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Rani Somani, Iram Zaidi, Shipra Jaidka International Journal Of Clinical
Pediatric Dentistry, January-April 2011;4(1):69-75
Presented By: Roshni Maurya
PRP (Platelet rich plasma) :concentrated source of
autologous PLTs. Platelet concentrate APG(Autologous platelet gel) Buffy coat
GDC
Anuclear piece of cytoplasm Include hemostasis, α-granule,lysosomal granule,
dense granules
GDC
At least 7 different growth factors that stimulate bone & soft tissue healing
PDGF aa,bb,ab TGF b1,b2 VEGF EGF
GDC
Do not contain insulin-like growth factors nor BMP
Adhesion molecule fibronectin vitronectin fibrin
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Injury PLT activation Within 10 min,α-granule
migrate to the cell membrane surface and secrete growth factors ( inactive →active form)
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GDC
PLT exhausted after 7 days Macrophage by low oxygen
tension, acidity, lactate concentration
Secrete same growth factors Activated until it is down
regulated by the restoration of normal oxygen tension
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Graft is completely permeated by new capillaries
Initial osteoid formation Osteoclast resorb osteoid and
BMP released New bone formation and
maturation
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Platelet 는 cell replicaion, vascular
ingrowth,bone cell differentiation, early osteoid formation .. 등의 acativit 가 일어나도록 initiator 역할 담당함 .
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PDGF aa,bb,ab Promoting angiogenesis, re-
epithelization,formation of granulation tissue
Chemotaxis for mesenchymal cell(OB< FB,Macrophage…),monocyte,neutrophiles
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TGF β1,β2 Stimulate cell
replication similar to PDGF
Stimulate matrix production and guide differentiation towards cartilage or bone
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Most potent multifuctional regulator of bone cell metabolism(OB 에 TGF receptor 많다 .)
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Effects on endothelial cells
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Effect limited on the basal cells of skin and mucus membrane
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Inactive state
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activation
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Platelet
RBC
Normal blood PRP
4~7 times above a concentration of platelets than peripheral blood plates level
Bone mineral density 1.6~2,2 times increased
Rapid bone formation & earlier maturation.
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GDC
Native mandible Autogenous BG
PRP
Split thickness skin graft 후 donor site 의 healing 양상을 비교함
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Thrombin side : 5% epithelization 95% granulation tissue
PRP side ; 95% epithelization 5% granulation tissue
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Thrombin side: scarring hypo and hyper-pigmentation area 가 두드러짐
PRP side ;less scarringMuch less pigmentation change
Patient discomfort decrease
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GDC
↔
↔
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Growth factors contained PRP stimulated complete revascularization earlier and more complete
Early epithelial covering of exposed granulation tissue and C.T, the development of dermis is the mechanism that reduced scarring and a maximum regeneration of normal skin pigmentation
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Bovine thrombin + CaCl2
:clot initiator to activate PRP CJD(Creutzfeldt-jakob disease) : mad cow disease Postop bleeding : 100mg/ml of bovine factor Ⅴa
GDC
Pre-existing coagulation defect : thrombocytopenia, hypofibrinogenia… Hypersensitivity to bovine thrombin
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