Role of Autologous Platelet Gel (APG) in Bone Healing: A Rabbit Study

Purpose: The aim of the present study is to evaluate the influence and efficacy of autologous platelets on bone regeneration in a rabbit defects model. Materials and Methods: A total of 12 critical size tibial defects were produced in six New Zealand rabbits: A total of six defects were filled with autologous platelet gel (APG) and six defects were maintained as untreated controls. No membranes were used to cover the bone osteotomies. The histology and histomorphometry were performed at four weeks on retrieved samples of both groups. Results: No complications were reported in any of the animals nor for the defects produced. A significantly higher lamellar and woven bone percentage was reported for the APG group with a lower level of marrow spaces (p < 0.05). Evidence of newly formed bone was found in the superficial portion of the bone defect of APG samples where no aspects of bone resorption were observed. Conclusions: The evidence of the present research revealed that APG increases new bone formation restricted to the cortical portion and induces more rapid healing in rabbit bone defects than in untreated defects

From blood to regenerative tissue : How autologous platelet-rich fibrin can be combined with other materials to ensure controlled drug and growth factor release

Funding Information: This research was funded by the Latvian Council of Science research project No. lzp-2020/1-0054 ?Development of antibacterial autologous fibrin matrices in maxillofacial surgery (MATRI-X)?. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.The purpose of this review is to examine the latest literature on the use of autologous platelet-rich fibrin as a drug and growth factor carrier system in maxillofacial surgery. Autologous platelet-rich fibrin (PRF) is a unique system that combines properties such as biocompatibility and biodegradability, in addition to containing growth factors and peptides that provide tissue regeneration. This opens up new horizons for the use of all beneficial ingredients in the blood sample for biomedical purposes. By itself, PRF has an unstable effect on osteogenesis: therefore, advanced approaches, including the combination of PRF with materials or drugs, are of great interest in clinics. The main advantage of drug delivery systems is that by controlling drug release, high drug concentrations locally and fewer side effects within other tissue can be achieved. This is especially important in tissues with limited blood supply, such as bone tissue compared to soft tissue. The ability of PRF to degrade naturally is considered an advantage for its use as a “warehouse” of controlled drug release systems. We are focusing on this concentrate, as it is easy to use in manipulations and can be delivered directly to the surgical site. The target audience for this review are researchers and medical doctors who are involved in the development and research of PRFs further studies. Likewise, surgeons who use PRF in their work to treat patients and who advice patients to take the medicine orally.publishersversionPeer reviewe

Bone regeneration at extraction sockets filled with leukocyte-platelet-rich fibrin:an experimental pre-clinical study

We aimed to histomorphometrically evaluate the effects of Leucocyte-Platelet-Rich Fibrin (L-PRF), with and without the combination of a bone grafting material, for alveolar ridge preservation using an in vivo canine model. Seven dogs (Female Beagles, ~18-month-old) were acquired for the study. L-PRF was prepared from each individual animal by drawing venous blood and spinning them through a centrifuge at 408 RCF-clot (IntrasSpin, Intra-Lock, Boca Raton, FL). L-PRF membranes were obtained from XPression fabrication kit (Biohorizons Implant Systems, Inc., AL, USA). A split mouth approach was adopted with the first molar mesial and distal socket defects treated in an interpolated fashion of the following study groups: 1) Empty socket (negative control); 2) OSS filled defect 3) L-PRF membrane; and 4) Mix of Bio-Oss® with L-PRF. After six weeks, samples were harvested, histologically processed, and evaluated for bone area fraction occupancy (BAFO), vertical/horizontal ridge dimensions (VRD and HRD, respectively), and area of coronal soft tissue infiltration. BAFO was statistically lower for the control group in comparison to all treatment groups. Defects treated with Bio-Oss® were not statistically different then defects treated solely with L-PRF. Collapsed across all groups, L-PRF exhibited higher degrees of BAFO than groups without L-PRF. Defects filled with Bio-Oss® and Bio-Oss® with L-PRF demonstrated greater maintenance of VRD relative to the control group. Collapsed across all groups, Bio-Oss® maintained the VRD and resulted in less area of coronal soft tissue infiltration compared to the empty defect. Soft tissue infiltration observed at the coronal area was not statistically different among defects filled with L-PRF, Bio-Oss®, and Bio-Oss® with L-PRF. Inclusion of L-PRF to particulate xenograft did not promote additional bone heading at 6 weeks in vivo. However, we noted that L-PRF alone promoted alveolar socket regeneration to levels comparable to particulate xenografts, suggesting its potential utilization for socket preservation

