Platelet rich fibrin as a gingival tissue regeneration enhancer.

Tissue regenerative procedures aim to enhance regeneration of altered tissue. Extensive research has been carried out in this area and all proposed procedures present limitations. In this context the area of platelet-rich fibrin (PRF) research has gained tremendous awareness in the latest years. PRF is a low-cost regenerative modality that facilitates soft tissue regeneration derived from 100% autologous sources. It forms a fibrin mesh that liberates growth factors in a slow and prolonged manner and also contains supra-physiological concentrations of leukocytes. Reports from the literature have suggested that these leukocyte-rich blood-preparations are capable of improving wound healing, diminishing post-operative pain, and additionally minimizing the risk of infection. In our article we present the first clinical case where PRF was used as a wound healing accelerator of gingival lesions in a chemical soft tissue burn after teeth whitening.

Maxillary Sinus Augmentation Using Xenograft and Choukroun's Platelet-Rich Fibrin as Grafting Material: A Radiological Study.

AIM: The objective of the study was to assess the efficacy of xenograft (BIO-OSS) and platelet-rich fibrin in maxillary sinus augmentation using lateral window approach. MATERIALS AND METHODS: A total of 22 direct sinus lifts were done within a period of two years, and the results were analyzed using two parameters: (1) augmented bone height and (2) bone density in the maxillary sinus. Pre-operative and three-month CT scan was taken for all the 22 patients. Bone densities were calculated using CT scan, and the results were compared between xenograft (BIO-OSS) and platelet-rich fibrin (PRF). RESULTS: Statistical analysis of the two groups was performed using independent t test and paired t test, and results were tabulated.

Utilização do PRFL como aditivo na Odontologia / The uso of PRFL as an additive in dentistry

A perda dos dentes promove uma reabsorção do osso alveolar que muitas vezes inviabiliza a reabilitação oral através do uso de implantes por falta de suporte ósseo para retê-lo. Diversas técnicas têm sido utilizadas visando recuperar ou mesmo conservar o osso alveolar remanescente, como a expansão óssea, RTG, enxertos autógenos, homólogos, heterógenos, distração osteogênica. Porém nem sempre a resposta a essas técnicas tem sido adequada na regeneração trazendo muitas vezes morbidade e pouca regeneração. Choukroun desenvolveu o PRF (plasma rico em fibrina) e seu uso em cirurgia oral, tendo várias utilizações na implantodontia visando aumento ósseo, maior rapidez e segurança nas reconstruções alveolares, no levantamento do seio maxilar, no aumento do tecido ósseo e nas cirurgias periodontais. O PRF por ser um produto bioativo natural e autógeno apresenta um processo simples de preparação no qual é utilizada uma porção de sangue venoso autógeno que é centrifugado obtendo se uma membrana de fibrina com grande concentração de fatores de crescimento e leucócitos que além de estimular o crescimento do osso e dos tecidos moles, promove a angiogenese, a migração e proliferação celular e devido a presença leucocitária modula o processo inflamatório em seu time e intensidade. Por todos esses benefícios, além de ser um procedimento de baixo custo seu uso em cirurgias bucais é uma opção clinica viável

Comparative release of growth factors from PRP, PRF, and advanced-PRF.

OBJECTIVES: The use of platelet concentrates has gained increasing awareness in recent years for regenerative procedures in modern dentistry. The aim of the present study was to compare growth factor release over time from platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and a modernized protocol for PRF, advanced-PRF (A-PRF). MATERIALS AND METHODS: Eighteen blood samples were collected from six donors (3 samples each for PRP, PRF, and A-PRF). Following preparation, samples were incubated in a plate shaker and assessed for growth factor release at 15 min, 60 min, 8 h, 1 day, 3 days, and 10 days. Thereafter, growth factor release of PDGF-AA, PDGF-AB, PDGF-BB, TGFB1, VEGF, EGF, and IGF was quantified using ELISA. RESULTS: The highest reported growth factor released from platelet concentrates was PDGF-AA followed by PDGF-BB, TGFB1, VEGF, and PDGF-AB. In general, following 15-60 min incubation, PRP released significantly higher growth factors when compared to PRF and A-PRF. At later time points up to 10 days, it was routinely found that A-PRF released the highest total growth factors. Furthermore, A-PRF released significantly higher total protein accumulated over a 10-day period when compared to PRP or PRF. CONCLUSION: The results from the present study indicate that the various platelet concentrates have quite different release kinetics. The advantage of PRP is the release of significantly higher proteins at earlier time points whereas PRF displayed a continual and steady release of growth factors over a 10-day period. Furthermore, in general, it was observed that the new formulation of PRF (A-PRF) released significantly higher total quantities of growth factors when compared to traditional PRF. CLINICAL RELEVANCE: Based on these findings, PRP can be recommended for fast delivery of growth factors whereas A-PRF is better-suited for long-term release.