Wound healing is a staged process which involves the activity of leukocytes and platelets. For this process to work efficiently, the platelets play a vital role. The growth factors present in platelets are important to guide the regenerating cells to the area of healing. Platelet-rich-fibrin (PRF) is one such material that holds on to these growth factors enmeshed in the fibrin network resulting in their sustained release over a period of time that can accelerate the wound healing process. With this knowledge, research has been carried out for a past few years for the clinical application of PRF. Various platelet concentrates have been studied including the platelet-rich-plasma (PRP). However, the short duration of cytokine release and its poor mechanical properties have resulted in the search of a new material with adequate properties for clinical application and ease of preparation. PRF has found a place in the regenerative field owing to its advantages over PRP. This review focuses on the properties and various applications of PRF in the clinical practice. 1. Introduction Excogitation in the concept of tissue engineering has brought about a drastic improvement in the healing response of tissues. Various pathological etiologies result in dysfunction of the oral tissues and creation of bony defects, thus affecting the quality of life in these patients. The pivotal goal in periodontal and maxillofacial tissue regeneration is to reconstruct these defects which led to the search of a biofuel [1]. Focus has constantly been on devising a “wonder material” that is most effective in its regenerative potential. Various platelet-derived products or platelet concentrates have been introduced that act as biological mediators aiding the healing response. Platelet-rich fibrin (PRF) is one such product that has proved its worth and has edged past the others. The Choukroun’s platelet rich fibrin has opened the flood-gates in the field of dentistry, majorly focusing on the improved healing and regeneration [2]. Thus PRF has also been tagged as a healing biomaterial [2]. The world of medicine was acquainted with the regenerative potential of platelets in 1974. The platelet concentrates have been used for the improvement of reparation and regeneration of the soft and hard tissues after various periodontal surgical procedures. Using platelet concentrates is a way to accelerate and enhance the body’s natural wound healing mechanisms [2]. PRF is a second-generation platelet concentrate widely used to accelerate soft and hard tissue healing and is a strictly autologous
References
[1]
V. Gassling, T. Douglas, P. H. Warnke, Y. A？il, J. Wiltfang, and S. T. Becker, “Platelet-rich fibrin membranes as scaffolds for periosteal tissue engineering,” Clinical Oral Implants Research, vol. 21, no. 5, pp. 543–549, 2010.
[2]
V. Gupta, V. K. Bains, G. P. Singh, A. Mathur, and R. Bains, “Regenerative potential of platelet rich fibrin in dentistry: literature review,” Asian Journal of Oral Health and Allied Sciences, vol. 1, no. 1, pp. 22–28, 2011.
[3]
M. Toffler, N. Toscano, D. Holtzclaw, M. Del Corso, and D. D. Ehrenfest, “Introducing Choukroun’s platelet rich fibrin (PRF) to the reconstructive surgery milieu,” The Journal of Implant and Advanced Clinical Dentistry, vol. 1, no. 6, pp. 21–32, 2009.
[4]
V. L. W. Gasling, Y. Acil, I. N. Springer, N. Hubert, and J. Wiltfag, “Platelet-rich plasma and platelet-rich fibrin in human cell culture,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, vol. 108, pp. 45–48, 2009.
[5]
S. Prakash and A. Thakur, “Platelet concentrates: past, present and future,” Journal of Oral and Maxillofacial Surgery, vol. 10, no. 1, pp. 45–49, 2011.
[6]
R. E. Marx, E. R. Carlson, R. M. Eichstaedt, S. R. Schimmele, J. E. Strauss, and K. R. Georgeff, “Platelet-rich plasma: growth factor enhancement for bone grafts,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, vol. 85, no. 6, pp. 638–646, 1998.
[7]
E. Anitua, M. Sánchez, G. Orive, and I. Andía, “The potential impact of the preparation rich in growth factors (PRGF) in different medical fields,” Biomaterials, vol. 28, no. 31, pp. 4551–4560, 2007.
[8]
S. J. Froum, S. S. Wallace, D. P. Tarnow, and S. Cho, “Effect of platelet-rich plasma on bone growth and Osseointegration in human maxillary sinus grafts: three bilateral case reports,” International Journal of Periodontics and Restorative Dentistry, vol. 22, no. 1, pp. 45–53, 2002.
[9]
N. S. Arora, T. Ramanayke, Y. F. Ren, and G. E. Romanos, “Platelet-rich plasma: a literature review,” Implant Dentistry, vol. 18, no. 4, pp. 303–308, 2009.
