Platelet-Rich Fibrin Promotes Periodontal Regeneration and Enhances Alveolar Bone Augmentation

Abstract

In the present study we have determined the suitability of platelet-rich fibrin (PRF) as a complex scaffold for periodontal tissue regeneration. Replacing PRF with its major component fibrin increased mineralization in alveolar bone progenitors when compared to periodontal progenitors, suggesting that fibrin played a substantial role in PRF-induced osteogenic lineage differentiation. Moreover, there was a 3.6-fold increase in the early osteoblast transcription factor RUNX2 and a 3.1-fold reduction of the mineralization inhibitor MGP as a result of PRF application in alveolar bone progenitors, a trend not observed in periodontal progenitors. Subcutaneous implantation studies revealed that PRF readily integrated with surrounding tissues and was partially replaced with collagen fibers 2 weeks after implantation. Finally, clinical pilot studies in human patients documented an approximately 5 mm elevation of alveolar bone height in tandem with oral mucosal wound healing. Together, these studies suggest that PRF enhances osteogenic lineage differentiation of alveolar bone progenitors more than of periodontal progenitors by augmenting osteoblast differentiation, RUNX2 expression, and mineralized nodule formation via its principal component fibrin. They also document that PRF functions as a complex regenerative scaffold promoting both tissue-specific alveolar bone augmentation and surrounding periodontal soft tissue regeneration via progenitor-specific mechanisms.

A Comparative Study of Early Bone Formation with PRF, Bio-Oss and Osteoid Hydroxyapatite after Tooth Extraction in Rabbits

“…Abundant fibrin, platelets, various cytokines and substantial leukocytes are concentrated in PRF 5) . Compared with other biological bone materials, the PRF preparation is rather convenient, no other blood biochemical treatments were used during the production process and PRF was centrifuged from venous blood 6,7) . In terms of biological characteristic, fibrin plays a significant role in PRF.…”

Biodegradable polymers for dental tissue engineering and regeneration

“…In dentistry, the most recognized application of fibrin is in the platelet rich fibrin (PRF). PRF consists of an autologous leukocyte-plateletrich fibrin matrix with cytokines, platelets, and stem cells [337], that acts as biodegradable scaffold [338], favors the development of microvascularization, and is able to guide epithelial cell migration [339]. Also, PRF serves as vehicle in carrying cells involved in tissue regeneration and promotes sustained release of growth factors, stimulating the environment for wound healing [340].…”

Perioglas® And Prf As Graft Materials in The Treatment of Intrabony Defects in Chronic Generalized Periodontitis: A Clinical And Radiological Evaluation

“…Therefore, for successful preparation of PRF, speedy blood collection and immediate centrifugation (before the clotting cascade is initiated) was absolutely essential. PRF was obtained in the form of a membrane by squeezing out the fluids in the fibrin clot (8,9) . (Fig.…”

“…PRF is capable of increasing osteoblast attachment, proliferation and simultaneously up regulating collagen-related protein production. These actions in combination would effectively promote bone regeneration (8,9).…”