1
|
Dohle E, Schmeinck L, Parkhoo K, Sader R, Ghanaati S. Platelet rich fibrin as a bioactive matrix with proosteogenic and proangiogenic properties on human healthy primary cells in vitro. Platelets 2024; 35:2316744. [PMID: 38390838 DOI: 10.1080/09537104.2024.2316744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/04/2024] [Indexed: 02/24/2024]
Abstract
Blood concentrates like platelet rich fibrin (PRF) have been established as a potential autologous source of cells and growth factors with regenerative properties in the field of dentistry and regenerative medicine. To further analyze the effect of PRF on bone tissue regeneration, this study investigated the influence of liquid PRF matrices on human healthy primary osteoblasts (pOB) and co-cultures composed of pOB and human dermal vascular endothelial cells (HDMEC) as in vitro model for bone tissue regeneration. Special attention was paid to the PRF mediated influence on osteoblastic differentiation and angiogenesis. Based on the low-speed centrifugation concept, cells were treated indirectly with PRF prepared with a low (44 g) and high relative centrifugal force (710 g) before the PRF mediated effect on osteoblast proliferation and differentiation was assessed via gene and protein expression analyses and immunofluorescence. The results revealed a PRF-mediated positive effect on osteogenic proliferation and differentiation accompanied by increased concentration of osteogenic growth factors and upregulated expression of osteogenic differentiation factors. Furthermore, it could be shown that PRF treatment resulted in an increased formation of angiogenic structures in a bone tissue mimic co-culture of endothelial cells and osteoblasts induced by the PRF mediated increased release of proangiogenic growth factors. The effects on osteogenic proliferation, differentiation and vascularization were more evident when low RCF PRF was applied to the cells. In conclusion, PRF possess proosteogenic, potentially osteoconductive as well as proangiogenic properties, making it a beneficial tool for bone tissue regeneration.
Collapse
Affiliation(s)
- Eva Dohle
- FORM, Frankfurt Orofacial Regenerative Medicine, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Lena Schmeinck
- FORM, Frankfurt Orofacial Regenerative Medicine, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Kamelia Parkhoo
- FORM, Frankfurt Orofacial Regenerative Medicine, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Robert Sader
- FORM, Frankfurt Orofacial Regenerative Medicine, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Shahram Ghanaati
- FORM, Frankfurt Orofacial Regenerative Medicine, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Johann Wolfgang Goethe University, Frankfurt, Germany
| |
Collapse
|
2
|
Silva FFVE, Chauca-Bajaña L, Caponio VCA, Cueva KAS, Velasquez-Ron B, Padín-Iruegas ME, Almeida LL, Lorenzo-Pouso AI, Suárez-Peñaranda JM, Pérez-Sayáns M. Regeneration of periodontal intrabony defects using platelet-rich fibrin (PRF): a systematic review and network meta-analysis. Odontology 2024:10.1007/s10266-024-00949-7. [PMID: 38771493 DOI: 10.1007/s10266-024-00949-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/04/2024] [Indexed: 05/22/2024]
Abstract
One of the most promising approaches to correct periodontal bone defects and achieve periodontal regeneration is platelet-rich fibrin (PRF). This systematic review and meta-analysis aimed to evaluate the regeneration of periodontal bone defects using PRF compared to other regenerative treatments. The data search and retrieval process followed the PRISMA guidelines. An electronic search of MEDLINE, Cochrane, and PubMed databases was performed, selecting exclusively randomized clinical trials where the following were measured: probing depth reduction (PD), clinical attachment level gain (CAL), and radiographic bone fill (RBF). Out of 284 selected articles, 32 were chosen based on inclusion criteria. The use of platelet-rich fibrin (PRF) + open flap debridement (OFD), PRF + metformin, PRF + platelet-rich plasma (PRP), and PRF + OFD/bone graft (BG) significantly reduced PD and improved CAL and RBF. However, the combination of PRF + BG, PRF + metformin, and PRF + STATINS reduced CAL. The intervention of PRF combined with different treatments such as metformin, OFD, PRP, BG, and STATINS has a significant impact on improving PD and CAL. The use of PRF significantly improved the regeneration of periodontal bone defects compared to other treatments.
Collapse
Affiliation(s)
- Fábio França Vieira E Silva
- Faculty of Medicine and Dentistry, Oral Surgery and Implantology Unit (MedOralRes, Oral Medicine, Universidade de Santiago de Compostela. Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela University Hospital Complex, Rúa da Choupana, S/N, 15706, Santiago de Compostela, A Coruña, Spain
| | - Luis Chauca-Bajaña
- Periodontics and Implantology Oral Research. College Dentistry, Ecuador. Faculty of Medicine and Dentistry, University of Guayaquil, Oral Medicine, Oral Surgery and Implantology Unit, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | | | | | - Byron Velasquez-Ron
- Dental Prosthesis Department Research. College Dentistry, University of the Americas. UDLA. Av, Colon y 6 de Diciembre, Campus Colón, Quito-Ecuador, Ecuador
| | - Maria Elena Padín-Iruegas
- Human Anatomy and Embryology Area, Department of Functional Biology and Health Sciences, Faculty of Physiotherapy, University of Vigo, 36001, Pontevedra, Spain
| | - Lays Lamolha Almeida
- Department of Dental Medicine, Federal Fluminense University, Rio de Janeiro, 28625650, Brazil
| | - Alejandro Ismael Lorenzo-Pouso
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782, Santiago de Compostela, Spain
| | - José Manuel Suárez-Peñaranda
- Faculty of Medicine and Dentistry, Oral Surgery and Implantology Unit (MedOralRes, Oral Medicine, Universidade de Santiago de Compostela. Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela University Hospital Complex, Rúa da Choupana, S/N, 15706, Santiago de Compostela, A Coruña, Spain.
| | - Mario Pérez-Sayáns
- Faculty of Medicine and Dentistry, Oral Surgery and Implantology Unit (MedOralRes, Oral Medicine, Universidade de Santiago de Compostela. Health Research Institute of Santiago de Compostela (IDIS), Instituto de los Materiales de Santiago de Compostela (iMATUS), Avenida Do Mestre Mateo, 25, 15782, Santiago de Compostela, A Coruña, Spain
| |
Collapse
|
3
|
Karcı B, Savas HB. Comparison of growth factor levels in injectable platelet-rich fibrin obtained from healthy individuals and patients with chronic periodontitis: a pilot study. BMC Oral Health 2024; 24:527. [PMID: 38702671 PMCID: PMC11069209 DOI: 10.1186/s12903-024-04301-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/26/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND This study aimed to assess and compare the concentrations of growth factors, white blood cells (WBCs), and platelets in injectable platelet-rich fibrin (i-PRF) derived from people with healthy periodontal conditions and those with chronic periodontitis. METHODS Venous blood samples were obtained from 30 patients diagnosed with chronic periodontitis (test group) and 30 participants with healthy periodontal conditions (control group). The i-PRF was then acquired from centrifuged blood. The growth factors (VEGF, IGF-1, TGF-β1, PDGF-BB and EGF) released from the i-PRF samples were compared between groups with ELISA testing. The amounts of WBCs and platelets were also compared. RESULTS No significant differences in the concentrations of growth factors were found between the groups (the mean values for the control and test groups were, respectively: IGF: 38.82, 42.46; PDGF: 414.25, 466.28; VEGF: 375.69, 412.18; TGF-β1: 21.50, 26.21; EGF: 138.62, 154.82). The test group exhibited a significantly higher WBC count than the control group (8.80 vs. 6.60, respectively). However, the platelet count did not show a statistically significant difference between the groups (control group 242.0 vs. test group 262.50). No significant correlation was observed between WBC count and growth factor level in either group. CONCLUSIONS The growth factor levels in i-PRFs did not exhibit significant difference between the two groups. This suggests that the levels of these growth factors may be unaffected by the periodontal disease.
Collapse
Affiliation(s)
- Bilge Karcı
- Faculty of Dentistry, Department of Periodontology, Alanya Alaaddin Keykubat University, Alanya, Antalya, Turkey.
| | - Hasan Basri Savas
- Faculty of Medicine, Department of Biochemistry, Mardin Artuklu University, Mardin, Turkey
| |
Collapse
|
4
|
Ural ÜM. The effect of injectable platelet rich fibrin as a nonsurgical treatment of the female stress urinary incontinence. Arch Gynecol Obstet 2024; 309:2229-2236. [PMID: 38424182 DOI: 10.1007/s00404-024-07431-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/12/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE The complications of surgical treatments of stress urinary incontinence have led to the search for less invasive and safer treatment procedures. We aimed to investigate the efficacy of locally administered injectable platelet-rich fibrin (i-PRF), an autologous material that plays an important role in tissue regeneration, in women with stress urinary incontinence. METHODS Thirty-four women were included in this prospective, single-center, and interventional study, suffering from stress urinary incontinence refractory to conservative treatment. Three consecutive i-PRF injections were applied to the mid-urethra localization at anterior vaginal wall with an interval of 1 month. ICIQ-SF, UDI-6, IIQ-7 and POPDI-6 questionnaires were used to measure pre‑treatment, 1 month and 6 months post‑treatment symptom severity and the clinical outcomes were recorded. RESULTS The mean age of the patients was 51.5 ± 9.8 years. ICIQ-SF, UDI-6, IIQ-7 and POPDI-6 questionnaires results revealed significant clinical improvement of stress urinary incontinence severity afer the administration of i-PRF (p < 0.001). The results at 1 and 6 months after treatment did not change statistically significantly. CONCLUSION This study demonstrated that locally administiration of i-PRF is efective in relieving SUI symptoms with high success rates without any adverse effects reported. i-PRF injection may have the potential to be a novel, minimally invasive, and low-risk procedure, that could be an alternative and simple treatment modality to surgery for female patients with stress urinary incontinence. Additionally, it may create new avenues for research on therapeutic implementation of i-PRF.
