Application of Advanced Platelet-Rich Fibrin Plus in Oral Wound Healing and Pain Management: A Systematic Literature Review

Background: The growing interest in the field of platelet-rich fibrins has led to the development of novel generations of these concentrates, with one of the newest additions being advanced platelet-rich fibrin plus (A-PRF+). The updated centrifuge protocol utilized for the preparation of A-PRF+ has been shown to provide blood clots with more white blood cells and growth factors trapped in the fibrin matrix, presenting a more homogenous distribution. The objective of this study was to assess the available randomized clinical trials (RCTs), in order to evaluate the effects that the addition of A-PRF+ can have on postoperative quality of life and soft tissue healing after dental surgery. Materials and Methods: To perform a systematic review based on high-quality results, only RCTs were taken into consideration. The search included articles published between 1 January 2014 and 31 December 2024, indexed in the PubMed, Cochrane, Library, Embase, Scopus, and Google Scholar databases. Nine full texts were finally acquired after the screening of articles, from which relevant data were extracted. Results: A-PRF+ positively influenced the postoperative quality of life in patients. The subjective analysis of pain and its management via painkiller intake indicated that, in general, the addition of A-PRF+ into protocols results in less pain, pain that lasts for a shorter time, and pain that is more easily managed through medication, as a lower number of pills was needed to restore comfort. Furthermore, the occurrence of facial swelling and trismus was also reported to be lower in the A-PRF+ groups. As for soft tissue healing, A-PRF+ significantly enhanced the epithelialization process, total wound area reduction, and inflammation in the surrounding tissues. This positive effect was most noticeable at 7- and 14-day follow-ups. The addition of A-PRF+ also had a positive effect on postoperative bleeding by significantly reducing the bleeding time, providing benefits for patients undergoing antiplatelet drug therapy in particular. Conclusions: The addition of A-PRF+ into the surgical protocol can positively enhance the patient’s quality of life, reduce the need for postoperative medication, and improve the patient’s confidence by reducing potential swelling and trismus. A-PRF+ also positively influences soft tissue wound healing, further enhancing the postoperative well-being of patients, and provides an excellent hemostatic effect even in patients that are on antiplatelet drug therapy.