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In vitro evaluation of the effects of leukocyte-platelet rich fibrin on disinfection of a rough implant surface Schuldt, Luisa Antonia


Objectives: Peri-implantitis is a frequent and serious clinical problem affecting between 1 and 47% of implants. Bacterial contamination of the roughened implant surface plays a major role in the etiology and progression of the disease. Successful treatment of peri-implantitis requires disinfection of the rough implant surface. There is no generally accepted protocol for implant disinfection. Autologous leukocyte and platelet-rich fibrin (L-PRF) membranes can be produced from autologous human blood via a one-step centrifugation procedure. It was hypothesized that the antimicrobial defense system of L-PRF may decontaminate the SLAⓇ implant surface. The objective of this study was to test the efficacy of L-PRF for SLAⓇ implant surface disinfection. Methods: Collagen-coated SLAⓇ (sand blasted, large grit acid etched) titanium discs were inoculated with dispersed dental plaque with a minimum bacterial cell concentration of 3.2 × 10⁷ CFU/ml. After 21 days of anaerobic incubation at 37C, discs were rinsed with 12 ml 0.9% NaCl to remove unattached biofilm, and exposed for 48 hours to Leukocyte-Platelet Rich Fibrin (L-PRF) in DMEM. Disks with or without rinsing with 12 ml of 0.9 % NaCl were fixed for SEM. Bacterial counts and perforations in bacteria were quantified from standardized scanning electron micrographs of the implant surface. The rinsing solution was collected and Western blot analysis was performed. L-PRF disks were compared with the control group (rinse). Results: Difference in presence of bacteria displaying perforation of the cell wall between cell–rich L-PRF treated samples and rinsed control group was statistically significant (p < 0.0001, Fisher's Exact Test). Western blot analysis of the rinse fluid demonstrated presence of Platelet Factor-4. Activated platelets in intimate contact with bacteria were detected on SEM images. SEM analysis demonstrated a statistically significant reduction of residual bacteria in the lacunae of the rough SLAⓇ surface after L-PRF treatment. (p< 0.05, Kruskal-Wallis). Conclusions: Autologous L-PRF may have potential as a biological means to decontaminate rough implant surfaces, possibly by exploiting the antimicrobial effects of platelets.

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