Collapse
Affiliation(s)
- Ülkü Mete Ural
- Department of Obstetrics and Gynecology, Faculty of Medicine, Bolu Abant İzzet Baysal University, Gölköy Yerleşkesi, 14030, Bolu, Turkey.
| |
Collapse
|
5
|
Yavuz A, Güngörmek HS, Kuru L, Doğan B. Treatment of multiple adjacent gingival recessions using leucocyte- and platelet-rich fibrin with coronally advanced flap: a 12-month split-mouth controlled randomized clinical trial. Clin Oral Investig 2024; 28:291. [PMID: 38691209 PMCID: PMC11062988 DOI: 10.1007/s00784-024-05694-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/24/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE This split-mouth randomized study aimed to assess efficacy of leucocyte-platelet-rich fibrin (L-PRF) versus connective tissue graft (CTG) in achieving root coverage (RC) for multiple adjacent gingival recessions (MAGRs) throughout 12-month period. MATERIALS AND METHODS The study enrolled 59 teeth from 12 patients with Miller Class I MAGRs ≥ 2 mm on bilateral or contralateral sides. Patients were randomly assigned to receive coronally advanced flap (CAF) with either CTG (control) or L-PRF (test) treatment. Various parameters, including plaque and gingival index, clinical attachment level, recession depth, probing depth, recession width (RW), papilla width (PW), keratinized tissue width (KTW), gingival thickness (GT), percentage of RC, complete root coverage (CRC), and location of the relative gingival margin concerning the cemento-enamel junctions (GMCEJ) after CAF, were recorded at baseline, 3-, 6-, and 12-months post-surgery. On June 29, 2021 the study was registred to ClinicalTrials.gov (NCT04942821). RESULTS Except KTW and GT gain, all clinical parameters, RC, and CRC were similar between the groups at all follow-up periods (p > 0.05). The higher GT and KTW gains were detected in the control group compared to test group at 12 months (p < 0.05). Both RC and CRC were positively associated with initial PW and GMCEJ, but negatively with initial RW (p < 0.05). CONCLUSIONS The current study concludes that L-PRF were equally effective as CTG in treating MAGRs in terms of RC and CRC. Additionally, RC and CRC outcomes appeared to be influenced by GMCEJ, PW, and RW. CLINICAL RELEVANCE L-PRF could represent a feasible substitute for CTG in treating MAGRs.
Collapse
Affiliation(s)
- Atacan Yavuz
- Department of Periodontology, Institute of Health Sciences, Marmara University, Istanbul, Türkiye
| | - Hatice Selin Güngörmek
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, 34854, Türkiye
| | - Leyla Kuru
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, 34854, Türkiye
| | - Başak Doğan
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, 34854, Türkiye.
- Department of Oral Health Science and Translational Research, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA.
| |
Collapse
|
6
|
Siddiqui HP, Sennimalai K, Kaur A, Selvaraj M, Monga N, Mohaideen K. Does the adjunctive use of autologous platelet concentrate during secondary alveolar bone grafting reduce the risk of wound dehiscence? A systematic review and meta-analysis. J Craniomaxillofac Surg 2024:S1010-5182(24)00165-3. [PMID: 38729847 DOI: 10.1016/j.jcms.2024.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/10/2024] [Accepted: 04/27/2024] [Indexed: 05/12/2024] Open
Abstract
Wound dehiscence is a common complication after secondary alveolar bone grafting (SABG), leading to unfavourable surgical outcomes. Studies have shown that autologous platelet concentrates (APC) may enhance wound healing and improve outcomes. Therefore, this review aimed to evaluate in patients with alveolar clefts, whether using APC and iliac crest bone graft can mitigate the likelihood of wound dehiscence formation compared with those who underwent iliac bone grafting only following SABG. A comprehensive literature search was conducted using various electronic databases, including PubMed, Embase, Scopus, Web of Science, EBSCOhost, Ovid MEDLINE, LILACS, Cochrane Library, and grey literature, to include studies until July 31, 2023, without any restriction to language and time of publication. Only randomized (RCT) and controlled (CCT) clinical trials were included. Two independent reviewers screened the studies based on the predefined criteria, after which a qualitative and quantitative analysis was conducted. The search yielded 821 studies, of which seven were deemed eligible for systematic review. The risk of bias assessment done using "The Cochrane collaboration tool for risk of bias assessment" for six RCTs and the "Risk of Bias in Non-randomized Studies - of Interventions" for one CCT revealed a moderate to high risk of bias. The meta-analysis of five studies showed that the overall risk of developing wound dehiscence was lower in the APC group (RR = 0.33; 95% CI: 0.16, 0.71; p = 0.005; χ2 = 0.82; I2 = 0%). Subgroup analyses based on study design further supported these findings. Although the adjuvant use of APC for alveolar cleft reconstruction reduces the risk of wound dehiscence, more studies with increased scientific rigour and fewer confounding variables are warranted.
Collapse
Affiliation(s)
| | - Karthik Sennimalai
- Department of Orthodontics, All India Institute of Medical Sciences, Vijaypur, Jammu, Jammu & Kashmir, India.
| | - Amanjot Kaur
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Vijaypur, Jammu, Jammu & Kashmir, India.
| | - Madhanraj Selvaraj
- Division of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
| | - Nitika Monga
- Division of Non-Communicable Diseases, Indian Council of Medical Research Headquarters, New Delhi, India.
| | - Kaja Mohaideen
- Department of Dentistry, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India.
| |
Collapse
|
7
|
Mourão CF, Dohle E, Bayrak B, Winter A, Sader R, Ghanaati S. Leukocytes within Autologous Blood Concentrates Have No Impact on the Growth and Proliferation of Human Primary Osteoblasts: An In Vitro Study. Int J Mol Sci 2024; 25:4542. [PMID: 38674127 PMCID: PMC11050025 DOI: 10.3390/ijms25084542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
Platelet-rich fibrin (PRF) is a widely used autologous blood concentrate in regenerative medicine. This study aimed to characterize the cellular composition and distribution of different PRF matrices generated by high (710 g) and low (44 g) relative centrifugal forces (RCFs) and to analyze their bioactivity on human primary osteoblasts (pOBs). PRF was separated into upper layer (UL) and buffy coat (BC) fractions, and their cellular contents were assessed using histological and immunohistochemical staining. The release of platelet-derived growth factor (PDGF) and transforming growth factor (TGF-β) was quantified using an ELISA. Indirect PRF treatment on pOBs was performed to evaluate cell viability and morphology. A histological analysis revealed higher quantities of leukocytes and platelets in the low-RCF PRF. TGF-β release was significantly higher in the low-RCF PRF compared to the high-RCF PRF. All PRF fractions promoted pOB proliferation regardless of the centrifugation protocol used. The low-RCF PRF showed higher TGF-β levels than the high-RCF PRF. These findings contribute to understanding the cellular mechanisms of PRF and provide insights into optimizing PRF protocols for bone regeneration, advancing regenerative medicine, and improving patient outcomes.
Collapse
Affiliation(s)
- Carlos Fernando Mourão
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA 02111, USA;
| | - Eva Dohle
- FORM—Frankfurt Orofacial Regenerative Medicine, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Johann Wolfgang Goethe University, 60590 Frankfurt, Germany; (B.B.); (A.W.); (R.S.)
| | - Büşra Bayrak
- FORM—Frankfurt Orofacial Regenerative Medicine, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Johann Wolfgang Goethe University, 60590 Frankfurt, Germany; (B.B.); (A.W.); (R.S.)
| | - Anne Winter
- FORM—Frankfurt Orofacial Regenerative Medicine, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Johann Wolfgang Goethe University, 60590 Frankfurt, Germany; (B.B.); (A.W.); (R.S.)
| | - Robert Sader
- FORM—Frankfurt Orofacial Regenerative Medicine, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Johann Wolfgang Goethe University, 60590 Frankfurt, Germany; (B.B.); (A.W.); (R.S.)
| | - Shahram Ghanaati
- FORM—Frankfurt Orofacial Regenerative Medicine, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Johann Wolfgang Goethe University, 60590 Frankfurt, Germany; (B.B.); (A.W.); (R.S.)
| |
Collapse
|
8
|
Anapu MP, Atluri KR, Chandra Tripuraneni S, Issrani R, Bader AK, Alkhalaf ZA, Sghaireen MG, Prabhu N, Rbea DH Alshammari R, Khalid G, Matab G, Khan FH. Evaluation of effect on stability of implants with and without platelet rich fibrin using a resonance frequency analyzer - An in-vivo study. Heliyon 2024; 10:e27971. [PMID: 38623195 PMCID: PMC11016576 DOI: 10.1016/j.heliyon.2024.e27971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 03/03/2024] [Accepted: 03/08/2024] [Indexed: 04/17/2024] Open
Abstract
Background Although the conventional replacement for lost teeth has been partial or full dentures, the need for a fixed, esthetic, and functional restoration makes dental implants a reliable alternative. Aim To evaluate the initial and final stability of platelet rich fibrin coated implants using resonance frequency analyzer. Method ology: Thirteen patients with two or more missing teeth were informed about the procedure, and a consent form was obtained after cone beam computer tomography evaluation. Blood was drawn from the anticubital area of the patient, which was centrifuged to obtain platelet-rich fibrin. In all, 26 implants were placed, among which 13 were platelet-rich fibrin-coated (test group) and 13 were without platelet-rich fibrin (control group), and implant stability quotient values were recorded. Results The mean age of the patients was 34.4 (SD = 4.28). Majority of the patients were males (9; 69.2%) whereas there were only four (30.8%) female patients. When comparison between overall primary implant stability with and without PRF was done, the mean difference was 5.12 and this difference was not statistically significant (p = 0.221) whereas a statistically significant difference (p = 0.019) was found when comparison between overall secondary implant stability was done with and without PRF. The primary and secondary stability values for the control group were 69.18 ± 7.45 and 73.84 ± 8.21 respectively, and the primary and secondary stability values for the test group were 64.06 ± 12.66 and 81.49 ± 7.61 respectively, which showed statistically significant differences among the groups. The difference in these values signify that primary stability is more in control group whereas secondary stability is more in case group. This signifies that PRF enhances the stability of implant. Conclusion Implants coated with platelet-rich fibrin exhibited better osseointegration than implants without platelet-rich fibrin.