[10]
R. E. Marx, “Platelet rich plasma: evidence to support its use,” Journal of Oral and Maxillofacial Surgery, vol. 64, pp. 489–496, 2004.
[11]
D. M. Dohan, J. Choukroun, A. Diss et al., “Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, vol. 101, no. 3, pp. E37–E44, 2006.
[12]
D. M. Dohan Ehrenfest, G. M. de Peppo, P. Doglioli, and G. Sammartino, “Slow release of growth factors and thrombospondin-1 in Choukroun's platelet-rich fibrin (PRF): a gold standard to achieve for all surgical platelet concentrates technologies,” Growth Factors, vol. 27, no. 1, pp. 63–69, 2009.
[13]
J. Choukroun, A. Diss, A. Simonpieri et al., “Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, vol. 101, no. 3, pp. E56–E60, 2006.
[14]
W. V. Giannobile, R. A. Hernandez, R. D. Finkelman et al., “Comparative effects of platelet-derived growth factor-BB and insulin-like growth factor-I, individually and in combination, on periodontal regeneration in Macaca fascicularis,” Journal of Periodontal Research, vol. 31, no. 5, pp. 301–312, 1996.
[15]
E. Lucarelli, A. Beccheroni, D. Donati et al., “Platelet-derived growth factors enhance proliferation of human stromal stem cells,” Biomaterials, vol. 24, no. 18, pp. 3095–3100, 2003.
[16]
V. Sunitha Raja and E. Munirathnam Naidu, “Platelet-rich fibrin: evolution of a second-generation platelet concentrate,” Indian Journal of Dental Research, vol. 19, no. 1, pp. 42–46, 2008.
[17]
V. Moulin, “Growth factors in skin wound healing,” European Journal of Cell Biology, vol. 68, no. 1, pp. 1–7, 1995.
[18]
D. M. Dohan, J. Choukroun, A. Diss et al., “Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part III: leucocyte activation: a new feature for platelet concentrates?” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, vol. 101, no. 3, pp. E51–E55, 2006.
[19]
M. W. Mosesson, K. R. Siebenlist, and D. A. Meh, “The structure and biological features of fibrinogen and fibrin,” Annals of the New York Academy of Sciences, vol. 936, pp. 11–30, 2001.
[20]
H. F. Dvorak, V. S. Harvey, P. Estrella, L. F. Brown, J. McDonagh, and A. M. Dvorak, “Fibrin containing gels induce angiogenesis. Implications for tumor stroma generation and wound healing,” Laboratory Investigation, vol. 57, no. 6, pp. 673–686, 1987.
[21]
V. Nehls and R. Herrmann, “The configuration of fibrin clots determines capillary morphogenesis and endothelial cell migration,” Microvascular Research, vol. 51, no. 3, pp. 347–364, 1996.
[22]
X. Feng, R. A. F. Clark, D. Galanakis, and M. G. Tonnesen, “Fibrin and collagen differentially regulate human dermal microvascular endothelial cell integrins: stabilization of αv/β3 mRNA by fibrin,” Journal of Investigative Dermatology, vol. 113, no. 6, pp. 913–919, 1999.
[23]
J. D. Loike, B. Sodeik, L. Cao et al., “CD11c/CD18 on neutrophils recognizes a domain at the N terminus of the Aα chain of fibrinogen,” Proceedings of the National Academy of Sciences of the United States of America, vol. 88, no. 3, pp. 1044–1048, 1991.
[24]
M. Kawamura and M. R. Urist, “Human fibrin is a physiologic delivery system for bone morphogenetic protein,” Clinical Orthopaedics and Related Research, no. 235, pp. 302–310, 1988.
[25]
T. R. Appel, B. P？tzsch, J. Müller, J. von Lindern, S. J. Bergé, and R. H. Reich, “Comparison of three different preparations of platelet concentrates for growth factor enrichment,” Clinical Oral Implants Research, vol. 13, no. 5, pp. 522–528, 2002.
[26]
N. K. Kiran, K. S. Mukunda, and T. N. Tilakraj, “Platelet concentrates: a promising innovation in dentistry,” Journal of Dental Sciences and Research, vol. 2, no. 1, pp. 50–61, 2011.
