Clinical Application of Platelet-Rich Fibrin in Pediatric Dentistry

Sowndarya Gunasekaran; Soundarya Sakthivel; B. Shanthala M.; George Babu; Vidhya Vijayan

doi:10.1055/s-0041-1736269

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Review Article

12 (

); 186-190

doi:

10.1055/s-0041-1736269

Clinical Application of Platelet-Rich Fibrin in Pediatric Dentistry

Sowndarya Gunasekaran^1,, Soundarya Sakthivel², B. Shanthala M.³, George Babu³, Vidhya Vijayan³

1Department of Paediatrics and Preventive Dentistry, Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation Deemed to be University, Ariyanoor, Salem, India

2Department of Oral Medicine and Radiology, AB Shetty Memorial Institute of Dental Sciences, Nitte (Deemed to be University), Mangalore, India

3Department of Paediatrics and Preventive Dentistry, Coorg Institute of Dental Sciences, Kodagu, Karnataka, India

Address for correspondence Sowndarya Gunasekaran, Assistant Professor, Department of Paediatrics and Preventive Dentistry, Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation Deemed to be University, NH 47 Sankari Main Road, Ariyanoor, Salem 636308, India (e-mail: drsowndaryag@vmsdc.edu.in)

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This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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This article was originally published by Thieme Medical and Scientific Publishers Pvt. Ltd. and was migrated to Scientific Scholar after the change of Publisher.

Abstract

Platelet-rich fibrin (PRF) is a fibrin matrix in which platelet cytokines, growth factors, and cells are trapped and may be released after a certain time and that can serve as a resorbable membrane. It can be obtained from blood with the help of a simple process. PRF is basically a concentrate of growth factors that promote wound healing and regeneration, which is used in various disciplines of dentistry to repair various lesions and regenerate dental and oral tissues. Although the use of PRF is well-documented, its use in pediatric dentistry remains unexplored, due to its restrictions and on account of the fact that it is a blood-derived product. PRF has been used globally to enhance tissue healing. This article provides an insight into the use of PRF in pediatric dentistry, its benefits, limitations, and recommendations.

Keywords

apexogenesis

direct pulp capping

regenerative endodontics

scaffolds

platelet-rich plasma

Show Related Articles from PubMed

Introduction

Platelet-rich fibrin (PRF) has been used in dentistry for more than a decade now. Its application in pediatric dentistry can be vital, but it has not been explored. PRF is an autologous product that contains elevated levels of nonactivated, functional intact platelets within a fibrin matrix that releases a relatively constant concentration of growth factors over a few days. Immediately after drawing blood, it is centrifuged, and PRF is produced. It is vitally used in regeneration of hard tissue such as continued root formation, healing after disimpaction, and healing after soft-tissue damage such as gingival surgeries. The production of PRF is easy but the major concern arises in drawing blood from pediatric patients. PRF's application in pediatric dentistry varies from pulp capping and pulpotomy to apexogenesis and healing of extraction socket. Review of literature on the use of PRF in pediatric dentistry is sparse. Studies using bioactive materials containing host's endogenous growth factors represent a paradigm shift from the conservative clinical approach to more predictable regenerative solutions in dentistry.

Platelet-rich Fibrin

PRF is a bioactive surgical additive material prepared from the centrifuging patient's whole blood, a second-generation platelet concentrate described by Choukroun et al.¹ PRF is used to accelerate tissue healing. PRF is a simple and nonexpensive chairside process that results in a resorbable fibrin matrix, supplemented with rich platelets and leukocytes. It provides a rich source of growth factors, which includes platelet-derived growth factors, transforming growth factors, vascular endothelial growth factor, and insulin-like growth factor.² The growth factors are gradually released during the time of the healing. PRF is used in dentistry due to its unique healing potential.³⁴

Preparation of PRF

Preparation for PRF production follows a standard protocol, as described by Choukroun et al.¹ A total of 5 mL of whole venous blood is drawn with anticoagulant in 10 mL tubes and immediately centrifuged at 3000 rotations per minute (rpm) for 10 minutes. The blood is contacted with the test tube wall during the centrifuging process, leading to the activation of platelets which, in turn, in turn initiate coagulation cascade. The resultant product will consist of three layers (Fig. 1):

Fig. 1 Platelet-rich fibrin (PRF) in test tube after centrifuging showing platelet-poor plasma, PRF clot, and red blood cells (RBCs).

