Platelet Concentrates in Periodontal Regeneration: A Review of Current Evidence and Clinical Perspectives.

Periodontitis is a chronic inflammatory disease characterized by irreversible destruction of the periodontal ligament, cementum, and alveolar bone, making true periodontal regeneration a significant therapeutic challenge. Autologous platelet concentrates have emerged as promising biological adjuncts because they provide a fibrin scaffold enriched with platelets, leukocytes, and growth factors that promote angiogenesis, cell proliferation, extracellular matrix synthesis, and wound healing. This review summarizes the biological basis, classification, mechanisms of action, and current clinical evidence regarding platelet-rich plasma (PRP), platelet-rich fibrin (PRF), advanced platelet-rich fibrin (A-PRF), injectable platelet-rich fibrin (i-PRF), and titanium-prepared platelet-rich fibrin (T-PRF) in periodontal regeneration. Current evidence indicates that PRF is the most extensively investigated preparation and demonstrates consistent improvements in probing pocket depth, clinical attachment level, and radiographic bone fill, particularly in periodontal intrabony defects when used as an adjunct to open flap debridement or bone grafting; a recent network meta-analysis reported statistically significant standardized improvements in all three outcomes favoring PRF-based therapy. Evidence supporting the use of platelet concentrates in furcation defects, gingival recession, periodontal plastic surgery, and extraction socket preservation is encouraging but remains limited by heterogeneity in study design and preparation protocols. Overall, platelet concentrates represent valuable adjuncts to regenerative periodontal therapy; however, standardized preparation methods and well-designed multicenter randomized controlled trials are required to establish the comparative effectiveness of newer platelet concentrate preparations and optimize their clinical application.