[go: up one dir, main page]
Skip to main content
Springer Nature Link
Log in

Platelet rich fibrin: a new paradigm in periodontal regeneration

  • Original Paper
  • Published:
Cell and Tissue Banking Aims and scope Submit manuscript

Abstract

Among the great challenges facing clinical research is the development of bioactive surgical additives regulating inflammation and increasing healing. Although the use of fibrin adhesives and platelet-rich plasma (PRP) is well documented, they have their own limitations. Hence, reconstructive dental surgeons are looking for an “edge” that jump starts the healing process to maximize predictability as well as the volume of regenerated bone. Overcoming the restrictions related to the reimplantation of blood-derived products, a new family of platelet concentrate, which is neither a fibrin glue nor a classical platelet concentrate, was developed in France. This second generation platelet concentrate called platelet-rich fibrin (PRF), has been widely used to accelerate soft and hard tissue healing. Its advantages over the better known PRP include ease of preparation/application, minimal expense, and lack of biochemical modification (no bovine thrombin or anticoagulant is required). This article serves as an introduction to the PRF “concept” and its potential clinical applications with emphasis on periodontal regeneration.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

ALP:

Alkaline phosphatase

CCE:

Crestal core elevation

CD:

Cluster of Differentiation

cPRP:

Concentrated platelet-rich plasma

CR3:

Complement Receptor 3

FDBA:

Freeze-dried bone allograft

FDPs:

Fibrinogen degradation products

GBR:

Guided bone regeneration

IGF:

Insulin-like growth factor

IL:

Interleukin

IL-1Ra:

Interleukin-1 receptor antagonist

L-PRF:

Leucocyte- and platelet-rich fibrin

MCAF:

Modified coronally advanced flap

OFD:

Open flap debridement

OMSFE:

Osteotome-mediated sinus floor elevation

OPG:

Osteoprotegrin

PDGF:

Platelet-derived growth factor

p-ERK:

Phosphorylated extracellular signal-regulated protein kinase

PPP:

Platelet-poor plasma

PRF:

Platelet-rich fibrin

PRFe:

PRF extract

PRFM:

Platelet-rich fibrin matrix

PRP:

Platelet-rich plasma

RBCs:

Red blood cells

TGF:

Transforming growth factor

TNF:

Tumor necrosis factor

VEGF:

Vascular endothelial growth factor

WBCs:

White blood cells

References

  • Anilkumar K, Geetha A, Umasudhakar TR, Ramakrishnan T, Vijayalakshmi R, Pameela E (2009) Platelet-rich-fibrin: a novel root coverage approach. J Indian Soc Periodontol 13:50–54

    Article  PubMed  CAS  Google Scholar 

  • Aroca S, Keglevich T, Barbieri B, Gera I, Etienne D (2009) Clinical evaluation of a modified coronally advanced flap alone or in combination with a platelet-rich fibrin membrane for the treatment of adjacent multiple gingival recessions: a 6-month study. J Periodontol 80:244–252

    Article  PubMed  CAS  Google Scholar 

  • Braccini F, Dohan DM (2007) The relevance of Choukroun’s platelet rich fibrin (PRF) during facial aesthetic lipostructure (Coleman’s technique): preliminary results (in French). Rev Laryngol Otol Rhinol (Bord) 128:255–260

    CAS  Google Scholar 

  • Braccini F, Tardivet L, Dohan Ehrenfest DM (2009) The relevance of Choukroun’s platelet-rich fibrin (PRF) during middle ear surgery: preliminary results. Rev Laryngol Otol Rhinol (Bord) 130:175–180

    CAS  Google Scholar 

  • Carlson NE, Roach RB Jr (2002) Platelet-rich plasma: clinical applications in dentistry. J Am Dent Assoc 133:1383–1386

    PubMed  CAS  Google Scholar 

  • Chang Y-C, Zhao J-H (2011) Effects of platelet-rich fibrin on human periodontal ligament fibroblasts and application for periodontal infrabony defects. Aust Dent J 56:365–371

    Article  PubMed  Google Scholar 

  • Chang I-C, Tsai C-H, Chang Y-C (2010) Platelet-rich fibrin modulates the expression of extracellular signal-regulated protein kinase and osteoprotegerin in human osteoblasts. J Biomed Mater Res 95A:327–332

    Article  CAS  Google Scholar 

  • Chang Y-C, Wu K-C, Zhao J-H (2011) Clinical application of platelet-rich fibrin as the sole grafting material in periodontal intrabony defects. J Dent Sci 6:181–188

    Article  Google Scholar 

  • Charrier JB, Monteil JP, Albert S, Collon S, Bobin S, Dohan Ehrenfest DM (2008) Relevance of Choukroun’s platelet-rich fibrin (PRF) and SMAS flap in primary reconstruction after superficial or subtotal parotidectomy in patients with focal pleiomorphic adenoma: a new technique. Rev Laryngol Otol Rhinol (Bord) 129:313–318

