Leukocyte and platelet-rich fibrin in oro-maxillo-facial surgery: Safety, efficacy and clinical protocol recommendations from randomized controlled clinical trials
Ziyad S Haidar
University of the Andes, Chile
: Dent Health Curr Res
Objectives: Leukocyte and Platelet-Rich Fibrin (L-PRF) is a 3-D autogenous biomaterial obtained via the simple and rapid centrifugation of whole blood patient samples, in the absence of anti-coagulants, bovine thrombin, additives or any gelifying agents. A relatively new “revolutionary” step in second generation platelet concentrate-based therapeutics, the clinical safety more so, efficacy and effectiveness of L-PRF remains highly-debatable, whether due to preparation protocol variabilities, limited evidence-based scientific and clinical literature and/or inadequate understanding of its bio-components. This critical review provides an update on the application and clinical potential/effectiveness of L-PRF during oral surgery procedures, limited to evidence obtained from human Randomized and Controlled Clinical Trials. Recent functional recommendations on L-PRF preparation protocols are provided to the interested clinician as well as the involved researcher. Data: All available/accessible clinical trials. Sources: PubMed (from Jan 2014 – Feb 2016). Study Selection: Eligibility criteria included: “Human Randomized Controlled Clinical Trials” and “Use of Choukroun’s classic L-PRF preparations only”. Conclusions: Autologous L-PRF is often associated with early bone formation and maturation; accelerated soft-tissue healing; and reduced post-surgical pain, edema and discomfort. Preparation protocols require revision and standardization. Well-designed RCTs (according to the CONSORT statement) are also needed for validation. Furthermore, a better analysis of rheological properties, biocomponents and bioactive function of L-PRF preparations would enhance the cogency, comprehension and therapeutic potential of the reported findings or “observations”; a step closer towards a new era of “super” dental bio-materials and -scaffolds. Clinical Significance: L-PRF is a simple, malleable and safe biomaterial suitable for use in oral surgery. An innovative tool in Regenerative Dentistry, L-PRF seems a robust and possibly a cost-effective biomaterial alternate for oro-dental tissue repair and regeneration.