PLATELET RICH FIBRIN GEL A NEW MANTRA FOR WOUND HEALING. Dr. Irfanul Haque (Resident) Dr . S.Girish Rao Consultant Faciomaxillary Surgeon. Introduction. Healing of hard and soft tissue is a complex procedure Scaffold (collagen and bone minerals)
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Consultant Faciomaxillary Surgeon
a)Platelet derived growth factors
b)Transforming growth factors beta
c)Vascular endothelial growth factors
d) Epithelial growth factors (EGF)
e)Insulin-like growth factor-1(IGF-1)
With an overview of the healing cascades in mind
A natural human blood clot contains
95% red blood cells (RBCs),
on the other hand, PRF blood clot contains
Lindeboom J AH, Mathura KR, Aartman I HA, Kroon F HM, Milstein D M, Ince C. “Influenceof the application of platelet-enriched plasma in oral mucosal wound healing. Clin. Oral. Impl.Res.2007;18; pg 133-139
Increased numbers of degranulating platelets
increased concentration of GF or signal proteins
Undifferentiated stem cells migrate toward the GF
proliferation of cells required for healing
The Journal of Lancaster General Hospital • Summer 2007 • Vol. 2 – No. 2
(THIS STUDY WAS FUNDED BY ICMR)
dextrose-ACD) and centrifuged using a tabletop centrifuge for 20 min at 3400-4000 rpm.
METHOD FOR GEL PREPERATION
10ml venous blood drawn
Blood placed in table top
Centrifuged at 3400rpm for
Central layer of PRF obtained
Exposure of impacted tooth
Comparison of healing parameters between control group and test group:
The difference in mean soft tissue healing recorded between control group and test group is found to be statistically significant (P<0.001). Higher mean soft tissue healing in recorded in control group compared to test group and this difference is found to be statistically significant
CASE with PRF
CONTRO L without PRF
AT 1 MONTH FOLLOW UP:
3RD MONTH FOLLOW UP:
6TH MONTH FOLLOW UP:
Matteo Chiapasco, Alessandro Rossi, Jason Jones Motta and Michele Crescentini , Spontaneous Bone Regeneration After Enucleation of Large Mandibular Cysts: A Radiographic Computed Analysis of 27 Consecutive Cases J Oral MaxillofacSurg 58:942-948, 2000
On technique described the basis of pixels value bone density at different time points relative
BONE REGENERATION: technique described
A study done to assess the ability of novel autologous platelet-rich fibrin matrix membrane (PRFM) to facilitate healing in patients with chronic lower-extremity ulcers. From the results of this small-scale pilot study, they found PRFM shows significant healing potential for closing of chronic leg ulcers.
Autologous platelet-rich fibrin matrix as cell therapy in the healing of chronic lower-extremity ulcers .Wound Repair and Regeneration volume 16, issue 6, pages 749–756, November–December 2008
A study was conducted ,where they placed PRF gel during closure following total knee arthoplasty, they found that rate of wound healing was faster.
William J. Berghoff, William S. Pietrzak, Richard D. Rhodes, platelet rich fibrin application during closure following total knee arthoplasty. ClinOrthop 2006 ;29 :7
P. Steenvoorde, L.P. Van doorn, C. Naves, oskam, use of autologous platelet-rich fibrin on
hard-to-heal wounds,Journal Of Wound Care , Vol 1 7 , No 2 , F ebruary 2 0 0 8
Study conducted to evaluate the effectiveness of platelet-rich fibrin (PRF )on the regeneration of autogenous cancellous bone and marrow grafted in the alveolar cleft. Autogenous cancellous bone grafting with PRF, which significantly reduces postoperative bone resorption, is a reliable technique for alveolar bone grafting of cleft patients.
Eriko Marukawa*, HidekazuOshina, Gaichi Iino, Keiichi Morita, Ken OmuraReduction of bone resorption by the application of platelet-rich fibrin(PRF )in bone grafting of the alveolar cleft . Journal of Cranio-Maxillo-Facial Surgery 39 (2011) 278e283
In summation the PRF GEL :
In the modern surgical practice, PRF is boon for faster healing as it is autologous, easy to procure and is cost effective too…
References: platelet-rich fibrin on a range of hard-to-heal wounds (chronic leg ulcers) achieved
1). S.Girish Rao et al , Bone Regeneration in Extraction Sockets with Autologous Platelet Rich Fibrin GelJMOSI(2013)Vol 12,Issue 1,Page11-16
2) Marx R, Carlson ER, Eichstaedt RM, et al. Platelet Rich Plasma growth factors
enhancement for bonegrafts.(1998) Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85:
3) O‟Connell S, Carroll R, Beavis A, et al. Flow cytometric characterization of Cascade
platelet-rich fibrin matrix (PRFM); The impact of exogenous thrombin on platelet
concentrates (PC). Musculoskeletal Transplant Foundation. Edison, N. J. 2006.
4) Lucarelli E, Beretta R, Dozza B, Tazzari TL, O‟Connell S ,Ricci F, Pierini M, Squarzoni
S, Pagliaro PP, Oprita EI, and Donati D (2010) A recently developed bifacial platelet-rich
fibrin matrix.European cells and materials 20;13-23
5) Carroll RJ, Amoczky SP, Graham S, O‟Connell SM. Characterization of autologous
growth factors in Cascade platelet rich fibrin matrix (PRFM). Edison, NJ: Musculoskelatal
Transplant Foundation 2005.
6) Simon BI, Zatcoff AL, Kong JJW and O‟Connell SM. (2009) Clinical and Histological
Comparison of Extraction Socket Healing Following the Use of Autologous Platelet-Rich
Fibrin Matrix (PRFM) to Ridge Preservation Procedures Employing Demineralized Freeze
Dried Bone Allograft Material and Membrane The Open Dentistry Journal 3; 92-99
7) Kuo TF , Lin MF, Lin YH, Lin YC, Su RJ, Lin HW, Wing P (2011) Implantation of
platelet-rich fibrin and cartilage granules facilitates cartilage repair in the injured rabbit knee:
preliminary report .CLINICS;66(10):1835-1838.
Thank (2011) Implantation ofYou!