RE: Fibrin Network and Platelets Densities in Platelet‑Rich Fibrin (PRF) Membranes Produced from Plastic Tubes Without Additives—A New Approach to PRF Clinical Use

Carlos Fernando Mourão*, Nelson Pinto, Iris Anastasia Panos, Luiz Juliasse, Bruno Vasconcelos Gurgel

*Autor correspondiente de este trabajo

Producción científica: Contribución a una revistaErratumrevisión exhaustiva

Resumen

Our group read with interest the recent article by Silva et al. [1] evaluating platelet-rich fibrin (PRF) membranes produced using plastic tubes without additives as an alternative to glass- or silica-coated tubes. While the study offers valuable insights, we have some concerns regarding the methodology.

First, the use of the Carstairs method for histological analysis [2], though valid, poses limitations. This traditional staining method blurs the distinction between platelets and fibrin, making it difficult to assess each component accurately. Moreover, it is labor-intensive and prone to interference from various factors, such as red blood cell aggregation and staining artifacts, which could compromise the accuracy of the results. This method, primarily staining both platelets and fibrin [3], can be imprecise and lacks the specificity offered by modern techniques like flow cytometry. The labor-intensive nature of the Carstairs method, along with its susceptibility to interference and its qualitative rather than quantitative focus, might limit the applicability of the findings in clinical settings. Future studies might benefit from incorporating more advanced and automated techniques, such as scanning electron microscopy (SEM), to provide a more detailed and accurate visualization of the fibrin network.

It is essential to consider that in a study attempting to avoid the use of silica, the researchers still used glass containers to speed up clot formation in plastic tubes. This created a discrepancy in the methodology. The researchers aimed to compare PRF membranes from different types of tubes, but the use of glass in the process for plastic tubes may have unintentionally affected the results, leading to biased conclusions. The overlapping use of glass across different protocols raises concerns about the validity of directly comparing the outcomes of these varied tube types.

Moreover, the study’s findings on the use of plastic tubes without additives for PRF production are promising. However, the long-term clinical implications and safety of this method are still unclear. Previous research, such as the work by Dohan et al. [4], about six years from the first publication on PRF, did not report any significant issues related to the use of silica-coated tubes. Recently, there have been concerns about the cytotoxicity of silica tubes [5], which highlights the need for ongoing vigilance and research in this area. However, it is worth noting that there have been no reports of infections or significant issues associated with PRF tubes in the past two decades. This suggests that the current methods, including the use of silica-coated tubes, have generally been safe and effective.

Finally, based on previous studies [4, 5], the question about the “long-term safety and effectiveness” of this PRF production using silica-coated or glass tubes is evident. In addition, if there are some concerns from the researchers about silica additives, the absence of clinical complications over two decades of PRF use suggests a cautious approach to further in vitro studies.
Idioma originalInglés
PublicaciónJournal of Maxillofacial and Oral Surgery
DOI
EstadoAceptada/en prensa - 2024

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