Platelet-rich fibrin and its use in dentistry

Review/ Derleme =S5 MEDICINE DOI: 10.47582/jompac.1212693 J Med Palliat Care 2022; 3(4): 386-393 PALLIATIVE CARE Platelet-rich fibrin and its use in dentistry Trombositten zengin fibrin ve dis hekimliginde kullanim1 Sarah Khaled, ®Ebru Olgun, ®Meltem Hendek Kirikkale Universitesi Dis Hekimligi Fakiiltesi, Periodontoloji Anabilim Dali, Kirikkale, Turkiye Cite this article as/ Bu makaleye atif icin: Khaled S, Olgun E, Hendek M. Platelet-rich fibrin and its use in dentistry. J Med Palliat Care 2022; 3(4): 386-393. ABSTRACT PRE is often defined as an autogenous fibrin biomaterial rich in leukocytes and platelets and is clinically easy to obtain and use. Various methods are available to prepare platelet concentrates, albeit the contents of platelet concentrates obtained by different methods also vary. Accordingly, they are divided into P-PRE, L-PRE, i-PRE, A-PRE, and A-PRF+, considering the thrombocyte leukocyte concentrates and fibrin contents. PRF is widely adopted in dentistry as promoting angiogenesis, immunity, and epithelial proliferation. Keywords: PRE, P-PRE, L-PRE, i-PRF, A-PRF, A-PRF+ OZ TZE, lokositten ve trombositten zengin otojen bir fibrin biyomateryali olarak tanimlanmustir . TZF’nin elde eldilmesi ve klinik kullanim1 kolaydir. Trombosit konsantrelerinin hazirlanmasinda degisik yontemler mevcuttur. Farkli yontemlerle elde edilen trombosit konsantrelerinin igerigi de farklidir. Buna gore trombosit lékosit konsantrelerinin ve fibrin igerikleri géz 6niinde bulundurularak S-TZE, L-TZE, E-TZE, G-TZF ve G-TZF+ olarak gruplara ayrilmaktadir. TZEF, anjiojenez, bagisiklik ve epitel proliferasyonu destekledigi icin dis hekimliginde yaygin bir sekilde kullanilmaktadir. Anahtar Kelimeler: TZE, S-TZE, L-TZE, E-TZE, G-TZE, G-TZF+ INTRODUCTION The use of platelet concentrations in medicine was initiated in the 1990s and has expanded until today. Platelets are cells that initiate and promote wound healing by releasing various growth factors. Such growth factors create signals stimulating cell proliferation and affect connective tissue healing, bone regeneration and repair, increase in mitogenesis of fibroblasts and angiogenesis of the wound site, and macrophage activation (29). The use of growth factors to contribute to wound healing has been found to be rather interesting, and thus, many platelet-derived blood products have been developed using different techniques. Yet, the literature has conceptual confusion since different platelet-derived blood products, in other words, platelet-derived blood concentrations, are called by similar names. All available platelet-rich plasma (PRP) methods bear some common aspects. Blood is drawn with anticoagulant just before surgery and immediately centrifuged. Platelet concentration preparation time is variable but is always accomplished within an hour. The first centrifugation step separates the blood into three layers: while red blood cells are at the very bottom layer, acellular plasma (platelet-poor plasma) occupies the top layer. The thrombocyte-rich buffy coat is found between these two layers. Finally, the platelet concentrate is administered to the surgical site through an injector with thrombin and/or calcium chloride (or similar factors) to trigger platelet activation and fibrin polymerization (13). PRE, on the other hand, is the latest developed of these protocols. In this protocol, blood is drawn without any anticoagulant and immediately centrifuged. A natural coagulation process is allowed, and L-PRF is easily collected without the intervention of any biochemical agent in the blood (i.e., without the need for anticoagulants, thrombin, or calcium chloride) (12). This open-intervention method is considered the simplest and lowest-cost one ever developed (15). Corresponding Author /Sorumlu Yazar: Sarah Khaled, Kirikkale Universitesi Dis Hekimligi Fakiiltesi Periodontoloji Anabilim Dali, Kirikkale, Tiirkiye E-mail /E-posta: sarakhaled@gmail.com Received / Gelis: 30.11.2022 | Accepted/ Kabul: 20.12.2022 Ee) OS© This work is licensed under a Creative Commons Attribution 4.0 International License. 386 BY NC NO ] Med Palliat Care 2022; 3(4): 386-393 Choukroun’s Platelet-rich Fibrin The PREF protocol was first described by Choukroun in France in 2001 and introduced in the review series published by Dohan et al. (7) in 2006. PRF is a secondgeneration platelet concentrate that allows for obtaining a membrane rich in platelets and growth factors. The protocol is not dependent on a medical device or specialized machine and can be easily adopted. Unlike fibrin glue or PRP, it is not a blood-derived product. Venous blood is collected into dry glass tubes and centrifuged at a low speed [about 400g: 3000 rpm-10 min. or 2700 rpm-12 min.]. Since no anticoagulant is given to the blood in PREF, clotting begins as soon as the blood contacts the tube (10). Platelet activation and fibrin polymerization are promptly triggered in the absence of anticoagulants. Fibrinogen is initially forme