Collapse
Affiliation(s)
- Mounica Priya Anapu
- Department of Prosthodontics, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnaoutapalli, India
| | - Kaleswara Rao Atluri
- Department of Prosthodontics, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnaoutapalli, India
| | - Sunil Chandra Tripuraneni
- Department of Prosthodontics, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnaoutapalli, India
| | - Rakhi Issrani
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
| | - Alzarea K. Bader
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
| | - Zainab A. Alkhalaf
- Department of Prosthetic Dental Sciences, Ministry of Health, Kingdom of Saudi Arabia
| | - Mohammed Ghazi Sghaireen
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
| | - Namdeo Prabhu
- Department of Oral & Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | | | - Ghosoun Khalid
- College of Medicine, University of Hail, Hail, Kingdom of Saudi Arabia
| | - Ghada Matab
- College of Medicine, University of Hail, Hail, Kingdom of Saudi Arabia
| | - Farida Habib Khan
- Department of Family and Community Medicine, College of Medicine, University of Hail, Hail, Kingdom of Saudi Arabia
| |
Collapse
|
9
|
Adamska P, Pylińska-Dąbrowska D, Stasiak M, Kaczoruk-Wieremczuk M, Kozłowska E, Zedler A, Studniarek M. Treatment of Odontogenic Maxillary Sinusitis with the Use of Growth Factors in Advanced Platelet-Rich Fibrin for Immediate Closure of Oro-Antral Communication: A Case Report. Int J Mol Sci 2024; 25:4339. [PMID: 38673924 PMCID: PMC11049874 DOI: 10.3390/ijms25084339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Chronic odontogenic maxillary sinusitis (COMS), a prolonged inflammation of the maxillary sinus lasting over 12 weeks, is often a result of periapical lesions, marginal periodontitis, and complications like oro-antral communication (OAC) and fistula (OAF). OAC, commonly emerging post-teeth extraction in the lateral maxilla, lacks documented treatments using advanced platelet-rich fibrin (A-PRF). This study evaluates A-PRF's efficacy in treating COMS and immediately sealing extensive OAC. A case of a 28-year-old male with COMS linked to a periapical lesion and supernumerary molars is presented. Treatment involved extracting specific teeth while preserving adjacent ones and using A-PRF for immediate OAC closure. A-PRF, enriched with growth factors, was pivotal in healing, showcasing enhanced tissue regeneration, pain reduction, and faster recovery. The findings suggest A-PRF as an effective adjunct in treating extensive OAC and COMS, proposing its inclusion in standard treatment protocols. This study underscores A-PRF's potential in improving outcomes for patients with COMS and related complications.
Collapse
Affiliation(s)
- Paulina Adamska
- Division of Oral Surgery, Faculty of Medicine, Medical University of Gdańsk, 7 Dębinki Street, 80-210 Gdańsk, Poland;
| | - Dorota Pylińska-Dąbrowska
- Department of Dental Prosthetics, Faculty of Medicine, Medical University of Gdańsk, 18 Orzeszkowej Street, 80-204 Gdańsk, Poland;
| | - Marcin Stasiak
- Division of Orthodontics, Faculty of Medicine, Medical University of Gdańsk, Aleja Zwycięstwa 42c, 80-210 Gdańsk, Poland;
| | - Magdalena Kaczoruk-Wieremczuk
- Individual Specialist Oral Surgery Practice Magdalena Kaczoruk-Wieremczuk, 41/31 Władysława Wysockiego Street, 17-100 Bielsk Podlaski, Poland;
| | - Ewa Kozłowska
- Institute of Manufacturing and Materials Technology, Faculty of Mechanical Engineering and Ship Technology, Gdańsk University of Technology, 11/12 Gabriela Narutowicza Street, 80-233 Gdańsk, Poland;
| | - Adam Zedler
- Division of Oral Surgery, Faculty of Medicine, Medical University of Gdańsk, 7 Dębinki Street, 80-210 Gdańsk, Poland;
| | - Michał Studniarek
- Department of Radiology, Faculty of Medicine, Medical University of Gdańsk, 17 Smoluchowskiego Street, 80-210 Gdańsk, Poland;
| |
Collapse
|
10
|
Torumtay Cin G, Lektemur Alpan A, Açikgöz G, Özlü Uçan G. Ultrasonographic analysis of palatal donor site healing accelerated with platelet-rich fibrin following subepithelial connective tissue harvesting. J Appl Oral Sci 2024; 32:e20230448. [PMID: 38655988 DOI: 10.1590/1678-7757-2023-0448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/21/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE Platelet-rich fibrin (PRF) contains a variety of growth factors and bioactive molecules that play crucial roles in wound healing and angiogenesis. We aimed to evaluate the effects of PRF on tissue thickness and vascularization of the palatal donor site by ultrasound (USG) following subepithelial connective tissue harvesting. METHODOLOGY A subepithelial connective tissue graft was harvested from the palatal region with a single incision for root coverage in 20 systemically healthy patients. In the test group (n = 10), the PRF membrane was placed at the donor site, whereas no material was applied in the control group (n=10). Palatal tissue thickness (PTT) and pulsatility index (PI) were evaluated by USG at baseline and on the 3rd, 7th, 14th, 30th, and 90th days after surgery. The early healing index (EHI) was used to evaluate donor site healing for 30 days. RESULTS PTT was significantly higher in the PRF group on the 3rd and 14th days after surgery when compared to the controls. In the PRF-treated group, PI levels were significantly higher than in the controls, especially on the 14th day. PTT increased significantly 90 days after surgery compared to the test group baseline, but controls showed a significant decrease. The PRF group showed statistically significant improvements in EHI scores compared to controls on days 3, 7, and 14. This study found a negative correlation between PI values and EHI scores on postoperative days three and seven in the test group. CONCLUSION USG is a non-invasive, objective method to radiographically evaluate the regenerative effects of PRF on palatal wound healing after soft tissue harvesting. To overcome graft inadequacy in reharvesting procedures, PRF application may enhance clinical success and reduce possible complications by increasing tissue thickness and revascularization in the donor area.
Collapse
Affiliation(s)
- Gizem Torumtay Cin
- Pamukkale University, Faculty of Dentistry, Department of Periodontology, Denizli, Turkey
| | - Aysan Lektemur Alpan
- Pamukkale University, Faculty of Dentistry, Department of Periodontology, Denizli, Turkey
| | - Gözde Açikgöz
- Pamukkale University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Denizli, Turkey
| | - Gülfem Özlü Uçan
- Gelişim University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, İstanbul, Turkey
| |
Collapse
|
11
|
Gasparro R, Di Lauro AE, Campana MD, Rosiello N, Mariniello M, Sammartino G, Marenzi G. Effectiveness of Autologous Platelet Concentrates in the Sinus Lift Surgery: Findings from Systematic Reviews and Meta-Analyses. Dent J (Basel) 2024; 12:101. [PMID: 38668013 PMCID: PMC11049363 DOI: 10.3390/dj12040101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/20/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Maxillary sinus augmentation is one of the most predictable procedures for the rehabilitation of the posterior maxilla. The current overview aimed to summarize the findings provided by systematic reviews (SRs) and meta-analyses on the effectiveness of autologous platelet concentrates (APCs) in sinus lift and to assess the methodological quality of the included SRs. Three electronic databases have been explored. SRs and meta-analyses addressing the effectiveness of APCs in sinus lift technique were included. Clinical, radiographic and histomorphometric findings were considered for APCs as solely grafting materials and APCs in combination with biomaterials. Outcomes were implant survival rate (ISR), implant stability (IS), implant failure (IF), postoperative complications, histomorphometric findings, radiographic bone gain, bone volume and bone density. The methodological quality of the included SRs was assessed using the updated version of "A Measurement Tool to Assess Systematic Review" (AMSTAR-2). Thirty SRs were included. The methodological quality of the included reviews ranged from critically low (3 studies) to high (9 studies). The included SRs showed favorable clinical outcomes, short-term new bone formation and no biological complications when APCs were used both as solely graft material or in combination with other biomaterials. However, no significant additional effects in the long-term period were observed. APCs did not add any further positive effects compared to the physiological healing derived by the natural blood clot. The current overview of SRs highlighted the need for high-quality SRs evaluating the role of APCs in sinus lift though network meta-analyses, in order to identify the most powerful material for sinus lift augmentation. The use of APCs improves the healing of soft tissues and the postoperative quality of life in the short-term period. Thus, its application can be recommended.
Collapse
Affiliation(s)
| | | | | | | | | | - Gilberto Sammartino
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Oral Surgery, University of Naples Federico II, 80131 Naples, Italy; (R.G.); (A.E.D.L.); (M.D.C.); (N.R.); (M.M.); (G.M.)
| | | |
Collapse
|
12
|
Oliveira JA, da Silveira MI, Soares LFF, Alves RDO, Carrera TMI, Azevedo MR, Oliveira GJPLD, Pigossi SC. Wound-healing agents for palatal donor area: A network meta-analysis. Clin Oral Implants Res 2024; 35:359-376. [PMID: 38315151 DOI: 10.1111/clr.14241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/18/2023] [Accepted: 01/13/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND The aim of this systematic review and network meta-analysis (NMA) was to assess the efficacy of different wound-healing agents for palatal donor area management after soft tissue graft harvesting. METHODS Electronic searches in six databases were conducted for publications up to October 2023. Studies with data from patients undergoing therapeutic approaches using agents for palatal healing after gingival graft harvesting were included. Data about postoperative pain, wound-healing and postoperative complications reported for each agent were extracted. Three different tools were used for the risk of bias within studies evaluation (Murad tool for case series and case report, RoB 2.0 tool for randomized studies and ROBINS-I tool for non-randomized studies). A Bayesian random effects NMA was conducted for postoperative pain levels and wound healing. RESULTS Eighty-four publications were included in the systematic review (qualitative analysis), with 14 of these subjected to NMA (quantitative analysis). The summarized results from the qualitative and quantitative analysis showed that all wound-healing agents evaluated promoted better pain control and wound healing compared to spontaneous healing and hemostatic sponges alone. The NMA outcomes reveal that leucocyte- and platelet-rich fibrin (L-PRF) was the most effective agent in reducing postoperative pain in all analyzed periods. Moreover, the L-PRF seems to accelerate wound healing and reduce postoperative complications compared to other agents. CONCLUSION In conclusion, the L-PRF was the most effective agent in reducing postoperative pain, accelerating wound healing and reducing postoperative complications after harvesting soft tissue grafts from the palatal area.
