of 200 clinical studies across different fields (Estrin et al., 2025) described less pain in PRF groups in almost all studies. However, differences in preparation methods prevented a meta-analysis, and the authors disclosed a connection with a company holding intellectual property rights relating to PRF production. These caveats matter when reading about the benefits of this method.

The research mainly concerns surgical removal of impacted lower wisdom teeth, the procedures after which patients report the most pain. Whether PRF is worthwhile for a simpler extraction is decided individually by the dentist. Socket healing is explained in the article on what to do after tooth extraction.

Platelet-rich fibrin has also been studied for treating an existing dry socket. A meta-analysis by Ávila-Oliver et al. (2025) included 4 studies and 179 patients: PRF improved socket healing and reduced painkiller use compared with other treatments, but its effect on pain intensity remained uncertain.

Does platelet-rich fibrin help rebuild bone?

The effect of platelet-rich fibrin on bone is less certain than its effect on soft tissue. Strauss et al. (2018, 12 randomised studies) found moderate evidence of benefit in ridge preservation after extraction and in early implant integration with bone. However, a newer review by Meneses-Santos et al. (2026, 13 studies, 599 sockets) found no significant effect on ridge width or height on tomography, with very low certainty of evidence.

For sinus floor elevation, adding PRF or similar preparations to a bone substitute increased the proportion of new bone on microscopic examination in the meta-analysis by Zhang et al. (2025, 16 studies), but did not change implant stability or survival. A 2014 Cochrane review found insufficient evidence that adding platelet-rich plasma to a sinus graft reduces implant loss.

A systematic review by Miron et al. (2017) concluded that studies convincingly demonstrating the role of PRF in bone regeneration were still lacking, whereas most studies in periodontal and soft tissue treatment showed favourable results.

Which procedures use platelet-rich fibrin?

A dentist may suggest platelet-rich fibrin where research indicates a benefit, and should explain what can and cannot be expected. The strength of evidence varies by procedure.

• Surgical removal of an impacted lower wisdom tooth: studies indicate less dry socket and pain, although the reviews are of low quality.
• Gum surgery and soft tissue grafting: reviews describe mostly favourable results.
• Sinus floor elevation and bone grafting: PRF is added to a bone substitute, but an effect on implant survival has not been demonstrated.
• Socket preservation before an implant: research findings are mixed.
• Implant placement: a 2018 review found moderate evidence of benefit in early healing.

Is PRF safe, and what should you tell your dentist?

Platelet-rich fibrin is made entirely from the patient’s own blood, without anticoagulants or foreign additives, and preparation requires only a blood sample from a vein (Castro et al., 2017). The ridge preservation studies these authors reviewed even recorded less pain at sites where L-PRF was used.

Meneses-Santos et al. (2026) found no significant benefits or harms from PRF in ridge preservation. However, there are few high-quality studies, and preparation methods differ between studies, making comparison difficult.

Before surgery, tell your dentist about blood disorders, clotting problems and all medicines you take, especially anticoagulants. Do not stop taking them yourself: the Scottish Dental Clinical Effectiveness Programme (SDCEP) guidelines from 2022 stress that these medicines should not be changed before dental treatment without a clinician’s decision.

If your dentist suggests platelet-rich fibrin, a few questions can help establish what to expect. The answers will also help clarify whether this addition is justified in your case.

• Why is fibrin being proposed for this procedure, and what effect can be expected?
• How many tubes of blood will be taken, and how long does preparation take?
• Is PRF preparation a separate item in the treatment plan, and what does it cost?
• How would healing proceed if the procedure were performed without fibrin?

Platelet-rich fibrin at DentalBlue

In DentalBlue’s price list, “Fibryna bogatopłytkowa, 2 próbki” (platelet-rich fibrin, 2 samples) costs 800 zł and “Usunięcie zęba z osoczem” (tooth extraction with plasma) 1 000 zł. The dentist decides whether a blood-derived preparation is appropriate for a particular procedure after examination and imaging in the clinic’s own radiology unit (panoramic X-ray or CBCT), and explains what the item includes. Surgical procedures are performed under local anaesthesia or, in patients assessed as suitable, general anaesthesia. The final scope and cost are agreed at the consultation, and prices may change.