PDGF-BB Release Profile Following the Use of Platelets Rich Fibrin (PRF) and Plasma Rich Growth Factors (PRGF) In Treating Periodontal Intrabony Defects

Abstract

Clinicians are frequently faced with the challenge of treating patients with significant alveolar bone loss due to periodontal disease, congenital abnormalities, tumors, traumatic injury, or resorption secondary to tooth loss. Conventional treatment procedures may be ineffective in achieving bone regeneration, leaving both the clinician and the patient dissatisfied with the outcome. Growth factors (GFs) have long been believed to have the potential to accelerate the healing process and, therefore, enhance tissue regeneration in challenging clinical scenarios. GFs are natural biological mediators that regulate key cellular events that are part of the process of tissue repair and regeneration. After binding of GFs to specific cell membrane receptors of target cells, intracellular signaling pathways are induced, which typically resultsin the activation of genes that may ultimately change cellular activity and phenotype. However, the effect of each GF is regulated through a complex system of feedback loops, which involve other GFs, enzymes, and binding proteins. Recent advances in the areas ofcellular and molecular biology allowed better understanding of the functions of GFs andtheir participation in the different phases of wound healing. In vitroand in vivostudies haveconfirmed that GFs can enhance the capacity of tissues to regenerate by regulating cell chemoattraction, differentiation and proliferation. (Zaho et al 2004, Ripamonti et al 2005).One of the most extensively studied GFs is platelet-derived growth factor (PDGF). Thisgrowth factor has been well characterized and has broad wound healing activities in bothhard (bone) and soft (skin, gingival) tissue. Recently, a combination of purified recombinanthuman PDGF (rhPDGF) with synthetic ceramic matrices

(beta-tricalcium phosphate [β-TCP]) has been proposed as a periodontal regenerative agent. The efficacy of growth factorenhanced matrices in periodontal therapies has been rigorously examined in a variety ofpreclinical animal models and long-term human clinical studies. Novel tissue engineering techniques have been developed to regenerate bone in challenging defect sites, where spontaneous repair is not achievable. (Lynch et al 2005).