Does PRF, PRP or CGF made from your own blood really speed up bone healing?

All of them start the same way: blood taken from your arm is spun in a centrifuge just before surgery begins. As it spins, the blood separates into layers by weight, and a band where platelets are concentrated forms in the middle. Platelets are known as the cells that stop bleeding, but they also carry the signalling molecules that drive wound healing. The surgeon separates out this layer and places it in the wound. Everyone agrees on this much; the argument is about how much difference this layer makes to the outcome.

The names you come across describe different ways of preparing the product. PRP, platelet-rich plasma, is the oldest generation; it is liquid, and anticoagulants are usually added during preparation. PRF, platelet-rich fibrin, is produced with a single spin and no additives, and takes the form of a gel or a thin membrane through clotting itself; the most studied version in the literature contains white blood cells and is known as L-PRF. CGF, concentrated growth factors, is a newer type prepared with a centrifuge that changes speed during the spin. The term sticky bone that you may hear in clinics is not a separate material: it is the name given to bone graft granules mixed with this product into a mass with a dough-like consistency that does not fall apart.

The evidence stands firmest for soft tissue and the first few days after surgery. In a systematic review and meta-analysis of socket preservation published in Periodontology 2000, nine of the 11 randomised trials using L-PRF report better soft tissue closure and faster resurfacing than healing on its own; two find no difference. In the same review, eight of the 11 studies show a statistically significant drop in pain, most marked in the first three days; two studies also record lower use of painkillers.

Another meta-analysis, on impacted wisdom tooth (third molar) surgery, shows the same split even more clearly. In this study, published in BMC Oral Health, PRF significantly reduces pain on day three and swelling on day one, and markedly lowers the rate of dry socket. Against that, no difference is found at any time point in restricted mouth opening, and the values measured as markers of bone healing show no significant difference between PRF and the control group. The authors' own words are that PRF reduces some post-operative problems, not all of them.

The picture becomes mixed once you move to hard tissue. In the meta-analysis from the socket preservation review above, L-PRF reduces the socket's width loss and height loss by a sub-millimetre but statistically significant amount, and increases how much of the socket fills in. But the same authors attach a substantial caveat: of the 35 papers included in the review, only eight carry a low risk of bias and 11 a high risk, and the variation between studies is large enough to rule out a firm conclusion. The same review also states that the literature comparing these products with other graft materials is limited and inconclusive. So the statement that more bone forms rests on a measured trend, not a proven advantage.

Sinus floor elevation is the second area where these products are most discussed, and here the evidence is even weaker. A systematic review in Materials states that there is not enough solid evidence to reach a firm judgement on the benefit of using platelet concentrates alone as a graft material, and that adding PRF to another graft material gives the impression that it does not improve sinus lift outcomes. A 2024 review in BMC Oral Health uses more positive language for CGF, but it states clearly that the variation between studies rules out a meta-analysis, and that these early, promising results need confirming in large, long-term studies.

There is a point easy to miss while reading this: it is not clear which technique is superior within bone augmentation itself. Cochrane's review of horizontal and vertical bone augmentation before implants reports that bone can be built up with various techniques, but which one works better remains unclear, and complications are common, particularly with vertical augmentation. A product made from your own blood is a side issue added to an area with this much uncertainty already in it. It does not decide the main question: which surgery is done, and whether the bone genuinely needs building up at all.

In the area we work in, this topic has a narrow place, and let us say so plainly. Bone graft and sinus floor elevation are procedures of the conventional implant route; in the three-day plan, anchorage is taken from the hard bone deep in the jaw, so these steps do not come up in most cases, and blood concentrates are not a frequently used item either. If this topic concerns you, you are probably on the conventional route: a graft, a sinus lift or a difficult extraction is planned. If a clinic describes this product as the main reason for the treatment's success and offers it as a separate item at extra cost, the question to ask is not how the preparation is done, but which measurable outcome is expected to change in your case.

The distinction below shows the situations where blood concentrates come up, and where they do not. Whether one is used in your case is decided by the type of surgery planned, not by patient preference.

The sequence below describes a typical session where a blood concentrate is added to an extraction or a graft procedure. All the steps happen within the same appointment, just before surgery starts and partway through it.

1. 1

   Making the decision

   Which procedure it will be used in, and for what purpose, is decided during planning. Supporting soft tissue closure is one reason; mixing it into the graft is another. Ask which reason applies in your case; a reason that cannot be explained in two sentences is usually not a sound one.

2. 2

   Taking the blood

   A few tubes of blood are taken from your arm just before surgery starts. This step is no different from an ordinary blood test; you feel the needle go in, some light pressure and a brief sting.

3. 3

   The centrifuge

   The tubes are placed in a machine that spins for a few minutes, and the blood separates into layers. Preparation protocols differ in speed, duration and tube type; some of the variation in results in the literature comes from exactly this.

4. 4

   Applying it

   The layer obtained is used in one of three ways, depending on where it is needed: shaped into a thin membrane and laid over the wound, placed as a gel into the extraction socket, or mixed with graft granules into a mass that does not fall apart. What clinics call sticky bone is this third form.

5. 5

   Closing and monitoring healing

   The gum is closed without tension and stitched. At later check-ups, what is checked is whether the wound is closing, how the swelling is settling, and, if a graft was placed, whether the area is staying quiet. The real assessment of the bone is made on a follow-up image taken months later.

6. 6

   Whether it comes up in your case

   The answer to this depends on the surgery planned and cannot be given without an image. If you have a panoramic X-ray or a CBCT scan, send it through the form; we will reply within 24 hours on whether adding bone is genuinely needed and which options are on the table. The final decision is made after an examination and a CBCT scan.

A blood concentrate is not a treatment; it is an addition. Here are the other things discussed for the same issue, and they are usually what decides the outcome.

The chance of a product made from your own blood triggering an immune reaction is as good as zero, and that is this method's strongest point. The risks come more from the procedure itself and from the expectations built around it.

The sequence below shows the general course after an extraction or graft procedure that included a blood concentrate. It can shift by a few days depending on the person and the size of the surgery.

1. The first three days

   Swelling and tenderness usually peak on day two or three, then ease off. This early period is also where reviews find the clearest difference in pain. Cold compresses, soft, lukewarm food and taking the medicines you have been given regularly are the basis of this period.

2. Week one and two

   The wound edges close, and stitches are removed during this period. The expected healing of the surface becomes visible here. Avoid chewing on that side, do not probe the area with your tongue, and do not rinse vigorously.

3. The first month

   The gum settles into its shape, and daily life returns to normal. If the procedure was for soft tissue alone, the process is largely complete by this point.

4. After the third month

   If a graft was placed, the real assessment happens here, with a follow-up image. Whether the bone is sufficient is checked, and the implant decision follows from that. Having used a blood concentrate is not a reason to shorten this timescale.

In most clinics, blood concentrates are priced as a separate line rather than absorbed into the surgery. You will not find figures here; these are the things to look at when reading a quote:

Whether it is a separate item or included in the procedure

Some clinics charge separately when they use it; others count it within the surgery. When you get a quote, ask clearly which one this line is.

How many areas and sessions it is used in

Using it in a single extraction socket is not the same job as using it with a graft in both jaws at once. The number of tubes prepared and the time spent increase with the number of areas.

Which type is used

PRP, PRF and CGF need different equipment and consumables. Asking which one will be used, and why that type was chosen, is the quickest way to understand a quote.

The scope of the main procedure

What sets the total is not this addition but the surgery underneath it: whether a graft is placed, whether the sinus floor is elevated, how many implants are planned. Make sure this scope is clear before discussing the extra line.