Testimonials from key opinion leaders on their experience with L-PRF
Click on a picture to continue to their testimonial.
Marc Quirynen, Em. Professor, Department of Periodontology, Catholic University Leuven, Leuven, Belgium. L-PRF: A Dream Becoming Reality In 2012, I first encountered L-PRF during a presentation by Prof. Nelson Pinto. I was astounded by what I saw and thought, "Even if only fifty percent of what I heard is true, it's still unbelievable." Nelson's lecture marked the beginning of a fantastic journey, possibly the highlight of my career. Our department's motto, "What can be asserted without evidence can be dismissed without evidence," underscored the urgent need for evidence-based and clear recommendations for L-PRF preparation and clinical applications. This realization led me to initiate a series of randomized controlled trials. The scientific community's feedback on my L-PRF lectures was mixed, with both believers and skeptics. To address this, Prof. Pinto and I organized the 1st ENHD (Enhanced Natural Healing in Dentistry) congress in Leuven in October 2016. Over 500 clinicians from 38 countries, including many key opinion leaders, attended this two-day, company-independent meeting with hands-on sessions. The success of this event inspired us to host another meeting in June 2018, which attracted over 450 participants and 30 renowned speakers who shared their experiences with L-PRF. They confirmed its applicability and simplicity in oral surgery. Today, L-PRF is a routine procedure in our periodontology clinic, used systematically for various periodontal techniques, including GTR, ARP, GBR, soft-tissue management, sinus floor augmentation, regeneration of intra-bony craters around teeth and implants, and improving osseointegration. To help clinicians achieve similar results, I created this company-independent, open-access, and free website with detailed clinical recommendations summarized in step-by-step flow charts, illustrated by numerous cases and short videos for each indication. These recommendations are based on our experience and supported by evidence-based research, the cornerstone of wise clinical decision-making. Each indication includes an extensive literature review to highlight expected outcomes and explain discrepancies in reported results. This underscores the importance of following recommendations and how small modifications can significantly impact outcomes. I also edited a special issue of the Perio 2000 journal, published in February 2025, with Professors Juan Blanco, Hom-Lay Wang, and Nikolaos Donos as co-editors, and published a book on “L-PRF in Oral Regenerative Procedures” together with Prof. Pinto in 2022. While the first-generation platelet concentrates (PRP, PRGF) had many shortcomings, the second-generation concentrates show much more promise. However, recent modifications to the original L-PRF protocol (A-PRF, A-PRF+, T-PRF, H-PRF) may confuse some colleagues, and I remain unconvinced of their clinical benefits. I hope that after exploring my website, you will feel confident using L-PRF. I believe it will simplify your work, making periodontal surgery less technique-dependent, more forgiving of mistakes, and less stressful. More importantly, it will allow you to better serve your patients with fewer complications, lower morbidity, less pain, faster healing, and potentially lower treatment costs. By promoting its use in oral surgery, convincing skeptics, and conducting research with minimal financial support and maximum scientific freedom, I am confident that both clinicians and patients will benefit from this innovative concept. I also aim to convince colleagues in other medical fields of L-PRF's benefits in wound healing, a significant challenge I feel responsible for tackling. Current observations on L-PRF's impact on treating non-responding chronic wounds or burns highlight its potential. This is, in my mind, the ultimate goal of an academician. I extend my gratitude to my dream team in Leuven, especially Chris Dekeyser, Wim Teughels, Andy Temmerman, and Anna Castro, for their support in the Department of Periodontology. I also thank my researchers (PhD and current doctoral students) who helped prepare the clinical recommendations and understand L-PRF's basic characteristics: Catherine Andrade, Ana Belen Castro, Simone Cortellini, Rutger D’Hondt, Manoetjer Siawasch, Joe Merheb, Andy Temmerman, and Jize Yu. Additionally, I thank the entire Perio-team, including nurses and secretaries, for their tremendous daily support and commitment during the past twelve years of L-PRF research. My sincere thanks go to my good friend Nelson Pinto for his openness and help in the early days of building our L-PRF experience. Our long discussions and shared frustrations after initial feedback formed the basis of this website. Once again, it became clear that sharing knowledge is fundamental to progress. "Wisdom is not a product of schooling but of the lifelong attempt to acquire it."
Nelson Pinto, Professor Faculty of Dentistry, Universidad de Los Andes Santiago, Chile. Professor Center of Translational Medicine Faculty of Medicine Universidad de la Frontera Temuco, Chile. A Life Experience with Leukocyte-Platelet Rich Fibrin (L-PRF) and Naturally Guided Regeneration Therapy (NGRT) As a regenerative medicine and tissue engineering researcher, I have always aimed to develop and refine evidence-based therapies that optimize wound healing and tissue regeneration. Over the years, my journey with Leukocyte- and Platelet-Rich Fibrin (L-PRF) and Naturally Guided Regeneration Therapy (NGRT) has profoundly transformed my research and clinical practice. At the same time, I have influenced how other clinicians worldwide approach wound healing. A Paradigm Shift in Tissue Regeneration Before fully embracing L-PRF and Naturally Guided Regeneration Therapy, conventional regenerative techniques often presented challenges—particularly in achieving predictable tissue regeneration, reproducibility, and long-term stability. While traditional methods provided reasonable outcomes, they frequently required complex procedures, synthetic materials, or costly interventions that did not always align with the body's natural healing capacity. Through my research and clinical experience, I discovered that the key to optimal tissue regeneration lies in harnessing the body's biological potential in harmony with minimally invasive surgical techniques and friendly biomaterials. As a 100% autologous material, L-PRF provides a unique fibrin matrix rich in growth factors and immune cells, creating an ideal microenvironment for tissue regeneration. Transformative Outcomes in Dentistry and Medicine The introduction of L-PRF into my work has led to remarkable improvements in soft and hard tissue regeneration. By naturally enhancing angiogenesis, reducing inflammation, and accelerating healing, L-PRF has significantly improved patient outcomes across various dental and medical applications: •Periodontal Regeneration: enhances hard and soft tissue healing. •Oral Implantology: enhances, accelerates, and modifies osseointegration. •Ridge preservation: No bone graft and/or artificial membranes are needed. •Horizontal and Vertical Bone Augmentation: reduces the amount of bone graft. Artificial membranes are rarely needed, reducing treatment time and improving clinical outcomes. •Sinus lift procedures: reduce the need for bone grafts, shorten the healing time, better outcomes and long-term prognosis. •Soft tissue healing enhances outcomes and reduces the time needed for healing. •Chronic wounds: include diabetic foot, pressure, and venous ulcers, complex non-responding ulcers, and Lepra wounds. •Bone regeneration: in orthopedic and maxillofacial surgery, it enhances outcomes and shortens healing time. •Soft tissue healing in aesthetic and plastic surgery enhances outcomes. •Skin regeneration: enhances outcomes and reduces healing time in burns and reconstructive esthetic procedures. •Improved post-surgical recovery in various medical and dental procedures. Beyond the clinical benefits, this approach simplifies procedures, reduces complications, and minimizes patient morbidity, aligning perfectly with minimally invasive, patient-centered care principles. Leading the Future of Regenerative Medicine Through Naturally Guided Regeneration Therapy, we have moved beyond traditional approaches and embraced a more biological healing model. This method respects and actively amplifies the body's regenerative mechanisms, offering predictable, long-term success without reliance on synthetic biomaterials. L-PRF's simplicity, cost-effectiveness, and scientific foundation make it an indispensable tool for the future of regenerative medicine and tissue engineering. As research continues to validate and expand its applications, I firmly believe this approach will redefine the standard of care in regenerative therapies. A Call to the Scientific and Clinical Community For researchers and clinicians seeking to enhance their approach to tissue regeneration, NGRT with L-PRF is more than a technique —it is a complete paradigm shift. Integrating this therapy into my practice has profoundly changed my perspective on tissue regeneration and wound healing. I have witnessed firsthand its transformative impact on patient outcomes across multiple medical and dental fields. Gratitude to a Global Community The Therapy of Naturally Guided Regeneration (NGRT) would not be where it is today without the dedication, passion, and support of an incredible global community of clinicians, researchers, and colleagues. I am deeply grateful to all those who have embraced this approach, contributed to its advancement, and shared their experiences to help refine and expand its applications. Special recognition goes to Prof. Marc Quirynen, whose tremendous contributions to the scientific evidence and promotion of L-PRF technology and NGRT worldwide have been pivotal in advancing this field. His dedication to research and education has been invaluable in bridging the gap between science and clinical practice, making regenerative therapies more accessible and widely adopted. Your trust, collaboration, and commitment to innovation have been instrumental in NGRT's success. Through our collective efforts, we continue to push the boundaries of regenerative medicine and improve the lives of countless patients worldwide. I am honored to be part of this regenerative revolution and remain committed to advancing naturally guided therapies that shape the future of medicine. The more we embrace the body's natural regenerative potential, the closer we come to unlocking a new era of tissue healing. After over 20 years, we can confidently say, "What we thought impossible yesterday could be routine tomorrow with Naturally Guided Regeneration Therapy (NGRT)."
