Platelet extracts, mainly represented by platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), have received great attention in various endodontic topics; such as vital pulp therapy, regeneration, trauma, and endo-perio lesions. Their utilization opens up a new avenue in clinical dentistry.
PRF was first described by Choukroun et al. (2006), it is a second-generation platelets concentrates, and has many advantages over PRP including easy preparation and absence of blood manipulation. PRF is a living biomaterial composed of cytokines, leukocytes, stem cells, and platelets, entrapped in tetra molecular fibrin meshwork, which act as a scaffold, supports micro vascularization, and works as a transport for carrying cells, which are important for hard and soft tissue regeneration. However, its initial formulations lacked a liquid concentrate of proteins. For this reason, significant advancements were recently made to obtain a liquid or flowable version of PRF called injectable-PRF by introducing the “low-speed concept”, lowering blood centrifugation speed and time. In agreement with this hypothesis, more platelets, leukocytes, and growth factors are retained in the supernatant fluid before the coagulation cascade. This flowable, natural blood concentrate allows ease of access and flow within the root canal. Furthermore, it allows mixing with biomaterials used in endodontics, this combination promises to help achieve great soft and hard tissue repair. It is a minimally invasive technique that will raise the bar of tissue regeneration in endodontics, because of its low-cost, enhanced curative effect and can be produced immediately at the chairside.
As it is considered an autologous biomaterial, it does not elicit a foreign body reaction. Under the condition of regenerative, trauma, or inflammatory disease, it can alleviate the immune response, and favor restoration, and repair. i-PRF may be a suitable strategy to ease patients’ pain and meet clinical needs.