Regeneración tisular guiada por concentrados autologos plaquetarios en implantología oseointegrada: plasma rico en leucocitos y fibrina (L-PRF)
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2012
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es
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Universidad Andrés Bello
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Licencia CC
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Resumen
Introducción: La capacidad del cuerpo para retornar a su nivel funcional y fisiológico es limitada. Una pérdida de la dentición promueve un colapso de los tejidos blandos y una atrofia de la cresta alveolar con una pérdida ósea promedio del 40% en sentido vertical y 60% en sentido horizontal en los 6 meses posteriores si no se utilizan técnicas regenerativas tisulares. Los factores de crecimiento contenidos en la sangre pueden acelerar y optimizar los procesos regenerativos de la cavidad oral. Los estudios sobre concentrados plaquetarios provenientes del tejido sanguíneo y su utilización en cirugía bucomaxilofacial datan de la década de los 80's, desarrollándose paulatinamente diversos métodos en su preparación. Beneficios importantes en cuanto optimización y aceleración de los procesos reparativos se vieron con la aparición del Plasma Rico en Plaquetas, aunque también presentaron dificultades ocasionadas principalmente por las sustancias agregadas para su activación. Con la aparición reciente en la última década del Plasma Rico en Fibrina (L-PRF), también conocido como la segunda generación de concentrados plaquetarios, parecen simplificarse los procedimientos ahorrarse costos y evitarse los efectos no deseados. Objetivo: Realizar una revisión bibliográfica de los casos documentados en la literatura
científica desde los años 2008 a 2012 en los que se empleó el L-PRF con la finalidad de
elaborar un análisis cualitativo de los casos más relevantes que nos orienten en los resultados
que se obtienen de su uso actual basados en la evidencia.
Materiales y Método: Fueron realizadas búsquedas específicas a través de la web en las
siguientes bases de datos médicas y journals: Medline/Pubmed, Science Direct, Wiley,
Ebcohost, American Academy of lmplant Dentistry, lndian Society of Periodontology. Se
empleó terminología MESH específica con los términos: "Platelet Rich Fibrin", se escogieron
trabajos científicos de alta calidad desarrollados en complemento con instituciones
universitarias. Se clasificaron principalmente con la relevancia de que sean casos que tengan
relación con procedimientos regenerativos de tejidos en cavidad oral en los que se haya
empleado el L-PRF en humanos.
Resultados: De un total de 753 artículos arrojados por los motores de búsqueda, 10 casos
fueron cuidadosamente seleccionados de acuerdo a los criterios propuestos: 3 presentaron el
uso de L-PRF sólo como injerto en levantamiento de seno maxilar y colocación simultánea de
implantes dentales. 2 casos en el que se utilizó el L-PRF acompañado de Bio Oss en
levantamiento seno maxilar. 3 caso en los que se utilizó el L-PRF como material biológico en
la preservación y regeneración tisular en alvéolos dentarios. 1 caso en el que se utilizó el L-PRF
como coadyuvante antihemorrágico en pacientes anticoagulados que iban a ser
sometidos a cirugía de corazón abierto y 1 caso en el que se usó el L-PRF en una fenestración
anterosuperior.
Conclusiones: El L-PRF al ser utilizado como injerto biológico de relleno muestra una
respuesta favorable en cuanto al volumen y densidad del tejido óseo obtenido de la
regeneración tisular, acompañando a una disminución en el tiempo que llevan los procesos
reparativos de tejidos duros y blandos.
