Leczenie ran po zabiegach z zakresu chirurgii stomatologicznej i implantologicznej może być długotrwałe z uwagi na towarzyszące procesy zapalne, choroby przyzębia oraz rozległe uszkodzenia tkanek. Jedną z metod przyspieszania regeneracji tkanek może być w takim przypadku zastosowanie fibryny bogatopłytkowej.
Fibryna bogatopłytkowa (ang. advanced platelet-rich fibrine, A-PRF) to materiał autogenny otrzymywany w wyniku obróbki własnej krwi pacjenta. W składzie A-PRF znajdują się monocyty oraz białkowe czynniki wzrostu. Fibryna bogatopłytkowa aktywnie wspiera mechanizmy gojenia tkanek w ranie pozabiegowej, a jednocześnie wpływa na poziom mediatorów przeciwzapalnych i prozapalnych. Wspiera również osteogenezę.
Mechanizm działania A-PRF
Ze względu na to, że fibryna bogatopłytkowa jest materiałem autogennym, charakteryzuje się ona pełną biozgodnością i nie powoduje reakcji alergicznych.
A-PRF ma formę trójwymiarowej sieci włóknika. W przeciwieństwie do osocza bogatopłytkowego, które również jest stosowane w leczeniu ran, fibryna ulega powolnej degradacji, podczas której zawarte w niej czynniki są stopniowo uwalniane.
Fibryna bogatopłytkowa ma wpływ na kolagenogenezę, angiogenezę oraz osteogenezę. Dzięki temu przyspiesza proces regeneracji zarówno tkanek miękkich, jak i twardych. W przypadku tkanek twardych po zastosowaniu A-PRF stwierdza się lepszą odbudowę i mineralizację. Ponadto A-PRF przeciwdziała powstawaniu miejscowego stanu zapalnego, którego objawami mogą być dolegliwości bólowe, obrzęk oraz utrudnione gojenie.
Zastosowanie fibryny bogatopłytkowej zapewnia również mechaniczne zabezpieczenie obszaru pozabiegowego i zmniejsza ryzyko nieprawidłowego wytworzenia skrzepu w łożysku rany.
Do zalet tej metody terapii należą również niskie koszty oraz prostota i niewielka inwazyjność zabiegu (pobranie i odwirowanie krwi żylnej pacjenta).
Zastosowanie A-PRF w chirurgii stomatologicznej
Fibryna bogatopłytkowa znajduje zastosowanie w procedurach, które wymagają zabiegów augmentacyjnych przy niedoborach tkanek miękkich i twardych. A-PRF wykorzystuje się m.in. do zabezpieczania i leczenia zębodołów poekstrakcyjnych, przy podnoszeniu dna zatoki szczękowej, w przeszczepach kości i tkanek miękkich.
Źródło:
J. Nowak, K. Masłowska i in., „ocena procesu gojenia tkanek z zastosowaniem A-PRF u bliźniąt monozygotycznych”, „Chirurgia Plastyczna i Oparzenia” 2020, 8(1): 7-11.
Przeczytaj także: Co to jest ziarnina i w jakich przypadkach może utrudniać gojenie ran?
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