Abstract
The aim of this study was to evaluate the effect of local and systemic administration of antimicrobials to leukocyte- and platelet-rich fibrin (L-PRF). For part A, 16 tubes of venous blood were collected from each of eight systemically healthy subjects. Prior to blood centrifugation, 12 of the 16 tubes were injected with 0.125 ml, 0.25 ml or 0.50 ml metronidazole solution. One set of L-PRF membranes was used to assess the release of vascular endothelial growth factor AB, platelet-derived growth factor, transforming growth factor beta 1, and bone morphogenetic protein 2 at indicated time points. The metronidazole release over time by L-PRF membranes was also evaluated. The remaining L-PRF membranes were placed on the surface of agar plates inoculated with three different periodontal pathogens to determine their antibacterial activity. For part B, another six subjects were enrolled with three subjects taking 2 g amoxicillin and three subjects 500 mg metronidazole as prophylaxis prior to a periodontal treatment. Before and 2 h after consuming one of the prescribed antimicrobials, three tubes of blood were collected for preparing L-PRF membranes. These membranes were used to measure the antibacterial activity against periodontal pathogens. No statistically significant difference could be found in the release of growth factors between L-PRF membranes with and without incorporation of metronidazole solution. The release of metronidazole could be detected up to day 3, however with the highest concentration during the first 4 h. This concentration was dose dependent. The antibacterial capacity of L-PRF membranes increased significantly for both the systemic intake, and after the addition of metronidazole solution to the blood tubes before centrifugation, the latter again dose dependent. The antibacterial capacity of L-PRF against the periodontal pathogens tested can significantly be enhanced by the addition of antimicrobials, without disadvantage for the release of growth factors.
Highlights
Over the past 10 years, the scientific research on platelet-rich fibrin (PRF) has tremendously increased
leukocyte- and platelet-rich fibrin (L-PRF) membranes incorporated with metronidazole solution showed a similar pattern of release as control L-PRF membranes and no statistically significant differences could be detected in the amount of growth factors among the four groups
This study demonstrated that addition of local antimicrobials to the L-PRF preparation procedure resulted in L-PRF membranes with significantly higher antibacterial capacity due to the release of the incorporated antimicrobial
Summary
Over the past 10 years, the scientific research on platelet-rich fibrin (PRF) has tremendously increased. This resulted in more insight into the biological and mechanical properties, and in new preparation strategies. Substantial effort is paid to evaluate the release of growth factors by PRF. PRF showed an inhibitory effect on the growth of the main periodontal pathogens, such as Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum[12]. The application of PRF in conjunction with another bio-active material has been described in the literature. L-PRF has been modified with silver nanoparticles to improve the mechanical properties and antibacterial activity[28]
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