Numerous studies have demonstrated the therapeutic effect of autologous platelet-rich plasma in the bone and soft tissues healing process after reconstructive surgery in dentistry. The high therapeutic efficacy of the treatment is combined with the simplicity of platelets concentrate getting with the help of differential centrifugation of whole blood.
One of the latest advances in dentistry is the use of platelet gel (PG) for improving the process of soft and hard tissues healing after surgery. PG accelerates the healing and recovery processes in a case of refractory generalized aggressive periodontitis, reconstructive oral and maxillofacial surgery (eg, sinus lifting), surgical reconstruction of alveolar clefts, oral-antral and oral-nasal fistulas and osteo-integrated implants installation. The efficiency of the PG for soft tissue healing process and free connective transplant epithelialization, manipulations with muco-periosteal flap and soft tissues enhancing in cosmetic interventions into the oral cavity is shown.
The final PG product contains 3-5 times more platelets than a normal blood does (up to 1 million platelets in 1 ml of plasma), which increases the concentration of natural growth factors produced by platelets, stimulates angiogenesis, attracts undifferentiated stem cells into the damaged area and starts the process of cell division involved into the process of tissue regeneration. The platelet-rich plasma contains platelet-derived growth factor (PDGF), transforming growth factor (TGF), vascular endothelial growth factor (VEGF), epithelial growth factor (EGF) and adhesion molecules (fibrin, fibronectin, vitronectin). PG fibrin component provides the bone material particle binding and contributes osteo-conduction through special network forming, which performs the role of the skeleton that supports the growth of new bone. The combination of these factors helps to reduce the time of bone tissue growth and maturation.
Advantages of PG usage are safety (no risk of infectious disease getting or immunogenic reactions appearing) and non-invasiveness of the procedure itself, growth factors and cytokines directly in wound area delivery, speed and simplicity of PG drug preparation.
Fort PG obtaining, just before the surgery 45-60 ml of blood is taken from the patient into the syringe, which contains the anticoagulant citrate-based dextrose. The blood is fractionated by two-fold centrifugation. As a result of the first cycle of centrifugation, red blood cells at a low speed are separating from white blood cells, platelets, and platelet-poor plasma. At this stage, we obtain plasma drug with the low platelets' concentration. For platelet concentrate obtaining the repeated centrifugation of plasma fraction is required. Platelet-rich plasma is kept sterile in its liquid form within 8 hours, so that it can be used for and during long surgical procedures.
Platelet activation occurs by intermixing of 7 ml of platelet concentrate with 1 ml of a mixture, which contains 5000ED of bovine topical thrombin and 10% of calcium chloride solution, plus 1 ml of air, which is required for vesicles involved into the mixing process formation. After 10 seconds of shaking the material acquires the consistency of a viscous gel which is injected into the wound, cut or is put on the bone material. During the first 10 minutes, platelets secrete about 70% of growth factors, which are contained in them, with the following complete release of these growth factors within an hour. Platelet gel remains active during about 8 days, after which the platelets are dying out. The PG usage accelerates the healing of soft tissues and promotes a rapid mineralization of the newly emerging bone.
Not every centrifuge is suitable for PG getting. Ideal for such a purpose is an automated installation of SmartPReP double centrifugation, in which the container with blood is exposed to two-fold centrifugation under sterile conditions without opening the container before the stage of platelet-rich plasma intake starts. A cheaper but less effective alternative way is the use of laboratory centrifuges, which are also differ in their capabilities according to terms of efficiency of whole blood differential centrifugation.
One of the latest advances in dentistry is the use of platelet gel (PG) for improving the process of soft and hard tissues healing after surgery. PG accelerates the healing and recovery processes in a case of refractory generalized aggressive periodontitis, reconstructive oral and maxillofacial surgery (eg, sinus lifting), surgical reconstruction of alveolar clefts, oral-antral and oral-nasal fistulas and osteo-integrated implants installation. The efficiency of the PG for soft tissue healing process and free connective transplant epithelialization, manipulations with muco-periosteal flap and soft tissues enhancing in cosmetic interventions into the oral cavity is shown.
The final PG product contains 3-5 times more platelets than a normal blood does (up to 1 million platelets in 1 ml of plasma), which increases the concentration of natural growth factors produced by platelets, stimulates angiogenesis, attracts undifferentiated stem cells into the damaged area and starts the process of cell division involved into the process of tissue regeneration. The platelet-rich plasma contains platelet-derived growth factor (PDGF), transforming growth factor (TGF), vascular endothelial growth factor (VEGF), epithelial growth factor (EGF) and adhesion molecules (fibrin, fibronectin, vitronectin). PG fibrin component provides the bone material particle binding and contributes osteo-conduction through special network forming, which performs the role of the skeleton that supports the growth of new bone. The combination of these factors helps to reduce the time of bone tissue growth and maturation.Advantages of PG usage are safety (no risk of infectious disease getting or immunogenic reactions appearing) and non-invasiveness of the procedure itself, growth factors and cytokines directly in wound area delivery, speed and simplicity of PG drug preparation.
Fort PG obtaining, just before the surgery 45-60 ml of blood is taken from the patient into the syringe, which contains the anticoagulant citrate-based dextrose. The blood is fractionated by two-fold centrifugation. As a result of the first cycle of centrifugation, red blood cells at a low speed are separating from white blood cells, platelets, and platelet-poor plasma. At this stage, we obtain plasma drug with the low platelets' concentration. For platelet concentrate obtaining the repeated centrifugation of plasma fraction is required. Platelet-rich plasma is kept sterile in its liquid form within 8 hours, so that it can be used for and during long surgical procedures.Platelet activation occurs by intermixing of 7 ml of platelet concentrate with 1 ml of a mixture, which contains 5000ED of bovine topical thrombin and 10% of calcium chloride solution, plus 1 ml of air, which is required for vesicles involved into the mixing process formation. After 10 seconds of shaking the material acquires the consistency of a viscous gel which is injected into the wound, cut or is put on the bone material. During the first 10 minutes, platelets secrete about 70% of growth factors, which are contained in them, with the following complete release of these growth factors within an hour. Platelet gel remains active during about 8 days, after which the platelets are dying out. The PG usage accelerates the healing of soft tissues and promotes a rapid mineralization of the newly emerging bone.
Not every centrifuge is suitable for PG getting. Ideal for such a purpose is an automated installation of SmartPReP double centrifugation, in which the container with blood is exposed to two-fold centrifugation under sterile conditions without opening the container before the stage of platelet-rich plasma intake starts. A cheaper but less effective alternative way is the use of laboratory centrifuges, which are also differ in their capabilities according to terms of efficiency of whole blood differential centrifugation.