platelet concentrates in dentistry

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PLATELET CONCENTRATES-

Bioengineering Dentistrys Regenerative DreamsAKSHAY DHANDE 4TH BDS

GOVERNAMENT DENTAL COLLEGE AND HOSPITAL,HYDERABAD.

INTRODUCTION:Tissue regeneration is a thought provoking area in the field of dentistry.

Platelets had been proven to be a good source of growth factors.

Using platelet concentrates, is a way to accelerate and enhance the bodys natural wound healing mechanisms.

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HISTORY:Regenerative potential of platelets was introduced in 1970s and its clinical applications began in the field of medicine in 1980s.

Fibrin glue in Europe in 1970s.

Whitman et al -Platelet rich plasma in 1997

Platelet rich fibrin was first developed in France by Choukroun et al in 2001.

DR.CHOUKROUN

The richest of resources in nature, lie in the nature itself

UNDERSTANDING PLATELETSArise from cytoplasmic fragmentation of Megakaryocyte.

Enter the circulation as -nuclear cells.

Has a life span of 7 10 days.

They measure 23 m in diameter.

MECHANISM OF WOUND HEALING :

CLASSIFICATION OF PLATELET CONCENTRATES : Platelet Rich PlasmaPlatelet Rich fibrinP-PRPL-PRPP-PRFL-PRF

CLASSIFICATION : FIRST GENERATION

SECOND GENERATIONP-PRPWithout leucocytes,low density fibrinLiquid or gel solutionsL-PRPWith leucocytes , low density fibrinLiquid or gel solutions

P-PRF Without leucocytes ,high density fibrinstrong gel forms,solid materialL-PRFWith leucocytes ,high density fibrinstrong gel forms,solid materialI-PRF Injectable formA-PRFAdvanced formT-PRFTitanium tubes

PREPARATIONS OF PLATELET

CONCENTRATES

PREPARATION OF PRP

PREPARATION OF PRF

10 ml sample collection sample in test tubes centrifugation at 3000 rpm for 10 min

after centrifugation

PRF PRF in sterile metal cup

PRF is placed on the grid PRF setup box PRF membranes

ADVANTAGES OF PRF OVER PRPNo biochemical handling of blood.Simplified and cost effective process.No use of bovine thrombin and anticoagulants.Favorable healing due to low polymerization.More efficient cell migration and proliferation.Supportive effect on immune system.Helps in haemostasis.

APPLICATIONS OF Platelets RICH FIBRIN IN DENTISTRY

IN ENDODONTICSThe use of triple antibiotic paste for canal disinfection along with PRF strengthens the effectiveness of sterilization in carious teeth, infected dentin, periapical lesions and necrotic pulp.

PRF causes proliferation of pulp cells and also increases the expression of osteoprotegerin and Alkaline phosphatase activity.

PRF and tricalcium phosphate(TCP) bone graft have synergistic effect in treating periapical cysts.

Biological connector for neoangiogenesis and vascularization.

Apical matrix barrier for in root end apexification.

Apical plug in apexification.

Pulpal floor perforation repair.

As a scaffold for dentin pulp regeneration.

Periapical cyst treated with PRF

PRF in pulp regeneration periapical inflammation

IN PERIODONTICSHealing biomaterial in implant and periodontal surgical procedure.

Osteo conductive and Osteo inductive properties.

Good bone fill along with gain in clinical attachment was seen when PRF was used in addition to hydroxyapatite.

Treating intrabony defects and furcations.

Sinus lift procedures.

Furcation treated with PRF PRF in root coverage procedure

IN ORAL AND MAXILLOFACIAL SURGERY:

Cyst treated with PRF Extraction sockets with PRF

Residual defect after extraction treated with bone graft and PRF

Developing alveolar ridge in anterior maxilla

IN IMPLANTOLOGY:PRP when coated on the surface of an implant releases an array of growth factors which enhance the early wound healing providing an initial stabilization for the implant.

Better osseointegration capability.

PRF as sinus augmentation adjunct and suggested simultaneous sinus lift implantation using PRF as a sole grafting material.

CONCLUSIONPlatelet concentrates are a novel ingress of tissue engineering to clinicians and researchers in the field of dentistry.

Being a completely natural, physiologic, and economical source of autologous product, it possesses beneficial effects of eliminating concerns about immunogenic reactions and disease transmission.

However, since knowledge on this topic is still in its preliminary stage, the effectiveness of these platelet concentrates in regenerative procedures should be evaluated in studies comprising of large samples and their clinical applications in randomized control trials has to be encouraged.

REFERENCESJournal of Dental Research and Review.

International Journal of Medicine.

The Korean Academy of Conservative Dentistry.

Journal of Conservative Dentistry and Endodontics.

The Saudi Journal for Dental Research.

Annals of Oral & Maxillofacial Surgery.

Those things are better which are perfected by nature than those which are finished by art

-De Nature Decorum

THANK YOU