Collapse
Affiliation(s)
- Jovânia Alves Oliveira
- School of Dentistry, Alfenas Federal University (Unifal-MG), Alfenas, Minas Gerais, Brazil
- Department of Periodontology and Implantodontology, School of Dentistry, Federal University of Uberlandia - UFU, Uberlandia, Minas Gerais, Brazil
| | | | - Lélio Fernando Ferreira Soares
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, UNESP - São Paulo State University (FOAr/UNESP), Araraquara, São Paulo, Brazil
| | - Roberta de Oliveira Alves
- Department of Periodontology and Implantodontology, School of Dentistry, Federal University of Uberlandia - UFU, Uberlandia, Minas Gerais, Brazil
| | - Thaísa Macedo Iunes Carrera
- Department of Periodontology and Implantodontology, School of Dentistry, Federal University of Uberlandia - UFU, Uberlandia, Minas Gerais, Brazil
| | - Mayra Resende Azevedo
- Department of Periodontology and Implantodontology, School of Dentistry, Federal University of Uberlandia - UFU, Uberlandia, Minas Gerais, Brazil
| | | | - Suzane Cristina Pigossi
- Department of Periodontology and Implantodontology, School of Dentistry, Federal University of Uberlandia - UFU, Uberlandia, Minas Gerais, Brazil
| |
Collapse
|
13
|
Ramírez DG, Inostroza C, Rouabhia M, Rodriguez CA, Gómez LA, Losada M, Muñoz AL. Osteogenic potential of apical papilla stem cells mediated by platelet-rich fibrin and low-level laser. Odontology 2024; 112:399-407. [PMID: 37874511 PMCID: PMC10925562 DOI: 10.1007/s10266-023-00851-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/31/2023] [Indexed: 10/25/2023]
Abstract
To evaluate the osteogenic potential of platelet-rich fibrin (PRF) and low-level laser therapy (LLLT) on human stem cells from the apical papilla (SCAP) we isolated, characterized, and then cultured in an osteogenic medium cells with PRF and/or LLLT (660 nm, 6 J/m2-irradiation). Osteogenic differentiation was assessed by bone nodule formation and expression of bone morphogenetic proteins (BMP-2 and BMP-4), whereas the molecular mechanisms were achieved by qRT-PCR and RNA-seq analysis. Statistical analysis was performed by ANOVA and Tukey's post hoc tests (p < 0.05* and p < 0.01**). Although PRF and LLLT increased bone nodule formation after 7 days and peaked at 21 days, the combination of PRF + LLLT led to the uppermost nodule formation. This was supported by increased levels of BMP-2 and -4 osteogenic proteins (p < 0.005). Furthermore, the PRF + LLLT relative expression of specific genes involved in osteogenesis, such as osteocalcin, was 2.4- (p = 0.03) and 28.3- (p = 0.001) fold higher compared to the PRF and LLLT groups, and osteopontin was 22.9- and 1.23-fold higher, respectively (p < 0.05), after 7 days of interaction. The transcriptomic profile revealed that the combination of PRF + LLLT induces MSX1, TGFB1, and SMAD1 expression, after 21 days of osteogenic differentiation conditions exposition. More studies are required to understand the complete cellular and molecular mechanisms of PRF plus LLLT on stem cells. Overall, we demonstrated for the first time that the combination of PRF and LLLT would be an excellent therapeutic tool that can be employed for dental, oral, and craniofacial repair and other tissue engineering applications.
Collapse
Affiliation(s)
- David Gutiérrez Ramírez
- Buccal Innovation Research Group, Faculty of Dentistry, Universidad Antonio Nariño, Popayán, Colombia
| | | | | | - Camilo Alfonso Rodriguez
- Faculty of Dentistry. Research Group of Oral Health, Universidad Antonio Nariño, Bogotá, Colombia
| | - Lina Andrea Gómez
- School of Medicine, Biomedical Research Center (CIBUS), Universidad de La Sabana, Chía, Colombia
| | - Mónica Losada
- Cellular and Functional Biology and Biomolecule Engineering Research Group, Faculty of Science, Universidad Antonio Nariño, Bogotá, Colombia
| | - Ana Luisa Muñoz
- Cellular and Functional Biology and Biomolecule Engineering Research Group, Faculty of Science, Universidad Antonio Nariño, Bogotá, Colombia.
- Fundación Banco Nacional de Sangre Hemolife, Calle 23 No. 116-31, Bodega 26. Parque Industrial Puerto Central, Bogotá, Colombia.
| |
Collapse
|
14
|
Ibrahim SSA, Mandil IA, Ezzatt OM. Injectable platelet rich fibrin effect on laser depigmented gingiva: a clinical randomized controlled split mouth trial with histological assessment. J Appl Oral Sci 2024; 32:e20230307. [PMID: 38536994 PMCID: PMC11018297 DOI: 10.1590/1678-7757-2022-0307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/16/2023] [Accepted: 01/22/2024] [Indexed: 04/17/2024] Open
Abstract
OBJECTIVE To determine whether intra-mucosal injection of injectable platelet-rich fibrin (i-PRF) can promote healing after Diode Laser Gingival Depigmentation (DLGD). METHODOLOGY A total of 20 arch sites of hyperpigmented gingiva of 10 patients underwent DLGD. For each patient, two arch sites were randomly assigned for either intra-mucosal injection of i-PRF (G1-i-PRF) (n=10 sites) or no treatment (G2-Control): (n=10 sites). Wound Healing Score (WHS), patient satisfaction, and Pigmentation Index (DOPI) were measured at 1 week and 1 and 3 months postoperatively. Histological assessment of tissue specimens was performed at baseline and 1 week. RESULTS The percentage change in WHS at 1 week was significantly higher in G1 (58.34±15.43) compared to G2 (37.50±11.79). At day 1, 50% of patients in G1 were pain free compared with 75% in G2, who had mild pain. Mean DOPI decreased significantly at 3 months in both groups (P-value <0.001), without significant differences between groups. G1 specimens showed significantly higher epithelial thickness (P-value <0.001), as well as a higher number of blood vessels and less percentage of inflammatory cells. CONCLUSIONS i-PRF demonstrated better clinical and histological healing potential and less patient discomfort compared to sites without treatment after DLGD. Registered at https://clinicaltrials.gov/ as (NCT05283668).
Collapse
Affiliation(s)
- Suzan Seif Allah Ibrahim
- Ain-Shams University, Faculty of Dentistry, Department of Oral Medicine, Periodontology and Oral Diagnosis, Cairo, Egypt
- Nahda University, Faculty of Dental Medicine, Department of Oral Medicine, Periodontology Oral Diagnosis and Radiology, Beni Suef, Egypt
| | - Ibrahim Abu Mandil
- Ain-Shams University, Faculty of Dentistry, Department of Oral Medicine, Periodontology and Oral Diagnosis, Cairo, Egypt
| | - Ola Mohamed Ezzatt
- Ain-Shams University, Faculty of Dentistry, Department of Oral Medicine, Periodontology and Oral Diagnosis, Cairo, Egypt
- Ain-Shams University, Faculty of Dentistry, Central Lab of Stem Cells and Biomaterial Applied Research (CLSBAR), Cairo, Egypt
| |
Collapse
|
15
|
Najafi Z, Rahmanian-Devin P, Baradaran Rahimi V, Nokhodchi A, Askari VR. Challenges and opportunities of medicines for treating tendon inflammation and fibrosis: A comprehensive and mechanistic review. Fundam Clin Pharmacol 2024:e12999. [PMID: 38468183 DOI: 10.1111/fcp.12999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/20/2024] [Accepted: 02/19/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Tendinopathy refers to conditions characterized by collagen degeneration within tendon tissue, accompanied by the proliferation of capillaries and arteries, resulting in reduced mechanical function, pain, and swelling. While inflammation in tendinopathy can play a role in preventing infection, uncontrolled inflammation can hinder tissue regeneration and lead to fibrosis and impaired movement. OBJECTIVES The inability to regulate inflammation poses a significant limitation in tendinopathy treatment. Therefore, an ideal treatment strategy should involve modulation of the inflammatory process while promoting tissue regeneration. METHODS The current review article was prepared by searching PubMed, Scopus, Web of Science, and Google Scholar databases. Several treatment approaches based on biomaterials have been developed. RESULTS This review examines various treatment methods utilizing small molecules, biological compounds, herbal medicine-inspired approaches, immunotherapy, gene therapy, cell-based therapy, tissue engineering, nanotechnology, and phototherapy. CONCLUSION These treatments work through mechanisms of action involving signaling pathways such as transforming growth factor-beta (TGF-β), mitogen-activated protein kinases (MAPKs), and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), all of which contribute to the repair of injured tendons.
Collapse
Affiliation(s)
- Zohreh Najafi
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Pouria Rahmanian-Devin
- Department of Pharmaceutics, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vafa Baradaran Rahimi
- Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Nokhodchi
- Lupin Pharmaceutical Research Center, 4006 NW 124th Ave., Coral Springs, Florida, Florida, 33065, USA
- Pharmaceutics Research Laboratory, School of Life Sciences, University of Sussex, Brighton, BN1 9QJ, UK
| | - Vahid Reza Askari
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
16
|
Yari A, Fasih P, Ghotbi N, Badkoobeh A, Goodarzi A, Hosseini Hooshiar M. Do Platelet-Rich Concentrates Improve the Adverse Sequelae of Impacted Mandibular Third Molar Removal? J Oral Maxillofac Surg 2024:S0278-2391(24)00130-7. [PMID: 38513712 DOI: 10.1016/j.joms.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Several measures have been implemented to minimize the side effects of impacted third molar (M3) removal including the use of platelet-rich fibrin (PRF). PURPOSE This study compared the effects of three modifications of PRF (leukocyte-PRF [L-PRF], advanced-PRF [A-PRF], and advanced-PRF plus [A-PRF +]) on the side effects of impacted M3 removal. STUDY DESIGN, SETTING, AND SAMPLE This double-blinded randomized controlled trial was conducted at the Oral Surgery Department of Kashan University between September 2022 and May 2023 on patients undergoing mandibular impacted M3 removal. Exclusion criteria were age over 30, local inflammation and infection, medication usage, and systemic disease. INDEPENDENT VARIABLE The independent variable was the PRF product grouped into four categories (control, L-PRF, A-PRF, and A-PRF+). Study subjects were randomly distributed among the four groups. MAIN OUTCOME VARIABLE(S) The main outcome variables were postoperative sequelae including measures of soft tissue healing, pain, analgesic use, alveolar osteitis, trismus, and swelling. Subjects were assessed at baseline and on days 1, 2, 3, and 7 postsurgery. COVARIATES Age, sex, duration of surgery, and side of surgery were the covariates. ANALYSES Changes at different time points were analyzed using repeated measures analysis of variance. Pairwise comparisons were performed if significant. P values ≤.05 were considered statistically significant. RESULTS The sample consisted of 64 subjects (16 per group). All three modifications of PRF yielded significantly better soft tissue healing index than the control group on days 2, 3, 7, and 14 postoperatively (P > .05). A-PRF and A-PRF + had significantly better healing index than L-PRF on the third day (P = .02, P = .01). All the study groups significantly reduced visual analog scale pain score than the control group on days 1, 2, and 3. A-PRF and A-PRF + had significantly lower visual analog scale scores than L-PRF on the second day (P = .003, P = .02). No significant difference was found in maximum mouth opening during follow-up sessions (P = .2). Study groups had less facial swelling on days 2 and 3 than the control group (P < .05). CONCLUSION AND RELEVANCE L-PRF, A-PRF, and A-PRF + can improve postoperative outcomes after M3 removal but may not impact trismus. A-PRF and A-PRF + may be more effective than L-PRF in promoting soft tissue healing and reducing pain. A-PRF and A-PRF + have comparable results.
