Regenerative Effect of Platelet Concentrates in Oral and Craniofacial Regeneration

Abstract

Platelet concentrates (PCs) are biological autologous products derived from the patient's whole blood and consist mainly of supraphysiologic concentration of platelets and growth factors (GFs). These GFs have anti-inflammatory and healing enhancing properties. Overall, PCs seem to enhance bone and soft tissue healing in alveolar ridge augmentation, periodontal surgery, socket preservation, implant surgery, endodontic regeneration, sinus augmentation, bisphosphonate related osteonecrosis of the jaw (BRONJ), osteoradionecrosis, closure of oroantral communication (OAC), and oral ulcers. On the other hand, no effect was reported for gingival recession and guided tissue regeneration (GTR) procedures. Also, PCs could reduce pain and inflammatory complications in temporomandibular disorders (TMDs), oral ulcers, and extraction sockets. However, these effects have been clinically inconsistent across the literature. Differences in study designs and types of PCs used with variable concentration of platelets, GFs, and leucocytes, as well as different application forms and techniques could explain these contradictory results. This study aims to review the clinical applications of PCs in oral and craniofacial tissue regeneration and the role of their molecular components in tissue healing.

Keywords: clinical applications; growth factors; oral tissue regeneration; platelet concentrates; platelets.

Figure 1

Panoramic view of both jaws illustrating the anatomic structures and the pathological conditions.

Figure 2

Maxillary sinus augmentation using lateral window approach. (A) Perforation of sinus membrane during lateral window approach in sinus lifting with simultaneous implant placement. (B) PRP was used to cover the perforated sinus membrane.

Figure 3

Alveolar maxillary width reconstruction using allograft cortico-cancellous block. (A) exposure of alveolar ridge. (B) Fixation of bone graft with fixation screws. (C) PRP covering the bone graft material.

Figure 4

Alveolar socket preservation using bone graft covered with PRP. (A) Extraction socket. (B) Bone graft applied inside the extraction socket. (C) PRP covered bone graft material.

Figure 5

PRP use in treatment of alveolar osteitis (inflammation of alveolar socket). (A) Alveolar socket. (B) PRP applied in the extraction socket. (C) Figure 8 suture type used to stabilize the PRP in the alveolar socket.

Figure 6

PRP injection as an adjunctive treatment with corticosteroids for resistant oral pemphigus vulgaris. (A) 1.5 ml of PRP was injected once a week for 3 weeks. (B) Pemphigus vulgaris lesion located posterior to mandibular third molar. (C) One week after last injection. (D) Six weeks after last injection. (E) Six months after last injection.