Influence of periodontitis and diabetes on structure and cytokine content of platelet‐rich fibrin

Background Platelet‐rich fibrin (PRF) is a second‐generation platelet concentrate with multiple applications in wound healing and regeneration in both periodontitis and diabetes. However, the three dimensional (3‐D) structure and cytokine content of PRF might be altered in patients suffering from either/both of the chronic inflammatory conditions, ultimately influencing the efficacy of PRF as a biomaterial for regenerative medicine. Aim The aim of the present study was hence to evaluate the effect of both these chronic inflammatory diseases on the 3‐D structure of PRF membrane. An attempt was also made to compare the growth factor content between the plasma and RBC ends of the prepared PRF gel. Materials & Methods L‐PRF was prepared for twenty participants, healthy (5), periodontitis (5), T2DM (5) and T2DM with periodontitis (5). Porosity and fiber diameter of PRF membranes was visualized under FE‐SEM and measured using ImageJ Software. PDGF‐BB and TGF‐β1 levels in PRF gel were assessed by ELISA. Results The average diameter of fibrin fibers under FE‐SEM was 0.15 to 0.30 micrometers. Porosity was higher at the plasma end (p = 0.042). Red blood cell (RBC) end of the membrane had thinner fibers arranged in a comparatively more dense and compact structure with smaller porosities. Healthy subjects had the least porous PRF compared to subjects with either/both of the chronic conditions. PDGF‐BB levels were similar along all the four groups. TGF‐β1 levels were highest in healthy subjects. Discussion 3‐D structure and growth factor content of PRF are influenced by a person's periodontal and/or diabetic status. The RBC end of the PRF membrane, as compared to the plasma end, has thinner fibers arranged in a comparatively more dense and compact structure with smaller porosities, and hence should be favored during periodontal regenerative procedures. Conclusion Both periodontitis and diabetes have a significant influence on the 3‐D structure and growth factor content of PRF produced.