Collapse
Affiliation(s)
- Amir Yari
- Assistant Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Kashan University of Medical Sciences, Kashan, Iran.
| | - Paniz Fasih
- Assistant Professor, Department of Prosthodontics, School of Dentistry, Kashan University of Medical Sciences, Kashan, Iran
| | - Nader Ghotbi
- General Dentist, Isfahan Azad University, School of Dentistry, Isfahan, Iran
| | - Ashkan Badkoobeh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Qom University of Medical Sciences, Qom, Iran
| | - Ali Goodarzi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hosseini Hooshiar
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences & Department of Periodontology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
17
|
Sharan J, Shivakumar I, Shivakumar A, Kamal VK, Chaudhari PK, Challasany S, Marya A. Does the use of platelet-rich fibrin enhance the rate of orthodontic tooth movement? A systematic review and meta-analysis. J Oral Biol Craniofac Res 2024; 14:192-200. [PMID: 38434677 PMCID: PMC10909602 DOI: 10.1016/j.jobcr.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 02/15/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction This review synthesizes the available evidence pertinent to the effect of platelet-rich fibrin on the rate of orthodontic tooth movement during comprehensive orthodontic treatment. Method This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Nine electronic databases were searched until January 2024 without restrictions, followed by a hand search of the reference lists. Controlled randomized split-mouth human studies assessing the effect of platelet-rich fibrin on the rate of orthodontic tooth movement were included. All relevant data from the included studies were extracted and pooled for qualitative and quantitative analysis. Risk-of-Bias was assessed using the Cochrane Risk of Bias tool. The certainty of the evidence was graded using the Grading of Recommendations, Assessment, Development, and Evaluation tool. Results From 515 studies, eleven randomized clinical trials were included for qualitative analysis and nine for quantitative analysis. The certainty of the evidence for these studies was low to moderate. The overall risk of bias for most studies was of some concern. The pooled estimate of the data from ten studies has a mean revealed difference of 1.31 (0.13-2.48) at a 95 % confidence interval with significant heterogeneity. Conclusions This systematic review suggest that platelet-rich fibrin enhances the orthodontic tooth movement rate, but the evidence quality was moderate. Further, based on the currently available evidence, the effectiveness of platelet-rich fibrin on the acceleration of orthodontic tooth movement could not be fully established. Trial registration PROSPERO: (CRD42021261836).
Collapse
Affiliation(s)
- Jitendra Sharan
- Unit of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Indumathi Shivakumar
- Department of Prosthodontics, Faculty of Dentistry, SEGi University, Selangor, Malaysia
| | - Arunachalam Shivakumar
- Division of Children & Community Oral Health, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Vineet Kumar Kamal
- Division of Epidemiology and Biostatistics, Indian Council of Medical Research-National Institute of Epidemiology, Chennai, India
| | - Prabhat Kumar Chaudhari
- Department of Orthodontics and Dentofacial Orthopedics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | | | - Anand Marya
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
| |
Collapse
|
18
|
Abdel-Haffiez SH, Khalil NM. Effect of platelet rich plasma injection on bone formation in the expanded mid-palatal suture in rabbits: a randomized controlled animal study. BMC Oral Health 2024; 24:167. [PMID: 38308245 PMCID: PMC10835953 DOI: 10.1186/s12903-024-03922-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 01/21/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Mid-Palatal suture expansion needs long retention period due to delayed bone formation in the expanded suture. Platelet-rich plasma (PRP) is a concentrated source of growth factors which increase bone formation. The aim of this study was to evaluate the effect of PRP injection on bone formation in expanded mid palatal suture in rabbits. METHODS In this prospective randomized controlled animal study, Twenty male rabbits (8-weeks-old) were subjected to mid-palatal expansion for 5 days. Animals were afterwards randomly divided into control group A & study group B. PRP was prepared and injected in the mid-palatal suture in animals belonging to group B only. After 6 weeks of retention, all animals were euthanized, and premaxillae were prepared for histological, histomorphometric and immunohistochemical analysis. Student t-test and paired t-test were used to compare the means of the two groups and within the same group respectively. Significance level set at p ≤ 0.05. RESULTS Histomorphometric analysis revealed a significant increase (p < 0.001) in the mean percentage of new bone in the study group (14.4%) compared to the control (1.4%). Suture width in study group was significantly wider than the control group (278.8 ± 9μms and 120.4 ± 3.4μms, p < 0.001). There was a significant increase in vascular density in study group than control group (309 ± 65.34 and 243.86 ± 48.1, p = 0.021). Osteopontin immuno-expression revealed a significant increase in optical density in study group than control group (0.21 ± 0.02 & 0.12 ± 0.01, p < 0.001). CONCLUSIONS In rabbit model, PRP injection can accelerate new bone formation in the expanded mid-palatal suture when compared to the control. This could hopefully result in a more stable midpalatal expansion and a reduced retention period.
Collapse
|
19
|
Tapashetti R, Bhutani N, Deodurg S, Kulkarni A. A Comparative Evaluation of Efficacy of Root Surface Biomodification using MTAD, MTAD+I-PRF on Adhesion of Fibrin Clot to Dentin Sem Study. J Pharm Bioallied Sci 2024; 16:S431-S433. [PMID: 38595435 PMCID: PMC11001077 DOI: 10.4103/jpbs.jpbs_649_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 08/17/2023] [Accepted: 08/31/2023] [Indexed: 04/11/2024] Open
Abstract
Root biomodifiers help in removing the smear layer following mechanical debridement. In this context, we evaluated and compared the in vitro efficacy of MTAD, MTAD+I-PRF, and phosphate-buffered saline-conditioned dentin surfaces by examining the distribution of the fibrin network using scanning electron microscopy. It was concluded that MTAD can serve as a potentially useful root conditioner/biomodifier. Further, the adjunct of MTAD+I-P resulted in more fibrin network linkage on the dentinal surface when compared to MTAD alone which can be of great utility in Advanced Regenerative Therapy.
Collapse
Affiliation(s)
- Roopali Tapashetti
- Department of Periodontics, Al Badar Rural Dental College and Hospital, Kalaburagi, Karnataka, India
| | - Neha Bhutani
- Department of Periodontics, Al Badar Rural Dental College and Hospital, Kalaburagi, Karnataka, India
| | - Shweta Deodurg
- Department of Periodontics, Al Badar Rural Dental College and Hospital, Kalaburagi, Karnataka, India
| | - Amruta Kulkarni
- Department of OSMF, Al Badar Rural Dental College and Hospital, Kalaburagi, Karnataka, India
| |
Collapse
|
20
|
Gelormini F, D'antico S, Ricardi F, Parisi G, Borrelli E, Marolo P, Conte F, Salafia M, Reibaldi M. Platelet concentrates in macular hole surgery. A journey through the labyrinth of terminology, preparation, and application: a comprehensive review. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-023-06365-x. [PMID: 38270630 DOI: 10.1007/s00417-023-06365-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/16/2023] [Accepted: 12/28/2023] [Indexed: 01/26/2024] Open
Abstract
The surgical management of macular holes is undergoing continuous evolution, with recent focus on the utilization of platelet concentrates as a promising adjunctive intervention. Currently, they present a valid surgical approach for achieving anatomical and functional success with a non-inferiority comparably to the alternative surgical techniques. Nonetheless, the utilization of varied platelet concentrates terminologies, coupled with the lack of standardization in their preparation methodologies, engenders both lexical confusion and challenges in comparing scientific studies published up until now. In this review, we summarized the published evidence concerning the application of platelet concentrates in macular holes surgery, aiming to clarify the terminology and methodologies employed and to establish a common consensus facilitating further development and diffusion of this promising technique.
Collapse
Affiliation(s)
- Francesco Gelormini
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10122, Turin, Italy
| | - Sergio D'antico
- Blood Bank, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Federico Ricardi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10122, Turin, Italy.
| | - Guglielmo Parisi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10122, Turin, Italy
| | - Enrico Borrelli
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10122, Turin, Italy
| | - Paola Marolo
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10122, Turin, Italy
| | - Fabio Conte
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10122, Turin, Italy
| | - Marika Salafia
- Blood Bank, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Michele Reibaldi
- Department of Surgical Sciences, Eye Clinic Section, University of Turin, 10122, Turin, Italy
| |
Collapse
|
21
|
Besi E, Pitros P. The role of leukocyte and platelet-rich fibrin in the prevention of medication-related osteonecrosis of the jaw, in patients requiring dental extractions: an observational study. Oral Maxillofac Surg 2024:10.1007/s10006-023-01204-z. [PMID: 38182917 DOI: 10.1007/s10006-023-01204-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/25/2023] [Indexed: 01/07/2024]
Abstract
PURPOSE Medication-related osteonecrosis of the jaw (MRONJ) is a significant complication which can present following a dental extraction in patients receiving anti-resorptive and anti-angiogenic medications. The purpose of this study was to investigate the possible beneficial effect of L-PRF in the prevention of MRONJ in patients receiving these medications and requiring dental extractions. METHODS Thirty-nine patients were included and divided into two groups, depending on whether L-PRF was used after the required dental extraction or not. Subsequently, the patients were categorised into low and high-risk for developing MRONJ, as recommended by the SDCEP guidance. RESULTS None of the patients in the L-PRF group returned with established MRONJ. Five high-risk patients in the control group presented with established MRONJ in the follow-up appointment. A significant statistical difference (p = 0.04) was observed following a comparison of the high-risk patients of the two groups. CONCLUSION These encouraging results suggest that L-PRF may be useful in the prevention of MRONJ following a dental extraction especially in patients of the higher risk category. A protocol for the management of this type of patients is also introduced.
