Platelet gel in oral and maxillofacial surgery: a single-centre experience

Abstract

Background: Platelet gel is a blood product intended for non-transfusion, therapeutic purposes; it is produced by combining platelet concentrate with cryoprecipitate. Platelet gel stimulates tissue growth and is a key player in tissue regeneration. As an allogeneic product, platelet gel is obtained from the blood of a common type O blood donor, with a platelet count >200×10(3)/μL. Most of the beneficial effects of this product are due to the numerous growth factors (PDGF, TGF-β, IGF-1 and IGF-2, EGF, VEGF and FGF) contained in the alpha-granules of platelets. The aim of this study was to confirm that platelet gel is a valuable aid for the surgical repair of alveolar bone loss.

Materials and methods: Our study was carried out on 87 patients with inflammatory or dysembryoplastic osteolytic lesions >2 cm in diameter in jaw bones. For most patients the platelet gel was collected into a 450 mL bag and kept frozen at -40 °C until, whereas for a small group of patients the gel was prepared and activated in the sterile field of the operating theatre.

Results: All of our patients reported a decrease in painful symptoms immediately after surgery. Follow-up showed considerable acceleration of the healing processes in soft tissues and faster bone regeneration.

Conclusion: Multicentre studies are needed in order to standardise the methods for producing platelet gel and the clinical use of this product. Furthermore, for research purposes in vitro studies are needed to increase knowledge on the functional network and platelet growth factors and also to investigate the biochemical and molecular mechanisms involved.

Figure 1

Views from inside the mouth.

Figure 2

Maxillary osteolytic lesion on the left side.

Figure 3

Intra-operative view.

Figure 4

Platelet-rich plasma gel.

Figure 5

Cavity filling time with gel.

Figure 6

Flap suture.

Figure 7

Follow up 6 months after surgery.

Figure 8

OPT and CT follow-up, 6 months after surgery.

Figure 9

Osteolytic lesion of the inferior jaw.

Figure 10

Intra-operative view.

Figure 11

Cavity filling time with platelet-rich plasma.

Figure 12

Flap suture.

Figure 13

OPT follow-up 6 months after surgery.