Anton Sculean, Professor & Chairman Department of Periodontology, University of Bern, Bern, Switzerland. In the last two decades, the use of various types of blood concentrates for regeneration of soft and hard oral tissues has attracted enormous interest with an immense flow of arising data. Novel formulations of platelet rich fibrin (PRF) have been shown to provide additional benefits in terms of faster wound healing following various periodontal and implant related surgical procedures making the use of PRF a part of the daily routine of many clinicians. Despite the plethora of published data on the use of PRF for different clinical indications, clear, evidence based guidelines on why, when, how, and which type of PRF formulation should be used are still lacking, often leaving the clinician in front of a dilemma. It is thus, more timely than ever to provide clear guidelines on why, when and how to use PRF alone or combined with different hard and soft tissue grafting materials in various clinical scenarios and give clear, clinically useful recommendations. The two authors of the guidelines, Prof. Marc Quirynen and Prof. Nelson Pinto are “the leading team” in the field of PRF research, two colleagues who have been involved from the very beginning in the use of PRF and in the development of novel, more efficient clinical protocols for oral but also extra-oral tissue regeneration. The two authors are not only worldwide known and respected researchers, but also active clinicians with extensive long-term clinical experience in periodontology and implant dentistry. Thus, I cannot imagine a more competent team being able to perfectly merge scientific evidence with clinical experience, a nowadays certainly seldom combination. I am convinced that the present guidelines represent a unique, scientifically through and clinically relevant work, which provides a landmark on the clinical applications of PRF in oral tissue regeneration and sets future trends for research. It is a must for every dental professional interested in the use of PRF.
Nikos Donos, Professor Periodontology & Implant Dentistry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London (QMUL), London, U.K. Autologous platelet concentrates (APCs) are bioactive substances derived from a patient’s own blood through a simple chair-side centrifugation process. They have emerged as a treatment alternative in wound healing and regenerative procedures due to their ability to enhance both soft and hard tissue healing. The biological rationale behind their use lies in the delivery of a concentrated mix of platelets, leukocytes, and other therapeutic blood components—such as fibrinogen/fibrin, growth factors, cytokines, and circulating cells—directly to the surgical site to enhance the body’s natural healing and tissue regeneration processes. Currently, a number of protocol refinements aim in making APCs more streamlined and effective. A growing body of literature indicates that APCs may accelerate wound healing, reduce post-operative complications, and enhance bone regeneration. Their clinical applications span ridge preservation, guided bone regeneration, sinus augmentation, treatment of challenging wounds, and medication-related osteonecrosis of the jaws. As autologous products, they eliminate the risk of rejection or incompatibility. The relative simplicity of their protocol and possible regenerative potential may make APCs a valuable option in modern clinical practice.
Juan Blanco, Professor & Chair of the Department of Surgery and Medico-Surgical specialties (area of Stomatology, Unit of Periodontology) Universidade De Santiago de Compostela, Santiago de Compostela, Spain. In my opinion, the so called “second generation platelet aggregates”, although we are still in the beginning of their development, have some particular characteristics (macroscopically and microscopically) that allow us to implement them clinically to improve the outcome of our surgery. Literature, in summary, advises its use in several clinical indications, such as: ridge preservation, covering lateral window in sinus lift approach, several bone augmentation techniques (L-PRF bone block) and even in soft tissue management (soft tissue healing and mucogingival surgery). This autologous product has changed my daily practice in the benefit of my patients. This means that not only we increase our success in the clinical outcome but also in the patients related outcomes (PROMS). Other advantages are manageability, reproducibility, and naturally produced (based on natural coagulation procedure without any additives). It is a fact that more basic science and clinical evidence must be developed. My first experience with L-PRF was in 2015 in a very severe case (bone atrophy in the upper jaw) where I failed once before. Today, and after 5 years follow-up, the patient is really happy with her implant supported prostheses still in place. This was possible after a bone reconstruction with an L-PRF block and the posterior implant installation. Today I am using L-PRF routinely for socket preservation, sinus lift, bone grafting (horizontal, vertical), every extraction socket, and some cases of mucogingival surgery. I am convinced that in the near future this material or another similar one, will be used by every clinician routinely in daily practice, and the indications of its use will definitely increase.
Hom-Lay Wang, Professor and Director of Graduate Periodontics, Department of Periodontics and Oral Medicine, The University of Michigan, School of Dentistry, Michigan, USA. My name is Dr. Hom-Lay Wang, and I am a Professor and Director of Graduate Periodontics at the University of Michigan School of Dentistry. Platelet-rich plasma (PRP), an autologous platelet concentrate, includes variations such as L-PRF, A-PRF, H-PRF, and CGF. This biomaterial, derived from the patient’s own blood, has the potential to enhance clinical outcomes. PRF can aid in soft-tissue closure and improve the handling of bone grafts by forming "sticky bone" when combined with graft material. In my clinical experience, PRF has been beneficial in supporting primary wound closure and promoting soft tissue healing and possibly indirect bone regeneration. I encourage you to explore its use in your practice and assess the outcomes for yourself. Best wishes,
Joao Caramês, Professor and Chair Department of Oral Surgery and Implantology, Unit of Oral Surgery, Faculty of Dental Medicine, University of Lisbon, Lisbon, Portugal. As oral surgeons we recognize the biologic potential of Leukocyte Platelet-Rich Fibrin (L-PRF) on both soft and hard tissue regeneration. Obtained and presented as a high-density fibrin network or as a liquid form, after a blood sample and an elective centrifugation process, L-PRF is widely accepted by patients. Both presentations contribute to produce a biologically powerful fibrin scaffold, which is one of the most crucial components of tissue wound healing. L-PRF encases a supraphysiologic concentration of growth factors released for more than seven days, that significantly contribute to angiogenesis and tissue remodelling. The concept of L-PRF block was also a “game-changer”! Liquid fibrinogen fraction traps the bone substitute and L-PRF membranes into a block, providing excellent graft stability. Its consistency and elasticity allow us to modulate the block into the bone defect with unmatched adaptability. Moreover, the strong interconnectivity of the fibrin matrix within the graft prevents undesired soft-tissue ingrowth, which is often a concern in bone regeneration. The graft stability provided by the L-PRF block is also particularly relevant issue in sinus floor augmentation procedures. In cases of Schneiderian membrane perforations, L-PRF membranes are easily manipulated and a valid alternative barrier to membrane healing and repair. The overall body of research consistently supports the promising and beneficial effects of L-PRF in bone augmentation and soft tissue healing. This conclusion was also found in a clinical study preformed by me and my team, using L-PRF/particulate xenograft in GBR for horizontal bone augmentation with simultaneous implant placement in fully edentulous patients to enhance lip support. As recognized by the oral science community, further studies specially well-designed clinical trials are welcome to confirm the regenerative potential perceived for L-PRF.
Enrico Rescigno, General Vascular Surgeon, Department of Vascular Surgery, Leonardi e Riboli Hospital Lavagna, Genoa, Italy. Back in 2015, I first encountered L-PRF through a friend of mine, a dentist….. but in an unexpected role—as a patient. The experience was entirely unforeseen. After extracting one of my teeth, my friend drew blood from my arm, leaving me both incredulous and astonished. “What on earth are you going to do with that?” I asked, curious and slightly unsettled. He simply replied, “You’ll see, you’ll see.” A few minutes later, he returned with two yellowish clots, saying, “I’m applying L-PRF—the new frontier of regenerative medicine.” He placed the clots into the socket where my tooth had been, closed it with two stitches, and quickly dismissed me with a casual, “Call me tomorrow.” In the past, I had already experimented with PRP (Platelet-Rich Plasma) on my patients at the Vascular Surgery Clinic of my hospital in Lavagna, about 40 km from Genoa, Italy. However, the results had not been encouraging, so I was quite sceptical about trying it in my own mouth. Once I got home, I braced myself for the usual swelling and pain, preparing ice packs and painkillers. But as the hours passed… nothing. The night went by… still nothing. The next morning, to my utter amazement, I woke up feeling well-rested, with no swelling or pain, as if I had merely undergone a routine dental cleaning. That afternoon marked the beginning of my deep passion for L-PRF—a passion that still drives me today. Since then, I have used L-PRF to treat intensely painful skin ulcers that previously required analgesics and sedatives just to allow sleep—only to witness spontaneous restorative sleep from the very first application. I have healed post-traumatic and post-burn wounds that had remained stagnant for months despite numerous conventional dressings. I have successfully treated diabetic foot wounds that had resisted years of advanced dressings and consultations with multiple specialists—dermatologists, vascular surgeons, orthopaedists, diabetologists, wound care experts, and plastic surgeons—ultimately preventing amputations. By using L-PRF in cases of significant skin loss, I have avoided the need for flaps and skin grafts, which are not only highly invasive and painful but also come with substantial healthcare costs. In my experience, L-PRF has proven to be effective, safe, highly analgesic, easy to use, free of complications, and remarkably cost-effective. This technology, which appears to have immense regenerative potential, opens up new therapeutic horizons that are still waiting to be explored and deserve further investigation.