Collapse
Affiliation(s)
- Eleni Besi
- Oral Surgery Department, Edinburgh Dental Institute, University of Edinburgh, Lauriston Building, Lauriston Place, Edinburgh, EH3 9HA, UK
- Oral Surgery Department, Queen Mary University, Barts and the London School of Medicine and Dentistry, Turner Street, London, E1 2AD, UK
| | - Panagiotis Pitros
- Oral Surgery Department, Edinburgh Dental Institute, University of Edinburgh, Lauriston Building, Lauriston Place, Edinburgh, EH3 9HA, UK.
| |
Collapse
|
22
|
de Lima Barbosa R, Rodrigues Santiago Rocha N, Stellet Lourenço E, de Souza Lima VH, Mavropoulos E, Mello-Machado RC, Spiegel C, Mourão CF, Alves GG. The Association of Nanostructured Carbonated Hydroxyapatite with Denatured Albumin and Platelet-Rich Fibrin: Impacts on Growth Factors Release and Osteoblast Behavior. J Funct Biomater 2024; 15:18. [PMID: 38248685 PMCID: PMC10817063 DOI: 10.3390/jfb15010018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/24/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024] Open
Abstract
Platelet-rich Fibrin (PRF), a second-generation blood concentrate, offers a versatile structure for bone regeneration due to its composition of fibrin, growth factors, and cytokines, with adaptations like denatured albumin-enriched with liquid PRF (Alb-PRF), showing potential for enhanced stability and growth factor dynamics. Researchers have also explored the combination of PRF with other biomaterials, aiming to create a three-dimensional framework for enhanced cell recruitment, proliferation, and differentiation in bone repair studies. This study aimed to evaluate a combination of Alb-PRF with nanostructured carbonated hydroxyapatite microspheres (Alb-ncHA-PRF), and how this association affects the release capacity of growth factors and immunomodulatory molecules, and its impact on the behavior of MG63 human osteoblast-like cells. Alb-PRF membranes were prepared and associated with nanocarboapatite (ncHA) microspheres during polymerization. MG63 cells were exposed to eluates of both membranes to assess cell viability, proliferation, mineralization, and alkaline phosphatase (ALP) activity. The ultrastructural analysis has shown that the spheres were shattered, and fragments were incorporated into both the fibrin mesh and the albumin gel of Alb-PRF. Alb-ncHA-PRF presented a reduced release of growth factors and cytokines when compared to Alb-PRF (p < 0.05). Alb-ncHA-PRF was able to stimulate osteoblast proliferation and ALP activity at lower levels than those observed by Alb-PRF and was unable to positively affect in vitro mineralization by MG63 cells. These findings indicate that the addition of ncHA spheres reduces the biological activity of Alb-PRF, impairing its initial effects on osteoblast behavior.
Collapse
Affiliation(s)
- Renata de Lima Barbosa
- Graduate Program in Science and Biotechnology, Fluminense Federal University, Niteroi 24210-201, Brazil
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24033-900, Brazil
| | | | - Emanuelle Stellet Lourenço
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24033-900, Brazil
| | - Victor Hugo de Souza Lima
- Graduate Program in Science and Biotechnology, Fluminense Federal University, Niteroi 24210-201, Brazil
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24033-900, Brazil
| | - Elena Mavropoulos
- Brazilian Center for Physics Research, Rio de Janeiro 22290-180, Brazil
| | | | - Carolina Spiegel
- Department of Cellular and Molecular Biology, Fluminense Federal University, Niteroi 24033-900, Brazil
| | - Carlos Fernando Mourão
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | - Gutemberg Gomes Alves
- Graduate Program in Science and Biotechnology, Fluminense Federal University, Niteroi 24210-201, Brazil
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24033-900, Brazil
| |
Collapse
|
23
|
Balice G, Bettocchi L, Rexhepi I, Serroni M, Romano L, Sinjari B, De Ninis P, Murmura G, Paolantonio M, Femminella B. Evaluation of Post-Operative Morbidity and Palatal Wound Healing after Implant Uncovering Surgical Procedure Performed with Apically Positioned Flap (APF) and Leukocyte and Platelet-Rich-Fibrin (L-PRF): An Original Technique. Medicina (Kaunas) 2024; 60:96. [PMID: 38256357 PMCID: PMC10819806 DOI: 10.3390/medicina60010096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/14/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024]
Abstract
Background and Objectives: Dental implants are recognized as an effective treatment in the management of edentulous patients; controversies surround the connection between the sufficiency of keratinized gingiva (KG) and peri-implant health. Maintaining an ample amount of peri-implant KG is crucial for minimizing gingival inflammation, highlighting the need for regular consideration of soft-tissue augmentation. Among the diverse periodontal plastic surgical procedures, the apically positioned flap (APF) is notable for its ability to enhance the width of keratinized tissue while minimizing patient morbidity. The aim of this study was to evaluate the effects of L-PRF on palatal wound healing and patient discomfort after surgery. Materials and Methods: Twenty patients with two adjacent submerged fixtures in the maxilla and buccal keratinized gingiva widths < 2 mm were treated with APF and L-PRF. Clinical evaluations were performed at 1, 2, 3, and 4 weeks post-surgery, focusing on parameters such as complete wound epithelialization (CWE), postoperative discomfort (D), changes in feeding habits (CFH), alteration of sensitivity (AS) around the wound area, and the consumption of analgesics. Results: Our data revealed CWE in 5 patients by the end of the second week, with the remaining 15 achieving CWE by the end of the third week. For D and CHF, a statistically significant improvement was recorded for all cases between the first and second weeks, as well as AS, although less substantial, by the third week. No significant changes were noted for AS over the initial two weeks. Conclusions: These findings suggest that L-PRF may enhance wound healing and decrease patient discomfort following APF for fixture uncovering.
Collapse
Affiliation(s)
- Giuseppe Balice
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (G.B.); (L.B.); (M.S.); (L.R.); (B.S.); (M.P.); (B.F.)
| | - Luca Bettocchi
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (G.B.); (L.B.); (M.S.); (L.R.); (B.S.); (M.P.); (B.F.)
| | - Imena Rexhepi
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (G.B.); (L.B.); (M.S.); (L.R.); (B.S.); (M.P.); (B.F.)
| | - Matteo Serroni
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (G.B.); (L.B.); (M.S.); (L.R.); (B.S.); (M.P.); (B.F.)
| | - Luigi Romano
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (G.B.); (L.B.); (M.S.); (L.R.); (B.S.); (M.P.); (B.F.)
| | - Bruna Sinjari
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (G.B.); (L.B.); (M.S.); (L.R.); (B.S.); (M.P.); (B.F.)
| | - Paolo De Ninis
- “Luisa D’Annunzio” Institute for High Culture, 65123 Pescara, Italy;
| | - Giovanna Murmura
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (G.B.); (L.B.); (M.S.); (L.R.); (B.S.); (M.P.); (B.F.)
| | - Michele Paolantonio
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (G.B.); (L.B.); (M.S.); (L.R.); (B.S.); (M.P.); (B.F.)
| | - Beatrice Femminella
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (G.B.); (L.B.); (M.S.); (L.R.); (B.S.); (M.P.); (B.F.)
| |
Collapse
|
24
|
Siddiqui HP, Sennimalai K, Bhatt K, Samrit VD, Duggal R. Effect of adjuvant autologous platelet concentrates on secondary repair of alveolar clefts: A systematic review and meta-analysis. Spec Care Dentist 2024; 44:12-27. [PMID: 36721338 DOI: 10.1111/scd.12830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To review the existing evidence on the adjuvant use of autologous platelet concentrates (APCs) with iliac crest bone graft (ICBG) in the reconstruction of the secondary alveolar cleft. METHODS Electronic databases were searched systematically until November 2022. Clinical trials comparing the three-dimensional radiological outcomes of patients who underwent secondary alveolar bone grafting (SABG) with ICBG and APCs to those with ICBG alone and the radiological outcomes assessed 6 months after surgery were included. Two authors performed the study selection and the assessment of the risk of bias. Meta-analysis was performed using the random-effects model to determine the risk ratio (RR) for developing wound dehiscence and the mean difference (MD) with a 95% confidence interval (CI) for the percentage of newly formed bone. RESULTS Nine studies (seven RCT and two CCT) were included with a low to high risk of bias. At the 6-month follow-up, the study group revealed insignificant results regarding the percentage of newly formed bone (MD = 6.49; 95% CI: -0.97, 13.94; p = .09; χ2 = 0.01; I2 = 71%). In addition, the overall risk of developing wound dehiscence was lower in the study group (RR = 0.34; 95% CI: 0.15, 0.78; p = .01; χ2 = 0.67; I2 = 0%). CONCLUSION Currently, there is insufficient evidence to support the adjuvant use of APCs with ICBG on enhanced bone regeneration following secondary alveolar bone grafting. However, combining ICBG and APCs might be beneficial in reducing the risk of developing wound dehiscence.
Collapse
Affiliation(s)
- Hamza Parvez Siddiqui
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
- College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - Karthik Sennimalai
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
- Department of Orthodontics, All India Institute of Medical Sciences, Jammu, J&K, India
| | - Krushna Bhatt
- Division of Oral and Maxillofacial Surgery, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vilas D Samrit
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Ritu Duggal
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
25
|
Mohamed Abdel-Aziz L, Abdallah SA, Mohammed bakr N, Bahaa SM, Zainalabdeen EH, Alsharif M, Elsayed SA. Effectiveness of a polycaprolactone scaffold combined with platelet-rich fibrin as guided tissue regeneration materials for preserving an implant-supported overdenture. Saudi Dent J 2024; 36:151-157. [PMID: 38375393 PMCID: PMC10874784 DOI: 10.1016/j.sdentj.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 02/21/2024] Open
Abstract
Objectives This study aimed to assess the effectiveness of ridge preservation using a polycaprolactone (PCL) scaffold combined with platelet-rich fibrin (PRF) to promote bone regeneration before implantation. Materials and Methods This prospective study was conducted at Al-Azhar University in Egypt. It included 30 participants requiring the extraction of their last mandibular premolar before constructing an implant-supported overdenture. The participants were divided into three groups: Group A was treated with a PCL scaffold and PRF as ridge preservative materials, Group B was treated with PRF alone, and Group C (control) was treated with no preservative material. Bone samples were collected for histomorphometric analysis at implant placement. Results The participants' mean age was 65.3 ± 4.27 years, and 18 (60%) were male. Postoperative alveolar bone lengths differed significantly between Groups A and B (P = 0.001). However, alveolar bone width changes did not differ significantly among groups. In contrast, the postoperative bone density and loss differed significantly among groups (P = 0.001). Conclusion Combining two ridge preservation techniques (PCL and PRF) enhanced participants' alveolar bone remodelling by decreasing its resorption and maintaining its width.