Platelet-poor plasma.
PRF clot.
Red blood cells (RBCs).

Fibrinogen, which is concentrated on the higher part of the tube, is converted into fibrin by the circulating thrombin, thus the platelet-trapped fibrin clot is formed in the middle, RBCs at the bottom, and acellular plasma at the top. The PRF is then removed from the test tube using surgical tweezers and separated from other layers using sterile scissors. PRF is squeezed between the sterile gauze pads (Fig. 2) to obtain a membranous film, which can be packed into the tooth for specific procedures.

Fig. 2 Platelet-rich fibrin (PRF) is squeezed between the sterile gauze pads.

Constituents of PRF

Growth factors released from PRF have been cited in Table 1.

Table 1 Growth factor cells present in PRF and their function⁵⁶

Cells	Functions
Interleukin 1	Key moderator of inflammation control and stimulates T-helper lymphocytes
Interleukin 6	Activates B lymphocytes, stimulates secretion of antibodies
Interleukin 4	Aids in multiplication and differentiation of activated B lymphocytes. Aids healing by controlling inflammation
Tumor necrosis factor-α	Activates monocytes, stimulates remodeling capacities of fibroblasts
Cytokine vascular endothelial growth factor	Promotes angiogenesis
Platelet-derived growth factors	Maintains migration, multiplication and endurance of mesenchymal cell lineages
Insulin-like growth factor	Cell proliferation arbitrator in apoptosis, employs chemotactic results against human osteoblasts
Transforming growth factor β1	Triggers multiplication of fibroblasts and periodontal ligament cells, amplifies collagen manufacture
Vascular endothelial growth factor	Supports the cohesion of the endothelial cell lining of the blood vessel and stimulates neoangiogenesis throughout the wound healing
Fibroblast growth factor	Controls ectodermal origin cells and demonstrates chemotactic and mitogenic efforts on periodontal ligament fibroblast cells

Abbreviation: PRF, platelet-rich fibrin.

Mechanism of Action

PRF aids in wound healing mainly through the action of growth factors,^5678910 which are present in abundance in it. A flowchart describing the series of action is given in Fig. 3.

Uses of PRF in Pediatric Dentistry

As Medicament in Pulpotomy

Patidar et al¹¹ conducted a clinical study evaluating PRF and mineral trioxide aggregate (MTA) as a pulpotomy medicament in primary molars. Clinical evaluation was done at 1-, 3- and 6-monthsintervals to check symptoms of pain, tenderness to percussion, soft-tissue swelling, pathologic mobility, and sinus formation. Radiological evaluation was performed at an interval of 6 months and considered successful if there was no furcal or periapical radiolucency, no canal calcification, and no internal and external resorption. The findings from this study revealed that PRF can be used successfully as an appropriate alternative material in pulpotomy of primary teeth. Manhas et al¹² in a clinical study evaluated and compared PRF as pulp dressing material in primary molar pulpotomy. The current study evaluates MTA, PRF + MTA, and PRF + Ca (OH)₂ as a pulpotomy medicament in primary molars at 1-, 3-, and 6-months followed by clinical and radiographic assessment. It was concluded that there is a favorable future for PRF in the specialty of deciduous tooth vital pulp therapy.

In Apexogenesis of Young Permanent Teeth

Mittal et al¹³ evaluated the regenerative ability of PRF and artificial scaffolds in dying incomplete root development of permanent teeth, and observed that PRF and collagen are superior scaffolds to chitosan and placentrex for apexogenesis. Hongbing et al¹⁴ conducted a retrospective controlled study and concluded that using PRF as scaffold for revascularization achieved similar results compared with the technique of inducing periapical bleeding with regard to the healing of the periapical lesion, continued root formation and resolution of clinical signs and symptoms.¹⁵¹⁶ A systematic review conducted by Miron et al¹⁷ evaluated 7 in vitro, 11 in vivo, and 31 clinical studies. As much as 100% of the in vivo studies and 85.7% of the in vitro studies affirmed a statistically significant superiority for combining PRF with regenerative treatments. As much as 87% clinical studies suggested the use of PRF for the regeneration of tissues and wound healing for various treatment procedures in dentistry.¹⁸¹⁹