Pascal Valentini, Program Director of the Post Graduate of Oral Implantogy, University of Corsica, Corte, France. The literature does not leave any doubt about the necessity to gather three factors in order to obtain tissue regeneration in a bone defect: cells, scaffold and signalling molecules, growth factors, which should be able to re-vascularize the defect and to stimulate bone forming cells activity. It is not a problem to get the first two but the issue was the third one. The use of synthetic molecules as PDGF, BMPs was not really successful. By chance today we have L-PRF which is a very predictable natural source of growth factors. By mixing it with a biomaterial, as a scaffold, we have an effective, non-invasive and an affordable tool to regenerate bone in a predictable way. I have been convinced by this idea of applying biology to a clinical protocol. It is a very simple way to mimic nature. I have been using mostly l-PRF combined with an-organic bovine bone for huge bone defect regeneration and in specific situation for sinus grafting, with an excellent outcome.
Sašo Ivanovski, Head of School and Professor of Periodontology, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), School of Dentistry, The University of Queensland, Herston, Queensland, Australia. As a second-generation autologous platelet concentrate, L-PRF appears to hold significant potential for enhancing regenerative outcomes. Notwithstanding inherent issues of patient variability and sensitivity to the preparation protocol, I particularly see advantages in using PRF as an effective and efficient way to enhance the regenerative potential of other implantable biomaterials, especially in challenging clinical scenarios. While further work is required to fully appreciate the clinical potential of PRF in different clinical application, it’s ready availability and cost effectiveness make an attractive candidate for regenerative applications.
Richard Miron, Visiting Professor Department of Periodontology, University of Bern, Bern, Switzerland. The use of platelet concentrates in regenerative medicine and dentistry has had a tremendous impact on modern patient care. In fact, entire issues of top-ranking peer-reviewed journals have dedicated over 400 pages describing its proper use in medicine. This work, led by Professor Marc Quirynen, has had a profound impact on helping patients heal more effectively and in shorter time periods. This work expands on the initial concept of platelet rich plasma (PRP) that has led to the development of platelet rich fibrin (PRF) widely used in regenerative medicine/dentistry. These discoveries, over the years, have helped patients heal from complex wounds not only found in dentistry, but also those that expand into complex diabetic ulcers, joint issues in sports medicine applications, and also chronic wounds that up until recently have not been treated optimally. More than 5000 peer-reviewed scientific publications have been published on PRP/PRF, yet little scientific information is spread to the rest of the world. I applaud those that are taking part in this novel initiative to bring this technology to the forefront of medicine and making it widely visible in a non-commercial way. It is now well understood and accepted that the body has an innate and intrinsic ability to heal itself. By concentrating supra-physiological doses of these wound healing factors in PRF, we are able to treat a multitude of diseases successfully and this website provides free access into many key concepts related to PRP/PRF in a non-commercial and non-biased way.
Yannick Spaey, Head of department of Oral and Maxillofacial surgery Maria Hospital, Pelt, Belgium; Consultant, Department of Oral and Maxillofacial surgery, University Hospital Leuven, Belgium. I have known professor Marc Quirynen since my studies in dentistry, where he taught me about the basics of periodontology. Few years later we met again as colleagues in the PEERS of a well-known implant brand. But it was not until 2013 that I really got to know him. With the first presentation of Nelson Pinto on L-PRF in Leuven, he did put his neck on the line by introducing a technique that looked like hocus pocus to the medical profession in Belgium. I remember thinking that if only 10% would be true…. Nevertheless, I bought the centrifuge and started using the technique in implantology. By trying it for a non-healing wound on the leg of a friend’s mother the train left and soon all kinds of wounds were being treated with L-PRF in my office. Since the introduction in Belgium professor Quirynen has organized annually congresses and symposia about L-PRF and every year more and more colleagues from other specialties have attended them, showing the increasing impact of what he started in 2013. Now, not a day goes by in practice that me and my colleagues are not using it in implantology, skin cancer treatment, non-healing wounds, MRONJ, facial aesthetics or orthognathic surgery. To my opinion it is a great technique with many more possibilities than so far known, but only one major downside, namely the limited knowledge of the individual composition of blood to date. Moreover, I think that L-PRF has, besides all the good it does for healing, given me a friend too. I will certainly have this book in my library and do think it is a huge step forward for the awareness of L-PRF.
Catherine Davies, ZD Hair Clinic, Johannesburg, South Africa & Advanced PRF Education, Venice, Florida, USA. Incorporating platelet concentrates into my clinical practice has been a valuable and transformative tool. It is a cost-effective modality that has consistently aided in reducing healing time and improving overall outcomes. I have been particularly impressed with its ability to enhance scar quality, resulting in more favorable aesthetic results. In the context of hair transplantation, platelet concentrates have contributed to faster post-operative healing and have been associated with earlier follicular growth, improving both patient satisfaction and clinical outcomes. Additionally, in patients with burn scars and contractures, the use of platelet concentrates has led to improved mobility and more refined aesthetic results, offering meaningful functional and cosmetic benefits. In the public health setting in South Africa, where cost-effectiveness is crucial, the use of platelet concentrates has proven to be a practical and impactful addition. It allows for enhanced patient care while remaining accessible and sustainable within limited-resource environments. Platelet concentrates have truly elevated the quality of care I am able to offer across a variety of treatment areas.
Mohammad Sabeti, Advanced Specialty Program in Endodontics, UCSF School of Dentistry, San Francisco, California, USA Platelet aggregates present a straightforward, biological, and natural solution for tissue regeneration, fitting the need for eco-friendly biomaterials. A growing body of evidence supports their use across various dental procedures, including socket preservation, endodontic microsurgeries (different defect types), sinus lifts, ridge and socket preservation, and bone augmentation. As autologous materials, they inherently reduce the risk of adverse reactions. L-PRF, a clinical application leveraging natural wound healing, shows considerable future promise as our understanding of its mechanisms deepens. The established safety profile, expanding evidence base, and versatility of L-PRF provide confidence in its ongoing development and application in dental medicine and surgery.
Amerigo Giudice, Professor School of Dentistry, Magna Graecia University of Catanzaro, Catanzaro, Italy. "L-PRF, an autologous platelet concentrate, has become an essential component of my clinical strategy in managing and preventing medication-related osteonecrosis of the jaws (MRONJ). Its biological, additive-free composition supports wound healing in a manner that aligns closely with the underlying pathophysiology of MRONJ—namely, compromised vascularity and impaired bone regeneration. My first impactful experience with L-PRF in the context of MRONJ occurred in a complex case involving a patient undergoing long-term bisphosphonate therapy. Following an unsuccessful initial attempt to manage an extraction site, I incorporated L-PRF during a second intervention, combined with conservative debridement. The outcome was striking: complete soft tissue closure, bone healing, and, most importantly, resolution of the necrotic area without recurrence. This experience fundamentally shifted my clinical approach. Today, I routinely utilize L-PRF in high-risk patients—particularly those receiving antiresorptive or antiangiogenic medications—during extraction, implant placement, and MRONJ-related surgical debridement. Its function as a biological scaffold not only enhances soft tissue closure but also appears to modulate inflammation and promote angiogenesis, both of which are critical in MRONJ-prone sites. Clinically, patients benefit from faster healing, reduced postoperative complications, and an overall improvement in quality of life. From a scientific perspective, L-PRF embodies the principle of harnessing the body’s inherent regenerative capacity. The natural concentration of leukocytes, platelets, and growth factors within the fibrin matrix creates a favourable microenvironment that stimulates cellular activity essential for tissue repair. This is especially relevant in MRONJ, where the normal healing cascade is often disrupted. Emerging research continues to corroborate these clinical observations, reinforcing L-PRF’s role in wound stabilization and bone regeneration. While continued research will help refine its applications, the existing evidence—coupled with consistent clinical outcomes—provides strong justification for L-PRF as both a preventive and adjunctive treatment modality in MRONJ. Its excellent safety profile, ease of use, and high patient acceptance further support its integration into surgical protocols for at-risk individuals. In my view, L-PRF represents not merely a therapeutic option but a paradigm shift in the management of complex healing scenarios. Especially in vulnerable patients, every opportunity to support natural regeneration should be fully embraced—and L-PRF allows us to do just that."
Reinhard Gruber, Professor Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria I understand PRF as a clinical application of the evolutionary conserved biological principle - wound healing. PRF not only contains but is even enriched in the natural ingredients we find in our blood - to prepare PRF, our personal wound dressing. It is fascinating to see how cells involved in wound healing effectively respond when exposed to PRF under experimental conditions. Our continued work, now in its third decade, deciphering the molecular and cellular mechanism of how PRF exerts its activity, underscores the significant potential of PRF to support wound healing and inspires us to push research further. We invite you to join us in this dynamic field of study.
