Antimicrobial Effects of Platelet Rich Fibrin

Abstract

Background: Other than releasing a bunch of growth factors and molecules, platelet concentrates (PCs), especially platelet-rich fibrin (PRF) has a potential role in antimicrobial activities. Aim: The aim of this present systematic review was to collect, evaluate, and compare the available evidence regarding the antimicrobial efficacy of all types of PRF and to highlight the underlying mechanisms along with their potential benefits based on their actions, investigated by clinical and in vitro studies. Materials and Methods: Systematic approach was followed in the selection of studies. A detailed search was done in electronic databases such as PUBMED/MEDLINE, GOOGLE SCHOLAR, and SCIENCE DIRECT using specific search items with language restricted to English. All in vitro studies and clinical studies which assessed the antimicrobial activity of PRF alone or along with antibiotics or a type of PRF were included in the study. Other studies which included antimicrobial effects of other forms of PCs such as platelet-rich plasma (PRP), platelet gel, and animal studies were all excluded from the study. Results: After the initial and final screening of articles, only eight met the required criteria, of which seven were in vitro studies and one was a clinical study. All the studies evaluated the efficacy of one or more forms of PRF either against bacterial pathogens or showed inhibition of growth in culture. Conclusion: Based on the systematic review, PRF possesses antimicrobial efficacy against pathogens and the exact mechanism of the antimicrobial efficacy needs further investigation. The enhanced property of PRF against pathogens might be due to the release of platelets and preparation protocols such as lesser time and centrifugal speed. Further, PRF should be considered to be used as local drug delivery system which will be a potential treatment against periodontopathogens in the future.

Evaluation of advanced platelet-rich fibrin (PRF) as a bio-carrier for ampicillin/sulbactam

“…The proportion of leukocytes in PRF decreases as centrifugation force increases (i-PRF: lower centrifugation force and high proportion of leukocytes, PRF: higher centrifugation force and thus lower proportion of leukocytes) [ 10 ]. This could explain why PRP and i-PRF have an antimicrobial effect in these previous studies, but PRF without previous ampicillin/sulbactam treatment demonstrated no such antimicrobial effect in our study [ 16 , 17 , 31 ].…”

“…Even though the full effect mechanism is not yet fully understood, PRF has been demonstrated to possess antimicrobial features without additional work-up or preparation [15][16][17]. Studies have demonstrated that PRF has a bactericidal and growth-inhibiting effect against both biofilm-forming and periodontal microorganisms.…”

Comparison of Antimicrobial Activity against Porphyromonas gingivalis between Advanced Platelet-Rich Fibrin and Injectable Platelet-Rich Fibrin

“…The use of low-speed centrifugation to obtain new types of PRF has previously been explored, having the advantage of producing a high number of cells such as leukocytes [ 8 ]. I-PRF (injectable PRF) is available in injectable form and coagulates a few minutes after injection [ 2 ] while A-PRF+ (advanced PRF) has shown superior properties when compared with standard PRF [ 8 ].…”

“…The use of low-speed centrifugation to obtain new types of PRF has previously been explored, having the advantage of producing a high number of cells such as leukocytes [ 8 ]. I-PRF (injectable PRF) is available in injectable form and coagulates a few minutes after injection [ 2 ] while A-PRF+ (advanced PRF) has shown superior properties when compared with standard PRF [ 8 ]. These two types of PRF have great potential for further clinical application because they are simple to prepare and use and do not require the addition of anticoagulants [ 6 ] and also have an enriched antimicrobial content [ 7 ].…”

“…These two types of PRF have great potential for further clinical application because they are simple to prepare and use and do not require the addition of anticoagulants [ 6 ] and also have an enriched antimicrobial content [ 7 ]. A-PRF has outstanding advantages, including the increased release of proteins and growth factors, proliferation of fibroblasts, its ability to migrate, and expression of growth factors [ 8 ]. I-PRF contains various components such as antimicrobial proteins, complement binding proteins, and antimicrobial peptides [ 7 ].…”