Evaluation of the effectiveness of platelet-rich plasma therapy in peri-implant soft tissue remodeling

Relevance. Peri-implant soft tissue management remains a frequent clinical challenge in dental practice. Adequate thickness and width of keratinized peri-implant mucosa are essential for the long-term stability and functional performance of implant-supported prosthetic restorations. At present, platelet-rich plasma (PRP) therapy has emerged as a minimally invasive alternative to conventional soft tissue grafting. The preparation of viable platelets with active growth factors requires the use of specialized collection tubes and a swing-bucket centrifuge.

Objective: To evaluate the clinical effectiveness of PRP therapy for peri-implant soft tissue remodeling.

Materials and methods. During the study period, 72 dental implants were placed in 56 patients, who were divided into two study groups. In Group 1, peri-implant soft tissue grafting was performed simultaneously with implant placement and healing abutment connection. In Group 2, platelet-rich plasma was administered via four intramucosal injections at peri-implant sites with soft tissue deficiency at weekly intervals. Intergroup comparisons of keratinized mucosa thickness and width were performed using the independent Student’s t-test. Changes in mucosal width were additionally analyzed using two-way repeated-measures analysis of variance (ANOVA), with group, measurement direction, and time as factors. Data are presented as mean ± standard deviation (M ± SD).

Results. Three months after implant placement, the thickness of keratinized peri-implant mucosa increased by 1.4 mm in Group 1 and by 1.1 mm in Group 2. The intergroup difference was statistically significant (p < 0.05). In the vestibular direction, changes in keratinized mucosa width did not differ significantly between groups (p > 0.05). In contrast, statistically significant differences were observed in the oral direction (p < 0.05). Although Group 1 demonstrated a greater increase in mucosal width, predominantly on the oral aspect, clinical examination revealed that peri-implant soft tissues in Group 2 appeared denser and more homogeneous.

Conclusion. PRP therapy represents an effective and minimally invasive alternative to surgical soft tissue augmentation, providing measurable increases in both the thickness and width of keratinized peri-implant mucosa. The observed improvement in soft tissue firmness suggests enhanced peri-implant mucosal integration; however, long-term clinical outcomes require further investigation. Despite a smaller increase in oral mucosal width compared with surgical grafting procedures, PRP therapy appears to promote the formation of a denser and potentially more stable peri-implant transmucosal seal.

1. Marx RE. Platelet-rich plasma (PRP): what is PRP and what is not PRP? Implant Dentistry. 2001;10(4):225-228. https://doi.org/10.1097/00008505-200110000-00002

2. Marx RE. Platelet-rich plasma: evidence to support its use. Journal of Oral and Maxillofacial Surgery. 2004;62(4):489-496. https://doi.org/10.1016/j.joms.2003.12.003

3. Dhillon MS, Behera P, Patel S, Shetty V. Orthobiologics and platelet rich plasma. Indian Journal of Orthopaedics. 2014;48(1):1-9. https://doi.org/10.4103/0019-5413.125477

4. Wasterlain AS, Braun HJ, Harris AH, Kim HJ, Dragoo JL. The systemic effects of platelet-rich plasma injection. American Journal of Sports Medicine. 2013;41(1):186-193. https://doi.org/10.1177/0363546512466383

5. Yushkov B.G. Platelets and regeneration. Bulletin of Siberian Medicine. 2021;20(2):216-227 (In Russ.). https://doi.org/10.20538/1682-0363-2021-2-216-227

6. Golebiewska EM, Poole AW. Platelet secretion: From haemostasis to wound healing and beyond. Blood Reviews. 2015;29(3):153-162. https://doi.org/10.1016/j.blre.2014.10.003

7. Flaumenhaft R, Sharda A. Platelet secretion. In: Michelson AE, Cattaneo M, Frelinger AL, Newman PJ, editors. Platelets (Amsterdam: Elsevier). 2019:349-370. https://doi.org/10.1016/B978-0-12-813456-6.00019-9

8. Stellos K, Langer H, Daub K, Schoenberger T, Gauss A, Geisler T et al. Platelet-derived stromal cell– derived factor-1 regulates adhesion and promotes differentiation of human CD34+ cells to endothelial progenitor cells. Home Circulation. 2008;2(2):206–215. https://doi.org/10.1161/CIRCULATIONAHA.107.714691