Helena Francisco, Professor Department of Oral Surgery and Implantology, Unit of Oral Surgery, Faculty of Dental Medicine, University of Lisbon, Lisbon, Portugal. As oral surgeons we recognize the biologic potential of Leukocyte Platelet-Rich Fibrin (L-PRF) on both soft and hard tissue regeneration. Obtained and presented as a high-density fibrin network or as a liquid form, after a blood sample and an elective centrifugation process, L-PRF is widely accepted by patients. Both presentations contribute to produce a biologically powerful fibrin scaffold, which is one of the most crucial components of tissue wound healing. L-PRF encases a supraphysiologic concentration of growth factors released for more than seven days, that significantly contribute to angiogenesis and tissue remodelling. The concept of L-PRF block was also a “game-changer”! Liquid fibrinogen fraction traps the bone substitute and L-PRF membranes into a block, providing excellent graft stability. Its consistency and elasticity allow us to modulate the block into the bone defect with unmatched adaptability. Moreover, the strong interconnectivity of the fibrin matrix within the graft prevents undesired soft-tissue ingrowth, which is often a concern in bone regeneration. The graft stability provided by the L-PRF block is also particularly relevant issue in sinus floor augmentation procedures. In cases of Schneiderian membrane perforations, L-PRF membranes are easily manipulated and a valid alternative barrier to membrane healing and repair. The overall body of research consistently supports the promising and beneficial effects of L-PRF in bone augmentation and soft tissue healing. This conclusion was also found in a clinical study preformed by me and my team, using L-PRF/particulate xenograft in GBR for horizontal bone augmentation with simultaneous implant placement in fully edentulous patients to enhance lip support. As recognized by the oral science community, further studies specially well-designed clinical trials are welcome to confirm the regenerative potential perceived for L-PRF.
Sören Jepsen, Professor and Chairman, Department of Periodontology, Operative and Preventive Dentistry, University Hospital of Bonn, Bonn, Germany From the very beginning of our careers in periodontology we have been intrigued by the prospects of periodontal regeneration. Now, many years later we follow with fascination the evolution of growth factor delivery via the latest generation of autogenous platelet concentrates and the emerging evidence supporting their use in periodontal indications such as recessions, furcations and vertical defects.
Sushil Koirala, Punyaarjan-Chronic Wound Healing Program, Punyaarjan Foundation, Kathmandu, Nepal. L-PRF -The power of healing from within……….. I recall that it wasn't till the end of 2014 that I began to grasp understanding about the science of L-PRF and its clinical uses. It was when the Thai Implant Association invited me to chair and moderate a scientific session during the Bangkok Implant Symposium-2015, that I started reading pieces of literature, evidences and clinical uses about L-PRF to comprehend the essence of the lecture “Challenging the Paradigms of Hard and Soft Tissue Regeneration; “Natural Guided Regeneration” that was being delivered by Prof. Dr. Nelson Pinto from Chile; and to moderate the session professionally. Although it was a ‘dental implantology’ Congress, towards the end of the lecture, Dr. Pinto presented a few clinical slides on how the L-PRF Natural Guided Regeneration protocol could be used to heal chronic foot ulcers in a natural, reliable and most affordable way. Frankly speaking, the last part of his lecture reshaped my perspective on the strength of modern science and technology to promote humanity. I was delighted to note the autologous approach of ‘L-PRF Natural Guided Regeneration’ precisely fit within the boundaries of the Vedic philosophy to respect mother nature, do no harm, and promote the power of healing from within; the very principles that had laid the foundations to my career. During the lecture break, I had an abrupt conversation with Dr. Pinto and I requested him to visit my country to train and equip the Nepalese medical doctors and the team of Punyaarjan Foundation with the same protocols and equipment. My sincere goal was to set up Punyaarjan-Wound Healing Clinics in several parts of Nepal and other Asian countries to serve the destitute and impoverished who could not afford costly and sophisticated conventional medical and surgical approaches for the treatment of their chronic wounds. As an adamant believer in “In Giving – You Receive”, I always considered service and social work as an inseparable part of my life. I decided to use my time, energy, and knowledge for the benefit of society, and the nature introduced me to Dr. Nelson Pinto, a humble, dedicated and most importantly, a compassionate friend, who came as inspiration in my life and catalysed my endeavours in social service. It was in March 2016, my friend Nelson visited Nepal on the invitation of our Punyaarjan Foundation. I took him to many well-reputed medical and dental hospitals, institutes, and professional societies in Nepal to lecture and demonstrate his L-PRF Natural Guided Regeneration concept. During this first visit, he trained a team headed by Prof. Shankar Rai, a distinguished plastic and reconstructive surgeon chief of Nepal Burn Society, Kirtipur Hospital, and with his support and alliance, we were able to inaugurate our first Punyaarjan -Wound Healing Clinic through the hands of Nelson himself. Over time, the Punyaarjan Foundation has so far set up 9 such clinics in Nepal and Myanmar. With the success of our first clinic, we were able to explore new areas for L-PRF and initiated a wound healing project in partnership with Anandaban Hospital to treat leprosy related foot ulcers using the L-PRF wound care protocol as a major treatment approach in the hospital. I joyfully recall that in 2018, I was invited by Prof. Quirynen from the department of periodontology Catholic University of Leuven to present a clinical and social experience of the Punyaarjan Wound Healing Clinic in the treatment of trophic ulcers in patients with Hansen’s disease (Leprosy) using the L-PRF wound care protocol in Nepal, during the 2nd European Meeting on Enhanced Natural Healing in Dentistry, Leuven, Belgium. And, now after working in the chronic wound healing field for almost half a decade, and having been involved in multiple local pilot studies and 100s of successful healing of chronic leprosy and other wounds through our collaborative Punyaarjan Wound Healing Clinics in Nepal and Myanmar by exclusively using the L-PRF, our team in Asia is confident enough to proclaim that the L-PRF is the simplest, most affordable and predictable approach to treat the chronic wounds. And, I believe the L-PRF technology and protocol of chronic wound healing should be promoted globally, with egoless professional harmony, love, and compassion engrained within the heart to change the lives of millions worldwide.
Gil Alcoforado, Rector, Instituto Universitario Egas Moniz, Almada, Portugal. When the PRP technique was introduced in the Dental field, I felt then that there was not enough data then to convince me to use it. I believe time showed I was right. When the L-PRF technique was introduced in Dentistry I felt that, probably, this technique was somewhat different. However, again I decided to wait. When I saw people whom I consider serious researchers and clinicians, such as Nelson Pinto and Marc Quirynen involved in L-PRF and saw their preliminary results, I decided to give it a try. I started slowly with specific well-chosen cases, like guided bone regeneration procedures and maxillary sinus lifts. In one of those cases, I had a small perforation of the Schneiderian membrane, and I easily closed it with a couple of L-PRF membranes. From that day on, I decided I would not perform any sinus lift procedure without L-PRF. In one of my first GBR cases using L-PRF, I placed the implant which remained exposed on its coronal third on its buccal side. I have performed a GBR procedure as I used to do using tightly secured collagen membranes with pins. After placing my graft, I covered the whole crest with L-PRF membranes. At the time of uncovering and after opening the flap, I could not see the implant which was completely covered by bone. Again, I have realized that this procedure was enhancing my treatment protocols immensely. When I started using L-PRF Blocks, some of these procedures became much easier. I have expanded my own indications, this time following some of the research which has been published lately. I had several cases with teeth which needed extraction with roots protruding well into the sinus and leaving oroantral communications. Since I predicted this might be so, I performed the extraction, curetted the area and applied the L-PRF plugs. It was gratifying to see, four months later, that the alveolus had healed completely, and the sinusitis was also resolved, as it can be seen on the CBCT before and after. I have recently started using L-PRF in periodontal bone defects. The effect was extremely positive even after only 2 months as can be seen in this example of a distal bone defect on this lower molar. For those clinicians who master all these surgical techniques, I am sure they will see that L-PRF will improve their results considerably. Adding the L-PRF technique will not complicate the overall procedure and by simplifying certain steps of that procedure, like the L-PRF Block, it could even shorten the intervention time. The existing evidence is more than enough to apply the L-PRF to all the types of surgical procedures that I have indicated, among others. However, and since there is a lot of research work being done, all this new research which will soon appear will only expand the number of clinical indications for its use.
Tara Aghaloo, Professor in the Section of Oral and Maxillofacial Surgery, Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, USA. i-PRF and L-PRF have been game-changers in bone and soft tissue regeneration. As our patients become more medically compromised, a concentration of growth factors that aid in vascularity and wound healing are just what the field needs. Whether I’m using it as a dressing over a palatal graft donor site, making “sticky bone” for horizontal or vertical bone grafting, or covering a Schneiderian membrane perforation, PRF has made my clinical practice more streamlined with less complications, faster healing, and more confidence in treating patients at risk for compromised wound healing.
