The effect of Nanobone® in combination with platelet rich fibrin on bone regeneration following enucleation of large mandibular cysts

Histomorphometric and immunohistochemical assessment of treated dentin matrix delivered by platelet-rich fibrin for socket preservation in rabbit model

OBJECTIVES

This study aimed to test treated dentine matrix (TDM) with platelet-rich fibrin (PRF) for socket preservation, following tooth extraction compared to synthetic grafting material Nanobone (NB) with PRF.

MATERIALS AND METHODS

Study was conducted on New Zealand rabbits (n = 40). Bilateral first lower premolar extraction was performed, with one side left empty and the other side filled with (PRF) in one group (n = 20). In the other group (n = 20), one side was filled with TDM/PRF while the other side was filled with NB/ PRF. After one and three months, rabbits were euthanized, and the socket area was examined using haematoxylin and eosin (H&E) and Goldner Masson trichrome stains. One-way ANOVA and post-hoc tests were used for histomorphometric analysis. Immunohistochemical analysis of osteopontin was carried out.

RESULTS

Histological analysis of NB/PRF and TDM/PRF groups showed a higher level of new bone formation in comparison to the control and PRF groups. Histomorphometric analysis revealed a significant increase in new bone formation in the TDM/PRF group compared to the NB/PRF group after one and three months (p = 0.042 and p < 0.001), respectively. There were no significant differences in the percentages of unmineralized bone between the TDM/PRF and NB/PRF groups at both intervals (p = 0.375 and 0.352, respectively). Regarding immunohistochemistry, NB/PRF showed the highest osteopontin immune expression followed by TDM/PRF. No significant differences were detected between both groups at both intervals (p = 0.234 & 0.607 respectively).

CONCLUSIONS

TDM/PRF showed the ability to form new bone in extraction sockets in rabbits.

CLINICAL RELEVANCE

TDM/PRF can be used as an alveolar bone grafting material for socket preservation.

Comparative Evaluation of Efficacy of Platelet Rich Plasma (PRP) and Platelet Rich Fibrin (PRF) in Bone Regeneration after Surgical Removal of Impacted Bilateral Mandibular Third Molars - A Comparative Study

Aims and Objectives: To compare the efficacy of platelet rich plasma (PRP) and platelet rich fibrin (PRF) in bone regeneration after removal of impacted bilateral third molars. Materials and Methods: The study was carried out as an open clinical trial on 20 patients chosen from the ones referred to the department of Oral & Maxillofacial Surgery for surgical removal of bilateral mandibular third molar. Patients were prepared for surgical procedure, Inferior alveolar nerve block given using 2% lignocaine hydrochloride with 1:2,00,000 adrenaline. Third molar were removed by flap reflection and bone drilling. Finally, PRF in lower left mandibular third molar region and PRP in lower right mandibular third molar region was inserted and wound closure was done. Cone bean computer tomography (CBCT) was made on 1st postoperative day and 4 months after surgery to evaluate alveolar bone height and density. Result: Alveolar bone height and bone density at post-operative 1st day and 4 months were compared between PRP and PRF group. The bone density and bone volume were analyzed, and there was no significant difference between bone density in PRP and PRF at day 1 and 4th month. Conclusion: As per our study and evaluation, in our postoperative follow up there was no statistically significant differences in bone regeneration by placement of PRP and PRF in extracted socket of third molar. Thus, with this study we can conclude that PRF, would be a good option to Oral and Maxillofacial Surgeons in the near future due to ease of extraction.

Bone Grafts and Substitutes in Dentistry: A Review of Current Trends and Developments

After tooth loss, bone resorption is irreversible, leaving the area without adequate bone volume for successful implant treatment. Bone grafting is the only solution to reverse dental bone loss and is a well-accepted procedure required in one in every four dental implants. Research and development in materials, design and fabrication technologies have expanded over the years to achieve successful and long-lasting dental implants for tooth substitution. This review will critically present the various dental bone graft and substitute materials that have been used to achieve a successful dental implant. The article also reviews the properties of dental bone grafts and various dental bone substitutes that have been studied or are currently available commercially. The various classifications of bone grafts and substitutes, including natural and synthetic materials, are critically presented, and available commercial products in each category are discussed. Different bone substitute materials, including metals, ceramics, polymers, or their combinations, and their chemical, physical, and biocompatibility properties are explored. Limitations of the available materials are presented, and areas which require further research and development are highlighted. Tissue engineering hybrid constructions with enhanced bone regeneration ability, such as cell-based or growth factor-based bone substitutes, are discussed as an emerging area of development.

Application of Platelet Rich Fibrin in Tissue Engineering: Focus on Bone Regeneration

Bone tissue engineering (BTE) is a strategy for reconstructing bone lesions, which is rapidly developing in response to higher demands for bone repairing. Recently, this method, along with the emergence of functionally graded, biocompatible and biodegradable materials, has been expanded. Moreover, scaffolds with chemical, physical and external patterns have induced bone regeneration. However, the maintenance of healthy bone and its regeneration in the human body needs a series of complex and accurate processes. Hence, many studies have been accompanied for reconstructing bone by using blood-derived biomaterials, especially platelet-rich fabricates. The most important reason for using platelet-rich formulations in bone regeneration is based on releasing growth factors from alpha granules in platelets, which can induce osteogenesis. Moreover, the presence of fibrin nano-fiber structures as a constituent can provide a good substrate for cell attachments. This study attempts to review the history, structure, and biology of platelet-rich fibrin (PRF) as well as in vitro, pre-clinical, and clinical studies on the use of PRF for bone regeneration.