Abstract
Platelet-Rich fibrin (PRF) is a three-dimensional (3-D) autogenous biomaterial obtained via simple and rapid centrifugation from the patient’s whole blood samples, without including anti-coagulants, bovine thrombin, additives, or any gelifying agents. At the moment, it is safe to say that in oral and maxillofacial surgery, PRFs (particularly, the pure platelet-rich fibrin or P-PRF and leukocyte and platelet-rich fibrin or L-PRF sub-families) are receiving the most attention, essentially because of their simplicity, cost-effectiveness, and user-friendliness/malleability; they are a fairly new “revolutionary” step in second-generation therapies based on platelet concentration, indeed. Yet, the clinical effectiveness of such surgical adjuvants or regenerative platelet concentrate-based preparations continues to be highly debatable, primarily as a result of preparation protocol variability, limited evidence-based clinical literature, and/or poor understanding of bio-components and clinico-mechanical properties. To provide a practical update on the application of PRFs during oral surgery procedures, this critical review focuses on evidence obtained from human randomized and controlled clinical trials only. The aim is to serve the reader with current information on the clinical potential, limitations, challenges, and prospects of PRFs. Accordingly, reports often associate autologous PRFs with early bone formation and maturation; accelerated soft-tissue healing; and reduced post-surgical edema, pain, and discomfort. An advanced and original tool in regenerative dentistry, PRFs present a strong alternative and presumably cost-effective biomaterial for oro-maxillo-facial tissue (soft and hard) repair and regeneration. Yet, preparation protocols continue to be a source of confusion, thereby requiring revision and standardization. Moreover, to increase the validity, comprehension, and therapeutic potential of the reported findings or observations, a decent analysis of the mechanico-rheological properties, bio-components, and their bioactive function is eagerly needed and awaited; afterwards, the field can progress toward a brand-new era of “super” oro-dental biomaterials and bioscaffolds for use in oral and maxillofacial tissue repair and regeneration, and beyond.
Highlights
Even though significant improvements in restoration and/or replacement approaches and supplies have been accomplished over the last decades, the repair and regeneration of defects remains a challenge [1]
Probing depth (PD) reduction, average clinical attachment (CAL) gain, defect fill, percentage defect fill and post-treatment gingival margin stability were significantly greater in the Platelet-Rich fibrin (PRF)-treated group. (P < 0.05)
The surgeon is faced with an ample collection of regenerative techniques and materials to choose from
Summary
Even though significant improvements in restoration and/or replacement approaches and supplies have been accomplished over the last decades, the repair and regeneration of defects remains a challenge [1]. Current clinical approaches that have been used to reconstruct and heal complex defects, including different multi-disciplinary methods of bone grafting, such as autologous bone grafts, distraction osteogenesis, allografts, bone-graft substitutes, and/or guided bone regeneration, are deemed restricted on a daily basis. This is often multi-factorial; whether due to the limited self-renewal capacity of the defect and/or the limited donor supply, increased morbidity, risk of antigenicity, and foreign body reactions associated with the grafts used. While several oro-dental soft and hard tissues have been regenerated using mesenchymal stem cells (oro-dental sources mainly), the translation of novel biomaterials to the clinic has been slow.
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