    CAS  Google Scholar 

  • Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, Dohan AJ, Mouhyi J, Dohan DM (2006a) 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 101:E56–E60

    Article  PubMed  Google Scholar 

  • Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, Dohan AJ, Mouhyi J, Dohan DM (2006b) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part V: histologic evaluations of PRF effects on bone allograft maturation in sinus lift. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101:299–303

    Article  PubMed  Google Scholar 

  • Choukroun JI, Braccini F, Diss A, Giordano G, Doglioli P, Dohan DM (2007) Influence of platelet rich fibrin (PRF) on proliferation of human preadipocytes and tympanic keratinocytes: a new opportunity in facial lipostructure (Coleman’s technique) and tympanoplasty? Rev Laryngol Otol Rhinol (Bord) 128:27–32

    CAS  Google Scholar 

  • Clark RA (2001) Fibrin and wound healing. Ann N Y Acad Sci 936:355–367

    Article  PubMed  CAS  Google Scholar 

  • Danielsen PL (2008) Platelet-rich fibrin in human acute wound models. PhD Thesis, University of Copenhagen

  • Del Corso M, Toffler M, Dohan Ehrenfest DM (2010) Use of an autologous leukocyte and platelet-rich fibrin (L-PRF) membrane in post-avulsion sites: an overview of Choukroun’s PRF. J Implant Adv Clin Dent 1:27–35

    Google Scholar 

  • Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B (2006a) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101:E37–E44

    Article  PubMed  Google Scholar 

  • Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B (2006b) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101:E45–E50

    Article  PubMed  Google Scholar 

  • Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B (2006c) 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 101:E51–E55

    Article  PubMed  Google Scholar 

  • Dohan DM, Corso MD, Diss A, Mouhyi J, Charrier JB (2010) Three-dimensional architecture and cell composition of a Choukroun’s platelet-rich fibrin clot and membrane. J Periodontol 81:546–555

    Article  Google Scholar 

  • Dohan Ehrenfest DM, Rasmusson L, Albrektsson T (2009) Classification of platelet concentrates: from pure patelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol 27:158–167

    Article  PubMed  CAS  Google Scholar 

  • Gassling V, Douglas T, Warnke PH, Acil Y, Wiltfang J, Becker ST (2010) Platelet-rich fibrin membranes as scaffolds for periosteal tissue engineering. Clin Oral Implants Res 21:543–549

    Article  PubMed  Google Scholar 

  • Goldsby RA, Kindt TJ, Osborne BA, Kuby J (2003) Cytokines. In: Goldsby RA, Kindt TJ, Osborne BA, Kuby J (eds) Immunology, 5th edn. W.H. Freeman & Company, New York, pp 276–298

    Google Scholar 

  • He L, Lin Y, Hu X, Zhang Y, Wu H (2009) A comparative study of platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) on the effect of proliferation and differentiation of rat osteoblasts in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:707–713

    Article  PubMed  Google Scholar 

  • Huang F-M, Yang S-F, Zhao J-H, Chang Y-C (2010) Platelet-rich fibrin increases proliferation and differentiation of human dental pulp cells. J Endod 36:1628–1632

    Article  PubMed  Google Scholar 

  • Ikram N, Hassan K, Tufail S (2004) Cytokines. Int J Pathol 2:47–58

    Google Scholar 

  • Inchingolo F, Tatullo M, Marrelli M, Inchingolo AM, Scacco S, Inchingolo AD, Dipalma G, Vermesan D, Abbinante A, Cagiano R (2010) Trial with platelet-rich fibrin and bio-Oss used as grafting materials in the treatment of the severe maxillary bone atrophy: clinical and radiological evaluations. Eur Rev Med Pharmacol Sci 14:1075–1084

    PubMed  CAS  Google Scholar 

  • Jameson CA (2007) Autologous platelet concentrate for the production of platelet gel. Lab Med 38:39–42

    Article  Google Scholar 

  • Kang Y-H, Jeon SH, Park J-Y, Chung J-H, Choung Y-H, Choung H-W, Kim E-S, Choung P-H (2011) Platelet-rich fibrin is a Bioscaffold and reservoir of growth factors for tissue regeneration. Tissue Eng Part A 17:349–359

    Article  PubMed  CAS  Google Scholar 

  • Kishimoto T (1989) The biology of Interleukin-6. Blood 74:1–10

    PubMed  CAS  Google Scholar 

  • Kishimoto T, Akira S, Narazaki M, Taga T (1995) Interleukin-6 family of cytokines and gp130. Blood 86:1243–1254

    PubMed  CAS  Google Scholar 

  • Lucarelli E, Beretta R, Dozza B, Tazzari PL, O’ Connell SM, Ricci F, Pierini M, Squarzoni S, Pagliaro PP, Oprita EI, Donati D (2010) A recently developed bifacial platelet-rich fibrin matrix. Euro Cell Mater 20:13–23

    CAS  Google Scholar 

  • Marx RE (2001) Platelet-rich plasma (PRP): what is PRP and what is not PRP? Implant Dent 10:225–228