Collapse
Affiliation(s)
- Lobna Mohamed Abdel-Aziz
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Shahenda A. Abdallah
- Biomaterial, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Noura Mohammed bakr
- Oral and Dental Biology Department, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Sara M. Bahaa
- Removable Prosthodontic Department, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Ebtihal H. Zainalabdeen
- Department of Oral Basic and Clinical Sciences, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| | | | - Shadia A. Elsayed
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
- Department of Oral & Maxillofacial Surgery, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
| |
Collapse
|
26
|
Hama S, Yokoi T, Orita K, Uemura T, Takamatsu K, Okada M, Nakamura H. Peripheral nerve regeneration by bioabsorbable nerve conduits filled with platelet-rich fibrin. Clin Neurol Neurosurg 2024; 236:108051. [PMID: 37995621 DOI: 10.1016/j.clineuro.2023.108051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE To repair peripheral nerve defects and seek alternatives for autografts, nerve conduits with various growth factors and cells have been invented. Few pieces of literature report the effect of nerve conduits plus platelet-rich fibrin (PRF). This study aimed to investigate the effectiveness of nerve conduits filled with PRF. METHODS The model of a 10 mm sciatic nerve gap in a rat was used to evaluate peripheral nerve regeneration. The thirty rats were randomly divided into one of the following three groups (n = 10 per group). Autogenous nerve grafts (autograft group), conduits filled with phosphate-buffered saline (PBS) (PBS group), or conduits filled with PRF group (PRF group). We assessed motor and sensory functions for the three groups at 4, 8, and 12 weeks postoperatively. In addition, axon numbers were measured 12 weeks after repair of the peripheral nerve gaps. RESULTS Significant differences in motor function were observed between the autograft group and the other two groups at 12 weeks postoperatively. In the test to evaluate the recovery of sensory function, there were significant differences between the PBS group and the other two groups at all time points. The most axon number was found in the autograft group. The axon number of the PRF group was significantly more extensive than that of the PBS group. CONCLUSIONS The nerve conduit filled with PRF promoted the axon regeneration of the sciatic nerve and improved sensory function.
Collapse
Affiliation(s)
- Shunpei Hama
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan; Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | - Takuya Yokoi
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan; Department of Orthopaedic Surgery, Seikeikai Hospital, Osaka, Japan.
| | - Kumi Orita
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Takuya Uemura
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan; Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, Osaka, Japan
| | - Kiyohito Takamatsu
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan; Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | - Mitsuhiro Okada
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|
27
|
Chetana, Sidharthan S, Dharmarajan G, Iyer S, Poulose M, Guruprasad M, Chordia D. Evaluation of microneedling with and without injectable-platelet rich fibrin for gingival augmentation in thin gingival phenotype-A randomized clinical trial. J Oral Biol Craniofac Res 2024; 14:49-54. [PMID: 38188907 PMCID: PMC10770610 DOI: 10.1016/j.jobcr.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/12/2023] [Accepted: 10/24/2023] [Indexed: 01/09/2024] Open
Abstract
Objective The purpose of the current study was to investigate the effect of micro needling (MN) on gingival thickness (GT) and keratinized tissue width (KTW) in individuals with thin gingival phenotypes, either with or without injectable platelet-rich fibrin (i-PRF). Materials and methods In this randomized, split-mouth clinical trial, 15 systemically healthy patients, with thin gingival phenotype (<1.5 mm) were randomly treated with MN + i-PRF and MN. MN was performed on one side, and MN + i-PRF on the contralateral side of the same arch at 4 sessions with 10-day intervals. GT; KTW the primary outcome and Plaque index; gingival index Secondary outcome were assessed at baseline and at 1st, 3rd, and 6th months post-treatment. Results The results of the present study showed that both techniques demonstrated a statistically significant increase in GT. GT showed a statistically significant increase from baseline (0.453 ± 0.069 mm in MN, 0.451 ± 0.069 mm in MN + i-PRF) (p = 0.81) to 1 month (0.567 ± 0.075 mm in MN, 0.649 ± 0.075 mm in MN + i-PRF) (p < 0.001*). A follow-up at 3rd month (0.566 ± 0.076 mm in MN, 0.647 ± 0.091 mm in MN + i-PRF) (p < 0.001*) and 6th month (0.564 ± 0.076 mm in MN, 0.644 ± 0.089 mm in MN + i-PRF) (p < 0.001*) showed a statistically significant increase. Intergroup comparison showed a statistically significant GT increase in MN + i-PRF sites at all the time intervals. No, statistically significant difference in KTW was observed in both groups from baseline to 6 months. Conclusions The utilization of MN + i-PRF stands as a minimally invasive, non-surgical method to improve GT. Interestingly, using i-PRF as an additional component demonstrated more favorable outcomes compared to using MN alone in enhancing tissue thickness.
Collapse
Affiliation(s)
- Chetana
- Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant Tukaram Nagar, Pimpri, Pune, 411 018, Maharashtra, India
| | - Sangamithra Sidharthan
- Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant Tukaram Nagar, Pimpri, Pune, 411 018, Maharashtra, India
| | - Gopalakrishnan Dharmarajan
- Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant Tukaram Nagar, Pimpri, Pune, 411 018, Maharashtra, India
| | - Shraddha Iyer
- Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant Tukaram Nagar, Pimpri, Pune, 411 018, Maharashtra, India
| | - Mariam Poulose
- Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant Tukaram Nagar, Pimpri, Pune, 411 018, Maharashtra, India
| | - Meghana Guruprasad
- Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant Tukaram Nagar, Pimpri, Pune, 411 018, Maharashtra, India
| | - Dhakshay Chordia
- Department of General Surgery Saveetha Medical college, Thandalam, Chennai 602105, Tamil Nadu, India
| |
Collapse
|
28
|
Akkaya S, Toptaş O. Evaluation of the effects of platelet-rich fibrin and diode laser on gingival blood perfusion and early bone healing of the extraction socket: a randomized controlled clinical trial. Lasers Med Sci 2023; 39:2. [PMID: 38082098 DOI: 10.1007/s10103-023-03947-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 12/05/2023] [Indexed: 12/18/2023]
Abstract
Evaluation and comparison of the effect of platelet-rich fibrin (PRF), diode laser, and combination of PRF and diode laser on gingival blood perfusion and early bone formation of the extraction socket. Forty maxillary premolar sockets were randomized to four groups: control group, PRF group, diode laser group, and PRF + diode laser group. Gingival blood perfusion was measured at preoperative and postoperative 1, 3, 7, and 30 days. Fractal dimension analysis was performed immediately after the procedure and in the postoperative first month. Gingival perfusions significantly increased during 1 week compared to baseline for all groups with a mean of -4.43 ± 3.20, -5.99 ± 3.68, -5.45 ± 3.01, and -4.78 ± 2.82 respectively, and were at baseline 1 month later. There were no statistically significant differences between the groups at any time point. Although the increase of fractal dimension was higher in the PRF or diode laser group than in the control group with a mean of 0.085 ± 0.05, 0.100 ± 0.04, and 0.072 ± 0.04 respectively, no statistically significant differences were detected. Fractal dimension was significantly greater in PRF + diode laser group than in the control group with a mean of 0.138 ± 0.05 (p = 0.04). PRF, diode laser, and PRF + diode laser did not significantly affect the gingival perfusion, and the combined application of PRF and diode laser had positive effects on early bone regeneration in the extraction socket. PRF, diode laser, and PRF + diode laser provide better tissue healing of the extraction socket.
Collapse
Affiliation(s)
- Selda Akkaya
- Department of Oral and Maxillofacial Surgery, Private Practice, Istanbul, Turkey.
| | - Orçun Toptaş
- Department of Oral and Maxillofacial Surgery, Private Practice, Istanbul, Turkey
| |
Collapse
|
29
|
Costa MDMDA, Paranhos LR, de Almeida VL, Oliveira LM, Vieira WDA, Dechichi P. Do blood concentrates influence inflammatory signs and symptoms after mandibular third molar surgery? A systematic review and network meta-analysis of randomized clinical trials. Clin Oral Investig 2023; 27:7045-7078. [PMID: 37884621 DOI: 10.1007/s00784-023-05315-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/04/2023] [Indexed: 10/28/2023]
Abstract
OBJECTIVES To investigate, through a network meta-analysis, the effectiveness of blood concentrates in reducing pain perception, trismus, and edema after mandibular third molar extraction. MATERIALS AND METHODS An electronic search was performed in nine databases to locate randomized clinical trials comparing blood concentrate use after mandibular third molar extraction. Two authors selected and extracted the data independently. The individual risk of bias in the studies was assessed with the RoB v2.0 tool. A network meta-analysis compared postoperative pain and trismus scores after applying different blood concentrates, using the mean difference (MD) as an effect estimate. The GRADE approach assessed the certainty of evidence. RESULTS Thirty-one randomized clinical trials were included in the review and 18 in the meta-analysis. Leukocyte- and platelet-rich fibrin (L-PRF) was the most used blood concentrate, followed by platelet-rich plasma (PRP). The network meta-analysis, depending on the analyzed period, evaluated up to 1240 surgeries. Among the analyzed blood concentrates, advanced platelet-rich fibrin (A-PRF) performed better among the analyzed blood concentrates, decreasing postoperative pain in 1, 2, 3, and 7 days and reducing trismus up to the inflammatory peak compared to blood clots. Only two studies had a low risk of bias. CONCLUSIONS Based on very low certainty of evidence, using concentrates seemed efficient compared to blood clots in reducing pain and trismus after mandibular third molar surgeries. A-PRF decreased postoperative pain throughout the evaluated time and trismus during the acute inflammatory peak. CLINICAL RELEVANCE A-PRF after mandibular third molar extractions performed better among the analyzed blood concentrates and seemed efficient in improving postoperative quality by decreasing inflammatory signs and symptoms.
