Platelet Concentrates in Tooth Replantation: A Narrative Review and Evidence Synthesis of Periodontal and Pulpal Healing
Walaa Almarji, Mohannad LafloufABSTRACT
Objectives
The prognosis of an avulsed, replanted tooth over the long term hinges on whether the periodontal ligament (PDL) and the dental pulp can be preserved or regenerated. When extra‐oral dry time is prolonged, PDL necrosis follows, and the root becomes prone to inflammatory or replacement (ankylotic) resorption. Platelet concentrates—platelet‐rich plasma (PRP), leukocyte‐ and platelet‐rich plasma (L‐PRP), and platelet‐rich fibrin (PRF)—are autologous biomaterials that supply growth factors and may influence this healing process. This review asks whether autologous platelet concentrates reduce inflammatory and replacement (ankylotic) root resorption and improve periodontal and pulpal healing after delayed or intentional tooth replantation, compared with no adjunct, and whether residual periodontal ligament (PDL) viability changes this effect.
Material and Methods
This narrative synthesis (not a systematic review) draws together recent controlled clinical and animal studies with the case‐report and preclinical literature already captured in the only published systematic review on this topic. The search covered PubMed, Google Scholar, the Cochrane Library, Embase, Scopus, and Web of Science, from January to May 2026.
Results
In preclinical models, L‐PRP and PRF promote pulpal repair, tertiary dentin formation, and attenuated inflammatory root resorption, although neither consistently prevents ankylosis once PDL viability has been lost. In one retrospective comparative study of intentional replantation in hopeless teeth, PRF combined with root‐surface biomodification produced greater clinical attachment gain and a larger reduction in probing depth than replantation alone, a direction consistent with earlier case reports. Small, largely non‐randomized samples and unstandardized protocols still limit this evidence.
Conclusions
Platelet concentrates are biologically plausible adjuncts that improve periodontal and pulpal healing indices, yet they do not reliably prevent ankylosis. Their clinical role will remain undefined until prospective randomized trials with standardized protocols are available.