Platelet rich fibrin is not a barrier membrane! Or is it?

Abstract

Platelet-rich fibrin (PRF) is widely used in dentistry and other fields of medicine, and its use has become popular in dental implantology. In several published studies, PRF has been used as a barrier membrane. A barrier membrane is a sheet of a certain material that acts as a biological and mechanical barrier against the invasion of cells that are not involved in bone formation, such as epithelial cells. Among the basic requirements of a 'barrier membrane, occlusivity, stiffness, and space maintenance are the criteria that PRF primarily lacks; therefore, it does not fall under the category of barrier membranes. However, there is evidence that PRF membranes are useful in significantly improving wound healing. Does the PRF membrane act as a barrier? Should we think of adding or subtracting some points from the ideal requirements of a barrier membrane, or should we coin a new term or concept for PRF that will incorporate some features of a barrier membrane and be a combination of tissue engineering and biotechnology? This review is aimed at answering the basic question of whether the PRF membrane should be considered a barrier membrane or whether it is something more beyond the boundaries of a barrier membrane.

Microsurgical management of radicular cyst using guided tissue regeneration technique: A case report

“…Reports have shown that GTR has been implemented as an adjunct to radicular cyst enucleation and apicoectomy for enhancement of periapical tissue healing, prevention of soft tissue collapse, and improvement of treatment outcomes[ 11 , 16 , 17 ]. Full recovery of the area around the apex of a tooth includes the regeneration of alveolar bone, periodontal ligament cells and cementum.…”

“…GTR is a technique that uses a bone substitute material along with a membrane that serves both as a biological and physical shield to prevent cells that do not contribute to bone growth, such as epithelial cells, from invading the area. Moreover, GTR allows the migration of bone-forming cells from slow migration to bad sites, thereby ensuring selective cell re-population and guiding the proliferation of various tissues during the healing process[ 17 , 18 ]. Numerous studies have described this technique, with respect to the application of a wide range of materials and treatment protocols, all of which achieved clinical effectiveness.…”

“…The latter is a natural blood-derived structure associated with the immune system and platelet concentrate that exhibits several vital properties such as cell attachment, cell migration, cell proliferation, and cell differentiation. Additionally, it contains multiple growth factor-like platelet-derived growth factor, transforming growth factor β1, insulin-like growth factor, and vascular endothelial growth factor, all of which enhance stimulation of the healing of surgical wounds in big bones[ 17 ]. The PRF was also implemented as a post-enucleation membrane of a radicular cyst by Govindaraju et al [ 6 ], but without the addition of bone filler biomaterials[ 6 ].…”

“…The PRF was also implemented as a post-enucleation membrane of a radicular cyst by Govindaraju et al [ 6 ], but without the addition of bone filler biomaterials[ 6 ]. Despite the multiple and beneficial properties of PRF, its main disadvantage is that it resorbs within approximately 7-28 d, which is substantially shorter than the 4-6 wk required for most periodontal regeneration applications[ 17 ], and also shorter than the 16 to 24 wk required for bone enhancement[ 18 ]. Furthermore, its capacity to maintain space is compromised by its high rate of reabsorption[ 17 ].…”

“…Despite the multiple and beneficial properties of PRF, its main disadvantage is that it resorbs within approximately 7-28 d, which is substantially shorter than the 4-6 wk required for most periodontal regeneration applications[ 17 ], and also shorter than the 16 to 24 wk required for bone enhancement[ 18 ]. Furthermore, its capacity to maintain space is compromised by its high rate of reabsorption[ 17 ]. In the present study, the use of PRF membrane was ruled out in favor of a collagen membrane.…”