M. Infante da Câmara

Guided bone regeneration (GBR) is a technique widely used to restore alveolar bone defects and guarantee favourable anatomical conditions for oral rehabilitation.

The integration of autologous platelet aggregates such as PRF (platelet-rich fibrin) has emerged as a biological alternative aimed at enhancing regenerative results, given its richness in growth factors and immunomodulatory properties. However, despite growing enthusiasm, the clinical application of these biomaterials requires careful consideration.

The effectiveness of platelet aggregates depends on multiple factors, such as the centrifugation protocol, the surgical technique, the handling of the clot, the type of bone defect and the patient’s biological profile.

In vitro and in vivo studies suggest benefits in angiogenesis, bone maturation and modulation of inflammation, but clinical results remain heterogeneous. The lack of standardisation and inter-individual variability challenge the predictability of therapeutic effects.

This lecture proposes a critical reflection on the role of platelet aggregates in GBR, supported by current scientific literature. The cellular and molecular mechanisms involved will be discussed, as well as the most common clinical indications – including periodontal defects, maxillary sinus elevations and alveolar preservation.

The presentation will also address the limits of its isolated use, emphasising the need for integration with osteoconductive biomaterials and barrier membranes to achieve stable results.

By analysing clinical cases, situations will be exposed in which the hasty or poorly indicated use of these concentrates resulted in regenerative failures or post-operative complications, contrasting with situations in which their thoughtful use promoted predictable and biocompatible regeneration.

In this context, ‘weighing before treating’ is particularly important: it is essential to know the available evidence, master the technique and adapt the approach to the specific clinical case. More than a universal solution, platelet aggregates should be seen as a complementary tool, the success of which depends on careful patient selection, surgical technique and multidisciplinary treatment integration.