Comparison of the angiogenic efficacy of conventional leukocyte- and platelet-rich fibrin versus low-speed advanced platelet-rich fibrin: An in vitro chorioallantoic membrane assay study

Background. Platelet -rich fibrin (PRF) is widely used in periodontics for its wound healing potential. Two major variations of PRF are the original leukocyte- and platelet -rich fibrin (L-PRF) and the modified lowspeed advanced PRF (A-PRF). Objectives. The aim of the present study was to evaluate and compare the conventional L-PRF protocol and the low -speed A-PRF protocol in terms of angiogenic potential of PRF, using an in vivo chorioallantoic membrane (CAM) assay. Material and methods. Fifteen fertile Giriraja eggs were procured and after a 3 -day incubation period, randomly allotted into 3 groups: control; L-PRF; and A-PRF. A total of 20 mL of blood was collected from systemically healthy male volunteers aged 18-24 years, using a standard protocol. The PRF samples were inoculated on the CAM of the eggs. On the 10th day, the eggs were reopened and photographed. The parameters assessed were the number, length, size, and density of blood vessels, as well as the number of junctions formed. The photographs were analyzed using the ImageJ and ProgRes (R) CapturePro software. Results. Seven days after inoculation, both the A-PRF and L-PRF groups exhibited significantly better results than the control group in terms of the number (59.20 +/- 6.61 vs. 48.80 +/- 5.07 vs. 19.20 +/- 6.98), length (25,000 +/- 1,813.10 mu m vs. 17,000 +/- 282.90 mu m vs. 8,000 +/- 184.49 mu m), size (230,000 +/- 15,054.00 mu m2 vs. 200,000 +/- 8,295.27 mu m2 vs. 150,000 +/- 4,105.16 mu m2), and density (central: 9,100 +/- 296.78 vs. 5,370 +/- 272.42 vs. 1,420 +/- 564.36; peripheral: 9,094 +/- 400.14 vs. 3,370 +/- 479.39 vs. 5,420 +/- 746.73) of blood vessels, as well as the number of junctions formed (52 +/- 3.81 vs. 41 +/- 1.58 vs. 33 +/- 4.64), respectively. Conclusions. The angiogenic potential was increased by the exposure to both L-PRF and A-PRF. However, A-PRF demonstrated statistically significant benefits in terms of the number, length, size, and density of blood vessels, as well as the number of junctions formed in comparison with the control and L-PRF groups.