Autologous platelet concentrates: 'Ambit' in integrated health sciences

 Corresponding author: Sunanda Sudhakaran Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution License 4.0. Autologous platelet concentrates: 'Ambit’ in integrated health sciences Sunanda Sudhakaran *, Harish Kumar VV, Santhosh VC, Risvana S, Sruthi VG, and Aswathi S Department of Periodontics, KMCT Dental College, Mukkam, Kozhikode, Kerala. World Journal of Advanced Research and Reviews, 2025, 26(03), 1741-1746 Publication history: Received on 04 May 2025; revised on 14 June 2025; accepted on 16 June 2025 Article DOI: https://doi.org/10.30574/wjarr.2025.26.3.2361 Abstract Autologous Platelet Concentrates (APCs) prove to be a promising therapy in integrated health sciences, which utilizes the body’s natural healing mechanism. Derived from the patient’s own blood, APCs are rich in growth factors,cytokines, and other proteins that facilitate tissue regeneration by reducing the inflammation and promoting healing. The utilization of APCs, particularly in regenerative medicine, orthopedics, and dermatology, has garnered increasing attention due to their potential to improve healing outcomes and reduce the risk of immune rejection. By integrating APC therapies into clinical practice, health professionals can harness the biological properties of platelets to enhance tissue repair, accelerate recovery, and optimize patient outcomes. This review explores the valuable principles behind APCs, their applications across various medical disciplines, and the potential future developments in their integration within health systems. Keywords: Autologous; Platelet concentrates; Therapeutic benefits; Integrated Health Sciences 1. Introduction Wound healing engages a systematic event of physiological processes involving blood components, soluble mediators, cells, and extracellular matrix.1 The diseased periodontium heals unusually and requires the orchestrated reconstruction of both soft and hard tissue.2Superabundant growth factors and cytokines gets released from the extracellular matrices, resident cells and infiltrating cells which serve to promote the growth and differentiation of the periodontal tissues.3Certain growth factors have been successfully used at the site of injury that promotes the wound healing Autologous platelet concentrates (APCs) typify the bioactive additives procured from a patient's own blood, aiming to accelerate the natural healing and regeneration of tissues. They promote the healing favorably as it concentrates the cells and therapeutic elements of blood at the site of the wound or surgery.4 APCs are subsets of blood-derived products, which are categorized into four types, subdivisions of the two broader categories: Platelet-Rich Plasma (PRP) and Platelet-Rich Fibrin (PRF). As elaborated, in literature, APCs are further divided into four different families, based on their leukocyte content and fibrin structure as Pure Platelet-Rich Plasma (P-PRP), Leukocyteand Platelet-Rich Plasma (L-PRP), Pure Platelet-Rich Fibrin (P-PRF), and Leukocyte and PlateletRich Fibrin(L-PRF)5-9 This narrative review hunts through the plethora of possibilities with which the use of APC’s rules different arenas of medical science. World Journal of Advanced Research and Reviews, 2025, 26(03), 1741-1746 1742 2. Salient Features of APCs 2.1. Generations of APCs The First-generation APCs, Platelet-rich Plasma, have a limited quantity of plasma with enriched platelets obtained from patient's own blood. It is supposed to use along with bone grafts in treating periodontal defects 10Though PRP has enriched platelet concentrates, the protocol for its preparation is a bit complicated and expensive as it requires an anticoagulant during its preparation. 11-12 The shortcomings of first-generation APCs were overpowered by the second generation of platelet concentrates, Platelet-rich Fibrin. (PRF) The ease of preparation without an anticoagulant, cost effectiveness, and its high expertise in tissue regeneration make it an absolute APC. The crisis in storage, requirement of quick handling, prevention of the structural component of PRF from dehydration, and risk of bacterial contamination of the membranes if stored in refrigerators are the few shortcomings of PRF.13 2.2. Forms of PRF • L-PRF (Leukocyte-Platelet Rich Fibrin) • I-PRF (Injectable Platelet Rich Fibrin) • A-PRF (Advanced Platelet Rich Fibrin) • T-PRF (Titanium Platelet-rich fibrin) • P-PRF (Pure-Platelet Rich Fibrin) 2.3. Preparation Protocols for APCs The process of preparing APCs starts with the collection of the patient's own blood through venous puncture. The blood collected has to be processed with the help of a centrifuge to separate the different types of platelet concentrates depending on the preparation protocols as given below:14-18 (Table 1) Table 1 Preparation Protocols for APCs Type of Platelet concentrate Centrifuge Protocol Time Platelet Rich Plasma 1200 rpm 3300 rpm 12 min 7min Platelet rich Fibrin/L-PRF 2700-3000 rpm 12 min I-Platelet Rich fibrin 700-800 rpm 3-4 min Advanced Platelet Rich Fibrin 1500rpm 14 min Titanium Platelet rich fibrin 2700rpm 12min Concentrated Growth factor 2700-2400-2700-3000 rpm 2-4-4-3 min respectively Valuables of APC’s • Production of a homogenous and reproducible platelet product.19 • The regenerative properties of APCs are attributable to their formation of a 