lntroduction: The human body's ability to return to its functional and physiological level is limited. A loss of dentition promotes a collapse of the soft tissues and atrophy of the alveolar ridge with average bone loss 40% in height and 60% in width along 6 months if not used tissue regenerative techniques. Growth factors contained in the blood can be accelerated and optimize the regenerative processes of the oral cavity. Studies about platelet concentrate from blood and its use in maxillofacial surgery dating from the 80's years, gradually developed various methods in their preparation. Significant benefits in terms of optimization and acceleration of reparative processes were seen with the coming of Platelet Rich Plasma, also presented difficulties caused mainly by substances added for activation. The recent emergence in the last decade of Platelet Rich Fibrin (l-PRF), also known as the second generation of platelet concentrates, seems to simplify procedures that save costs and avoid unwanted effects. Objective: Perform a systematic review of the cases documented in the scientific literature from the years 2008-2012 which was used the l-PRF in order to make a qualitative analysis of the most relevant cases that guide us in the results obtained from actual use based on evidence. Materials and Methods: Specific searches were conducted via the web at the following medical databases and journals: Medline/Pubmed, Science Direct, Wiley, Ebcohost, American Academy of lmplant Dentistry, lndian Society of Periodontology. Specific MESH terminology was used with the words: "Platelet Rich Fibrin", were chosen high-quality scientific work developed in complement with universities. lt mainly classified relevance cases that are relevant to tissue regenerative processes in the oral cavity which is in the l-PRF was used in humans. Results: From 753 total articles released by the search engines, 1 O cases were carefully selected according to the criteria proposed: 3 had the use of l-PRF as grafting only in maxillary sinus lift and simultaneous placement of dental implants. 2 cases where were used together l-PRF and Bio Oss in maxillary sinus lift. 3 cases where was used the l-PRF as biological material in dental sockets. 1 case in which was used the l-PRF as an adjuvant antihemorrhagic in patients with anticoagulant therapy were undergoing open heart surgery and 1 case in which was used the l-PRF on maxillary fenestration. Conclusion: Use of l-PRF as filler biological graft shows a favorable response in volume and the density of bone tissue obtained from tissue regeneration, accompanying a decreased over the time leading reparative processes hard and soft tissues.
lntroduction: The human body's ability to return to its functional and physiological level is limited. A loss of dentition promotes a collapse of the soft tissues and atrophy of the alveolar ridge with average bone loss 40% in height and 60% in width along 6 months if not used tissue regenerative techniques. Growth factors contained in the blood can be accelerated and optimize the regenerative processes of the oral cavity. Studies about platelet concentrate from blood and its use in maxillofacial surgery dating from the 80's years, gradually developed various methods in their preparation. Significant benefits in terms of optimization and acceleration of reparative processes were seen with the coming of Platelet Rich Plasma, also presented difficulties caused mainly by substances added for activation. The recent emergence in the last decade of Platelet Rich Fibrin (l-PRF), also known as the second generation of platelet concentrates, seems to simplify procedures that save costs and avoid unwanted effects. Objective: Perform a systematic review of the cases documented in the scientific literature from the years 2008-2012 which was used the l-PRF in order to make a qualitative analysis of the most relevant cases that guide us in the results obtained from actual use based on evidence. Materials and Methods: Specific searches were conducted via the web at the following medical databases and journals: Medline/Pubmed, Science Direct, Wiley, Ebcohost, American Academy of lmplant Dentistry, lndian Society of Periodontology. Specific MESH terminology was used with the words: "Platelet Rich Fibrin", were chosen high-quality scientific work developed in complement with universities. lt mainly classified relevance cases that are relevant to tissue regenerative processes in the oral cavity which is in the l-PRF was used in humans. Results: From 753 total articles released by the search engines, 1 O cases were carefully selected according to the criteria proposed: 3 had the use of l-PRF as grafting only in maxillary sinus lift and simultaneous placement of dental implants. 2 cases where were used together l-PRF and Bio Oss in maxillary sinus lift. 3 cases where was used the l-PRF as biological material in dental sockets. 1 case in which was used the l-PRF as an adjuvant antihemorrhagic in patients with anticoagulant therapy were undergoing open heart surgery and 1 case in which was used the l-PRF on maxillary fenestration. Conclusion: Use of l-PRF as filler biological graft shows a favorable response in volume and the density of bone tissue obtained from tissue regeneration, accompanying a decreased over the time leading reparative processes hard and soft tissues.
Notas
Tesis (Magíster en Odontología, Especialización en Implantología Oseonintegrada)
Palabras clave
Regeneración (Biología), Plaquetas, Cirugía, Implantes Dentarios