9. Kontorshchikova K.N., Aleinik D.Ya., Erastov E.R., Bulat V.V., Bulat A.V., Kontorshchikov M.M. Content of plate growth factors in plasma and their influence on diploid fibroblasts in culture. International Journal of Humanities and Natural Sciences. 2021; (4-2):147-153. (In Russ.). doi: 10.24412/2500-1000-2021-4-2-147-153

10. Arora NS, Ramanayake T, Ren YF, Romanos GE. Platelet-rich plasma: a literature review. Implant Dentistry. 2009;18(4):303-310. https://doi.org/10.1097/ID.0b013e31819e8ec6

11. Dohan Ehrenfest DM, Bielecki T, Jimbo R, Barbé G, Del Corso M, Inchingolo F, et al. Do the fibrin architecture and leukocyte content influence the growth factor release of platelet concentrates? An evidence-based answer comparing a pure platelet-rich plasma (P-PRP) gel and a leukocyteand platelet-rich fibrin (L-PRF). Current Pharmaceutical Biotechnology. 2012;13(7):1145-1152. https://doi.org/10.2174/138920112800624382

12. Xu J, Gou L, Zhang P, Li H, Qiu S. Platelet-rich plasma and regenerative dentistry. Australian Dental Journal. 2020;65(2):131–142. https://doi.org/10.1111/adj.12754

13. Alves R.O., Orsi C.G., Oliveira JA, Rezende Barbosa GL, Oliveira GJPL, PBF Soares. Adjuvant effects of injectable platelet-rich fibrin (i-PRF) in the nonsurgical periodontal therapy: a split-mouth randomized controlled clinical trial. Clinical Oral Investigations. 2025;29(7):341. https://doi.org/10.1007/s00784-025-06423-0

14. Patel GK, Gaekwad SS, Gujjari SK, Kumar VSC. Platelet-Rich Fibrin in Regeneration of Intrabony Defects: A Randomized Controlled Trial. Journal of periodontology. 2017;88(11):1192-1199. https://doi.org/10.1902/jop.2017.130710

15. Chan M. Diagnosis and Treatment of Periimplant Mucositis and Periimplantitis: An Overview and Related Controversial Issues. Dental clinics of North America. 2024;68(1):167-202. https://doi.org/10.1016/j.cden.2023.08.001

16. Hussain RA, Miloro M, Cohen JB. An Update on the Treatment of Periimplantitis. Dent Clin North Am. 2021;65(1):43-56. https://doi.org/10.1016/j.cden.2020.09.003

17. Solovyev M.M., Yaremenko A.I., Orekhova L.Y., Solovyeva A.M. Project concept for the long-term preservation and restoration of masticatory and speech functions through a targeted, structured, and comprehensive stepwise prevention of alveolar bone loss. Parodontologiya. 2025;30(1):103-104 (In Russ.). Available from: https://elibrary.ru/item.asp?id=80841713

18. Melezhechkina I.A., Atrushkevich V.G., Berchenko G.N. Comparative morphological assessment of crosslinked and non-crosslinked xenograft biointegration quality. Parodontologiya. 2022;27(4):288-297 (In Russ.). https://doi.org/10.33925/1683-3759-2022-27-4-288-297

19. Vacek JS, Gher ME, Assad DA, Richardson AC, Giambarresi LI. The dimensions of the human dentogingival junction. Int J Periodontics Restorative Dent. 1994;14(2):154-65. Режим доступа: https://pubmed.ncbi.nlm.nih.gov/7928131

20. Attia S, Narberhaus C, Schaaf H, Streckbein P, Pons-Kühnemann J, Schmitt C, et al. Long-Term Influence of Platelet-Rich Plasma (PRP) on Dental Implants after Maxillary Augmentation: Retrospective Clinical and Radiological Outcomes of a Randomized Controlled Clinical Trial. Journal of Clinical Medicine. 2020; 9(2):355. doi: 10.3390/jcm9020355 новая ссылка

21. Khouly I, Pardiñas López S, Aliaga I, Froum SJ, Long-Term Implant Survival After 100 Maxillary Sinus Augmentations Using Plasma Rich in Growth Factors. Implant Dentistry. 2017; 26:199–208. doi: 10.1097/ID.0000000000000561

