Wound healing, as a standard biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For an effective healing, all four phases must occur in the correct sequence and time frame. Many factors can interfere with one or more phases of this process causing impaired wound healing. The task of managing non-healing wounds especially in instances with bone exposure is clinically challenging, if not difficult. Platelet-rich fibrin (PRF) represents a new step in the platelet gel therapeutic concept with simplified processing minus artificial biochemical modification. This article aims to describe a case of bone exposure after subepithelial connective tissue grafting and its management with platelet rich fibrin.
2. S. Guo and L.A. DiPietro. Factors Affecting Wound Healing. Critical reviews in oral biology & medicine. J Dent Res 89:219-229, 2010
3. Jain V, Triveni MG, Tarun Kumar AB, Mehta DS. Role of platelet-rich-fibrin in enhancing palatal wound healing after free graft. Contemp Clin Dent. 2012;3:S240-43.
4. Margolis DJ, Kantor J, Santanna J, Strom BL, Berlin JA. Effectiveness of platelet releasate for the treatment of diabetic neuropatic neuropatic foot ulcers. Diabetes Care.2001;24:483–8.
5. Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, et al. Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part IV: Clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:E56–60.
6. Zucchelli G, De Sanctis M. Long-term outcome following treatment of multiple Miller class I and II recession defects in esthetic areas of the mouth. J. Periodontol 2005;76: 2286–92.
7. Hou LT, Yan JJ, Liu CM, Huang JF, Jehing SM, Wong MY et al. Treatment of the gingival recession - literature review of current progress. Chin Dent J 2005; 24：71-8
8. Griffin TJ, Cheung WS, Zavras AI, Damoulis PD. Postoperative complications following gingival augmentation procedures. J Periodontol. 2006;77:2070–9.
9. Kulkarni MR, Thomas BS, Varghese JM, Bhat GS. Platelet rich fibrin as an adjunct to palatal wound healing after harvesting a free gingival graft: A case series. J Indian Soc Periodontol. 2014;18: 399–402.
10. Del Corso M, Toffler M, Ehrenfest DM, et al. Use of an Autologous Leukocyte and Platelet-Rich Fibrin (L-PRF) Membrane in Post-Avulsion Sites: An Overview of Choukroun's PRF. J Implant Adv Clin Dent. 2010;1:27–35s
11. Chang IC, Tsai CH, Chang YC. Platelet-rich fibrin modulates the expression of extracellular signal-regulated protein kinase and osteoprotegerin in human osteoblasts. J Biomed Mater Res A. 2010;95:327–32.
12. Diss A, Dohan DM, Mouhyi J, Mahler P. Osteotome sinus floor elevation using Choukroun’s platelet-rich fibrin as grafting material: a 1-year prospective pilot study with microthreaded implants. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105, 572e9.
13. Panda S, Doraiswamy J, Malaiappan S, Varghese SS, Del Fabbro M. Additive effect of autologous platelet concentrates in treatment of intrabony defects: a systematic review and meta-analysis. J Investig Clin Dent. 2016;7:13-26.