[27]
D. M. Dohan Ehrenfest, L. Rasmusson, and T. Albrektsson, “Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF),” Trends in Biotechnology, vol. 27, no. 3, pp. 158–167, 2009.
[28]
D. M. Dohan, J. Choukroun, A. Diss et al., “Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, vol. 101, no. 3, pp. E45–E50, 2006.
[29]
J. Choukroun, A. Diss, A. Simonpieri et al., “Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part V: histologic evaluations of PRF effects on bone allograft maturation in sinus lift,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, vol. 101, no. 3, pp. 299–303, 2006.
[30]
J. D. Kassolis, P. S. Rosen, and M. A. Reynolds, “Alveolar ridge and sinus augmentation utilizing platelet-rich plasma in combination with freeze-dried bone allograft: case series,” Journal of Periodontology, vol. 71, no. 10, pp. 1654–1661, 2000.
[31]
M. Del Corso, M. Toffler, and D. M. D. Ehrenfest, “Use of autologous leukocyte and platelet-rich fibrin (L-PRF) membrane in post-avulsion sites,” The Journal of Implant and Advanced Clinical Dentistry, vol. 1, no. 9, pp. 27–35, 2010.
[32]
A. Kumar, B. Fernandes, and C. Surya, “Platelet-rich fibrin: a promising approach for root coverage,” Journal of Interdisciplinary Dentistry, vol. 1, no. 2, pp. 115–118, 2011.
[33]
A. Sharma and A. R. Pradeep, “Autologous platelet-rich fibrin in the treatment of mandibular degree II furcation defects: a randomized clinical trial,” Journal of Periodontology, vol. 82, no. 10, pp. 1396–1403, 2011.
[34]
V. Jain, M. G. Triveni, A. B. T. Kumar, and D. S. Mehta, “Role of platelet rich fibrin in enhancing palatal wound healing after free gingival graft,” Contemporary Clinical Dentistry, vol. 3, pp. S240–S243, 2012.
[35]
F. Huang, S. Yang, J. Zhao, and Y. Chang, “Platelet-rich fibrin increases proliferation and differentiation of human dental pulp cells,” Journal of Endodontics, vol. 36, no. 10, pp. 1628–1632, 2010.
[36]
T. L. Sarrafian, H. Wang, E. S. Hackett et al., “Comparison of achilles tendon repair techniques in a sheep model using a cross-linked acellular porcine dermal patch and platelet-rich plasma fibrin matrix for augmentation,” Journal of Foot and Ankle Surgery, vol. 49, no. 2, pp. 128–134, 2010.
[37]
M. Sánchez, E. Anitua, J. Azofra, I. Andía, S. Padilla, and I. Mujika, “Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices,” The American Journal of Sports Medicine, vol. 35, no. 2, pp. 245–251, 2007.
[38]
A. P. Sclafani, “Platelet-rich fibrin matrix for improvement of deep nasolabial folds,” Journal of Cosmetic Dermatology, vol. 9, no. 1, pp. 66–71, 2010.
[39]
A. P. Sclafani, “Safety, efficacy, and utility of platelet-rich fibrin matrix in facial plastic surgery,” Archives of Facial Plastic Surgery, vol. 13, no. 4, pp. 247–251, 2011.
[40]
F. Braccini and D. M. Dohan, “The relevance of Choukroun's Platelet Rich Fibrin (PRF) during facial aesthetic lipostructure (Coleman's technique): preliminary results,” Revue de Laryngologie Otologie Rhinologie, vol. 128, no. 4, pp. 255–260, 2007.
[41]
S. M. O'Connell, T. Impeduglia, K. Hessler, X. Wang, R. J. Carroll, and H. Dardik, “Autologous platelet-rich fibrin matrix as cell therapy in the healing of chronic lower-extremity ulcers,” Wound Repair and Regeneration, vol. 16, no. 6, pp. 749–756, 2008.
[42]
A. M. Haleem, A. A. Singergy, D. Sabry et al., “The clinical use of human culture-expanded autologous bone marrow mesenchymal stem cells transplanted on platelet-rich fibrin glue in the treatment of articular cartilage defects: a pilot study and preliminary results,” Cartilage, vol. 1, no. 4, pp. 253–261, 2010.
[43]
T. E. L. Douglas, V. Gassling, H. A. Declercq et al., “Enzymatically induced mineralization of platelet-rich fibrin,” Journal of Biomedical Materials Research, vol. 100A, pp. 1335–1346, 2012.
