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Regeneração alveolar utilizando centrifugados sanguíneos
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Abstract(s)
A regeneração alveolar é um método amplamente utilizado na medicina dentária para aumentar a quantidade e a qualidade óssea em áreas de defeitos alveolares. O enxerto autólogo tem sido considerado o padrão de ouro para estas situações, embora apresente importantes limitações como maior morbidade, maior tempo cirúrgico, maior tempo de recuperação, maior incidência de complicações, o custo associado à colheita e preparação do material, e, em algumas situações, disponibilidade limitada.
Assim, a procura constante por um biomaterial confiável que permita aumentar as capacidades biológicas dos materiais de substituição óssea, levou ao aparecimento dos derivados sanguíneos, que funcionam como um conector biológico entre os diferentes elementos do enxerto, estimulando a diferenciação das células-troncos e a migração de células osteoprogenitoras para o centro do enxerto.
Os concentrados sanguíneos são produtos biológicos autólogos, derivados de uma amostra sanguínea do paciente, são constituídos principalmente por plaquetas, fibrina, leucócitos e fatores de crescimento. Estes apresentam elevadas concentrações de fatores de crescimento e citosinas que desempenham um papel vital na cicatrização de vários tecidos.
Tendo por base a presença de leucócitos e a arquitetura das fibras, os concentrados plaquetários são divididos em quatro grupos principais. Estas quatro famílias de derivados sanguíneos têm assinaturas, mecanismos biológicos e aplicações clínicas diferentes.
Os derivados sanguíneos são preparados através de técnicas de centrifugação gravitacional, sendo o grupo PRP obtido a partir de sangue com anticoagulante, enquanto o grupo PRF é obtido a partir de sangue sem anticoagulante. As preparações dos concentrados diferem substancialmente na quantidade e dinâmica da libertação dos fatores de crescimento.
A presente revisão bibliográfica tem como objetivo descrever os diferentes protocolos de obtenção dos concentrados sanguíneos, bem como apresentar a aplicação clínica dos PRGF, L-PRF e A-PRF na regeneração tecidular.
Alveolar regeneration is a method used in dentistry to increase bone quantity and quality in areas of alveolar defects. The autologous graft is considered the gold standard for these situations, but it is subject to important limitations such as greater morbidity, longer surgical time, longer recovery time, higher incidence of complications, cost associated with the harvest and preparation of the material, and, in some situations , limited availability. Thus, the constant search for a reliable biomaterial that can increase the biological capacities of bone replacement materials has led to the appearance of blood derivatives that function as a biological connector between the different elements of the graft, stimulating stem cell differentiation and of osteoprogenitor cells migration towards the center of the graft. The blood Concentrates are autologous biological products, derived from a patient's blood sample, consisting mainly of platelets, fibrin, leukocytes and growth factors. Also, they hold high concentrations of growth factors and cytokines which play a vital role in the healing of various tissues. Based on the presence of leukocytes and fiber architecture, the platelet concentrates are divided into four main groups. These four families of blood products are distinguish regarding signature, biological mechanisms and clinical applications. They are prepared using gravitational centrifugation techniques, the PRP being obtained from anticoagulated blood while the PRF is obtained from non-anticoagulated blood. Concentrate preparations differ substantially in the amount and dynamics of growth factor release. The present study aims to describe the different protocols for obtaining blood concentrates, as well as to present the clinical application of PRGF, L-PRF and A-PRF in tissue regeneration.
Alveolar regeneration is a method used in dentistry to increase bone quantity and quality in areas of alveolar defects. The autologous graft is considered the gold standard for these situations, but it is subject to important limitations such as greater morbidity, longer surgical time, longer recovery time, higher incidence of complications, cost associated with the harvest and preparation of the material, and, in some situations , limited availability. Thus, the constant search for a reliable biomaterial that can increase the biological capacities of bone replacement materials has led to the appearance of blood derivatives that function as a biological connector between the different elements of the graft, stimulating stem cell differentiation and of osteoprogenitor cells migration towards the center of the graft. The blood Concentrates are autologous biological products, derived from a patient's blood sample, consisting mainly of platelets, fibrin, leukocytes and growth factors. Also, they hold high concentrations of growth factors and cytokines which play a vital role in the healing of various tissues. Based on the presence of leukocytes and fiber architecture, the platelet concentrates are divided into four main groups. These four families of blood products are distinguish regarding signature, biological mechanisms and clinical applications. They are prepared using gravitational centrifugation techniques, the PRP being obtained from anticoagulated blood while the PRF is obtained from non-anticoagulated blood. Concentrate preparations differ substantially in the amount and dynamics of growth factor release. The present study aims to describe the different protocols for obtaining blood concentrates, as well as to present the clinical application of PRGF, L-PRF and A-PRF in tissue regeneration.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Concentrados plaquetários PRP PRF Fatores de crescimento