Platelet-Rich Fibrin (PRF) Analyzed for Cytokine Profiles - A Misguided Hope for Osteogenesis in Jawbone Defects? Research and Clinical Observational Study.

Background: Platelet-rich fibrin (PRF) blood concentrates are used in oral implantology and defect surgery to promote osteoneogenesis in Bone Marrow Defects in Jawbone (BMDJ), according to the morphology of fatty-degenerative osteonecrosis also called FDOJ.

Question: Can the benefit of PRF on alveolar osteoneogenesis be confirmed by cytokine analysis?.

Methods: The cytokine expressions of the PRF samples in 26 patients undergoing BMDJ/FDOJ surgery in the same session were analysed for seven cytokines (RANTES/CCL5; FGF-2; IL-1RA; Il-6; IL-8; MCP-1; TNF-a) by multiplex (Luminex). The FDOJ samples of these 26 BMDJ/FDOJ patients were analysed for the RANTES/CCL5 expression only.

Results: Cytokine expression in PRF is compared to reference values for healthy medullary bone of the jaw and BMDJ/FDOJ and shows that the cytokine expressions of the PRF samples do not compensate or counteract prima vista for the cytokine dysregulations present in the BMDJ/FDOJ areas.

Discussion: To define the aid of cytokines studied in PRF in the restoration of the immunological dysregulation in areas of BMDJ/FDOJ, literature is reviewed comparing RANTES/CCL5, IL-1ra, TNF-α and MCP-1/CCL2 expression in PRF and BMDJ/FDOJ. Immunoregulatory properties of PRF in alveolar bone restoration are evaluated.

Summary: PRF was mistakenly thought to be a cure for bone healing, which is here shown to be incorrect. Enoral Ultrasound Sonography of bone density is available for the clinical measurement of individually developed osteoneogenesis by PRF.

Conclusion: The multiplex analysis of PRF shows a dynamic and cytokine-based interaction with osteoneogenesis that is not yet fully clarified.