Influence of periodontitis and diabetes on structure and cytokine content of platelet‐rich fibrin

Abstract

BackgroundPlatelet‐rich fibrin (PRF) is a second‐generation platelet concentrate with multiple applications in wound healing and regeneration in both periodontitis and diabetes. However, the three dimensional (3‐D) structure and cytokine content of PRF might be altered in patients suffering from either/both of the chronic inflammatory conditions, ultimately influencing the efficacy of PRF as a biomaterial for regenerative medicine.AimThe aim of the present study was hence to evaluate the effect of both these chronic inflammatory diseases on the 3‐D structure of PRF membrane. An attempt was also made to compare the growth factor content between the plasma and RBC ends of the prepared PRF gel.Materials & MethodsL‐PRF was prepared for twenty participants, healthy (5), periodontitis (5), T2DM (5) and T2DM with periodontitis (5). Porosity and fiber diameter of PRF membranes was visualized under FE‐SEM and measured using ImageJ Software. PDGF‐BB and TGF‐β1 levels in PRF gel were assessed by ELISA.ResultsThe average diameter of fibrin fibers under FE‐SEM was 0.15 to 0.30 micrometers. Porosity was higher at the plasma end (p = 0.042). Red blood cell (RBC) end of the membrane had thinner fibers arranged in a comparatively more dense and compact structure with smaller porosities. Healthy subjects had the least porous PRF compared to subjects with either/both of the chronic conditions. PDGF‐BB levels were similar along all the four groups. TGF‐β1 levels were highest in healthy subjects.Discussion3‐D structure and growth factor content of PRF are influenced by a person's periodontal and/or diabetic status. The RBC end of the PRF membrane, as compared to the plasma end, has thinner fibers arranged in a comparatively more dense and compact structure with smaller porosities, and hence should be favored during periodontal regenerative procedures.ConclusionBoth periodontitis and diabetes have a significant influence on the 3‐D structure and growth factor content of PRF produced.

Clinical benefits of autologous platelet concentrate in periodontal intrabony defects: A network meta‐analysis of randomized controlled trials

“…The characteristics of autologous platelet concentrate are influenced by the age, health and nutrition status, autoimmunity, and genetic susceptibility of the individuals from which it originates [112, 113]. There is evidence showing that diabetes mellitus has an influence on the structure of platelet‐rich fibrin [112].…”

Quantitative Association of Platelet-Rich Fibrin (PRF) and Hyperacute Serum (HAS) with Glycemic Control (HbA1c) in Chronic Periodontitis Patients: An Ex vivo Study

“…[ 21 ] Gupta et al . [ 22 ] in a recent study proposed that PRF structure and cytokine profile may have been altered in patients suffering from periodontitis and diabetes.…”

“…[ 27 , 28 ] However, studies have suggested that the reduced or compromised wound healing capacity in uncontrolled diabetic patients may be due to a reduction in growth factors and prolonged inflammatory responses due to increased proinflammatory cytokines in T2DM patients. [ 22 , 29 , 30 ] Thus, a modification in the protocol (rpm and time) for obtaining PRF in diabetic patients may be investigated. Recently, Surmeli Baran et al .…”