Regenerative Effect of Platelet Concentrates in Oral and Craniofacial Regeneration.

Faez Saleh Al-Hamed,Haider Al-Waeli,Zahi Badran,Mohammed Mahri,Faleh Tamimi,Jesus Torres

doi:10.3389/fcvm.2019.00126

Abstract

Platelet concentrates (PCs) are biological autologous products derived from the patient's whole blood and consist mainly of supraphysiologic concentration of platelets and growth factors (GFs). These GFs have anti-inflammatory and healing enhancing properties. Overall, PCs seem to enhance bone and soft tissue healing in alveolar ridge augmentation, periodontal surgery, socket preservation, implant surgery, endodontic regeneration, sinus augmentation, bisphosphonate related osteonecrosis of the jaw (BRONJ), osteoradionecrosis, closure of oroantral communication (OAC), and oral ulcers. On the other hand, no effect was reported for gingival recession and guided tissue regeneration (GTR) procedures. Also, PCs could reduce pain and inflammatory complications in temporomandibular disorders (TMDs), oral ulcers, and extraction sockets. However, these effects have been clinically inconsistent across the literature. Differences in study designs and types of PCs used with variable concentration of platelets, GFs, and leucocytes, as well as different application forms and techniques could explain these contradictory results. This study aims to review the clinical applications of PCs in oral and craniofacial tissue regeneration and the role of their molecular components in tissue healing.

Highlights

Platelet concentrates (PCs) are biological autologous products derived from the patient’s whole blood that consist mainly of supraphysiological concentrations of platelets and growth factors (GFs)
platelet-rich plasma (PRP) and P-platelet rich fibrin (PRF) are prepared from anticoagulated blood, whereas L-PRF is prepared from non-anti-coagulated blood
This study aims to review the clinical applications of PCs in oral and maxillofacial surgery procedures including maxillary sinus augmentation, alveolar ridge augmentation, implant surgery, jaw cysts, periodontal surgery, socket preservation, endodontic surgery, alveolar clefts, cleft lip and palate, oroantral communication (OAC), oral ulcers, osteoradionecrosis, bisphosphonate related osteonecrosis of the jaw (BRONJ), and temporomandibular joint disorders

Summary

Introduction

Platelet concentrates (PCs) are biological autologous products derived from the patient’s whole blood that consist mainly of supraphysiological concentrations of platelets and growth factors (GFs). There are two main types of PCs: platelet-rich plasma (PRP) and platelet rich fibrin (PRF), which can be pure (i.e., P-PRP, P-PRF) or rich in leucocytes (i.e., L-PRP, L-PRF) [1, 2]. PCs can be prepared with or without red blood cells [3]. PC is prepared using gravitational centrifugation techniques, standard cell separators, or autologous selective filtration technique (plateletpheresis) [3]. PCs contain high concentrations of growth factors (GFs) and cytokines that play a vital role in the healing of various tissues. PCs have been used alone or as an adjunctive treatment to enhance soft and hard tissue regeneration in dentoalveolar, and maxillofacial surgeries [4,5,6]

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