The impact of leukocyte and platelet rich fibrin on regenerative endodontic healing

Preservation and restoration of the natural dentition have long been the goal of dental care, especially in immature teeth which became necrotic. However, a persistent peri-radicular infection, despite an adequate endodontic therapy, can threaten the survival of a tooth. To accelerate tissue healing, autologous platelet-rich preparations have been evaluated with encouraging results (Marx, 2004; Wirz et al., 2011). We can divide these platelet concentrates in 2 groups: the first generation platelet-rich plasma (PRP) and the second generation platelet rich fibrin (PRF). PRF is a simple technique developed in France by Dr. Choukroun in 2001 for specific use in oral and maxillofacial surgery. This technique requires neither anticoagulant nor bovine thrombin. It is nothing more than centrifuged autologous blood without any addition. Leukocyte and platelet rich fibrin (L-PRF) has a number of potential advantages: it creates a bioactive construct that stimulates the local environment for differentiation and proliferation of stem and progenitor cells (Dohan et al., 2006, Part II). Furthermore, it acts as an immune regulation node with inflammation retrocontrol abilities, such as slow continuous release of growth factors over a period of 7-14 day (Dohan and Choukroun, 2006, Part III). 
This is an interesting project in which the effect of L-PRF is being studied in the endodontic field. More specifically, the impact of L-PRF on the post-operative healing in regenerative endodontic treatment and endodontic microsurgery is being investigated. 
References: 
- Marx RE. Platelet-rich plasma: evidence to support its use. J OralMaxillofac Surg. 2004;62:489-96.
- Wirz S, Dietrich M, Flanagan TC, Bokermann G, Wagner W, Schmitz-Rode T, Jockenhoevel S. Influence of platelet-derived growth factor-AB on tissue development in autologous platelet-rich plasma gels. Tissue Eng Part A. 2011;17:1891-9.
- Choukroun J, Adda F, Schoeffler C. Uneopportunitéenparo-implantologie: le PRF. Implantodontie. 2001;42:55-62.
- Dohan DM, Choukroun J. Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part II: Platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 2006;101:E45-50.
- Dohan DM, Choukroun J. Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part III: Leucocyte activation: A new feature for platelet concentrates?Oral SurgOral Med Oral PatholOral RadiolEndod.2006;E51-55.