William Papaioannou, Professor, Department of Preventive and Community Dentistry, National and Kapodistrian University of Athens, Athens, Greece. Autologous platelet concentrates (APCs) provide significant treatment options in many different clinical situations, both for the oral cavity and in other parts of the body. It is truly impressive how they can assist in the surgical treatments of defects in both hard and soft tissues, harnessing the regenerative potential of the patient’s own blood. Especially PRF preparations have been shown in many clinical trials to be effective in providing enhanced healing and increased patient comfort. Moreover, the readily available blood of the patient used to produce platelet concentrates reduces the cost of treatment by avoiding expensive commercial grafts and membrane material. Professor Marc Quirynen is a leading teacher, researcher, and clinician in Periodontology. His contribution to this field, especially in the use of L-PRF, has added substantial knowledge and understanding of the healing potential provided by the growth factors released by APCs. He has been their tireless promoter, by performing the necessary and significant research on this biologically based treatment paradigm and transmitting his experience through countless publications and lectures. Now, with this free website dedicated to the application of L-PRF in oral surgery, the accumulated expertise of Professor Quirynen and other researchers is provided to oral health care clinicians. The necessary knowledge base and step-by-step application protocols is made clear to all and can guide them in providing biologically driven surgical treatment options. The future of periodontal care is in personalized medicine, and no better example of this is found in harnessing, to the maximum, the patient’s own healing capability. This website is an invaluable source of information for all clinicians.
Mazen El-Abiad, Université de Montréal, Montréal, Canada. Since 2016 and following the advice of Dr. Marc Quirynen that “the future of dentistry lies in the use of L-PRF”, I am using this tool with the original protocol (2700 rpm for 12 minutes) on a very regular basis in my practice. After a career of more than 20 years at the university (Université de Montreal) as a clinician, I am at present solely in private practice where 15 to 25 patients are seen on a daily basis with the help of three experienced hygienists. More than 4000 patients have been treated with this protocol in various treatment modalities. In fact, the L-PRF is used in the root-planing patients especially in patients with periodontitis stage 3 grade C, in osseous surgery patients, graft patients (free as well as connective tissue). The sticky bone covered by L-PRF membranes is used in ALL extraction cases preparing the sites for implant placement. Beside an exceptional healing with little or no inflammation after two weeks, the common thread of all patients treated with L-PRF compared to treatment without is the presence of minimal discomfort and pain post-operatively. In 30+ years of periodontal practice, L-PRF was truly a game changer, an invaluable and central tool to my actual practice that I cannot imagine it without.
Catalina Carvajal Contreras, CEO RNG Salud Center, Santiago, Chili. My name is Catalina Carvajal, Biotechnology Engineer and founder of RNG Salud, a medical center specializing in regenerative medicine dedicated to the treatment of wounds and local injuries using Naturally Guided Regeneration. I have over 11 years of experience in wound treatments using L-PRF and have witnessed the remarkable transformation this treatment generates in various types of wounds, whether they are cuts, ulcers, burns, post-surgical wounds, etc. The benefits are evident even in cases where the wound has been present for years and its progression has been unfavorable or at imminent risk of amputation. I would like to begin by expressing the great honor it has been for me to be part of the driving group behind this new and revolutionary treatment that has changed the lives of thousands of people worldwide, allowing us to restore well-being and quality of life to our patients. Patients have shown a faster and more efficient recovery compared to conventional treatments. Wounds that previously took a long time to heal now show significant improvement in a short period, changing the characteristics of the wound bed and the surrounding skin from the very first application and reducing the pain perceived by the patient in just a few days, leading to greater satisfaction for both patients and us as providers. Additionally, the application of L-PRF in wounds has considerably reduced complications and promoted better tissue regeneration, both functionally and aesthetically, as it has a more regenerative than scar-forming effect. The ability of L-PRF to stimulate the vascularization of the wound and cell proliferation is truly impressive. I have seen how chronic wounds that have been present for years and show unfavorable characteristics, such as dryness, maceration, the presence of slough, biofilm, or necrotic tissue, have responded positively to our treatment, reversing these characteristics and restoring quality of life to our patients. This has motivated us to expand its applications in various types of injuries, such as osteoarthritis, tears, tendinopathies, among others. The best part of our work is witnessing the change in attitude of patients upon seeing the first signs of improvement in a wound that they had only seen worsen, and the gratitude with which they bid farewell to our staff on the day they are discharged. In summary, my experience with L-PRF has been extremely positive. It has not only improved the quality of my treatments but has also strengthened my patients' confidence in the healing process. There is still much ground to cover, many things to discover, and many new applications to explore. Without a doubt, I will continue using this innovative technique to help every patient in need. Catalina Carvajal Contreras, CEO RNG Salud Center, www.rngsalud.com
Tiziano Testori, Adjunct Clinical Associate Professor, Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI, USA. In the atrophic maxilla often the condition of soft tissues is far from ideal but it can be corrected during the first or second stage of surgery. The proper management of soft tissues is closely connected with aesthetic factors and hygiene maintenance. The creation of an adequate layer of peri-implant keratinized tissue along with deepening of the fornix and thinning of tissues lead to a decidedly more favourable anatomy for oral hygiene at home. A further expansion of the vestibular arch and thickening of soft tissues allow a greater compensation of the patient's skeletal class and supply the prosthetist an adequate quantity of tissue for the prosthetic phase. Having thus gained more thickness and stability the tissue will be less prone to recession. I started using PRF several years ago when the techniques were different from today and the literature was still not so clear on the issue. I understood immediately that it could be a solution to various soft tissue problems and that it could improve my daily clinical practice. Today I use it often both in the management of peri-implant soft tissues and in extraction surgery. I often use it also for the management of complications in maxillary sinus lift and oral surgery. I believe that careful training is necessary for those who want to start using it, but I also recommend it to young colleagues. It is very important to learn the correct peripheral blood collecting techniques and the management of the operating protocols. I recommend those who want to learn this protocol to start dealing with the venipuncture techniques beginning with simple veins and gradually gaining enough competence to manage even patients with more complicated veins. The protocol must be followed strictly in order to avoid mistakes leading to adverse reactions in the patient. I think that in recent years a lot has been written about the L-PRF, today there is no doubt about its usefulness, however there is always room to improve on it with different sample studies opening up other possibilities in the field of oral surgery.
Yaniv Mayer, Director, postgraduate program in periodontology, Rambam Health Care Campus, Haifa, Israel. As a periodontist committed to excellence in patient care, I've integrated Leukocyte and Platelet-Rich Fibrin (LPRF) therapy into my practice with remarkable results. This innovative approach utilizes concentrated healing components from your own blood to create a powerful regenerative matrix that accelerates tissue healing naturally. In extraction cases, LPRF significantly reduces post-operative discomfort while preserving the socket architecture, optimizing sites for potential future implant placement. During sinus augmentation procedures, particularly when membrane perforations occur, LPRF serves as an effective biological repair material, creating a stable seal that protects the sinus cavity while promoting tissue regeneration. For periodontal regenerative therapies, LPRF enhances treatment outcomes by promoting more predictable soft tissue healing and bone regeneration. The physiological approach results in reduced inflammation, accelerated recovery, and improved tissue quality. What distinguishes LPRF therapy is its biocompatible nature, as it's derived exclusively from the patient's own blood without chemical additives. The procedure is efficiently performed chairside with minimal additional time. My clinical experience has demonstrated that patients receiving LPRF therapy typically experience reduced post-operative symptoms, require less pain medication, and return to normal function more rapidly than with conventional approaches. This advanced biological technique represents a significant advancement in periodontal care that benefits patients through enhanced comfort, expedited healing, and superior long-term outcomes.
Vanessa Ruiz Magaz, Associate Professor, Periodontology Department, Universitat Internacional de Catalunya, Barcelona, Spain. As a clinician deeply passionate about periodontics, oral surgery and regenerative dentistry, I have personally experienced the profound impact of Leucocyte-Platelet Rich Fibrin (L-PRF) in my daily practice. Over the years, I have sought ways to optimize healing, reduce complications, and improve patient comfort, and L-PRF has proven to be an invaluable tool in achieving these goals. One of the aspects I appreciate most about L-PRF is its ability to promote angiogenesis, reduce inflammation, and enhance both soft and hard tissue healing in a way that feels completely natural. In my own experience, incorporating L-PRF into procedures such as socket preservation, bone grafting, and mucogingival surgery has led to noticeably faster recovery times and improved surgical outcomes. Knowing that this technique leverages the patient’s own biology to accelerate healing without the risks associated with synthetic materials or foreign substances makes it even more rewarding. Beyond its biological benefits, L-PRF has transformed how I approach surgery. It’s a cost-effective, minimally invasive, and highly practical method that not only enhances clinical outcomes but also increases patient satisfaction. Seeing patients recover with minimal discomfort and improved healing has reinforced my confidence in this technique time and time again. For those considering regenerative options in oral and implant surgery, I wholeheartedly advocate for integrating L-PRF into treatment protocols. It has been a game-changer in my practice, and I believe it has the power to elevate the standard of care for any clinician looking to provide the best possible outcomes for their patients.
