Injectable platelet rich fibrin (i-PRF): opportunities in regenerative dentistry?
OBJECTIVE
Platelet rich plasma (PRP) has been utilized in regenerative dentistry as a supra-physiological concentrate of autologous growth factors capable of stimulating tissue regeneration. Despite this, concerns have been expressed regarding the use of anti-coagulants, agents known to inhibit wound healing. In this study, a liquid formulation of platelet rich fibrin (PRF) termed injectable-PRF (i-PRF) without the use of anti-coagulants was investigated.


METHODS
Standard PRP and i-PRF (centrifuged at 700 rpm (60G) for 3 min) were compared for growth factor release up to 10 days (8 donor samples). Furthermore, fibroblast biocompatibility at 24 h (live/dead assay); migration at 24 h; proliferation at 1, 3, and 5 days, and expression of PDGF, TGF-β, and collagen1 at 3 and 7 days were investigated.


RESULTS
Growth factor release demonstrated that in general PRP had higher early release of growth factors whereas i-PRF showed significantly higher levels of total long-term release of PDGF-AA, PDGF-AB, EGF, and IGF-1 after 10 days. PRP showed higher levels of TGF-β1 and VEGF at 10 days. While both formulations exhibited high biocompatibility and higher fibroblast migration and proliferation when compared to control tissue-culture plastic, i-PRF induced significantly highest migration whereas PRP demonstrated significantly highest cellular proliferation. Furthermore, i-PRF showed significantly highest mRNA levels of TGF-β at 7 days, PDGF at 3 days, and collagen1 expression at both 3 and 7 days when compared to PRP.


CONCLUSIONS
i-PRF demonstrated the ability to release higher concentrations of various growth factors and induced higher fibroblast migration and expression of PDGF, TGF-β, and collagen1. Future animal research is now necessary to further validate the use of i-PRF as a bioactive agent capable of stimulating tissue regeneration.


CONCLUSIONS
The findings from the present study demonstrate that a potent formulation of liquid platelet concentrates could be obtained without use of anti-coagulants.
Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA. rmiron@nova.edu.|Cell Therapy Institute, Center for Collaborative Research, Nova Southeastern University, Fort Lauderdale, FL, USA. rmiron@nova.edu.|Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI, USA. rmiron@nova.edu.
Richard J
RJ
Miron
Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA.|Department of Cranio-Maxillofacial Surgery, University of Bern, Bern, Switzerland.|Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
Masako
M
Fujioka-Kobayashi
Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA.
Maria
M
Hernandez
Department of Pediatric Dentistry, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA.
Umadevi
U
Kandalam
Department of Oral Implantology, University of Wuhan, Wuhan, China.
Yufeng
Y
Zhang
FORM, Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt Am Main, Germany.
Shahram
S
Ghanaati
Pain Clinic, Nice, France.
Joseph
J
Choukroun
D001672:Biocompatible Materials / Q000494:pharmacology; D018929:Cell Culture Techniques; D002465:Cell Movement / Q000187:drug effects; D049109:Cell Proliferation / Q000187:drug effects; D002470:Cell Survival / Q000187:drug effects; D004797:Enzyme-Linked Immunosorbent Assay; D005347:Fibroblasts / Q000378:metabolism; D036341:Intercellular Signaling Peptides and Proteins / Q000494:pharmacology*; D000073183:Platelet-Rich Fibrin; D060888:Real-Time Polymerase Chain Reaction; D012038:Regeneration / Q000187:drug effects*
D001672:Biocompatible Materials; D036341:Intercellular Signaling Peptides and Proteins
Blood platelets; Fibrin; Fibroblasts; Platelet rich fibrin; Regeneration; Wound healing