As a Pulp Capping Material

According to Bakshi et al,²⁰ PRF showed promising results when used as a direct pulp capping medicament, compared with MTA. Dou et al²¹ conducted a study to investigate the effect of Ca(OH)₂, MTA, iRoot BP, PRF and concentrated growth factors (CGF) on the proliferation, viability, apoptosis, and mineralization of human dental pulp cells and concluded that PRF and CGF are potential pulp-capping materials for vital pulp therapy. However, further studies on the potency of PRF and CGF as vital pulp-capping material and in vivo studies are necessary.^22232425

For Surgical or Extraction Wound Closure

PRF is a well-known to have wound healing and regenerative properties, which can used to enhance the healing of surgical wound after cyst or any other defect that causes a large amount of bone loss. In such cases, PRF can be mixed with bone graft and can be packed to the surgical site, in order to enhance healing in children (Fig. 4).^26272829

Fig. 4 Platelet-rich fibrin mixed with bone graft ready for loading in surgical site.

Limitation of PRF in Pediatric Dentistry

PRF cannot be used to fill large defects in case of cysts. Since autologous blood sample is used to obtain PRF, the quantities produced are low.³⁰³¹
Allogenic graft tissue is impractical, since PRF membranes are highly specific to the donor.³²³³
Preserving PRF is not feasible, as it will result in shrinkage due to dehydration and modification of the structural integrity as well as reduced growth factor content in PRF.³⁴

Advantages of PRF

No biological handling of blood.
Simplified and cost-effective process.
Anticoagulants not required.
Favorable healing due to slow polymerization.
More efficient cell migration and proliferation.
PRF has supportive effect on immune system.

Disadvantages of PRF

Amount available is low, because of autologous blood.
Quick handling of blood is needed, immediately after collection.
Drawing blood from pediatric patients is the major difficulty encountered in this procedure, since children are generally apprehensive to needles.

Conclusion

This article edifies the application of PRF in pediatric dentistry. PRF has been in use for over a decade in regenerative endodontics with an abundance of literature explaining its effectiveness; however, very less or few studies have been conducted on its use in primary dentition and young permanent teeth. Although PRF is found to be a promising material, there is vital need for clinical studies on the primary dentition to support its use, clinical efficacy, and long-term stability in pediatric patients.

Conflict of Interest

None declared.

