Abstract
Leukocyte and platelet-rich fibrin (L-PRF) is a 3-D autogenous biomaterial derived via simple and rapid centrifugation of whole blood patient samples, in the absence of anti-coagulants, bovine thrombin, additives or any gelifying agents. A relatively new “revolutionary” step in second generation platelet concentrate-based therapeutics, clinical effectiveness of L-PRF remains highly-debatable, whether due to preparation protocol variability, limited evidence-based clinical literature and/or inadequate understanding of its biocomponents. This critical review provides an update on the application of L-PRF during oral surgery procedures, in human Randomized and Controlled Clinical Trials only (up to February 2016). Accordingly, autologous L-PRF is often associated with early bone formation and maturation; accelerated soft-tissue healing; and reduced post-surgical pain and discomfort. L-PRF is a simple, malleable and safe biomaterial suitable for use in oral surgery. An innovative tool in Regenerative Dentistry, L-PRF is a strong alternative and possibly cost-effective biomaterial for oral-tissue regeneration. Preparation protocols require revision and standardization. Furthermore, a good analysis of its rheological properties, biocomponents and their bioactive function would enhance the validity, comprehension and therapeutic potential of the reported findings or observations; a step closer towards a new era of “super” dental biomaterials and bioscaffolds.
Highlights
Despite significant improvements, in reconstruction techniques and materials, during last decades, the regeneration of defects remains a challenge [1]
Five randomized clinical trials (RCTs) addressing the prospective application of leukocyte and platelet-rich fibrin (L-PRF) in the treatment of Periodontal intrabony defects (IBDs) were found
The identified studies allowed for the following comparisons: (a) L-PRF/Open flap surgery vs. Open flap surgery [10–12], (b) L-PRF/Bio-Oss® constructs (Bio-Oss®, Geistlich Pharma North America, Inc.) vs. L-PRF [13] and (c) L-PRF/DFDBA constructs vs. DFDBA (Demineralized Freeze-Dried Bone Allograft) [14]
Summary
In reconstruction techniques and materials, during last decades, the regeneration of defects remains a challenge [1]. 108 Bone Grafting - Recent Advances with Special References to Cranio-Maxillofacial Surgery used to reconstruct and heal complex defects, including different bone grafting methods, such as autologous bone grafts, allografts, bone-graft substitutes, distraction osteogenesis, and/or guided bone regeneration, are deemed restricted, on a daily basis. The gathered clot (or biomaterial) is stable, resilient, strong, adhesive and malleable, where it can be cut or adapted into different anatomical defects and applications: used directly as filling material, mixed with bone grating material, or compressed into a strong fibrin membrane. Alongside this established clinical ease of use
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