Evaluating the antimicrobial efficacy, growth factor release drug kinetics of titanium platelet-rich fibrin loaded with amoxiclav, metronidazole and neem gel: an in vitro study

Abstract

Objectives: The use of titanium platelet-rich fibrin (T-PRF) as a sustained drug delivery system (SDDS) has been limited. Hence present study aimed to evaluate the antimicrobial efficacy, drug kinetics and growth factor release of T-PRF injected with amoxicillin+clavulanic acid (amoxiclav gel), metronidazole (MTZ) and neem (NE) gels separately. Materials and Methods: 12 Healthy volunteers were recruited for this in vitro analysis. Drug kinetics were monitored at 0, 2, 24, 48, and 72 hours. Antimicrobial efficacy was assessed at 48 hours post inoculation in culture plates and growth factor release was measured at 3, 7 and 10 days. Kruskal– Wallis test, Dunn’s Post hoc test, Bonferroni’s correction and Mann–Whitney U test were used to compare the drug release over time frames, inhibition zone diameters (IZDs) and growth factor release were expressed in (mean and standard deviations) millimetres, pico g/mL and nano g/mL. Results: In terms of drug kinetics, both T-PRF clots and collagen sponges when injected with antibiotic/ herbal gels individually there was a sustained drug release up to 72 hours and there was a greater release observed in collagen sponge. IZDs were recorded for T-PRF injected with amoxiclav/MTZ/ NE gel for anti-microbial efficacy. Growth factor release was also observed for T-PRF plain and T-PRF injected with gels, with levels were numerically higher in T-PRF plain. Conclusion: Within the limitations of the study T-PRF demonstrated sustained drug release with superior antibacterial activity. Growth factor release was not compromised, aiding in the preservation of regenerative capacity. Therefore, T-PRF can be used as a SDDS.