Fibrin Rich in Leukocyte-Platelets (L-PRF) and Injectable Fibrin Rich Platelets (i-PRF), Two Opportunity in Regenerative Surgery: Review of The Sciences and Literature.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
PRF is a second-generation platelet concentrate and can be distinguished in P-PRF (Pure Plateletrich fibrin) and L-PRF (Leukocyte and Platelet-rich fibrin). An evolution of L-PRF is the injectable PRF (iPRF). In vivo, during the platelet clot formation, platelets are bound to β-integrin fibrin and the clot retracts itself. The PRF clot forms a solid fibrin matrix, displaying a complex tridimensional architecture. Measuring the levels of PDGF-BB, TGF-1β and IGF-1, in the PRF matrix, it was revealed that slow fibrin polymerization during PRF elaboration leads to the intrinsic platelet formation of cytokines and glycan chains inside the fibrin mesh. The PRF proximal part (the part closer to the red clot) contains platelets and leukocytes, found to be massively enclosed inside the fibrin net. Platelet localization inside PRF was examined through immunostaining and scanning electron microscope (SEM). Compared to the abrupt basal compression of PRF membrane (GPRF), preservation of plasma level, of 3D fibrin, and of platelets was found to be more intact in PRF membrane preparations obtained through metallic compression system (PRF-C) (L-PRF Wound Box). The pure plateletrich fibrin (P-PRF) and the leukocyte and platelet-rich fibrin (PRF-L) are biomaterials with solid fibrin or biomaterials containing leukocytes. No platelet concentration related problems were found in PRF, as all platelets in the drawn blood sample are activated and integrated inside the fibrin matrix of the clot. Approximately 97% of platelets and more than 50% of leukocytes are concentrated inside the PRF clot, which displays a specific tridimensional distribution. Almost all platelets (>97%) are absent inside test-tubes of groups tested after PRF membrane extraction. Factors freed by platelets contained in L-PRF induce and control the proliferation and migration of other cell types, involved in tissue repair, like smooth cell muscles (SMCs) and mesenchymal stem cells (MSCs). This review article focuses on the development of various platelet concentrates, their fabrication procedure, advantages and disadvantages for use in regenerative surgery and healing process.
Authors and Affiliations
Alessandro Crisci, Silvana Manfredi, Michela Crisci
Keywords
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- EP ID EP573537
- DOI 10.9790/0853-1804106679.
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