A novel platelet concentrate: titanium-prepared platelet-rich fibrin

Abstract

We developed a new product called titanium-prepared platelet-rich fibrin (T-PRF). The T-PRF method is based on the hypothesis that titanium may be more effective in activating platelets than the silica activators used with glass tubes in Chouckroun's leukocyte- and platelet-rich fibrin (L-PRF) method. In this study, we aimed to define the structural characteristics of T-PRF and compare it with L-PRF. Blood samples were collected from 10 healthy male volunteers. The blood samples were drawn using a syringe. Nine milliliters was transferred to a dry glass tube, and 9 mL was transferred to a titanium tube. Half of each clot (i.e., the blood that was clotted using T-PRF or L-PRF) was processed with a scanning electron microscope (SEM). The other half of each clot was processed for fluorescence microscopy analysis and light microscopy analysis. The T-PRF samples seemed to have a highly organized network with continuous integrity compared to the other L-PRF samples. Histomorphometric analysis showed that T-PRF fibrin network covers larger area than L-PRF fibrin network; also fibrin seemed thicker in the T-PRF samples. This is the first human study to define T-PRF as an autogenous leukocyte- and platelet-rich fibrin product. The platelet activation by titanium seems to offer some high characteristics to T-PRF.

Figures

Figure 1

The light microscopy analysis of the T-PRF clot. Hematoxylin and eosin staining. (A) The thick T-PRF fibrin network (light pink (n)) and cellular components (c) were not easily detectable. (B) The thick border (b) between the cellular structures (c), fibrin network (n), and dark blue leukocyte nuclei (l). (C) The cellular components region (c). Leukocytes (l) (dark blue). (D) The thick fibrin border (dark pink (b)), cellular structures (c), and well-organized fibrin network with continuous integrity. The magnifications (G) are indicated in each panel.

Figure 2

The light microscopy analysis of the L-PRF clot. Hematoxylin and eosin staining. (A) The L-PRF fibrin network (light pink (n)) and cellular components (c) were not easily detectable. (B) The L-PRF fibrin network (n) adjacent to the cellular area (c) and fibrin border (b) was not easily detectable. (C) Dark blue leukocyte nuclei (I), the border between cellular structures and fibrin network (n). (D) The cellular structures (c) were embedded in the fibrin network (n). The leukocyte nuclei (l) were stained dark blue with hematoxylin. The magnifications (G) are indicated in each panel.

Figure 3

The immunofluorescent microscopy analysis of the T-PRF and L-PRF fibrin network structure. (A) The mature and dense T-PRF fibrin network with small gaps (g). (B) The mature and dense L-PRF fibrin network with large gaps (g) between the fibrin meshwork. The magnifications (G) are indicated in each panel.

Figure 4

Scanning electron micrograph. (a) The border between the T-PRF fibrin matrix and cellular components. The RBCs (r) trapped within the fibrin matrix. The leukocytes (l) appeared as spherical structures with an irregular surface. The platelets were often enmeshed in the fibrin network but sometimes appeared as aggregates (p (white circle)) (SEM; original magnification ×3500). (b) The T-PRF fibrin matrix. The organized and mature fibrin structure tended to form a network. The RBCs (r) trapped within the fibrin matrix (SEM; original magnification ×5000). (c) The border between the L-PRF fibrin matrix and cellular components. The RBCs (r) were trapped within the fibrin matrix. The leukocytes (l) appeared as spherical structures with an irregular surface. The platelets were often enmeshed in the fibrin network but sometimes appeared as aggregates (p (white circle)) (SEM; original magnification ×3500). (d) The L-PRF fibrin matrix. The organized and mature line-like fibrin structure with thick and thin fibrils. The RBCs (r) were trapped within the fibrin matrix (SEM; original magnification ×5000).

Figure 5

Results of the histomorphometry measurements (mm²). aP < 0.05 versus L-PRF group.