Ziv Mazor, Associate Professor, Titu Maiorescu University, Bucharest, Romania & Faculty member of NYU continuing education in Implantology, New York, USA. I have started using blood derived autologous growth factors as early as 2002 using PRP following Dr Marx. Beginning 2006 I started with the use of L-PRF for both hard and soft tissue regeneration procedures following Dr Choukroun. In 2009 I have published the first study in the Journal of Periodontology showing the use of L-PRF as a sole graft material in lateral window sinus augmentation. I am a strong believer in the importance and advantage of using L-PRF for both soft and hard tissue regeneration and have been using it in my practice for every single regeneration procedure. I lecture and teach this specific subject both nationally and internationally and actually was the first to introduce it in the US at one of the American Academy of Periodontology annual meetings. There is no doubt today based on solid research that utilizing L-PRF promotes both soft and hard tissue regeneration and I advise each implantologist to embrace the concept, and to take continuing education courses in this subject and be in the front line of the dental implantology. I think without any doubt there is enough evidence-based data to use L-PRF in a safe manner. It's advantages as described both in the medical field as well as dentistry are solid and unshakable.
Björn Klinge, Em. Professor, Karolinska Institute, Department of Dental Medicine & Em. Professor, Malmo University, Faculty of Odontology, Malmo, Sweden. It is my great honour and pleasure to support the L-PRF-concept in clinical wound healing. Solid research brings evidence to the use of L-PRF in various clinical cases, including the promotion of both soft and hard tissue healing and regeneration, also for use in extra-oral wound care. It is noteworthy that the L-PRF product is autologous, meaning that it has only “biological ingredients” originating from the recipient. The recipient of the L-PRF product also being the donor of the included biologic “self” components. Thus, all foreign-body reactions are excluded. As always, more research is desired and will clarify molecular mechanism of action more in detail, and like all new concepts gradually involving larger test- and control groups in clinical studies. Since this is not a commercial product, maybe the marketing gets a bit less intrusive....
Marcel Wainwright, Professor, University of Sevilla, Department of Oral Surgery, Sevilla, Spain. Since more than 20 years I am experienced with blood concentrates and their application in oral surgery with different systems and to be honest, I could not work anymore without it. From bone augmentation to periodontal treatment, socket preservation to dental implants, the indications are numerous for L-PRF and still not completely investigated. The benefits for the surgeon, such as easy application and handling, faster soft tissue and hard tissue regeneration, less surgical complications, and almost universal indications, are pivotal. Patients also profit from reduced post-operative downtime with less pain and swelling, and shortened treatment time. This has become more and more crucial for the choice of the surgeon, since L-PRF has an increasingly awareness on the internet and social media. Of course, there are various systems on the market with different protocols and characters, like addition of clotting agents or not, centrifugation time, incubation or not, relative centrifugation forces and rounds per minute, dimension of the tube holder and angle, glass or plastic tubes with or without coating etc. But generally spoken, the concentration of leukocytes and thrombocytes embedded in fibrin and its slow release of growth factors does work in all of them and they do their job. Important in the application and the outcome of the product is the reduction of the centrifugal forces below 3000 rpm and I assume that this is one of the most important learning curves we had to make over the years as practitioners for a better cell vitality and viability. Last but not least it is important to understand that the blood concentrate´s quality is beyond the mentioned factors depending on the patient´s condition and medical history and, if necessary, has to be amended prior to the clinical application of L-PRF.
Moshe Goldstein, Professor, Director of postgraduate Periodontology at the Faculty of Dental Medicine of the Hadassah-Hebrew University Medical Center in Jerusalem, Jerusalem, Israel. The 1st issue of 97th volume (2025) of the Periodontology 2000 journal is dedicated to Autologous Platelet Concentrates in Oral Wound Healing and Reconstruction. The main editor is Professor Marc Quirynen from the KU Leuven University. He and his team managed to put together very updated reviews that cover perfectly a wide range of information about this topic. I find this to be the best and most comprehensive overall review related to PRF published. It is actually more than just a bunch of reviews; it is a real book and manual related to current knowledge about Platelets Concentrates. The articles are very “readable”, they cover extensively scientific and clinical data, and have the potential to be very useful for both scholars and clinicians. A work that would help experienced APTs’ users to expand their clinical abilities, and extremely useful for doctors that want to start using these techniques in their practices. As a former Postgraduate Program Director and former Chair of the EFP Postgraduate Committee, I would encourage every postgraduate students’ teacher to incorporate this issue of Periodontology 2000 in their curriculum.
Michiel Bonny, Dermatology Handelskaai & AZ Groeninge, Kortrijk, Belgium. Using L-PRF in the treatment of wounds has significantly changed my care for chronic ulcers. I've seen tremendous results with L-PRF even in ulcers that where complete stable for quite some time and were treated with all possible measures we have today. What patients really like is the biological, autologous origin of L-PRF, besides the only weekly change of the wound dressing. Along with the use in chronic ulcers, I find the use of L-PRF also very convenient for the healing of surgical wounds that otherwise would require major flap surgery for which patients are sometimes not eligible any more e.g. skin cancer surgery in the elderly population. I now consider L-PRF an essential part of my wound care protocol.
Franck Renouard, Implant Surgery, Private Practice, Paris, France. The first time I heard of the idea of using blood substitutes to improve wound healing was many years ago, at a lecture by Robert Marx in the United States. I was very excited by this innovation, but when I returned to France, my anaesthetist colleagues quickly dampened my enthusiasm. They, like a whole generation and more of medical practitioners in France, still bore the mental scars of the contaminated blood scandal of the late 80s. Taking blood and then ‘processing’ it to use it on patients was beyond the pale at that time. In time, however, very gradually, things began to happen, especially in the French medical teams working under Dr Joseph Choukroun. From afar, I monitored the progress being made regarding this technique, without, however, finding any good reason to use it in my own clinical practice. Later, Professor Marc Quirynen, who I had known for years, began to talk to me about L-PRF. I was immediately struck by the fact that this medical professional – well-known for his scrupulously conscientious approach to his work - was interested in this new technique, which was somewhat unorthodox. He explained that the Chilean dental surgeon Nelson Pinto had spoken to him about his ‘membranes’, which were having a miraculous effect on patients with bedsores, which were hard to treat using conventional methods. As a result, Dr Pinto and Professor Quirynen began to conduct research into the impact of L-PRF on tissue regeneration at the highly-regarded Catholic University of Leuven (KU Leuven). I attended several courses led by Marc Quirynen and was careful to look for errors or analytical biases that can cloud the critical faculties of sometimes over-enthusiastic researchers. However, the quality and meticulous nature of the studies ended up by winning me over. I acquired a centrifuge and some tubes and did my best to implement a seemingly easy protocol, which in reality involved myriad minutiae that had to be respected. When you start to use this technique, it’s advisable to choose simple clinical situations such as extraction sites. In time, as you begin to master the protocol, you can start to use it in a wider variety of areas. In my work, L-PRF is used in all sinus lifts, either as ‘filler’ or to help in the wound healing process. It’s also very useful in the event of small or medium-sized perforations of the Schneiderian membrane. Another very useful application for these membranes is in the closure of oro-antral communication. Although this technique is still quite rare, it has proven to be a simple and effective way of healing the small number of patients who have received this treatment. The most promising use of this concept is almost certainly the L-PRF block, which offers effective management of bone defects and a low failure rate. It is possible that in 10 years’ time this technique will have been replaced by more effective alternatives, but right now, in 2025, it would be strange of us to not adopt this protocol in our work or, at the very least, to take a close interest in it.
Iain Chapple, Professor of Periodontology, School of Health Sciences and Birmingham NIHR Biomedical Research Centre in Inflammation, University of Birmingham, Birmingham, UK. I am pleased to be able to offer my thoughts on the second-generation platelet aggregates. Whilst we are still in the early stages of their development and implementation, they offer a simple, biological and natural approach to tissue regeneration, which fits with the need to reduce the environmental impact of biomaterials for human use. The evidence-based for their use in procedures such as sinus lifts, ridge and socket preservation as well as bone augmentation procedures is increasing, and the autologous nature of the product reduces risks from adverse reactions and adverse immunological responses. Patients do not like the idea of xenografts, but the potential to use their own tissues in a manner that improves clinical as well as patient reported outcomes offers huge advantages. The simplicity of the procedure make it ideally suited to socket preservation Clearly, there is always a need for “more research”, but L-PRF as a clinical application draws upon the normal biology of wound healing, leveraging molecular and cellular mechanisms that arise naturally in the body. I believe L-PRF has significant future potential and look forward to the improvements in knowledge of its mode of action as new research emerges. Overall, the safety profile of L-PRF, the existing evidence base and the range of situation in which it appears to confer benefit, give confidence in its continued development and use in dental medicine and surgery.
Lior Shapira, Professor, Department of Periodontology, Hebrew University, Faculty of Dental Medicine, Hadassah Medical Center, Jerusalem, Israel. Using PRF in Clinical Practice As a clinician who has incorporated PRF and its variations into my practice and the university clinic, I am pleased to support this valuable educational initiative. The comprehensive, evidence-based approach this website takes toward PRF applications significantly contributes to our field. In my clinical practice as well as with my graduate students, I have successfully utilized PRF in numerous applications with consistently good results. For socket preservation following extractions, the addition of PRF plugs has notably accelerated healing and preserved ridge dimensions, reducing the need for additional augmentation procedures. In more complex cases involving vertical and lateral bone regeneration procedures, combining PRF with bone grafts enhanced volume stabilization and may promote faster neovascularization of bone, leading to more predictable outcomes. Additionally, using PRF membranes to cover the collagen membranes accelerated soft tissue healing. What makes this resource particularly valuable is its independence from commercial influence, ensuring that the information provided is guided solely by scientific evidence rather than marketing considerations. The dual focus on both clinician education and patient information addresses a critical need in our profession. The field of autologous blood concentrates continues to evolve, and having a centralized, regularly updated resource is invaluable for staying current with best practices.
