Antimicrobial effects of platelet rich fibrin: A systematic review on current evidence of research

Balaji, VR; Thiagarajan, Rama Krishnan; Niazi, Thanvir Mohamed; Ulaganathan, G; Manikandan, Dinesh Babu

doi:10.4103/jid.jid_66_20

Cited by 7 publications

(8 citation statements)

References 22 publications

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“…The proportion of leukocytes in PRF decreases as centrifugation force increases (i-PRF: lower centrifugation force and high proportion of leukocytes, PRF: higher centrifugation force and thus lower proportion of leukocytes) [ 10 ]. This could explain why PRP and i-PRF have an antimicrobial effect in these previous studies, but PRF without previous ampicillin/sulbactam treatment demonstrated no such antimicrobial effect in our study [ 16 , 17 , 31 ].…”

Section: Discussioncontrasting

confidence: 50%

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Evaluation of advanced platelet-rich fibrin (PRF) as a bio-carrier for ampicillin/sulbactam

et al. 2022

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Objectives Mechanisms of wound healing are often impaired in patients with osteonecrosis of the jaw (ONJ). According to the guidelines for the treatment of this disease, early surgical intervention is indicated. However, surgery often faces complications such as wound healing disorders. The application of platelet-rich fibrin (PRF) after necrosectomy between bone and mucosa may constitute a promising approach to improve surgical results. An aspect that was not investigated until now is that PRF acts as a “bio-carrier” for antibiotics previously applied intravenously. Materials and methods We investigated the antimicrobial properties of PRF in 24 patients presenting ONJ undergoing systemic antibiosis with ampicillin/sulbactam. We measured the concentration of ampicillin/sulbactam in plasma and PRF and performed agar diffusion tests. Ampicillin/sulbactam was applied intravenously to the patient 10 minutes for blood sampling for PRF. No further incorporation of patients’ blood or PRF product with antibiotic drugs was obtained. Four healthy patients served as controls. Results Our results revealed that PRF is highly enriched with ampicillin/sulbactam that is released to the environment. The antibiotic concentration in PRF was comparable to the plasma concentration of ampicillin/sulbactam. The inhibition zone (IZ) of PRF was comparable to the standard ampicillin/sulbactam discs used in sensitivity testing. Conclusions The results of our study demonstrated that PRF is a reliable bio-carrier for systemic applied antibiotics and exhibits a large antimicrobial effect. Clinical relevance We describe a clinically useful feature of PRF as a bio-carrier for antibiotics. Especially when applied to poorly perfused tissues and bone such as in ONJ, the local release of antibiotics can reduce wound healing disorders like infections.

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Section: Discussioncontrasting

confidence: 50%

“…Even though the full effect mechanism is not yet fully understood, PRF has been demonstrated to possess antimicrobial features without additional work-up or preparation [15][16][17]. Studies have demonstrated that PRF has a bactericidal and growth-inhibiting effect against both biofilm-forming and periodontal microorganisms.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of advanced platelet-rich fibrin (PRF) as a bio-carrier for ampicillin/sulbactam

et al. 2022

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Section: Introductionmentioning

confidence: 99%

“…The use of low-speed centrifugation to obtain new types of PRF has previously been explored, having the advantage of producing a high number of cells such as leukocytes [ 8 ]. I-PRF (injectable PRF) is available in injectable form and coagulates a few minutes after injection [ 2 ] while A-PRF+ (advanced PRF) has shown superior properties when compared with standard PRF [ 8 ]. These two types of PRF have great potential for further clinical application because they are simple to prepare and use and do not require the addition of anticoagulants [ 6 ] and also have an enriched antimicrobial content [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…These two types of PRF have great potential for further clinical application because they are simple to prepare and use and do not require the addition of anticoagulants [ 6 ] and also have an enriched antimicrobial content [ 7 ]. A-PRF has outstanding advantages, including the increased release of proteins and growth factors, proliferation of fibroblasts, its ability to migrate, and expression of growth factors [ 8 ]. I-PRF contains various components such as antimicrobial proteins, complement binding proteins, and antimicrobial peptides [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Antimicrobial Activity against Porphyromonas gingivalis between Advanced Platelet-Rich Fibrin and Injectable Platelet-Rich Fibrin

