MODERN VIEW ON THE EXPERIMENTAL AND CLINICAL JUSTIFICATION FOR THE USE OF PRF IN THE PROCESSES OF REPARATIVE SKIN REGENERATION
The article describes the use of fibrin glue, which is quite common in modern medical practice. It can be synthesized from the patient's venous blood or used as ready-made preparations.
Among fibrin clots, depending on the method of their preparation, one can distinguish:
- PRF which is an ordinary fibrin clot and is prepared in vacuum tubes with a plasma activator and centrifuged for about 8-12 minutes at a rate of 3000-3500 revolutions per minute.
- A-PRF (advanced) - in this cluster, growth factors have a higher concentration and a more even distribution, which helps reduce the speed of the centrifuge to 2,000 revolutions per minute, while the centrifugation time is 8-12 minutes.
- i-PRF (injectable) is a fibrinous clot formed after a few minutes after receiving blood plasma by centrifugation. The speed is 1500-2000 rpm, the centrifugation time is 3 minutes.
- Stickybone is a blood plasma that turns into a clot due to the content of fibrin in the plasma itself. The preparation is similar to the usual PRF, but due to the absence of the coagulant activator in the vial, the rate of formation of the fibrin clot is much lower.
The PRF contains an autologous fibrin matrix that is rich in leukocytes, platelets and cytokines, and has a tetramolecular structure that acts as a biodegradable framework. This matrix not only stimulates the development of the microvascular mesh, but also directs the migration of epithelial cells to the surface.
The effect of PRF and fat cells on the repair of defects in soft tissue of the maxillofacial area was investigated in pigs. It has been found that combined use of PRF and fat cells contributes to more efficient reparative regeneration processes than their single use.
The use of PRF is common in mucoadhesive surgery, mainly in donor areas, due to the possibility of leaving the fibrin membrane exposed, which stimulates the rapid healing of the wounds with a secondary tension. Also, PRF is used locally for gum recession. According to research by S.K. Agarwa PRF stimulates the increase in the width of the keratinous mucous membrane to 0.8-1.0 mm, reducing the gum recession, which in turn greatly enhances the aesthetics of the patient. The use of PRF is clinically grounded in the surgical treatment of pigmented gum area.
There was a wide use of PRF in cases of surgical treatment of radicular jaw cysts, including odontogenic facial granulomas, to replace the defect of bone tissue. The use of PRF promotes accelerated bone regeneration within 3 months after surgery. Radiologically, after 6 months, there is a complete recovery of bone tissue and a probable increase in bone density. The use of the PRF membrane helps to prevent inflammatory complications during tooth extraction, such as after an alveolus extraction, and can be used to break down the wall of the alveoli, which accelerates the processes of reparative regeneration in this area and creates better prospects for further dental implantation.
It is proved that the use of PRF causes the acceleration of the processes of reparative regeneration in various types of tissues, contributing to the improvement of treatment results.
2. Platelet-rich fibrin (PRF): A second-generation platelet concentrate / D.M. Dohan, J. Choukroun, A. Diss [etal.] // Oral Surg Oral Med Oral Pathol Oral Radiol Endod. – 2006. – Vol. 101. – P. 45–50.
3. Anopportunity in perio-implantology: The PRF / J. Choukroun, F. Adda, C. Schoeffler, A. Vervelle // Implantodontie. – 2001. – Vol. 42. – P. 55-62.
4. Role of plasma-rich fibrinin oral surgery / K.R. Kumar, K. Genmorgan, S.M.A. Rahman [etal.] // J Pharm Bio allied Sci. – 2016. – Vol. 8(1). – P. 36–38.
5. The adjunctive effect of Platelet‐Rich Fibrin to Connective Tissue Graftin the treatment of buccal recession defects: results of a randomized, parallel‐group controlled trial / H.G. Keceli, G. Kamak, E. Erdemir [etal.] // Journal of Periodontology – 2015. – Vol. 86. – P. 1221‐1230.
