Structural Analysis of Platelet-Rich Fibrin and its Applications in Regenerative Dentistry
https://orcid.org/0000-0002-8921-1327
Juan Pablo Hinojosa Sarria
https://orcid.org/0000-0001-7410-9007
Ana Isabel Restrepo Dorado
https://orcid.org/0000-0001-7900-9638
Ana Luisa Muñoz Ramírez
https://orcid.org/0000-0002-7566-2979
Néstor Fabián Velarde Trochez
https://orcid.org/0000-0002-5358-7912
Francy Ester Bastidas Daza
https://orcid.org/0000-0002-0725-683X
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Background: Platelet rich fibrin (PRF) is a platelet concentrate that is used most frequently in medicine and dentistry. Clinical results are variables because there are different protocols, centrifugation equipment and placement techniques. Ignorance of structural elements can affect the clinical outcome. Purpose: To describe the structural characteristics of Platelet Rich Fibrin in the different zones of the membrane. Methods: Experimental in vitro study with 15 blood samples taken from five healthy adult volunteers attending the dental clinic of the University Antonio Nariño, Popayán. The basal blood count was made, then blood was collected and centrifuged (10 minutes x 3000 rpm). The samples were analyzed histologically and with scanning electron microscopy (SEM). The structure of fibrin, platelets and leukocytes was described. Results: The average platelet count in whole blood was 251 ± 31.74 x103 x mm3 and in PRF it was 832±123.43 x103 x mm3. Macroscopically, three areas of the PRF were identified: an upper one with few platelets (FPP), a buffy coat (BC) and the corpuscular network zone (RBC). In the analysis of optical microscopy shows that in the BC area there is a higher platelet concentration. The SEM analysis proves that the structure of the fibrin network and cellular content is differential in each zone. Conclusion: From the structural knowledge of the PRF, applications that may be improve the performance of the biomaterial and therefore the clinical results can be proposed.
dentistry, tissue regeneration, regenerative dentistry, platelet concentrates, platelet-rich fibrin, scanning electron microscopyregeneración tisular, odontología, odontología regenerativa, concentrados plaquetarios, fibrina rica en plaquetas, microscopía electrónica de barridoodontologia, regeneração tecidual, odontologia regenerativa, concentrados de plaquetas, fibrina rica em plaquetas, microscopia eletrônica de varredura
2. Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(3):e56-60.
3. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol. 2009; 27(3): 158-67.
4. Borie E, Olivi DG, Orsi IA, Garlet K, Weber B, Beltran V, et al. Platelet-rich fibrin application in dentistry: a literature review. Int J Clin Exp Med. 2015; 8(5): 7922-9.
5. Tunali M, Ozdemir H, Kucukodaci Z, Akman S, Firatli E. In vivo evaluation of titanium-prepared platelet-rich fibrin (T-PRF): a new platelet concentrate. Br J Oral Maxillofac Surg. 2013; 51(5): 438-43.
6. Miron RJ, Fujioka-Kobayashi M, Bishara M, Zhang Y, Hernandez M, Choukroun J. Platelet-Rich Fibrin and Soft Tissue Wound Healing: A Systematic Review. Tissue Eng Part B Rev. 2017; 23(1): 83-99.
7. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 101(3): e37-44.
8. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part III: leucocyte activation: a new feature for platelet concentrates? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 101(3): e51-5.
9. Eren G, Gurkan A, Atmaca H, Donmez A, Atilla G. Effect of centrifugation time on growth factor and MMP release of an experimental platelet-rich fibrin-type product. Platelets. 2016; 27(5): 427-32.
10. Dohan Ehrenfest DM, Pinto NR, Pereda A, Jimenez P, Corso MD, Kang BS, et al. The impact of the centrifuge characteristics and centrifugation protocols on the cells, growth factors, and fibrin architecture of a leukocyte- and platelet-rich fibrin (L-PRF) clot and membrane. Platelets. 2017: 1-14.
11. Gutiérrez D, Restrepo A, Hinojosa J, Muñoz A, Ortiz Y. Centrifugation protocols to obtain platelet rich fibrin for dental applications. Innov Odontol. 2016; 1(1): 18-22.
12. Acosta P, Gutiérrez S, Bedoya M, García A, Moreno X. Evaluation of platelet-rich plasma effect at different times and concentrations on periodontal ligament fibroblast and osteoblast viability. Univ Odontol. 2017; 36(76): 1-23.
