Journal of Oral Implantology August 2014 - (Page 511)

LITERATURE REVIEW Platelet-Rich Preparations to Improve Healing. Part II: Platelet Activation and Enrichment, Leukocyte Inclusion, and Other Selection Criteria Vicki L. Davis, PhD1* Alaeddin B. Abukabda, MS2 Nicholas M. Radio, PhD3 Paula A. Witt-Enderby, PhD4 William P. Clafshenkel, PhD4 J. Vito Cairone, BS2 James L. Rutkowski, DMD, PhD3,5 Multiple platelet-rich preparations have been reported to improve wound and bone healing, such as plateletrich plasma (PRP) and platelet rich fibrin (PRF). The different methods employed during their preparation are important, as they influence the quality of the product applied to a wound or surgical site. Besides the general protocol for preparing the platelet-rich product (discussed in Part 1 of this review), multiple choices need to be considered during its preparation. For example, activation of the platelets is required for the release and enmeshment of growth factors, but the method of activation may influence the resulting matrix, growth factor availability, and healing. Additionally, some methods enrich leukocytes as well as platelets, but others are designed to be leukocyte-poor. Leukocytes have many important roles in healing and their inclusion in PRP results in increased platelet concentrations. Platelet and growth factor enrichment reported for the different types of platelet-rich preparations are also compared. Generally, TGF-b1 and PDGF levels were higher in preparations that contain leukocytes compared to leukocyte-poor PRP. However, platelet concentration may be the most reliable criterion for comparing different preparations. These and other criteria are described to help guide dental and medical professionals, in large and small practices, in selecting the best procedures for their patients. The healing benefits of platelet-rich preparations along with the low risk and availability of simple preparation procedures should encourage more clinicians to incorporate platelet-rich products in their practice to accelerate healing, reduce adverse events, and improve patient outcomes. Key Words: bovine thrombin, growth factors, leukocytes, platelet activation, platelet-rich plasma, wound healing INTRODUCTION 1 Center for Applied Research & Intellectual Property Development, Clarion University, Clarion, Pa. 2 Biology Department, Clarion University, Clarion, Pa. 3 Clarion Research Group, Clarion, Pa. 4 Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, Pa. 5 Private Practice, Clarion, Pa. * Corresponding author, e-mail: dr.vicki.davis@gmail.com DOI: 10.1563/AAID-JOI-D-12-00106 A utologous platelet-rich plasma (PRP) was first developed in the early 1970s, but its use was rarely reported until after the 1980s. Historically, PRP was mixed with thrombin and excess calcium resulting in activated platelets trapped within the fibrin network; within the matrix, platelets secrete bioactive substances that slowly Journal of Oral Implantology 511

Table of Contents for the Digital Edition of Journal of Oral Implantology August 2014

Helping, Rather Than Criticizing, a Colleague May Lead to a Lifetime of Referrals
Utilization of Ethyl Cyanoacrylate and 2-Octyl Cyanoacrylate Adhesives for Autogenous Bone Graft Fixation: Histomorphometric Study in Rats
Conventional Versus Implant-Retained Overlay Dentures: A Pilot Study of Masseter and Anterior Temporalis Electromyography
Axial Relationship Between Dental Implants and Teeth/Implants: A Radiographic Study
The Effect of Dynamic Loading on Bacterial Colonization of the Dental Implant Fixture–Abutment Interface: An In Vitro Study
Longitudinal Implant Stability Measurements Based on Resonance Frequency Analysis After Placement in Healed or Regenerated Bone
A Clinical Report on the Use of Closed-Tray, Hex-Lock-Friction-Fit Implant Impression Copings
Immediate Restoration of NobelActive Implants Placed Into Fresh Extraction Sites in the Anterior Maxilla
Clinical Study of Flap Design to Increase the Keratinized Gingiva Around Implants: 4-Year Follow-Up
Use of Subepithelial Connective Tissue Graft as a Biological Barrier: A Human Clinical and Histologic Case Report
Calvarial Autogenous Bone Graft for Maxillary Ridge and Sinus Reconstruction for Rehabilitation With Dental Implants
Staged Ridge Splitting Technique for Horizontal Expansion in Mandible: A Case Report
An Overview of Zirconia Dental Implants: Basic Properties and Clinical Application of Three Cases
Dental Gypsum Verification Jig to Verify Implant Positions: A Clinical Report
Platelet-Rich Preparations to Improve Healing. Part I: Workable Options for Every Size Practice
Platelet-Rich Preparations to Improve Healing. Part II: Platelet Activation and Enrichment, Leukocyte Inclusion, and Other Selection Criteria

Journal of Oral Implantology August 2014