Abstract

Background: Platelet-rich fibrin (PRF) is being used in dentistry as an over physiological concentrate of autologous growth factors capable of stimulating tissue regeneration and being increasingly more popular in private practice. Since about 20 years platelet concentrates are being used in oral and maxillofacial surgery. With various modifications, mainly concerning the presence or absence of leukocytes and their concentration, as well as the presence and consistency of the fibrin matrix, the scope of application has continuously expanded.

Methods: The range of developments and studies on PRF is extensive. On the one hand, technical aspects such as centrifuge speed, forces and duration, on the other hand medical factors such as influence of the individual donor on fibrin product, or the hematocrit or the count of erythrocytes on the fibrin matrix or aspects of the further processing of the fibrin matrices, for example by heat application, to slow down degradation, so that the PRF membrane could become comparable to collagen membranes, are studied.

Primary Results: An international effort to extend the application diversity can be observed, as well.

Principal Conclusions: In future, it can be expected that PRF will be a precious addition in maxillofacial surgery and also in the treatment of temporomandibular joint diseases, endodontics (pulp regeneration), the regeneration of peri-implant soft tissues around implants, the modification of the lip volume, to name a few.

Keywords: Platelet-rich Fibrin; Regeneration; Growth Factors; Improved Healing; Autologous

References

1. Marx RE., et al. “Platelet-rich plasma: Growth factor enhancement for bone grafts”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 85 (1998): 638-646.
2. Kawase T and Tanaka T. “An updated proposal for terminology and classification of platelet-rich fibrin”. Regenerative Therapy 7 (2017): 80-81.
3. Anitua E. “The use of plasma-rich growth factors (PRGF) in oral surgery”. Practical Procedures and Aesthetic Dentistry 13 (2001): 487-493.
4. Weibrich G., et al. “Collection efficiency and platelet counts of two different methods for the preparation of platelet-rich plasma”. Clinical Oral Implants Research 13 (2002): 437-443.
5. Anitua E., et al. “Implementation of a more physiological plasma rich in growth factor (PRGF) protocol: Anticoagulant removal and reduction in activator concentration”. Platelets 27 (2016): 459-466.
6. Choukroun J and Ghanaati S. “Reduction of relative centrifugation force within injectable platelet-rich-fibrin (PRF) concentrates advances patients' own inflammatory cells, platelets and growth factors: the first introduction to the low speed centrifugation concept”. European Journal of Trauma and Emergency Surgery 44 (2018): 87-95.
7. Ghanaati S., et al. “A Proof of the Low Speed Centrifugation Concept in Rodents: New Perspectives for In Vivo Research”. Tissue Engineering Methods 24 (2018): 659-670.
8. Ghanaati S., et al. “Advanced platelet-rich fibrin: a new concept for cell-based tissue engineering by means of inflammatory cells”. Journal of Oral Implantology 40 (2014): 679-689.
9. Dragonas P., et al. “Effects of leukocyte–platelet-rich fibrin (L-PRF) in different intraoral bone grafting procedures: a systematic review”. International Journal of Oral and Maxillofacial Surgery (2018): pii: S0901-5027 (18)30216-9.
10. Ghanaati S., et al. “Fifteen years of platelet rich fibrin (PRF) in dentistry and oromaxillofacial surgery: How high is the level of scientific evidence?” Journal of Oral Implantology (2018).
11. Anwandter A., et al. “Dimensional changes of the post extraction alveolar ridge, preserved with Leukocyte- and Platelet Rich Fibrin: A clinical pilot study”. Journal of Dentistry 52 (2016): 23-29.
12. Kumar YR., et al. “Platelet-rich fibrin: the benefits”. British Journal of Oral and Maxillofacial Surgery 54 (2016): 57-61.
13. Temmerman A., et al. “The use of leucocyte and platelet-rich fibrin in socket management and ridge preservation: a split-mouth, randomized, controlled clinical trial”. Journal of Clinical Periodontology 43 (2016): 990-999.
14. Ruga E., et al. “Platelet-rich fibrin and piezoelectric surgery: a safe technique for the prevention of periodontal complications in third molar surgery”. Journal of Craniofacial Surgery 22 (2011): 1951-1955.
15. Singh A., et al. “Platelet rich fibrin: a novel approach for osseous regeneration”. Journal of Maxillofacial Oral Surgery 11 (2012): 430-434.
16. Sammartino G., et al. “Prevention of hemorrhagic complications after dental extractions into open heart surgery patients under anticoagulant therapy: the use of leukocyte- and platelet-rich fibrin”. Journal of Oral Implantology 37 (2011): 681-690.
17. Hoaglin DR and Lines GK. “Prevention of localized osteitis in mandibular third-molar sites using platelet-rich fibrin”. International Journal of Dentistry (2013): 875380.
18. Tajima N., et al. “Evaluation of sinus floor augmentation with simultaneous implant placement using platelet-rich fibrin as sole grafting material”. International Journal of Oral Maxillofacial Implants 28 (2013): 77-83.
19. Bosshardt DD., et al. “Maxillary sinus grafting with a synthetic, nanocrystalline hydroxyapatite-silica gel in humans: histologic and histomorphometric results”. International Journal of Periodontics and Restorative Dentistry 34 (2014): 259-267.
20. Miron RJ., et al. “The effect of age, gender, and time between blood draw and start of centrifugation on the size outcomes of platelet-rich fibrin (PRF) membranes”. Clinical Oral Investigation (2018).
21. Shah R., et al. “Biological activation of bone grafts using injectable platelet-rich fibrin”. Journal of Prosthetic Dentistry (2018): pii: S0022-3913 (18)30279-8.
22. Hegab AF., et al. “Platelet-Rich Plasma Injection as an Effective Treatment for Temporomandibular Joint Osteoarthritis”. Journal of Oral and Maxillofacial Surgery 73 (2015): 1706-1713.
23. Lolato A., et al. “Platelet concentrates for revitalization of immature necrotic teeth: a systematic review of the clinical studies”. Platelets 27 (2016): 383-392.

Citation

Citation: Andreas Van Orten and Hakan Bilhan. “PRF from the Perspective of a Daily Practitioner: Where are the Limits?". Acta Scientific Dental Sciences 4.11 (2020): 54-59.

Copyright

Copyright: © 2020 Andreas Van Orten and Hakan Bilhan. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.