Application of Platelet Rich Fibrin and Osseomold Bone Graft in Different Intrabony Defects – 2 Case Reports

ABSTRACT:    Aims & objectives: The motto behind any periodontal treatment is arrest of periodontal disease and regeneration of lost periodontium. Various treatment strategies have been employed in treatment of intrabony defects, but the best way to obtain regeneration is probably by mimicking the actual occurring events that takes place in the formation of the periodontal tissues at embryonic stage. Conventional open flap debridement falls short of regenerating tissues destroyed by the disease and current regenerative procedures offer a limited potential towards attaining complete periodontal regeneration.Platelet rich fibrin (PRF), a second generation platelet concentrate is widely used in osseous regeneration.Case description: The present study aimed to explore the clinical and radiographical effectiveness of autologous PRF along with the osseomold bone graft in treatment of 2 different cases of intrabony defects in chronic periodontics subjects.Conclusion: Among the 2 subjects, case-1 had 2-wall defect and case-2 patient had 3-wall defect. Both the subjects reported to the department with a complaint of food impaction and with clinically accessible >7-8mm pocket.  Pocket depth was assessed at 1st week, 6months and 9months respectively and radio graphically bone gain was accessed at 3 month and 6 months

Radiographic & histopathological analysis in calvarias bone regeneration process by platelet-rich plasma, platelet-rich plasma–gel And auto bone chips in rat

A functional treatment for skeletal damages in orthopedic and oral maxillofacial surgeries is required. Platelet growth factors such as Platelet Derived Growth Factor (PDGF), Bone Morphogenic Factor (BMP), Transferring Growth Factor-β (TGF-β) and Insulin-like Growth Factor-1 (IGF-1) proceed wound healing and bone regeneration. In the present study we focused on the effect of platelet rich plasma (PRP), platelet rich plasma gel (PRP-Gel) and auto bone chips on this process. 30 male, 22 weeks old, Sprague-Dawley rats weighing 525 g were used. They were divided in three groups consisting of PRP (treated by Platelet-Rich Plasma), PRP-Gel (treated by it), Bone chips and Control (two cavities created in each animal in this group). After 16 weeks they were histologically investigated while in the periods of 40, 60, 90and 120 days, the radiography had been done. The radiographic analysis showed complete treatment in all groups; however, by the histo-pathological investigations by auto bone chips complete and PRP-Gel partial healing has been observed. By histo-morphometric surveys (100±25) % in bone chips and (50±25) % in PRP-Gel groups bone bridging were observed, whereas in PRP it was not noticeable. The Present study suggests that neither PRP, nor PRP-Gel could be as beneficial as bone chips. Statistically, in PRP-Gel group, due to the existence of fibrin and thrombin, solid bone bridging at the treated site is indicated. According to the previous studies, in which the key role of both inhibitory and stimulatory signals in controlling the bone regeneration were proven, we suggest that auto bone chips could completely enhance healing due to signals among blood factors, environmental tissues and skeletal particles.

The Use of Platelet-Rich Fibrin in Bone Grafting

In this century, there are two mostly practiced techniques for bone regeneration. These are autogenous bone grafting (ABG) and guided bone regeneration (GBR). It was reported in the late 1970s that platelets have a good regenerative effects. Platelets include growth factors that increase vascularization and collagen production by cell mitosis. Recently, most of the studies have indicated that platelet-rich fibrin (PRF) is a great healing potential for bony and soft tissue that derived from patients own blood. Most beneficial effects of PRF are easily derived directly from patient’s venous blood without any ingredients, and it has a great potential for hard and soft tissue regeneration. PRF has no inflammatory effects and can be used with all kind of graft materials. When used as a membrane, it helps protecting the surgical area to stimulate the healing of soft and bone tissues

Use of Leukocyte-and Platelet-Rich Fibrin for Bone Regeneration: A Systematic Review