References

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Dohan M D, Choukroun J, Diss A, et al.. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(03):e45-e50.
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Harrison P. Platelet function analysis. Blood Rev. 2005;19(02):111-123.
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Khiste V S, Naik Tari R. Platelet-rich fibrin as a biofuel for tissue regeneration. Int Sch Res Notices.
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Borie E, Oliví G D, Orsi A I, et al.. Platelet-rich fibrin application in dentistry: a literature review. Int J Clin Exp Med. 2015;8(05):7922-7929.
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Gassling L V, Açil Y, Springer N I, Hubert N, Wiltfang J. Platelet-rich plasma and platelet-rich fibrin in human cell culture. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(01):48-55.
[Google Scholar]
Hotwani K, Sharma K. Platelet rich fibrin - a novel acumen into regenerative endodontic therapy. Restor Dent Endod. 2014;39(01):1-6.
[Google Scholar]
Chatterjee A, Debnath K. Comparative evaluation of growth factors from platelet concentrates: an in vitro study. J Indian Soc Periodontol. 2019;23(04):322-328.
[Google Scholar]
Fernández-Delgado N, Hernández-Ramírez P, Forrellat-Barrios M. Platelet functional spectrum: from hemostasis to regenerative medicine. Rev Cuba Hematol Immunol Hemoter. 2012;28:200-216.
[Google Scholar]
Wu L C, Lee S S, Tsai H C, Lu H K, Zhao H J, Chang C Y. Platelet-rich fibrin increases cell attachment, proliferation and collagen-related protein expression of human osteoblasts. Aust Dent J. 2012;57(02):207-212.
[Google Scholar]
Patidar S, Kalra N, Khatri A, Tyagi R. Clinical and radiographic comparison of platelet-rich fibrin and mineral trioxide aggregate as pulpotomy agents in primary molars. J Indian Soc Pedod Prev Dent. 2017;35(04):367-373.
[Google Scholar]
Manhas M, Mittal S, Sharma K A, Gupta K K, Pathania V, Thakur V. Biological approach in repair of partially inflamed dental pulp using second-generation platelet-rich fibrin and mineral trioxide aggregate as a pulp medicament in primary molars. J Indian Soc Pedod Prev Dent. 2019;37(04):399-404.
[Google Scholar]
Mittal N, Parashar V. Regenerative evaluation of immature roots using prf and artificial scaffolds in necrotic permanent teeth: a clinical study. J Contemp Dent Pract. 2019;20(06):720-726.
[Google Scholar]
Lv H, Chen Y, Cai Z, et al.. The efficacy of platelet-rich fibrin as a scaffold in regenerative endodontic treatment: a retrospective controlled cohort study. BMC Oral Health. 2018;18(01):139.
[Google Scholar]
Kiran K N, Mukunda S K, Tilak Raj N T. Platelet concentrates: a promising innovation in dentistry. J Dent Sci Res. 2011;2:50-61.
[Google Scholar]
Gupta V, Bains K B, Singh P G, Mathur A, Bains R. Regenerative potential of platelet rich fibrin in dentistry: Literature review. Asian J Oral Health Allied Sci. 2011;1:22-28.
[Google Scholar]
Miron J R, Fujioka-Kobayashi M, Bishara M, Zhang Y, Hernandez M, Choukroun J. Platelet-rich fibrin and soft tissue wound healing: a systematic review. Tissue Eng Part B Rev. 2017;23(01):83-99.
[Google Scholar]
Keswani D, Pandey K R. Revascularization of an immature tooth with a necrotic pulp using platelet-rich fibrin: a case report. Int Endod J. 2013;46(11):1096-1104.
[Google Scholar]
Lauricella M A. Fibrin network variability. Acta Bioquim Clin Latinoam. 2007;41:7-19.
[Google Scholar]
Bakshi C, Bogra P, Singh V S, Gupta S, Makhija C. PRF in vital pulp therapy: case report. Baba Farid Univ Dent J. 2017;7(01):61-66.
[Google Scholar]
Dou L, Yan Q, Yang D. Effect of five dental pulp capping agents on cell proliferation, viability, apoptosis and mineralization of human dental pulp cells. Exp Ther Med. 2020;19(03):2377-2383.
[Google Scholar]
Maniyar N, Sarode S G, Sarode C S, Shah J. Platelet-Rich fibrin: A “wonder material” in advanced surgical dentistry. Medical Journal of Dr. DY Patil Vidyapeeth. 2018;11(04):287.
[Google Scholar]
Agrawal M, Agrawal V. Platelet rich fibrin and its applications in dentistry-A review article. Natl J Med Dent Res. 2014;2(03):51.
[Google Scholar]
Preeja C, Arun S. Platelet-rich fibrin: Its role in periodontal regeneration. Saudi J Dent Res. 2014;5(02):117-122.
[Google Scholar]
Ghanaati S, Herrera-Vizcaino C, Al-Maawi S, et al.. Fifteen years of platelet rich fibrin in dentistry and oromaxillofacial surgery: how high is the level of scientific evidence? J Oral Implantol. 2018;44(06):471-492.
[Google Scholar]
Singer J A, Clark A R. Cutaneous wound healing. N Engl J Med. 1999;341(10):738-746.
[Google Scholar]
Laurens N, Koolwijk P, de Maat P M. Fibrin structure and wound healing. J Thromb Haemost. 2006;4(05):932-939.
[Google Scholar]
Girish Rao S, Bhat P, Nagesh S K, et al.. Bone regeneration in extraction sockets with autologous platelet rich fibrin gel. J Maxillofac Oral Surg. 2013;12(01):11-16.
[Google Scholar]
Del Corso M, Toffler M, Dohan Ehrenfest M D. Use of an autologous leukocyte and platelet-rich fibrin (L-PRF) membrane in post-avulsion sites: an overview of Choukroun's PRF. J Implant Adv Clin Dent. 2010;1:27-35.
[Google Scholar]
Bansal S, Garg A, Khurana R, Chhabra P. Platelet-rich fibrin or platelet-rich plasma–which one is better? an opinion. Indian J Dent Sci. 2017;9(05):49.
[Google Scholar]
Choukroun J, Diss A, Simonpieri A, et al.. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(03):e56-e60.
[Google Scholar]
Sehgal M, Puri L, Yadav S, et al.. Immediate dental implants enriched with L-PRF in the esthetic zone. Case Rep Dent. 2018;2018:9867402.
[Google Scholar]
Huang M F, Yang F S, Zhao H J, Chang C Y. Platelet-rich fibrin increases proliferation and differentiation of human dental pulp cells. J Endod. 2010;36(10):1628-1632.
[Google Scholar]
Clipet F, Tricot S, Alno N, et al.. In vitro effects of Choukroun's platelet-rich fibrin conditioned medium on 3 different cell lines implicated in dental implantology. Implant Dent. 2012;21(01):51-56.
[Google Scholar]