22. Zhang Y, Chen X. The Role of Platelet-Rich Plasma in Dental Implant Surgery: A Review / Y. Zhan. Journal of Oral Implantology. 2021;47(1):12-20. https://doi.org/10.1563/AAID-JOI-D-20-00001

23. Lee C, Chen L. Efficacy of PRP in Periodontal Regeneration: A Meta-Analysis. Clinical Oral Investigations. 2022;(26)4:1235-1245. https://doi.org/10.1007/s00784-021-03760-z

24. Egierska D, Perszke M, Mazur M, Duś-Ilnicka I. Platelet-rich plasma and platelet-rich fibrin in oral surgery: A narrative review. Dental and Medical Problems. 2023;60(1):177-186. https://doi.org/10.17219/dmp/147298

25. Niemczyk W, Janik K, Żurek J, Skaba D, Wiench R. Platelet-Rich Plasma (PRP) and Injectable Platelet-Rich Fibrin (i-PRF) in the Non-Surgical Treatment of Periodontitis-A Systematic Review. International Journal of Molecular Sciences. 2024;25(12):6319. https://doi.org/10.3390/ijms25126319

26. Malcangi G, Patano A, Palmieri G, Di Pede C, Latini G, Inchingolo AD et al. Maxillary Sinus Augmentation Using Autologous Platelet Concentrates (Platelet-Rich Plasma, Platelet-Rich Fibrin, and Concentrated Growth Factor) Combined with Bone Graft: A Systematic Review. Cells. 2023;12(13):1797. https://doi.org/10.3390/cells12131797

27. Giannelli A, Forte M, D’Albis G, Cianciotta G, Limongelli L, Stef L. et al. Utilization of Platelet-Rich Plasma in Oral Surgery: A Systematic Review of the Literature. Journal of Clinical Medicine. 2025;14(8):2844. https://doi.org/10.3390/jcm14082844

28. Tomar N, Dahiya S, Sharma PK, Parihar AS, Mandal A, Sahoo AR. et al. Comparative Clinical Evaluation of Effectiveness of Platelet-Rich Plasma, Synthetic Allograft, and Bioresorbable Xenograft During Immediate Implant Placement. Cureus. 2022;14:e32121. https://doi.org/10.7759/cureus.32121

29. Bezerra BT, Pinho JNA, Figueiredo FED, Brandão JRMCB, Ayres LCG, da Silva LCF. Autogenous Bone Graft Versus Bovine Bone Graft in Association With PlateletRich Plasma for the Reconstruction of Alveolar Clefts: A Pilot Study. The Cleft Palate-Craniofacial Journal. 2019;56(1):134-140. https://doi.org/10.1177/1055665618770194

30. Osorio CC, Escobar LM, González MC, Gamboa LF, Chambrone L. Evaluation of density, volume, height and rate of bone resorption of substitutes of autologous bone grafts for the repair of alveolar clefts in humans: A systematic review. Heliyon. 2020;6(9):e04646. https://doi.org/10.1016/j.heliyon.2020.e04646

31. Feigin K, Shope B. Use of Platelet-Rich Plasma and Platelet-Rich Fibrin in Dentistry and Oral Surgery: Introduction and Review of the Literature. Journal of Veterinary Dentistry. 2019;36(2):109-123. https://doi.org/10.1177/0898756419876057

32. Nishiyama K, Okudera T, Watanabe T, Isobe K, Suzuki M, Masuki H, Okudera H, Uematsu K, Nakata K, Kawase T. Basic characteristics of plasma rich in growth factors (PRGF): blood cell components and biological effects. Clinical and Experimental Dental Research. 2016;2(2):96-103. https://doi.org/10.1002/cre2.26

33. Gutiérrez IQ, Sábado-Bundó H, Gay-Escoda C. Intraarticular injections of platelet rich plasma and plasma rich in growth factors with arthrocenthesis or arthroscopy in the treatment of temporomandibular joint disorders: A systematic review. Journal of Oral and Maxillofacial Surgery. 2022;123(5):e327-e335. https://doi.org/10.1016/j.jormas.2021.12.006