6. Thrombocidins, microbicidal proteins from human blood platelets, are C-terminal deletion products of CXC chemokines / J. Krijgsveld, S.A. Zaat, J. Meeldijk [etal.] // J BiolChem. – 2000. – Vol. 275. – P. 20374-20381.
7. Antimicrobial effect of platelet-rich plasma and platelet-rich fibrin / P.S. Badade, S.A. Mahale, A.A. Panjwani [etal.] // Indian J DentRes. – 2016. – Vol. 27. – P. 300-304.
8. The role of leukocytes from L-PRP/L-PRF in wound healing and immune defense: new perspectives / T. Bielecki, D.M. DohanEhrenfest, P.A. Everts, A. Wiczkowski // Curr Pharm Biotechnol. – 2012. – Vol. 13(7). – P. 1153-1162.
9. SunithaRaja V. Platelet-rich fibrin: Evolutionof a second-generation platelet concentrate / V. SunithaRaja, E. Munirathnam Naidu // Indian J DentRes – 2008. – Vol. 19. – P. 42-46.
10. A comparative study of 2 methods for obtaining platelet-rich plasma / F.M. Tamimi, S. Montalvo, I. Tresguerres, L. BlancoJerez // J OralMaxillofacSurg. – 2007. – Vol. 65(6). – P. 1084-1093.
11. Do the fibrin architecture and leukocyte content in fluence the growth factor release of platelet concentrates? An evidence-based answer comparing a pure platelet-rich plasm (P-PRP) geland a leukocyte- and platelet-rich fibrin (L-PRF) / D. M. DohanEhrenfest, T. Bielecki, R. Jimbo [etal.] // Current Pharmaceutical Biotechnology. – 2012. – Vol. 13(7). – P. 1145–1152.
12. Platelet-rich plasma: growth factor enhancement for bonegrafts / R.E. Marx, E.R. Carlson, R.M. Eichstaedt [etal.] // OralSurgery, OralMedicine, Oral Pathology, Oral Radiology, and Endodontics. – 1998. – Vol. 85(6). – P. 638–646.
13. Effects of PRF and released three growth factors on migration of rat adipose tissue-derived stemcells / J. Gao, M.G. Wang, S. Yang [etal.] // ShanghaiKouQiangYiXue. – 2015. – Vol. 24(6). – P. 667-673.
14. Autologous platelets as a source of proteins for healing and tissue regeneration / E. Anitua, I. Andia, B. Ardanza [etal.] // ThrombHaemost. – 2004. – Vol. 91(1). – P. 4-15.
15. Slow release of growth factors and thrombospond in-1 in Choukroun's platelet-rich fibrin (PRF): a gold standard to achieve for all surgical platelet concentrates technologies / D.M. DohanEhrenfest, G.M. dePeppo, P. Doglioli, G. Sammartino // GrowthFactors. – 2009. – Vol. 27(1). – P. 63–69.
16. Growth-promoting action and growth factor release by different platelet derivatives / F. Passaretti, M. Tia, V. D'esposito [etal.] // Platelets. – 2014. – Vol. 25(4). – P. 252–256.
17. Influence of Leukocyte- and Platelet-Rich Fibrin (L-PRF) in the Healing of Simple Post extraction Sockets: A Split-Mouth Study / G. Marenzi, F. Riccitiello, M. Tia [etal.] // Biomed Res Int. – 2015. – Vol. 205. – P. 369-373.
18. Bone regeneration in extraction sockets with auto logousplatelet rich fibringel / S. GirishRao, P. Bhat, K.S. Nagesh [etal.] // J MaxillofacOralSurg. – 2013. – Vol. 12. – P. 11-16.
19. Role of platelet-derived growth factor in wound healing / G.F. Pierce , T.A. Mustoe, B.W. Altrock [etal.] // J CellBiochem. – 1991. – Vol. 45(4). – P. 319-326.
20. Current knowledge and perspectives forthe use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxill of acial surgery part 1: period on tal and dentoalveolar surgery / M. delCorso, A. Vervelle, A. Simonpieri [etal.] // Current Pharmaceutical Biotechnology. – 2012. – Vol. 13(7). – P. 1207–1230.