Clinical effectiveness of albumin-enriched platelet-rich fibrin (Alb-PRF) in periodontal and peri-implant regenerative surgery: a systematic review

Alb-PRF is a heat-induced autologous fibrin biomaterial generated by combining thermally denatured serum albumin with liquid platelet-rich fibrin. Although its clinical use in periodontal and peri-implant procedures has increased, the available evidence remains limited and methodologically heterogeneous. This systematic review aimed to synthesize the biological rationale, clinical effectiveness, and methodological quality of Alb-PRF in periodontal and peri-implant applications. A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library from January 2013 to December 2025 in accordance with PRISMA 2020 guidelines. Grey literature sources, including Google Scholar and OpenGrey, were also screened. Randomized and controlled clinical trials as well as relevant in vivo animal studies evaluating Alb-PRF were included. Study selection and data extraction were independently performed by two reviewers using Rayyan, and methodological quality was assessed using the RoB-2, Newcastle-Ottawa Scale, or SYRCLE tools. Due to substantial heterogeneity in study design, clinical indications, and outcome measures, a narrative synthesis was performed. Seven studies were included (six clinical and one animal study), comprising 156 human participants and 24 animal samples, with follow-up periods ranging from 7 days to 6 months. Alb-PRF showed consistent benefits in early soft-tissue healing and postoperative comfort. However, evidence supporting its role in hard-tissue regeneration remains limited and inconclusive. Based on current evidence, Alb-PRF should be biologically interpreted as a soft-tissue phenotype-modulating adjunct that stabilizes the early healing microenvironment rather than as a primary hard-tissue regenerative material. Its clinical utility appears to be indication-specific and mainly related to early soft-tissue outcomes. Well-designed, standardized randomized controlled trials with longer follow-up periods are required to clarify its therapeutic role. PROSPERO registration number: CRD420251237466 (registered on 21 November 2025, version 1.0).