Bahar Eren Kuru, Professor, Dean of School of Dentistry & Head of Periodontology Department, Director of EFP-Accredited PG Program in Periodontology, Yeditepe University, Istanbul, Turkey. “Starting with well documented studies on platelet concentrates as adjuncts to bone graft materials during the treatment of periodontal intra-bony defects and sinus augmentation, prominence has now been given in our clinic to the use of leucocyte- and platelet-rich fibrin (L-PRF) as a highly promising bioactive additive in periodontal procedures for soft/hard tissue regeneration and wound healing. It is frequently used at Yeditepe University Faculty, of Dentistry Periodontology department, due to its significant contribution to tissue regeneration and wound healing, and its ability to reduce postoperative discomfort by regulating inflammation. L-PRF, made by the centrifugation of pure autologous blood, contains high concentration of platelets, leucocytes, growth factors in a very strong fibrin matrix. Its practical and rapid application allows it to be used as a standalone membrane. When combined with bone grafts, it facilitates handling and adaptation to the defect site, optimizing surgical efficiency and predictability. Our personal experiences reveal that L-PRF is easy to prepare, handle and apply in various modalities of periodontal surgeries whereas on the patients side, it is inexpensive and effectively minimizes the need for analgesics during postoperative period. Our recent study, evaluating the wound healing effects of L-PRF on the palatal donor area of a deeply harvested free gingival graft, is still ongoing. The current unpublished results show that L-PRF application is dramatically shortened the epithelization time of an open wound with enhanced patient comfort and satisfaction.”
Ebru Özkan Karaca, Associate Professor, Department of Periodontology, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey. “Starting with well documented studies on platelet concentrates as adjuncts to bone graft materials during the treatment of periodontal intra-bony defects and sinus augmentation, prominence has now been given in our clinic to the use of leucocyte- and platelet-rich fibrin (L-PRF) as a highly promising bioactive additive in periodontal procedures for soft/hard tissue regeneration and wound healing. It is frequently used at Yeditepe University Faculty, of Dentistry Periodontology department, due to its significant contribution to tissue regeneration and wound healing, and its ability to reduce postoperative discomfort by regulating inflammation. L-PRF, made by the centrifugation of pure autologous blood, contains high concentration of platelets, leucocytes, growth factors in a very strong fibrin matrix. Its practical and rapid application allows it to be used as a standalone membrane. When combined with bone grafts, it facilitates handling and adaptation to the defect site, optimizing surgical efficiency and predictability. Our personal experiences reveal that L-PRF is easy to prepare, handle and apply in various modalities of periodontal surgeries whereas on the patients side, it is inexpensive and effectively minimizes the need for analgesics during postoperative period. Our recent study, evaluating the wound healing effects of L-PRF on the palatal donor area of a deeply harvested free gingival graft, is still ongoing. The current unpublished results show that L-PRF application is dramatically shortened the epithelization time of an open wound with enhanced patient comfort and satisfaction.”
Georgios E. Romanos, Professor, Department of Periodontics and Endodontics, School of Dental Medicine, Stony Brook University, New York, USA & Professor of Oral Surgery and Implant Dentistry Johann Wolfgang Goethe University, Frankfurt, Germany I strongly believe that biology is the basis for development of technological disciplines and should always follow ethics and evidence-based therapy. The development of L-PRF for different indications in dental and craniofacial research has been used extensively the last few years in clinical settings. There is a lot of research and development of clinical protocols improving the soft tissue healing after surgery and controlling surgical complications. In the present days of customized medicine, the use of growth factors and especially L-PRF increases the clinical outcomes and more research is required to improve clinical medicine and patient-related outcomes. This might change treatment protocols and provide the required evidence, to bring the L-PRF in clinical settings as a standard of care in dentistry.
Antonio Sanz Ruiz, Chairman of Periodontology and Implant Dentistry Department, Faculty of Dentistry, University of Los Andes, Santiago, Chile. Trying to express my feelings regarding the use of L PRF, in a couple of simple words, I must say, “L-PRF changed my surgical approaches and life completely”. Since we started in the year 2010, timidly exploring the benefits of L PRF use in our patients, we discovered a magical world in this second generation of Leucocytes and platelets rich fibrin, capable of booster the healing process in soft and hard tissues. The previous experience using the PRP (the first generation of platelets concentrates) was not good, even using the best and more expensive machine to collect the platelets (1.5 million platelets/µL in 10 mL of end product from a 60 ml). Regularly with PRP, the results with soft tissue were better than with bone grafts. I never used just PRP to treat a socket or bone deficiencies, regularly I mixed it with bone grafts to get better material, but in general, the results were poor. This is also reflected in the literature. I started using L-PRF, to treat post-extraction sockets, formally to make alveolar ridge preservation. In our first cases, we used it along with allogenic graft materials, and the results were wonderful. At the same time, knowing the benefits described in the literature, very scarce at that time, I decided to use L PRF in soft tissue plastic surgery to enhance the healing of the surgical procedures. The results were dramatically better than the surgeries in which I did not use it. Since then, I started to use L PRF in all soft and hard tissue reconstructions. In socket preservation I have seen the most outstanding results even not comparable with any kind of graft material before. After 3 months, we have complete soft tissue closure, and very nice bone regeneration, allowing us to place an implant in a perfect living bone. Nowadays, in my practice, I never leave a socket without L PRF because I consider it is the best way to take care of our patients. In all the bone surgeries, L-PRF is part of the protocol, alone or mixed with Allogenic or Xenogenic graft materials, with again an outstanding result. In soft tissue plastic surgery, I use L-PRF instead of connective tissue graft with excellent results in some cases such us single recessions, using tunnel technique or CAF technique. In summary, there is a turning point in my professional surgical life, before and after L PRF. This simple autologous product obtained from autologous blood with no additives, preserving all the growth factors, adhesins, and cytokines in its fibrin network is our best surgical partner. Never fails, never is tired, and always ready to booster the healing of the tissues independent in which area of the body it is placed.
Homa H. Zadeh, Diplomate, American Board of Periodontology, VISTA Institute for Therapeutic Innovations, California, USA. As a clinician who has closely followed the literature on autologous blood products for years, I have encountered both compelling studies and others with more equivocal outcomes. Due to this variability, I was initially hesitant to incorporate autologous blood products into my practice until more definitive evidence emerged. However, once I began using platelet-rich fibrin (PRF), I quickly recognized its profound clinical benefits. As a researcher in tissue engineering, I recognize that PRF aligns with the core principles of tissue engineering, which involve the integration of cells, scaffolds, and signaling molecules to promote regeneration. PRF inherently provides all three components: •Cells: Platelets and leukocytes, which contribute to healing and immune modulation •Scaffold: A fibrin matrix that supports cellular migration and tissue integration •Signaling Molecules: A reservoir of growth factors and cytokines that enhance regeneration at the grafted site This natural combination makes PRF a powerful tool in regenerative medicine, facilitating predictable tissue healing and repair. Today, I routinely utilize both liquid and solid forms of PRF to enhance the biological activity of scaffolds for soft tissue and bone augmentation. My applications include: •Soft tissue regeneration in periodontal and peri-implant plastic surgery around teeth and implants •Guided bone regeneration (GBR) for alveolar ridge augmentation •Guided tissue regeneration (GTR) •Extraction socket grafting •Maxillary sinus augmentation •Vestibuloplasty Clinical trials have provided objective data supporting the efficacy of PRF across these applications. In my experience, PRF offers the following advantages: •Reduced patient morbidity following major surgical procedures, including significantly less pain, edema, inflammation, and bruising •Fewer post-operative complications, such as lower infection rates, reduced wound dehiscence, and minimized graft exposure •Accelerated wound healing, particularly in open healing situations like extraction socket management Many of these first-hand clinical observations align with outcomes reported in both human and animal studies. However, beyond the research, experiencing the transformative impact of PRF in daily clinical practice has been even more convincing. Patients readily embrace this approach, as they intuitively understand the concept of harnessing the body’s natural healing potential. Those who have undergone procedures with PRF—especially those who previously had similar treatments without it—consistently report a more comfortable recovery and better outcomes. Today, autologous blood products are an indispensable adjunct to regenerative and reconstructive surgical interventions in my practice, significantly enhancing both patient care and clinical success.