13. Dohan Ehrenfest DM. How to optimize the preparation of leukocyte- and platelet-rich fibrin (L-PRF, Choukroun's technique) clots and membranes: introducing the PRF Box. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 110. United States2010. p. 275-8; author reply 8-80.
14. Kumar YR, Mohanty S, Verma M, Kaur RR, Bhatia P, Kumar VR, et al. Platelet-rich fibrin: the benefits. Br J Oral Maxillofac Surg. 2015.
15. Verma UP, Yadav RK, Dixit M, Gupta A. Platelet-rich Fibrin: A Paradigm in Periodontal Therapy - A Systematic Review. J Int Soc Prev Community Dent. 2017; 7(5): 227-33.
16. Del Corso M, Vervelle A, Simonpieri A, Jimbo R, Inchingolo F, Sammartino G, et al. Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 1: Periodontal and dentoalveolar surgery. Curr Pharm Biotechnol. 2012; 13(7): 1207-30.
17. Ranganathan AT, Chandran CR. Platelet-rich fibrin in the treatment of periodontal bone defects. J Contemp Dent Pract. 2014; 15(3): 372-5.
18. Thombre V, Koudale SB, Bhongade ML. Comparative evaluation of the effectiveness of coronally positioned flap with or without acellular dermal matrix allograft in the treatment of multiple marginal gingival recession defects. Int J Periodontics Restorative Dent. 2013; 33(3): e88-94.
19. Giraldo T, Sossa H. Endodoncia regenerativa: utilización de fibrina rica en plaquetas autóloga en dientes permanentes vitales con patología pulpar. Revisión narrativa de la literatura. Acta Odontológica colombiana [en línea]. 2014; 4(1): 91-112.
20. Faizuddin U, Solomon RV, Mattapathi J, Guniganti SS. Revitalization of traumatized immature tooth with platelet-rich fibrin. Contemp Clin Dent. 2015; 6(4): 574-6.
21. Dohan Ehrenfest DM, Del Corso M, Diss A, Mouhyi J, Charrier JB. Three-dimensional architecture and cell composition of a Choukroun's platelet-rich fibrin clot and membrane. J Periodontol. 2010; 81(4): 546-55.
22. Schar MO, Diaz-Romero J, Kohl S, Zumstein MA, Nesic D. Platelet-rich concentrates differentially release growth factors and induce cell migration in vitro. Clin Orthop Relat Res. 2015; 473(5): 1635-43.
23. Kobayashi E, Fluckiger L, Fujioka-Kobayashi M, Sawada K, Sculean A, Schaller B, et al. Comparative release of growth factors from PRP, PRF, and advanced-PRF. Clin Oral Investig. 2016; 20(9): 2353-2360.
24. Pinto G, Pigossi SC, Pessoa T, Nicoli LG, Araujo R, Marcantonio C, et al. Successful Use of Leukocyte Platelet-Rich Fibrin in the Healing of Sinus Membrane Perforation: A Case Report. Implant Dent. 2018. In press
25. Bhatsange A, Shende A, Deshmukh S, Japatti S. Management of fenestration using bone allograft in conjunction with platelet-rich fibrin. J Indian Soc Periodontol. 2017; 21(4): 337-40.
26. Johns DA, Shivashankar VY, Maroli RK, Joseph R. Invasive cervical root resorption: Engineering the lost tissue by regeneration. Contemp Clin Dent. 2013; 4(4): 536-9.
27. Kobayashi M, Kawase T, Horimizu M, Okuda K, Wolff LF, Yoshie H. A proposed protocol for the standardized preparation of PRF membranes for clinical use. Biologicals. 2012; 40(5): 323-9.
28. Moradian H, Rafiee A, Ayatollahi M. Design and Fabrication of a Novel Transplant Combined with Human Bone Marrow Mesenchymal Stem Cells and Platelet-rich Fibrin: New Horizons for Periodontal Tissue Regeneration after Dental Trauma. Iran J Pharm Res. 2017; 16(4): 1370-8.
29. Bilginaylar K. Uncommon Odontogenic Orocutaneous Fistula of the Jaw Treated with Platelet-Rich Fibrin. Case Rep Dent. 2017; 2017: 7174217.
30. Aoki N, Kanayama T, Maeda M, Horii K, Miyamoto H, Wada K, et al. Sinus Augmentation by Platelet-Rich Fibrin Alone: A Report of Two Cases with Histological Examinations. Case Rep Dent. 2016; 2016: 2654645.