Advanced PRF, A-PRF의 우수성을 보여주는 논문 두 편!

J Periodontol. 2016 Sep 2:1-17. [Epub ahead of print]

Optimized Platelet Rich Fibrin With the Low Speed Concept: Growth Factor Release, Biocompatibility and Cellular Response.

Fujioka-Kobayashi M^1,2,3, Miron RJ¹, Hernandez M¹, Kandalam U⁴, Zhang Y⁵, Choukroun J⁶.

Author information

• ¹Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA.
• ²Department of Cranio-Maxillofacial Surgery, University of Bern, Bern, Switzerland.
• ³Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
• ⁴Department of Pediatric Dentistry, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA.
• ⁵Department of Oral Implantology, University of Wuhan, Wuhan, China.
• ⁶Pain Clinic, Nice, France.

Abstract

BACKGROUND:

Over the past decade, the use of leukocyte platelet rich fibrin (L-PRF) has gained tremendous momentum in regenerative dentistry as a low-cost fibrin matrix utilized for tissue regeneration. In this study, we characterized how centrifugation speed (G-force) along with centrifugation time influence growth factor release from fibrin clots, as well as the cellular activity of gingival fibroblasts exposed to each PRF matrix.

METHODS:

Standard L-PRF served as a control (2700rpm-12 minutes). Two test groups utilizing low-speed (1300rpm-14 min termed advanced-PRF, A-PRF) and low-speed+time (1300rpm-8 min; A-PRF+) were investigated. Each PRF matrix was tested for growth factor release up to 10 days (8 donor samples) as well as biocompatibility and cellular activity.

RESULTS:

The low speed concept (A-PRF, A-PRF+) demonstrated a significant increase in growth factor release of PDGF, TGF- β1, EGF and IGF with A-PRF+ being highest of all groups. While all PRF formulations were extremely biocompatible due to their autogenous sources, both A-PRF and A-PRF+ demonstrated significantly higher levels of human fibroblast migration and proliferation when compared to L-PRF. Furthermore, gingival fibroblasts cultured with A-PRF+ demonstrated significantly higher mRNA levels of PDGF, TGF-β and collagen1 at either 3 or 7 days.

CONCLUSIONS:

The findings from the present study demonstrate that modifications to centrifugation speed and time with the low-speed concept was shown to favor an increase in growth factor release from PRF clots which in turn may directly influence tissue regeneration by increasing fibroblast migration, proliferation and collagen mRNA levels. Future animal and clinical studies are now necessary.

KEYWORDS:

Blood; Fibrin; Regeneration; Wound healing; fibroblasts; platelets

Clin Oral Investig. 2016 Jan 25. [Epub ahead of print]

Comparative release of growth factors from PRP, PRF, and advanced-PRF.

Kobayashi E^1,2, Flückiger L³, Fujioka-Kobayashi M^1,4, Sawada K^1,2, Sculean A³, Schaller B¹, Miron RJ^5,6.

Author information

• ¹Department of Cranio-Maxillofacial Surgery, Bern University, Bern, Switzerland.
• ²Department of Oral and Maxillofacial Surgery, School of Life Dentistry at Niigata, The Nippon Dental University, Niigata, Japan.
• ³Department of Periodontology, Bern University, Bern, Switzerland.
• ⁴Department of Oral Surgery, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
• ⁵Department of Periodontology, Bern University, Bern, Switzerland. richard.miron@zmk.unibe.ch.
• ⁶Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland. richard.miron@zmk.unibe.ch.

Abstract

OBJECTIVES:

The use of platelet concentrates has gained increasing awareness in recent years for regenerative procedures in modern dentistry. The aim of the present study was to compare growth factor release over time from platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and a modernized protocol for PRF, advanced-PRF (A-PRF).

MATERIALS AND METHODS:

Eighteen blood samples were collected from six donors (3 samples each for PRP, PRF, and A-PRF). Following preparation, samples were incubated in a plate shaker and assessed for growth factor release at 15 min, 60 min, 8 h, 1 day, 3 days, and 10 days. Thereafter, growth factor release of PDGF-AA, PDGF-AB, PDGF-BB, TGFB1, VEGF, EGF, and IGF was quantified using ELISA.

RESULTS:

The highest reported growth factor released from platelet concentrates was PDGF-AA followed by PDGF-BB, TGFB1, VEGF, and PDGF-AB. In general, following 15-60 min incubation, PRP released significantly higher growth factors when compared to PRF and A-PRF. At later time points up to 10 days, it was routinely found that A-PRF released the highest total growth factors. Furthermore, A-PRF released significantly higher total protein accumulated over a 10-day period when compared to PRP or PRF.

CONCLUSION:

The results from the present study indicate that the various platelet concentrates have quite different release kinetics. The advantage of PRP is the release of significantly higher proteins at earlier time points whereas PRF displayed a continual and steady release of growth factors over a 10-day period. Furthermore, in general, it was observed that the new formulation of PRF (A-PRF) released significantly higher total quantities of growth factors when compared to traditional PRF.

CLINICAL RELEVANCE:

Based on these findings, PRP can be recommended for fast delivery of growth factors whereas A-PRF is better-suited for long-term release.

KEYWORDS:

Choukroun’s PRF; Growth factor release; Platelet concentrates; Platelet-rich fibrin; Platelet-rich plasma