Ioannis Polyzois, Professor/Consultant in Periodontology, Director, Postgraduate Program in Periodontology, Dublin Dental University Hospital, Trinity College, Dublin, Ireland. We have been utilizing L-PRF (Leukocyte-Platelet Rich Fibrin) in our periodontal and oral surgery clinics for nearly a decade and recently incorporated H-PRF into our practice. Both have proven to be invaluable tools, offering a natural and effective way to support healing and recovery. Since these therapies are derived from the patient’s own blood, they minimize concerns about foreign materials while promoting tissue regeneration in a safe and biologically harmonious manner. Patients who have undergone oral surgical procedures such as extractions and bone grafting with L-PRF have consistently experienced smoother healing, reduced post-operative discomfort, and faster recovery times. Many report less swelling and an easier return to daily activities, making the post-surgical process more comfortable and manageable. From a clinical standpoint, L-PRF has significantly improved soft tissue healing and enhanced bone regeneration, making it a valuable adjunct in both routine and complex cases. Additionally, it has been extensively used as a supportive treatment in managing osteonecrosis, particularly medication-related osteonecrosis of the jaw (MRONJ). Overall, the response to L-PRF has been overwhelmingly positive from both patients and clinicians. While every case is unique, its ability to accelerate and enhance the body’s natural healing process has made it an important component of our oral surgery treatments.
Karin Jepsen, Professor, Department of Periodontology, Operative and Preventive Dentistry, University Hospital of Bonn, Bonn, Germany. From the very beginning of our careers in periodontology we have been intrigued by the prospects of periodontal regeneration. Now, many years later we follow with fascination the evolution of growth factor delivery via the latest generation of autogenous platelet concentrates and the emerging evidence supporting their use in periodontal indications such as recessions, furcations and vertical defects.
Ivo Lambrichts, Professor, Faculty of Medicine and Life Sciences, Department of Morphology, Hasselt University, Hasselt, Belgium. Leukocyte- and Platelet-Rich Fibrin (L-PRF) is an autologous platelet concentrate that plays a crucial role in regenerative medicine due to its ability to promote tissue healing. My research team has extensively studied the positive effects of L-PRF on angiogenesis and wound healing. In a study published in Scientific Reports in 2018, we investigated the angiogenic properties of L-PRF. We found that L-PRF forms a fibrin matrix rich in platelets, leukocytes, and a variety of cytokines and growth factors. Notably, high levels of CXC chemokine receptor 2 (CXCR-2) ligands, epidermal growth factor (EGF) and vascular growth factor (VEGF) were identified. These components play a crucial role in stimulating endothelial cell proliferation, migration, and tube formation—essential steps in new blood vessel formation. Furthermore, our research demonstrated that L-PRF can induce blood vessel formation in vivo, highlighting the clinical potential of this easy-to-use platelet concentrate. Further research by our team has shown that L-PRF has a positive effect on peripheral nerve cells. The growth factors released by L-PRF improve survival and significantly stimulate the outgrowth and branching of neurites from dorsal root ganglion neurons. This suggests that L-PRF not only contributes to wound healing and angiogenesis but also holds potential in regenerating peripheral nerve damage. In summary, our findings highlight the versatile benefits of L-PRF in tissue regeneration. Due to its rich composition of growth factors and cytokines, L-PRF effectively promotes angiogenesis, accelerates wound healing, and supports the regeneration of damaged tissue and relieves pain, making it a valuable tool in various clinical applications.
Turker Ornekol, Managing Director at Cosmodent Center for Dentistry and dental implants, Istanbul, Turkey. Testament on the Positive Results of L-PRF As a practitioner in implant dentistry, I have consistently sought innovative techniques to improve patient outcomes and ensure the longevity of dental implants. One of the most impactful advancements in recent years has been the incorporation of Leukocyte-Platelet Rich Fibrin (L-PRF) into my practice. L-PRF has proven to be a game-changer, particularly in enhancing soft and hard tissue healing following implant procedures. Its autologous nature—derived from the patient’s own blood—minimizes the risk of allergic reactions and ensures biocompatibility. In my experience, L-PRF has consistently improved patient satisfaction, reduced postoperative challenges, and enhanced the predictability of implant success. The integration of this technique has allowed me to provide a higher standard of care, transforming the way I approach complex cases.
Peter Moy, Clinical Professor, Department of Oral & Maxillofacial Surgery, School of Dentistry, University of California-Los Angeles, Los Angeles, USA. It is with pleasure to write this testimonial in support of your idea and efforts to create an “Open Access” website dedicated to educating and teaching clinicians from around the world to the benefits of using Platelet Rich Fibrin (PRF). You have always been very objective in providing the highest standard in academic research and your publications in high impact-factor journals, such as Periodontology 2000, Clinical Implant Dentistry and Related Research, and Clinical Oral Implant Research have helped so many clinicians in transferring the scientific data into clinical practice. I have every expectation that you will do the same for this very confusing field and that you will show us the proper way to incorporate all of the potential applications of L-PRF! I am certain that your website devoted to understanding L-PRF and all of the additional iteration’s of L-PRF and its uses will be extremely valuable to our profession. I congratulate you and your team on organizing and providing us content on the application of L-PRF in both dentistry and medicine.
Yanmin Zhou, Professor, Department of Stomatology, Jilin University, Changchun, Jilin, China As a researcher with extensive involvement in the field of oral implantology, I initially utilized PRF for tooth extraction site preservation in 2003. At that time, I did not foresee the extent to this autologous material, which sourced from the patient's venous blood, would serve as a cornerstone throughout my two-decade research career. Notably, in 2010, I conducted a PRF-combined maxillary sinus lift procedure for a patient with severe alveolar bone height deficiency. During the operation, the elastic support characteristics exhibited by the PRF membrane led me to recognize its potential as an ideal biomaterial capable of simultaneously fulfilling the requirements of biocompatibility and mechanical stability. To date, the patient has consistently maintained a stable peri-implant bone volume of over 2mm, thereby providing further evidence of the long-term clinical efficacy and significance of PRF. In the realm of clinical technology practice and innovation, our team has developed several landmark PRF application systems. In maxillary sinus floor elevation, we introduced the PESS technique, which leverages the progressive expansion of PRF to achieve non-invasive lifting of the Schneiderian membrane. Furthermore, we have expanded the application of PRF from bone augmentation to soft tissue regeneration engineering. The fibrin network of PRF creates a microenvironment conducive to directional guidance for keratinized gingiva regeneration. Additionally, an open healing suture technique was devised for wounds requiring keratinized gingiva augmentation, fully exploiting the three-dimensional scaffold properties of PRF membranes to ensure mucosal closure at the alveolar ridge crest. Regarding preparation technology, systematic research enabled us to establish a dynamic adjustment model for centrifugal parameters, significantly improving the stability of active components within PRF membranes. We posit that the biological mechanisms underlying PRF serve as the foundational rationale for its classification as an exceptional biomaterial. PRF is an autologous graft replete with platelets, white blood cells, and a variety of cytokines. Clinical investigations have substantiated that the growth factors inherent in PRF possess the capacity to induce the proliferation and differentiation of osteoblasts, demonstrating superior efficacy in promoting early bone formation compared to Bio-Oss bone powder. The three-dimensional fibrin scaffold, obtained via gradient centrifugation, is not only enriched with critical active components such as autologous platelet-derived growth factor (PDGF) and transforming growth factor (TGF-β), but also achieves a prolonged release cycle of growth factors due to its progressive release characteristics. This feature confers a notable advantage in healing contexts, such as post-extraction alveolar bone remodeling and osseointegration around dental implants, where sustained stimulation is essential. We have carried out extensive clinical and fundamental research to investigate the role of PRF in soft and hard tissue augmentation. Both in fundamental experiments and clinical studies, we have consistently observed that PRF significantly enhances bone augmentation outcomes while effectively maintaining the width of keratinized gingiva. We possess a robust theoretical foundation supporting the safety and efficacy of PRF in clinical applications. Recently, through electron microscopy observations, we identified the unique phenomenon of mitochondrial transfer via PRF fiber scaffolds, which may elucidate its exceptional regenerative capacity in complex defect repair. In future ongoing research, we aim to further explore the underlying mechanisms of PRF, including its controlled release of growth factors and its multi-faceted regulation of signaling pathways. Over the course of two decades of clinical practice, the aggregation of thousands of cases has provided compelling evidence for the evolution of PRF technology. Initially serving as a simple biological barrier membrane, PRF has now advanced to become an intelligent biomaterial that integrates multiple functionalities, such as mechanical support, sustained release of growth factors, and immune modulation. This clinical evidence continually enhances our recognition that the most ideal regenerative materials are often embedded within the intrinsic biological intelligence of the human body. As a key contributor to the development of PRF technology, I have consistently held the conviction that its core value resides in "respecting and enhancing the intrinsic repair potential of the body". At present, our team is dedicated to constructing a PRF efficacy prediction model, which enables the formulation of personalized treatment protocols by analyzing specific biomarkers in patients' blood. We envisage collaborating with international experts to further investigate this dynamic and promising domain, thereby facilitating broader patient access to this safe, effective, and patient-centered regenerative medicine solution. This two-decade-long exploratory journey has profoundly reinforced my understanding that PRF serves not only as a vehicle for technological innovation but also as an optimal bridge connecting fundamental research with clinical requirements. It inspires us to decipher the mechanisms of life's self-healing capabilities with reverence and to shed light on the future direction of regenerative medicine through the advancement of science and technology.