Show Sections

[1] Choukroun J, Adda F, Schoeffler C, Vervelle A. Une opportunité en paro-implantologie: le PRF. Implantodontie. 2000;42:55-62.
[Google Scholar]

[2] Dohan M D, Choukroun J, Diss A, et al.. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(03):e45-e50.
[Google Scholar]

[3] Harrison P. Platelet function analysis. Blood Rev. 2005;19(02):111-123.
[Google Scholar]

[4] Khiste V S, Naik Tari R. Platelet-rich fibrin as a biofuel for tissue regeneration. Int Sch Res Notices.
[Google Scholar]

[5] Borie E, Oliví G D, Orsi A I, et al.. Platelet-rich fibrin application in dentistry: a literature review. Int J Clin Exp Med. 2015;8(05):7922-7929.
[Google Scholar]

[6] Gassling L V, Açil Y, Springer N I, Hubert N, Wiltfang J. Platelet-rich plasma and platelet-rich fibrin in human cell culture. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(01):48-55.
[Google Scholar]

[7] Hotwani K, Sharma K. Platelet rich fibrin - a novel acumen into regenerative endodontic therapy. Restor Dent Endod. 2014;39(01):1-6.
[Google Scholar]

[8] Chatterjee A, Debnath K. Comparative evaluation of growth factors from platelet concentrates: an in vitro study. J Indian Soc Periodontol. 2019;23(04):322-328.
[Google Scholar]

[9] Fernández-Delgado N, Hernández-Ramírez P, Forrellat-Barrios M. Platelet functional spectrum: from hemostasis to regenerative medicine. Rev Cuba Hematol Immunol Hemoter. 2012;28:200-216.
[Google Scholar]

[10] Wu L C, Lee S S, Tsai H C, Lu H K, Zhao H J, Chang C Y. Platelet-rich fibrin increases cell attachment, proliferation and collagen-related protein expression of human osteoblasts. Aust Dent J. 2012;57(02):207-212.
[Google Scholar]

[11] Patidar S, Kalra N, Khatri A, Tyagi R. Clinical and radiographic comparison of platelet-rich fibrin and mineral trioxide aggregate as pulpotomy agents in primary molars. J Indian Soc Pedod Prev Dent. 2017;35(04):367-373.
[Google Scholar]

[12] Manhas M, Mittal S, Sharma K A, Gupta K K, Pathania V, Thakur V. Biological approach in repair of partially inflamed dental pulp using second-generation platelet-rich fibrin and mineral trioxide aggregate as a pulp medicament in primary molars. J Indian Soc Pedod Prev Dent. 2019;37(04):399-404.
[Google Scholar]

[13] Mittal N, Parashar V. Regenerative evaluation of immature roots using prf and artificial scaffolds in necrotic permanent teeth: a clinical study. J Contemp Dent Pract. 2019;20(06):720-726.
[Google Scholar]

[14] Lv H, Chen Y, Cai Z, et al.. The efficacy of platelet-rich fibrin as a scaffold in regenerative endodontic treatment: a retrospective controlled cohort study. BMC Oral Health. 2018;18(01):139.
[Google Scholar]

[15] Kiran K N, Mukunda S K, Tilak Raj N T. Platelet concentrates: a promising innovation in dentistry. J Dent Sci Res. 2011;2:50-61.
[Google Scholar]

[16] Gupta V, Bains K B, Singh P G, Mathur A, Bains R. Regenerative potential of platelet rich fibrin in dentistry: Literature review. Asian J Oral Health Allied Sci. 2011;1:22-28.
[Google Scholar]

[17] Miron J R, Fujioka-Kobayashi M, Bishara M, Zhang Y, Hernandez M, Choukroun J. Platelet-rich fibrin and soft tissue wound healing: a systematic review. Tissue Eng Part B Rev. 2017;23(01):83-99.
[Google Scholar]

