Autologous Platelet Concentrates for Post-Extraction Healing in Irradiated Head and Neck Cancer Patients: A Systematic Review

Background/Objectives: Radiotherapy for head and neck cancer (HNC) compromises tissue vascularization and may delay post-extraction socket healing, with osteoradionecrosis (ORN) being a severe potential complication. Autologous platelet concentrates (APCs—including PRP, PRGF, PRF, A-PRF, and L-PRF) have been proposed to enhance mucosal and bone regeneration. This systematic review aimed to evaluate the efficacy and safety of APCs applied to extraction sockets in irradiated HNC patients. Materials and methods: A comprehensive search was conducted in MEDLINE (via PubMed), CENTRAL (Cochrane), and OpenGrey for studies published between January 2010 and June 2025. Eligible studies included randomized and non-randomized controlled trials comparing APCs with standard care or placebo in adults who had previously received radiotherapy. The primary outcome was the incidence of ORN; secondary outcomes included postoperative pain, wound closure (WC), healing index (HI), residual socket volume (RSV), edema, and other complications. Results: Four RCTs (95 patients; 315 extractions) were included. Postoperative pain levels were low and comparable between APC and control groups. ORN events were rare. One split-mouth trial found faster WC and lower RSV with PRGF, while others showed no clinically relevant medium-term differences. Study limitations included small samples, heterogeneity in APC types and outcomes, and incomplete follow-up. Conclusions: APCs may be safe in irradiated HNC patients, but current evidence remains inconclusive and suggests only modest or uncertain benefits over natural healing. Larger, standardized RCTs with extended follow-up are needed.