3D fibrin scaffold during platelet activation, cellular proliferation, including fibroblasts, osteoblasts20 • The growth factors derived from APCs are found to have a strong bacteriostatic effect against a polymicrobial environment in a wound, which might play a prophylactic role in wound site infection21 • APCs are rich in Platelet-derived growth factors which include transforming growth factor (TGF), Vascular endothelial growth factor (VEGF), Fibroblast growth factor (FGF), Epidermal growth factor (EGF), Insulinlike growth factor (IGF-1)22 World Journal of Advanced Research and Reviews, 2025, 26(03), 1741-1746 1743 3. Clinical Relevance of APCs (Intra Oral Applications) 3.1. APCs in Oral Medicine The anti-inflammatory properties of platelet-derived growth factor are found to be useful in treating atrophic-erosive Oral Lichen Planus, which is obstinate to corticosteroid treatment23In addition, the platelet concentrates were found to be effective in treating recurrent aphthous stomatitis 24 3.2. APCs in Endodontics The immature teeth requiring endodontic therapy demonstrated the complete apex closure along with an increase in dentinal wall thickness. which could be due to platelet degranulation and release of Growth factors by platelets contributing to regenerative endodontics.25 3.3. APCs in Oral Surgery The use of Platelet concentrates is effective in • Healing of extraction socketsUse of platelet concentrates as an adjunctive in extracted sockets has effectively reduced the incidence of dry socket and enhances the healing potential of the extracted socket. The sites treated with APCs have been found to have reduced postoperative pain and other postoperative complications 26 • Sinus lift surgeries -Use of Platelet concentrates enhances new bone formation, reduces inflammation, stimulates vascularization, thereby reducing postoperative pain and facial swelling.27 • Dental Implant surgeriesUse of Platelet concentrates either alone or in combination with exogenous bone grafting material fastens the process of osseointegration as well as soft tissue healing, minimizing the postoperative complications.19 3.4. APCs in Periodontology • Treatment of bony defects – application of APCs to the bony defects during open flap debridement provides beneficial effects when the defects are either filled, covered, or combined. Clinically patient-related outcome measures (PROM), probing pocket depth, and an improved clinical attachment level.28 • Role in Alveolar bone regeneration – depending on the classification of defects proposed by Benic & Hammerle, APCs can be used for the alveolar bone regeneration as follows:29 Table 2 Classification of bone defects (Benic &Hammerle) Type of defect Description of the defect Type of APCs used Class 2 Well-contained defect Non-contained defect Autologous fibrin membrane (L-PRF) Barrier membrane is added with flowable APCs Class 3 Dehiscence type of defect Barrier membrane is added Class 4 & 5 Horizontal and vertical type of defect APCs soaked with bone grafts are used • In Periodontal Plastic surgeriesAs the APCs support soft tissue healing, use of L-PRF, PRGF gels between the coronally advanced flap and root surface facilitates proper root coverage and improves the clinical periodontal parameters30 • In treating Endo Perio LesionUse of L-PRF and its derivatives treats apical marginal defects. These do improve the clinical attachment level, reduce probing pocket depth. Use of Platelet concentrates improve patient related outcome measure 31 3.5. Extra oral Application of APCs Healing of chronic wounds: • Application of platelet concentrates on to the chronic wounds like diabetic foot ulcers, leprosy ulcers, venous leg ulcers, burns have been reviewed and it proves to be successful as both a standard and adjunctive treatment World Journal of Advanced Research and Reviews, 2025, 26(03), 1741-1746 1744 of the same.32 The release of growth factors, regulation of cytokine mediators, and the antibacterial properties of the APCs contribute to a successful role in aiding the healing of chronic wounds33 In Ophthalmology • Use of APCs for dry eyes has been found effective when used as eye drops, one drop 6 times a day for 6 weeks 34 In Orthopedics • Tendon & ligament repairs have been effective when Platelet concentrates have been found to improve tendon strength and regeneration of tendons. Ultrasound-guided injections are effective in treating elbow tendonitis.35 In facial aesthetics • Varied usage of APCs elucidates its role in aesthetic facial treatments as well. It’s used as a volumizing substance in procedures like micro needling, intradermal injection, fillers around the eye, and peri-oral areas36 4. Conclusion APCs have been an endogenous biomaterial that has been used for many years in the medical field due to their valuable potential in healing, due to its regenerative capacity that accelerates the regeneration of lost tissues, both soft and hard tissue. Slowly but surely, there will be lots of headway in the field of regenerative medicine with APCs as a pioneer. Compliance with ethical standards Disclosure of conflict of interest No conflict of interest to be disclosed. References [1] Rodrigues M, Kosaric N, Bonham CA, Gurtner GC. Wound healing:a cellular perspective review. Physiol Rev. 2019;99:665-706 [2] AmericanAcademyofPeriodontology. 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