Introduction: Leukocyte- and platelet- rich fibrin (L-PRF) is a fibrin matrix in which the platelet cytokines, growth factors and cells are trapped and this material has been recruited in reconstruction of various defects. The aim of this study was to systematically review of the published data on the effectiveness of using L-PRF on regeneration of bone defects in oral and maxillofacial surgeries. Materials and Methods: Medline and Cochrane Central databases were searched for related articles up to and including August 2015. Being English, having ≥ four weeks follow-up, and clinical, radiographic, histological and histomorphometric assessments were the inclusion criteria. Results: Twenty-four animal studies and 45 human trials were included that reported the rate of new bone formation (NBF). Also, 38 human reports with low levels of evidence to list evaluating various applications of L-PRF in oral and maxillofacial reconstructions were assessed. Using L-PRF either solely or mixed in human trials was evaluated and divided into six groups of sinus floor augmentation and guided bone regeneration (GBR) technique, socket preservation, periodontal intra-bony defects (PID)  regeneration, peri-apical and endo-periodontal defects treatment, peri-implant bone regeneration and treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Moreover, other uses of L-PRF with bone regeneration purposes in oral and maxillofacial surgeries were discussed. Conclusion: As a consequence, although L-PRF either solely or mixed showed challengeable outcomes in animal studies, it was shown to be effective used to accelerate and enhance new bone formation in human studies. However, future clinical trials in some treatment areas are needed with larger sample sizes and long follow-ups to arrive at an evidence-based conclusion.

L-PRF: A “Super” Biomaterial for Naturally Guided Hard/Soft Tissue Bioengineering and Regeneration of Oro-Dental, Periodontal and Jaw Defects

Leukocyte and platelet-rich fibrin (L-PRF) is a 3-D autogenous biomaterial derived via simple and rapid centrifugation of whole blood patient samples, in the absence of anti-coagulants, bovine thrombin, additives or any gelifying agents. A relatively new “revolutionary” step in second generation platelet concentrate-based therapeutics, clinical effectiveness of L-PRF remains highly-debatable, whether due to preparation protocol variability, limited evidence-based clinical literature and/or inadequate understanding of its biocomponents. This critical review provides an update on the application of L-PRF during oral surgery procedures, in human Randomized and Controlled Clinical Trials only (up to February 2016). Accordingly, autologous L-PRF is often associated with early bone formation and maturation; accelerated soft-tissue healing; and reduced post-surgical pain and discomfort. L-PRF is a simple, malleable and safe biomaterial suitable for use in oral surgery. An innovative tool in Regenerative Dentistry, L-PRF is a strong alternative and possibly cost-effective biomaterial for oral-tissue regeneration. Preparation protocols require revision and standardization. Furthermore, a good analysis of its rheological properties, biocomponents and their bioactive function would enhance the validity, comprehension and therapeutic potential of the reported findings or observations; a step closer towards a new era of “super” dental biomaterials and bioscaffolds

Platelet-Rich Fibrin: Utilization in the Treatment of Periodontitis

Periodontitis is a chronic inflammatory disease affecting the supporting structures of the teeth and results in loss of supporting bone around the teeth leading to eventual tooth loss. It is a multifactorial disease that involves bacteria and host responses. Advanced options to treat periodontitis are aimed at regeneration procedures to restore lost periodontal structures. These include bone replacement grafts and the use of biological materials to enhance regeneration. Platelet-rich fibrin (PRF) is an autologous platelet-rich concentrate derived from a fibrin clot and is a natural source of growth factors derived from platelets, which are released over time and have been shown to have potential in periodontal procedures to enhance wound healing and regeneration. This chapter will focus on the past, current and future scope of PRF for treating periodontitis

Blood derivatives awaken in regenerative medicine strategies to modulate wound healing

Blood components play key roles in the modulation of the wound healing process and, together with the provisional fibrin matrix ability to selectively bind bioactive molecules and control its spatial-temporal presentation, define the complex microenvironment that characterize this biological process. As a biomimetic approach, the use of blood derivatives in regenerative strategies has awakened as a source of multiple therapeutic biomolecules. Nevertheless, and despite their clinical relevance, blood derivatives have been showing inconsistent therapeutic results due to several factors, including proper control over their delivery mechanisms. Herein, we highlight recent trends on the use biomaterials to protect, sequester and deliver these pools of biomolecules in tissue engineering and regenerative medicine approaches. Particular emphasis is given to strategies that enable to control their spatiotemporal delivery and improve the selectivity of presentation profiles of the biomolecules derived from blood derivatives rich in platelets. Finally, we discussed possible directions for biomaterials design to potentiate the aimed regenerative effects of blood derivatives and achieve efficient therapies.BBM acknowledges the financial support from FCT/MCTES (Fundação para a Ciência e a Tecnologia/Ministério da Ciência, Tecnologia, e Ensino Superior) and the Fundo Social Europeu através do Programa Operacional do Capital Humano (FSE/POCH), PD/59/2013 for PD/BD/113807/2015. MGF acknowledges European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 706996 (PrinTendon). PB acknowledges RECOGNIZE and NORTE2020 (UTAP-ICDT/CTM-BIO/0023/2014). RMD acknowledges SFRH/BPD/112459/2015.info:eu-repo/semantics/publishedVersio