## 4 Discussion
The utilization of platelet-rich fibrin has been linked to notable enhancements in various wound healing parameters, resulting in a more favorable outcome in terms of scar formation and overall scar appearance [47]. The combination of platelet-rich fibrin with nanosilver particles exhibited superior antimicrobial effectiveness compared to platelet-rich plasma with nanosilver [48]. Furthermore, when tested against anaerobic bacteria _E. faecalis_ and yeast-like fungi Candida albicans, both platelet-rich fibrin and simple platelet-rich plasma demonstrated equivalent performance [48]. The utilization of platelet-rich fibrin in various dental fields is experiencing a significant increase. Platelet-rich fibrin has been observed to demonstrate noteworthy effectiveness when incorporated into dental implant procedures. The impact of platelet-rich fibrin on the stability of dental implants was evaluated, and it was shown that platelet-rich fibrin enhanced secondary implant stability, offering potential implications for clinical application [49]. The platelet-rich fibrin matrix was combined with peripheral blood mesenchymal stem cells to enhance implant stability, which was evaluated by measuring bone-to-implant contact using resonance frequency analysis [50; 51]. This approach showed promise as a regenerative material for improving and reinforcing bone-to-implant contact, ultimately enhancing implant stability. Utilizing platelet-rich fibrin in the alveolus following tooth extraction effectively diminished the discomfort associated with alveolar osteeitis [52]. The variations in the impacts of platelet-rich fibrin may arise from differences in factors such as relative centrifugal force or revolutions per minute, the use of low-speed centrifugation versus high-speed centrifugation, as well as variations in centrifugation angles and platelet concentrations [4]. Platelet-rich fibrin was utilized in the management of multiple gingival recessions using the tunnel technique [53]. Platelet-rich fibrin has the potential to contribute to an increase in the percentage of mean root coverage [54]. The positive outcomes indicate that participants receiving platelet-rich fibrin may have benefited from adherence to oral hygiene instructions [55]. Different probing depths could potentially affect the outcomes when using platelet-rich fibrin in conjunction with graft material [56]. Moreover, due to individual differences in the activity of fibrin-rich platelets obtained from participants, standardization may be difficult. The group that underwent open flap debridement along with the application of platelet-rich fibrin showed a notable reduction in their inflammatory score when compared to both the group that received open flap debridement alone and the group that only had platelet-rich fibrin applied [57]. The combination of platelet-rich fibrin with calcium carbonate nanoparticles has not only slowed down its resorption rate but also heightened its osteogenic and osteoinductive qualities [58]. An earlier publication indicated that the combination of platelet-rich fibrin with bone mesenchymal stem cells had a greater capacity to reduce the expression of Notch1 and Wnt3a while simultaneously activating the Notch1/Wnt3a signaling pathway more efficiently [59]. Furthermore, the use of platelet-rich fibrin also led to a significant decrease in the expression of the inflammatory cytokines TNFA and IL1B [57]. A split-mouth clinical trial conducted across multiple centers, using randomization, demonstrated that the application of platelet-rich fibrin resulted in a reduction in post-surgical swelling and pain [60]. This study contains several limitations. One of the most important aspects to consider is the heterogeneity of the included studies. The studies included in this meta-analysis may vary in terms of design, sample size, and methodological quality, which could affect the generalizability of the findings [61].