|Year : 2019 | Volume
| Issue : 3 | Page : 97-98
A little goes a long way: The cruise of platelet concentrates in dentistry
Department of Conservative Dentistry and Endodontics, TN Government Dental College and Hospital, TN Dr. MGR Medical University, Chennai, Tamil Nadu, India
|Date of Submission||21-Nov-2019|
|Date of Acceptance||25-Nov-2019|
|Date of Web Publication||20-Dec-2019|
Dr. Kavitha Mahendran
Department of Conservative Dentistry and Endodontics, TN Government Dental College and Hospital, TN Dr. MGR Medical University, Chennai, Tamil Nadu
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mahendran K. A little goes a long way: The cruise of platelet concentrates in dentistry. J Interdiscip Dentistry 2019;9:97-8
| Clinical Relevance to Interdisciplinary Dentistry|| |
In pursuit of a versatile material that can evolve, replace, and mimic the various types of the dental tissues, our field has eventually directed its finger to the human race himself as a source of this much sought-after biomaterial. From the science of replacement to regeneration, a major breakthrough was in regenerative dentistry with the emergence of platelet concentrates.
Platelet concentrates are classified as follows: (i) pure platelet-rich plasma (PRP), (ii) leukocyte- and PRP, (iii) pure platelet-rich fibrin (PRF), and (iv) leukocyte- and PRF. Various other modifications of platelet concentrates have hence been introduced, namely injectable-PRF, advanced PRF, titanium PRF, and concentrated growth factor. Platelet concentrates have widely been used in dentistry to potentiate healing and to augment the regeneration process. Platelet concentrates have found a myriad of applications in various dental treatments such as root coverage procedures, management of intrabony defects, gingival recession, furcation defects, extraction socket preservation, and accelerated healing of wound, implant-supported prosthesis, periapical wound healing, immediate reimplantation and pulp regeneration.
Platelets are laden with numerous presynthesized growth factors which are released within 60 min of their activation, and they continue to synthesize growth factors throughout their life span. The very rationale behind using platelet concentrates in the field of medicine is that growth factors which are naturally released during the process of healing are autologously derived and proferred in the surgical site simulating the coagulation cascade. The added advantage of these platelet concentrates is that they are nonimmunogenic, have no risk of transmissible infections, act as natural scaffolds to promote wound healing, and regenerate tissues that are lost at the site of application.
The use of platelet concentrates has become so rampant in dentistry that the justification for this widespread use needs contemplation and it is necessary to analyze to what extent the application of these biological materials is evidence based. According to a systematic review and meta-analysis conducted by Pocaterra et al. (2016), there was no significant difference in bone augmentation for sinus lift procedures when PRF was used as an adjunct for bone grafting. There was neither a difference in the implant survival rate. Saleem et al. (2018) reported that when PRP was used adjunctively for infrabony regenerative treatment, there was a better gain in clinical attachment loss and reduced periodontal probing depth. Moraschini and Barbosa Edos (2016) conducted a systematic review and meta-analysis to assess the efficacy of PRF in gingival recession and concluded that PRF did not significantly improve root coverage, reduce clinical attachment loss, or augment keratinized mucosa width in gingival recession cases. Metlerska et al. (2019) performed a systematic review to assess the potency of autologous platelet concentrates in regenerative endodontic treatment and found that there was an increase in the length and thickness of the root and closure of the apical foramen in permanent teeth with root development. Noor Mohamed et al. (2018) concluded from a systematic review of pulpotomies in human teeth and stated that platelet concentrates did not produce significantly better results and further long-term studies are needed to substantiate the same.
Dentistry is one of the oldest medical professions dating back to 7000 BC, and a plethora of materials have since been used to treat various dental ailments. A mammoth breakthrough is seen in the current century after the dawn of the science of biomimetics and biomaterials. In spite, lacunae continue to exist in the implementation of evidence-based practice and scientific evidence, with these two factors existing as two discrete islands. At times, what is proven with evidence faces a lot of practical hurdles in clinical use and what is widely used in practice may lack sound evidence. As far as platelet concentrates are concerned, they encompass both these barriers: adequate evidence exists with regard to the regenerative properties of the material and its clinical use is also tangible. The authority of integrating both and authenticating the scope of this material is vested within the hands of the dentist, and this can be made possible by furnishing sound evidence by conducting more long-term randomized controlled trials. Let the dental fraternity join hands to unveil the marvel conceivable with a little drop of blood – a little goes a long way.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Pocaterra A, Caruso S, Bernardi S, Scagnoli L, Continenza MA, et al.
Effectiveness of platelet-rich plasma as an adjunctive material to bone graft: a systematic review and meta-analysis of randomized controlled clinical trials. Int J Oral Maxillofac Surg 2016; 45(8): 1027-34.
Saleem M, Pisani F, Zahid FM. Adjunctive Platelet-Rich Plasma (PRP) in Infrabony Regenerative Treatment: A Systematic Review and RCT's Meta-Analysis. Stem Cells Int 2018:9594235.
Moraschini V, Barboza E dos SP. Use of Platelet-Rich Fibrin Membrane in the Treatment of Gingival Recession: A Systematic Review and Meta-Analysis. J Periodontol 2016; 87:281-90.
Metlerska J, Fagogeni I, Nowicka A. Efficacy of Autologous Platelet Concentrates in Regenerative Endodontic Treatment: A Systematic Review of Human Studies. J Endod. 2019;45:20-30.
Noor Mohamed R, Basha S, Al-Thomali Y. Efficacy of platelet concentrates in pulpotomy - a systematic review. Platelets. 2018;29 :440-5.