Platelet concentration in platelet concentrates and periodontal regeneration-unscrambling the ambiguity

Abstract

Context:Platelet-rich-plasma (PRP) and Platelet-rich-fibrin (PRF) are extensively used autologous platelet concentrates in periodontal regeneration, and PRF has a better efficacy as compared to PRP. The rationale for this difference has often been attributed to the difference in the structure of the fibrin matrix. However, the effect of concentration of platelets on the regenerative potential of these concentrates is obscure.Aims:The study was conducted to evaluate and compare, clinically and radiographically, the efficacy of PRF and PRP in the treatment of periodontal endosseous defects and to assess the effect of platelet concentration on periodontal regeneration.Materials and Methods:Twenty intrabony defects were selected and divided into two groups randomly by the coin toss method. Group I received PRP and Group II subjects were treated with PRF. The platelet counts in PRP and PRF were analyzed. Clinical and radiological parameters were assessed at baseline and 3, 6, and 9 months postoperatively.Statistical Analysis:Kruskal–Wallis Chi-square test, Wilcoxon signed rank test, t-test, and Spearman's rank correlation were used for statistical analysis of data.Results:There was statistically significant improvement in all the parameters in the two groups except in relation to gingival recession. There was a statistically significant difference between the platelet count in Group I and Group II (P = 0.002).Conclusion:PRP and PRF appear to have nearly comparable effects in terms of periodontal regeneration. The concentration of platelets appears to play a paradoxical role in regeneration. The regenerative potential of platelets appears to be optimal within a limited range.

Actual quantitative attachment gain secondary to use of autologous platelet concentrates in the treatment of intrabony defects: A meta-analysis

“…Out of 98, 73 articles were further excluded reason being inappropriate control group, use of BGs and other materials etc. Finally a total number of 25 articles[19222324252627282930313233343536373839404142434445] were included for both quantitative and qualitative synthesis and further meta-analysis [Figure 1].…”

Additive effectiveness of autologous platelet-rich fibrin in the treatment of intrabony defects

“…[ 1 , 6 ] In the recent past, root-conditioning agents, bone replacement grafts, growth attachment factors and guided tissue regeneration procedures or combinations of these materials have been used for periodontal regeneration with various degrees of success. [ 21 ] GML, CAL, PI, PD measurements and the presence of bleeding on probing are commonly used to assess and monitor periodontal status. To improve periodontal health, treatment aims to reduce PD, maintain or improve CAL, and reduce bone defect depth and the incidence of bleeding on probing.…”

Autologous platelet-rich fibrin matrix in non-healing trophic ulcers in patients with Hansen's disease

“…showed that PRP has a higher platelet concentration when compared to PRF. [ 13 ] However, the superior effects of PRF when compared to PRP can be explained on the basis of study by Yazawa et al . which showed that, when incorporated into drug delivery systems such as fibrin, the mean concentration of growth factors in the platelet concentrates was three times or more than that observed with conventional platelet-rich plasma.…”