    Article  PubMed  CAS  Google Scholar 

  • Marx RE (2004) Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg 62:489–496

    Article  PubMed  Google Scholar 

  • Marx RE, Carlson ER, Eichstaedt RM, Schimmele SR, Strauss JE, Georgeff KR (1998) Platelet-rich plasma: growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85:638–646

    Article  PubMed  CAS  Google Scholar 

  • Mattuella LG, Bento LW, de Figueiredo JAP, Nör JE, de Araujo FB, Fossati ACM (2007) Vascular endothelial growth factor and its relationship with the dental pulp. J Endod 33:524–530

    Article  Google Scholar 

  • Mazor Z, Horowitz RA, Del Corso M, Prasad HS, Rohrer MD, Dohan Ehrenfest DM (2009) Sinus floor augmentation with simultaneous implant placement using Choukroun’s platelet-rich fibrin as the sole grafting material: a radiologic and histologic study at 6 months. J Periodontol 80:2056–2064

    Article  PubMed  Google Scholar 

  • Pradeep AR, Sharma A (2011a) Autologous platelet rich fibrin in the treatment of mandibular degree II furcation defects: a randomized clinical trial. J Periodontol 82:1396–1403

    Article  PubMed  Google Scholar 

  • Pradeep AR, Sharma A (2011b) Treatment of 3-wall intrabony defects in chronic periodontitis subjects with autologous platelet rich fibrin—a randomized controlled clinical trial. J Periodontol. doi:10.1902/jop.2011.110075

  • Pradeep AR, Rao NS, Agarwal E, Bajaj P (2012) Comparative evaluation of autologous platelet-rich fibrin and platelet-rich plasma in the treatment of three-wall intrabony defects in chronic periodontitis: a randomized controlled clinical trial. J Periodontol. doi:10.1902/jop.2012.110705

  • Raja SV, Naidu ME (2008) Platelet-rich fibrin: evolution of a second-generation platelet concentrate. Indian J Dent Res 19:42–46

    Article  Google Scholar 

  • Saluja H, Dehane V, Mahindra U (2011) Platelet-rich fibrin: a second generation platelet concentrate and a new friend of oral and maxillofacial surgeons. Ann Maxillofac Surg 1:53–57

    Article  PubMed  Google Scholar 

  • Simon BI, Gupta P, Tajbakhsh S (2011) Quantitative evaluation of extraction socket healing following the use of autologous platelet rich fibrin matrix in humans. Int J Periodontics Restor Dent 31:284–295

    Google Scholar 

  • Tilg H, Trehu E, Atkins MB, Dinarello CA, Mier JW (1994) Interleukin- (IL-6) as an anti-inflammatory cytokine: induction of circulating IL-1 receptor antagonist and soluble tumor necrosis factor receptor p55. Blood 83:113–118

    PubMed  CAS  Google Scholar 

  • Toffler M, Toscano N, Holtzclaw D, Corso MD, Dohan DM (2009) Introducing Choukroun’s platelet rich fibrin (PRF) to the reconstructive surgery milieu. J Implant Adv Clin Dent 1:22–31

    Google Scholar 

  • Tsai C-H, Shen S-Y, Zhao J-H, Chang Y-C (2009) Platelet-rich fibrin modulates cell proliferation of human periodontally related cells in vitro. J Dent Sci 4:130–135

    Article  Google Scholar 

  • Wu C-L, Lee S–S, Tsai C-H, Lu K-H, Zhao J-H, Chang Y-C (2012) Platelet-rich fibrin increases cell attachment, proliferation and collagen-related protein expression of human osteoblasts. Aust Dent J 57:207–212

    Article  PubMed  Google Scholar 

  • Zhao J-H, Tsai C-H, Chang Y-C (2011) Clinical and histologic evaluation of extraction socket healing filled with platelet rich fibrin. J Dent Sci 6:116–122

    Article  Google Scholar 

  • Zhao J-H, Tsai C-H, Chang Y-C (2012) Management of radicular cysts using platelet-rich fibrin and bioactive glass: a report of two cases. J Formos Med Assoc. doi:10.1016/j.jfma.2011.09.027

Download references

Author information

Authors and Affiliations

  1. Department of Periodontics, Rajarajeswari Dental College and Hospital, Mysore Road, Ramohalli Cross, Bangalore, 560060, India

    R. Vinaya Kumar

  2. Department of Conservative Dentistry and Endodontics, Rajarajeswari Dental College and Hospital, Mysore Road, Ramohalli Cross, Bangalore, 560060, India

    N. Shubhashini

Authors
  1. R. Vinaya Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. N. Shubhashini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. Vinaya Kumar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vinaya Kumar, R., Shubhashini, N. Platelet rich fibrin: a new paradigm in periodontal regeneration. Cell Tissue Bank 14, 453–463 (2013). https://doi.org/10.1007/s10561-012-9349-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10561-012-9349-6

Keywords