04 January 2023

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Blood components for non-transfusion use in oral surgery

By Davide Bencivenni, Pierantonio Bellini, Camilla Garuti, Ugo Consolo

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In dentistry, platelet concentrates are used in situations where tissue regeneration is required, with the aim of restoring and regenerating tissue altered or destroyed by pathologies or surgical trauma in a shorter time.

These are autologous products obtained with a minimal amount of venous blood, through manipulation with closed circuit systems. Among them, L-PRF has a safe and promising use in the dental field. It can be used alone or together with other graft materials according to the needs and is, due to its peculiarities, the most used among the blood components in oral surgery.

This article aims to define a complete picture of the current clinical applications of L-PRF and to share preliminary clinical cases.

Materials and Methods

Three clinical cases of oral surgery were performed, selected among the possible fields of application of L-PRF to date established in the literature, at the U.O. Gold Maxillofacial Surgery of the Polyclinic of Modena.

• Case 1: patient treated for dysodontiasis of 3.8; this element has a sagittal inclination greater than 50° and a considerable impact on the left second molar. These clinical conditions could lead, with a high probability, to periodontal damage for 3.7. For this, surgical extraction of the third molar was performed and L-PRF placement in the post-extraction socket.
• Case 2: exeresis of an inflammatory odontogenic cystic lesion in the premaxilla and filling of the defect with L-PRF associated with deproteinized heterologous bovine material to favor bone regeneration of the defect. L-PRF membranes were placed in the buccal portion of the defect.
• Case 3: treatment of bisphosphonate-induced osteonecrosis in which, following sequestrectomy and extensive curettage of the lesion, LLPRF membranes were inserted into the site of the sequestrum to fill the residual defect. In this case the blood component was used to bring a supra-physiological quantity of growth factors to the site of the operation and to stimulate neoangiogenesis, thus promoting bone healing but also the formation of a good mucous seal.

Results

Each with its own peculiarities, the patients treated did not report any swelling or post-operative pain. Clinical courses at 7 days appeared regular, with no signs and symptoms of infection or inflammation. In the controls performed at 6 months, the mucous seals were correctly maintained and radiographically the new bone formation already appeared in good condition.

Conclusions

From the cases performed by the authors, for the moment only a clinical impression can be deduced on which to make considerations from which to start for experimental studies on the application of L-PRF in different clinical situations. From this, in the future its role in oral surgery could be effectively clarified to be able to give the clinician guidelines regarding its use.

Clinical significance

Non-transfusion blood products, especially L-PRF, may be candidates for tissue regeneration. In the not-too-distant future, they could make it possible to reduce the use of heterologous biomaterials in favor of a completely autologous material, at reduced cost and potentially very effective. Furthermore, associated with biomaterial, it can enhance its effectiveness and make it more manageable by the surgeon himself.

This article appeared originally in Dental Cadmos: https://www.dentalcadmos.com/emocomponenti-a-uso-non-trasfusionale-in-chirurgia-orale/