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

GDC

Injury PLT activation Within 10 min,α-granule

migrate to the cell membrane surface and secrete growth factors ( inactive →active form)

GDC

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

GDC

GDC

Graft is completely permeated by new capillaries

Initial osteoid formation Osteoclast resorb osteoid and

BMP released New bone formation and

maturation

GDC

GDC

Platelet 는 cell replicaion, vascular

ingrowth,bone cell differentiation, early osteoid formation .. 등의 acativit 가 일어나도록 initiator 역할 담당함 .

GDC

GDC

PDGF aa,bb,ab Promoting angiogenesis, re-

epithelization,formation of granulation tissue

Chemotaxis for mesenchymal cell(OB< FB,Macrophage…),monocyte,neutrophiles

GDC

TGF β1,β2 Stimulate cell

replication similar to PDGF

Stimulate matrix production and guide differentiation towards cartilage or bone

GDC

Most potent multifuctional regulator of bone cell metabolism(OB 에 TGF receptor 많다 .)

GDC

Effects on endothelial cells

GDC

Effect limited on the basal cells of skin and mucus membrane

GDC

GDC

Inactive state

GDC

activation

GDC

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.

GDC

GDC

Native mandible Autogenous BG

PRP

Split thickness skin graft 후 donor site 의 healing 양상을 비교함

GDC

GDC

Thrombin side : 5% epithelization 95% granulation tissue

PRP side ; 95% epithelization 5% granulation tissue

GDC

Thrombin side: scarring hypo and hyper-pigmentation area 가 두드러짐

PRP side ;less scarringMuch less pigmentation change

Patient discomfort decrease

GDC

GDC

GDC

↔

↔

GDC

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

GDC

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

GDC

GDC

GDC

GDC

GDC

GDC