Conventional periodontal treatments such as scaling and root planing and surgical debridement are often insufficient to fully restore damaged periodontal structures (gingiva, periodontal ligament, cementum, and alveolar bone). Therefore, regenerative therapy approaches have emerged with the aim of stimulating natural biological processes so that periodontal tissues can be re-formed.
One of the key components is the use of Platelet-Rich Fibrin (PRF) as a biological substrate rich in growth factors. Research conducted by a Faculty of Dentistry UGM student, Wisely Fredrian, under the supervision of drg. Hendrawati, M.Kes. and drg. Nur Rahman Ahmad Seno A., M.D.Sc., Sp.Perio., entitled “The Role of Vascular Endothelial Growth Factor Content in Platelet-Rich Fibrin on Periodontal Tissue Healing,” examined how VEGF (Vascular Endothelial Growth Factor) in PRF contributes to the stages of periodontal tissue healing.
Mechanisms of VEGF in PRF for Periodontal Regeneration
Based on the research review:
- Angiogenesis in the Gingiva
VEGF in PRF stimulates the formation of new blood vessels in gingival tissues, enabling the delivery of oxygen, nutrients, and progenitor cells required for regeneration. - Stimulation of Osteoblast Activity in Alveolar Bone
VEGF also regulates osteoblast proliferation and differentiation, supporting new bone formation in alveolar areas affected by periodontal destruction. - Cementoblast Differentiation in Cementum
In the root area, VEGF supports the growth of cementoblast cells, which play a role in forming new cementum layers. - Formation of New Periodontal Ligament Attachment
Through biological signals from VEGF and other growth factors released by PRF, periodontal ligament regeneration can be promoted, strengthening the attachment between the tooth and supporting tissues.
The review also noted that VEGF release is higher in certain PRF variants, such as A-PRF+, compared to other variants (L-PRF, PRFM, i-PRF).
Advantages and Limitations of Regenerative Therapy
Advantages
- Can accelerate and improve healing outcomes compared to non-regenerative approaches.
- Uses autologous material (the patient’s own blood), resulting in minimal risk of immune or adverse reactions.
- Synergistic integration of biological aspects (growth factors) and the fibrin scaffold supports cell migration and proliferation.
Limitations
- Clinical effects depend on the concentration and release of VEGF and other factors in PRF.
- Not all periodontal cases are suitable for full regeneration, especially extensive lesions or severe supporting tissue damage.
- Different PRF variants may show differences in VEGF release efficiency and matrix stability.
Clinical Implications and Recommendations
- In regenerative periodontal practice, selecting the optimal PRF variant (e.g., A-PRF+) can result in higher VEGF release and better healing outcomes.
- Collaboration with additional scaffolds or biomaterials (e.g., hydroxyapatite, collagen) may enhance regenerative results.
- Long-term monitoring is essential to evaluate regeneration stability and prevent relapse.
- Further studies, including human clinical trials, are needed to better understand and widely apply this therapeutic approach.
References
WISELY FREDRIAN, drg. Hendrawati, M.Kes., drg. Nur Rahman Ahmad Seno A., M.D.Sc., Sp.Perio., Peran Kandungan Vasculae Endothelial Growth Factor Pada Platelet-Rich Fibrin terhadap Penyembuhan Jaringan Periodontal, https://etd.repository.ugm.ac.id/penelitian/detail/206988
Author: Rizky B. Hendrawan | Photo: Freepik