Pham

2023

International Journal of Biomaterials

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Platelet-rich fibrin (PRF) obtained via low-speed centrifugation has antimicrobial properties. This study was conducted to evaluate the effectiveness of advanced platelet-rich fibrin plus (A-PRF+) and injectable platelet-rich fibrin (I-PRF), obtained from patients with different periodontal states, against Porphyromonas gingivalis. A-PRF+ and I-PRF samples were obtained from venous blood of 60 subjects divided equally into three groups: periodontitis, gingivitis, and healthy gingiva groups. The antibacterial experiments evaluated biofilm inhibition, mature biofilm impact, and time-kill kinetics. The percent reduction in biofilm-growing and mature biofilm bacteria ranged from 39% to 49% and 3% to 7%, respectively. In the time-kill kinetics assay, PRF from the periodontitis group was more effective as an antimicrobial than that from the gingivitis and healthy gingiva group ( p < 0.001 ); I-PRF was more effective than A-PRF+ ( p < 0.05 ) and both of them showed peak antibacterial activity after 12 h of exposure. Both A-PRF+ and I-PRF exhibited antibacterial properties against P. gingivalis, but I-PRF appeared to be more effective. The PRF obtained from the different groups appeared to have different degrees of antimicrobial efficacy.

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Investigation of three common centrifugation protocols for platelet-rich fibrin (PRF) as a bio-carrier for ampicillin/sulbactam: a prospective trial

Straub,

Utz,

Stapf

et al. 2023

Clin Oral Invest

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Objectives Different platelet-rich fibrin (PRF) protocols exist and are known to differ in resulting mechanical and bioactive properties. Centrifugation parameters may also influence drug release, in particular antibiotics, when using PRF as a bio-carrier. We thus evaluated three common protocols regarding effects on the bio-carrier properties. Materials and methods In a prospective trial comprising 33 patients, we compared different protocols for PRF as a bio-carrier for ampicillin/sulbactam (SAM). Blood samples were taken shortly after a single dose of ampicillin/sulbactam (2 g/1 g) was administered to patients intravenously. PRF was obtained by centrifugation and three protocols were used: protocol A (1300 rpm, 8 min, RCF-max = 208 g), B (2300 rpm, 12 min, RCF-max = 652 g), and C (1500 rpm, 14 min, RCF-max = 276 g). The antibacterial activity of PRF was investigated against five oral species in vitro, based on agar diffusion methodology. Results The study demonstrates that a single dose of SAM is sufficient to reach high concentrations in PRF in all protocols (150 µg/ml), which is comparable to the plasma SAM concentration. Antibacterial activity was inferred from the diameter of inhibition zones seen in agar diffusion tests using PRF discs. Protocol B resulted in the largest inhibition zones. One-way ANOVA revealed statistically improved results for protocol B for some bacteria. Conclusions The study provides valuable data on PRF antibiotic enrichment, notably SAM. A single dose of SAM is sufficient to reach clinically relevant concentrations in PRF. Clinical relevance These findings potentially extend the application of PRF, for example in patients with osteonecrosis of the jaw or in oral surgery (e.g., stick bone).

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Antimicrobial effects of platelet rich fibrin: A systematic review on current evidence of research

Cited by 7 publications

References 22 publications

Evaluation of advanced platelet-rich fibrin (PRF) as a bio-carrier for ampicillin/sulbactam

Evaluation of advanced platelet-rich fibrin (PRF) as a bio-carrier for ampicillin/sulbactam

Comparison of Antimicrobial Activity against Porphyromonas gingivalis between Advanced Platelet-Rich Fibrin and Injectable Platelet-Rich Fibrin

Investigation of three common centrifugation protocols for platelet-rich fibrin (PRF) as a bio-carrier for ampicillin/sulbactam: a prospective trial

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