[18] Keswani D, Pandey K R. Revascularization of an immature tooth with a necrotic pulp using platelet-rich fibrin: a case report. Int Endod J. 2013;46(11):1096-1104.
[Google Scholar]

[19] Lauricella M A. Fibrin network variability. Acta Bioquim Clin Latinoam. 2007;41:7-19.
[Google Scholar]

[20] Bakshi C, Bogra P, Singh V S, Gupta S, Makhija C. PRF in vital pulp therapy: case report. Baba Farid Univ Dent J. 2017;7(01):61-66.
[Google Scholar]

[21] Dou L, Yan Q, Yang D. Effect of five dental pulp capping agents on cell proliferation, viability, apoptosis and mineralization of human dental pulp cells. Exp Ther Med. 2020;19(03):2377-2383.
[Google Scholar]

[22] Maniyar N, Sarode S G, Sarode C S, Shah J. Platelet-Rich fibrin: A “wonder material” in advanced surgical dentistry. Medical Journal of Dr. DY Patil Vidyapeeth. 2018;11(04):287.
[Google Scholar]

[23] Agrawal M, Agrawal V. Platelet rich fibrin and its applications in dentistry-A review article. Natl J Med Dent Res. 2014;2(03):51.
[Google Scholar]

[24] Preeja C, Arun S. Platelet-rich fibrin: Its role in periodontal regeneration. Saudi J Dent Res. 2014;5(02):117-122.
[Google Scholar]

[25] Ghanaati S, Herrera-Vizcaino C, Al-Maawi S, et al.. Fifteen years of platelet rich fibrin in dentistry and oromaxillofacial surgery: how high is the level of scientific evidence? J Oral Implantol. 2018;44(06):471-492.
[Google Scholar]

[26] Singer J A, Clark A R. Cutaneous wound healing. N Engl J Med. 1999;341(10):738-746.
[Google Scholar]

[27] Laurens N, Koolwijk P, de Maat P M. Fibrin structure and wound healing. J Thromb Haemost. 2006;4(05):932-939.
[Google Scholar]

[28] Girish Rao S, Bhat P, Nagesh S K, et al.. Bone regeneration in extraction sockets with autologous platelet rich fibrin gel. J Maxillofac Oral Surg. 2013;12(01):11-16.
[Google Scholar]

[29] Del Corso M, Toffler M, Dohan Ehrenfest M D. Use of an autologous leukocyte and platelet-rich fibrin (L-PRF) membrane in post-avulsion sites: an overview of Choukroun's PRF. J Implant Adv Clin Dent. 2010;1:27-35.
[Google Scholar]

[30] Bansal S, Garg A, Khurana R, Chhabra P. Platelet-rich fibrin or platelet-rich plasma–which one is better? an opinion. Indian J Dent Sci. 2017;9(05):49.
[Google Scholar]

[31] Choukroun J, Diss A, Simonpieri A, et al.. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(03):e56-e60.
[Google Scholar]

[32] Sehgal M, Puri L, Yadav S, et al.. Immediate dental implants enriched with L-PRF in the esthetic zone. Case Rep Dent. 2018;2018:9867402.
[Google Scholar]

[33] Huang M F, Yang F S, Zhao H J, Chang C Y. Platelet-rich fibrin increases proliferation and differentiation of human dental pulp cells. J Endod. 2010;36(10):1628-1632.
[Google Scholar]

[34] Clipet F, Tricot S, Alno N, et al.. In vitro effects of Choukroun's platelet-rich fibrin conditioned medium on 3 different cell lines implicated in dental implantology. Implant Dent. 2012;21(01):51-56.
[Google Scholar]

Clinical Application of Platelet-Rich Fibrin in Pediatric Dentistry

Abstract

Keywords

apexogenesis

direct pulp capping

regenerative endodontics

scaffolds

platelet-rich plasma

Introduction

Platelet-rich Fibrin

Preparation of PRF

Constituents of PRF

Mechanism of Action

Uses of PRF in Pediatric Dentistry

As Medicament in Pulpotomy

In Apexogenesis of Young Permanent Teeth

As a Pulp Capping Material

For Surgical or Extraction Wound Closure

Limitation of PRF in Pediatric Dentistry

Advantages of PRF

Disadvantages of PRF

Conclusion

Conflict of Interest

References

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