Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
The Miron Research Lab, Fort Lauderdale, FL, USA.
Clin Oral Investig. 2019 May;23(5):2179-2185. doi: 10.1007/s00784-018-2673-x. Epub 2018 Oct 2.
Platelet-rich fibrin (PRF) has been utilized in regenerative dentistry as a supra-physiological concentrate of autologous growth factors capable of stimulating tissue regeneration. Due to the variability in the macroscopic morphology/size of PRF membranes observed between patients, we were interested in studying the effects of patient age, gender, and time between blood draw and the start of centrifugation on the size outcomes of PRF membranes. Despite PRF therapy being increasingly more popular in private practice, to date, no study has investigated the effects of the delay between blood draw and the start of centrifugation in a clinical setting.
A total of 60 patients enrolled in this study were divided into 6 groups of 10 patients each, including male and female patients categorized into age groups 21-40, 41-60, and 61-80 years. From each patient, a total of five PRF membranes were fabricated from 10-mL tubes following centrifugation starting after 0, 30, 60, 90, and 120 s. In total, 300 PRF membranes were produced in this study to investigate the effects of patient age, gender, and time on the size outcomes of PRF membranes.
A longer delay by the clinician before starting centrifugation following blood draw led to a smaller final size of PRF membranes. At 90 s following blood draw, a significant (13%) reduction in PRF membrane size was observed. After 120 s, a significant (23%) reduction was observed. Additionally, female patients had on average 17% larger membranes compared to men (p < 0.05, 300 samples). Lastly, the size outcomes of the PRF membranes was largest in patients aged 61-80, followed by those aged 41-60 and 21-40. However, no statistically significant differences in PRF membrane sizes were reported between age groups.
The time at which a centrifugation procedure begins following blood draw is critical to optimize the size outcomes of PRF membranes. In general, approximately 15 s is required per tube to harvest 9-10 cc of blood. Therefore, a 60- to 90-s interval between blood draw and the start of centrifugation should be a parameter that is respected by clinicians to avoid significant changes in the macroscopic morphology/size of fabricated PRF membranes. Furthermore, females and older patients produced larger membranes, likely due to lower red blood cell counts derived from their peripheral blood.
The findings from the present study demonstrate that on average, a clinician has approximately 60-90 s between blood draw and the start of the centrifugation cycle to produce standard-sized PRF membranes. Shortly thereafter, a significant reduction in size is observed. Additionally, females and older patients were found to produce larger PRF membranes. Centrifugation protocols may therefore be adapted accordingly.
富含血小板纤维蛋白 (PRF) 已被用于再生牙科领域，作为一种超生理浓度的自体生长因子，能够刺激组织再生。由于患者之间 PRF 膜的宏观形态/大小存在差异，我们有兴趣研究患者年龄、性别以及采血与离心开始之间的时间对 PRF 膜大小结果的影响。尽管 PRF 治疗在私人诊所中越来越受欢迎，但迄今为止，尚无研究在临床环境中研究采血与离心开始之间的延迟对 PRF 膜的影响。
本研究共纳入 60 名患者，分为 6 组，每组 10 名患者，包括男性和女性患者，分为 21-40 岁、41-60 岁和 61-80 岁年龄组。从每位患者中，使用从 10-mL 管中获得的总共 5 个 PRF 膜，离心后开始离心，分别延迟 0、30、60、90 和 120 秒。在这项研究中总共产生了 300 个 PRF 膜，以研究患者年龄、性别和时间对 PRF 膜大小结果的影响。
临床医生在采血后开始离心之前的延迟时间越长，PRF 膜的最终尺寸越小。在采血后 90 秒时，PRF 膜的尺寸显著减少（13%）。120 秒后，观察到明显减少（23%）。此外，与男性相比，女性患者的膜平均大 17%（p<0.05，300 个样本）。最后，61-80 岁患者的 PRF 膜大小最大，其次是 41-60 岁和 21-40 岁患者。然而，各组之间 PRF 膜大小没有统计学差异。
采血后开始离心的时间对于优化 PRF 膜的大小结果至关重要。通常，每个管需要大约 15 秒才能采集 9-10cc 的血液。因此，采血与离心开始之间应保持 60-90 秒的间隔，临床医生应遵守该参数，以避免制造的 PRF 膜宏观形态/尺寸发生显著变化。此外，女性和老年患者产生的膜较大，可能是由于其外周血中的红细胞计数较低。
本研究结果表明，平均而言，临床医生在采血与离心循环开始之间有大约 60-90 秒的时间来产生标准大小的 PRF 膜。此后不久，观察到尺寸明显减小。此外，发现女性和老年患者产生的 PRF 膜较大。因此，可以相应地调整离心方案。