Collapse
Affiliation(s)
| | - Luiz Renato Paranhos
- Division of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Campus Umuarama, Av. Pará, 1720, Bloco 2G, sala 1, ZIP code, Uberlândia, Minas Gerais, 38405-320, Brazil.
| | - Vinícius Lima de Almeida
- Postgraduate Program in Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Leandro Machado Oliveira
- Division of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Walbert de Andrade Vieira
- Department of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Paula Dechichi
- Department of Cell Biology, Histology, and Embryology, Biomedical Science Institute, Federal University of Uberlândia, Uberlândia, Brazil
| |
Collapse
|
30
|
Chen B, Liu Y, Ke C, Xu S. A case of concentrated growth factor gel to fill the defect after large jaw cyst enucleation. Clin Case Rep 2023; 11:e8272. [PMID: 38046807 PMCID: PMC10689290 DOI: 10.1002/ccr3.8272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/18/2023] [Accepted: 11/09/2023] [Indexed: 12/05/2023] Open
Abstract
Management of large jaw cyst is challenging since high risks including pathologic fracture, limited opening, and insufficient bone healing occur after enucleation. The current case of concentrated growth factor (CGF) gel to fill defect after enucleation of large jaw cyst is rare. A 12-year-old boy with pain and swelling for 4 months in the left mandible region made a medical consultation at our hospital. Computerized tomography scan indicated that cystic lesion was found in the left mandible region. In this case, we present a patient with large jaw cyst (31 mm × 44 mm × 53 mm) who received enucleation followed by CGF gel filling the defect. The patient was discharged after 13 days without discomfort symptoms. The lesion size was reduced significantly at 1-month re-examination. No abnormality was detected in maxillofacial region at 1-year re-examination. Application of CGF gel is one of the possible options for filling defect after jaw cyst enucleation.
Collapse
Affiliation(s)
- Binxiong Chen
- Department of Burn and Plastic SurgeryShenzhen Longhua District Central HospitalShenzhenGuangdongChina
| | - Yueming Liu
- Department of Burn and Plastic SurgeryShenzhen Longhua District Central HospitalShenzhenGuangdongChina
| | - Changneng Ke
- Department of Burn and Plastic SurgeryShenzhen Longhua District Central HospitalShenzhenGuangdongChina
| | - Shi Xu
- Department of Burn and Plastic SurgeryShenzhen Longhua District Central HospitalShenzhenGuangdongChina
| |
Collapse
|
31
|
Fardi A, Kodonas K, Gogos C. A Bibliometric Analysis of Platelet Derivate Uses in Oral and Maxillofacial Surgery. J Oral Maxillofac Surg 2023; 81:1569-1586. [PMID: 37783365 DOI: 10.1016/j.joms.2023.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/10/2023] [Accepted: 09/09/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE Concentrated platelet derivatives (PDs) such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have been extensively applied in tissue engineering, and particularly in various fields of regenerative dentistry. The purpose of the present citation analysis was to compile the 100 top-cited articles on the PDs uses in oral and maxillofacial surgery. METHODS A cross-sectional search of the relevant studies in the Web of Science citation database was conducted to identify the 100 most-cited articles. All the included papers consisted of independent variables of this analysis. Covariates that were further considered were basic bibliometric indexes, such as publication year, publishing journal, authorship, institution and country of origin, study design, and field of study. The primary outcome variables were citation counts and citation density. A descriptive analysis of secondary outcome variables, namely bibliographic data such as keyword, abstract, title term co-occurrence analysis, thematic map and wordcloud analysis, was performed using the bibliometrix R and VOSviewer software. RESULTS The total citation count for the 100 most-cited articles ranged from 85 to 1821, with 2002 being the most productive year. With 15 articles, the Journal of Periodontology was the most represented journal, followed closely by the Journal of Oral and Maxillofacial Surgery and Clinical Oral Implants Research. The United States published the largest number of papers. Original basic science research studies on implantology and biology dominated the top-cited list. Randomized clinical trials and systematic reviews were adequately represented in the top-cited list. Platelet-derived growth factor and osteoprotegerin represented emerging minimally developed themes, while PRP, growth factors and fibrin, along with the applications of PRF in gingival recession and intra bony defects, were considered important motor themes. CONCLUSIONS The current study provides a complete list and in-depth analysis of the 100 most-cited publications relevant to PDs use in oral and maxillofacial surgery, identifying the most important research topics, most impactful authors, institutions, and countries. Though PRP studies were leading the top-cited list, publications focusing on PRF pesented higher citation density values, indicating a continuously increasing citation rate.
Collapse
Affiliation(s)
- Anastasia Fardi
- Department of Dentoalveolar Surgery, Surgical Implantology & Radiology, School of Dentistry, Aristotle University of Thessaloniki, Greece.
| | - Konstantinos Kodonas
- Assistant Professor, Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Greece
| | - Christos Gogos
- Professor, Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Greece
| |
Collapse
|
32
|
Molina-Barahona M, Delgado-Gaete B, Morales-Navarro D, Urbizo-Vélez J, Avecillas-Rodas R. Imaging Evaluation of Platelet-Rich Fibrin in Post-Exodontic Bone Regeneration: A Systematic Review. Dent J (Basel) 2023; 11:277. [PMID: 38132415 PMCID: PMC10742963 DOI: 10.3390/dj11120277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023] Open
Abstract
Tooth extraction is the most common procedure in dental practice. However, in the long term, it may cause alveolar ridge atrophy. This systematic review aimed to evaluate the role of platelet-rich fibrin (PRF) in post-exodontic alveolar ridge preservation in terms of its effectiveness in the regeneration of bone tissue as assessed by imaging and its efficacy compared to physiological bone healing. The study is presented in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. This systematic review was conducted using electronic databases such as PubMed, Scopus, Web of Science, and Science Direct. The gray literature search was conducted in the New York Academy of Medicine Grey Literature Report. All the studies in this systematic review were randomized controlled trials (RCTs). The risk of bias was performed according to the Cochrane Handbook for Systematic Reviews of Interventions 6.2 (RevMan 6.2). Considering the inclusion and exclusion criteria, we included 17 randomized clinical trials published up to 2022 investigating the efficacy of PRF in post-exodontic bone regeneration. Based on the results of clinical studies, it can be stated that despite not being statistically significant, PRF promotes neoformation and prevents bone loss between three and four months post-extraction.
Collapse
Affiliation(s)
- Magdalena Molina-Barahona
- Maxillofacial Radiology Department, Faculty of Dentistry, Universidad Catolica de Cuenca, Cuenca 010101, Ecuador;
- Faculty of Dentistry, Universidad de Ciencias Medicas de la Habana, Havana 104000, Cuba
| | - Bolívar Delgado-Gaete
- Maxillofacial Radiology Department, Faculty of Dentistry, Universidad Catolica de Cuenca, Cuenca 010101, Ecuador;
| | - Denia Morales-Navarro
- Maxillofacial Surgery Department, Universidad de Ciencias Medicas de la Habana, Havana 104000, Cuba; (D.M.-N.); (J.U.-V.)
| | - Joaquín Urbizo-Vélez
- Maxillofacial Surgery Department, Universidad de Ciencias Medicas de la Habana, Havana 104000, Cuba; (D.M.-N.); (J.U.-V.)
| | | |
Collapse
|
33
|
Li Z, Yang C, Wang J, Zheng K, Luo W. The application of CGF combined with GBR in alveolar bone increment for patients with anxiety disorder: A rare case report and literature review. Medicine (Baltimore) 2023; 102:e35905. [PMID: 37960737 PMCID: PMC10637472 DOI: 10.1097/md.0000000000035905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/12/2023] [Indexed: 11/15/2023] Open
Abstract
RATIONALE Selective serotonin reuptake inhibitors (SSRIs), one of the commonly used anti-anxiety drugs, may have impacts on bone metabolism and potentially lead to drug-induced osteoporosis. The traditional approach of oral implantation in individuals with both anxiety disorder and drug-induced osteoporosis poses a significant challenge. To address this issue, concentrated growth factor (CGF) has been utilized in patients undergoing concurrent alveolar ridge augmentation during oral implantation, resulting in favorable clinical outcomes. Consequently, combining CGF with guided bone regeneration (GBR) in alveolar bone increment may represent a promising new surgical approach for such patients. In this report, we present a case study of a 25-year-old male with anxiety disorder and drug-induced osteoporosis, in who CGF combined with GBR was employed in alveolar bone increment. PATIENT CONCERNS This article reports the case of a 25-year-old male who underwent cone beam computed tomography (CBCT) due to the absence of his right lower second molar for a period of six months. The CBCT scan revealed significant bone defects, which were attributed to the tooth loss and prolonged use of anti-anxiety drugs. Consequently, the patient sought medical assistance from our department. DIAGNOSES Based on the patient's self-report, he was diagnosed with an anxiety disorder. Additionally, the CBCT scan confirmed the loss of the right mandibular second molar and revealed the presence of dental irregularity and an alveolar bone defect. INTERVENTIONS During the patient's course of treatment with anti-anxiety medication, a combination of CGF and GBR was employed for the simultaneous implantation of the missing right mandibular second molar, along with bone augmentation. OUTCOMES The patient had a follow-up visit two weeks after the surgical procedure, and the wound in the operation area had healed satisfactorily. Six months later, CBCT images revealed excellent osseointegration. The buccal and lingual width of the alveolar bone measured 6.95mm, which was an increase of 1.35mm compared to the pre-implantation stage. LESSONS This article presents a case study in which CGF combined with GBR were utilized to address alveolar bone augmentation during the implantation phase in patients taking anti-anxiety medication. The results demonstrated that CGF combined with GBR, as a cutting-edge platelet concentrate technique, could effectively stimulate bone tissue proliferation in individuals who have been on long-term anti-anxiety medication, specifically in oral implant areas. This approach can help prevent poor osseointegration, promote higher osseointegration rates, and facilitate wound healing.
Collapse
Affiliation(s)
- Zhixin Li
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Chao Yang
- Department of Stomatology, The People's Hospital of Longhua, Shenzhen, China
- Research and Development Department, Shenzhen Uni-medica Technology CO., Ltd, Shenzhen, China
| | - Jinrong Wang
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Kaiyue Zheng
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Wen Luo
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| |
Collapse
|
34
|
Asfour MAR, Aljoujou AA, Saifo MS, Jabban HAL. The use of advanced-platelet rich fibrin (A-PRF) in the management of medication-related osteonecrosis of the jaw (MRONJ): A case report. Clin Case Rep 2023; 11:e8259. [PMID: 38028038 PMCID: PMC10675097 DOI: 10.1002/ccr3.8259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 11/01/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023] Open
Abstract
Medication-related osteonecrosis of the jaws (MRONJ) is a serious debilitating disease resulting from long-term treatment with Antiresorptive drugs such as Bisphosphonates or Denosumab, which significantly affects patients' quality of life. A 43-year-old female patient with stage 4 breast cancer and treated with Zoledronic Acid for bone metastases was referred to the Department of Oral Medicine at the Faculty of Dentistry, Damascus University. The main complaint was pain in the right maxilla. Intraoral examination showed an exposure of necrotic bone in the right maxillary region with presence of purulent exudate. The treatment plan was discussed with the patient. Treatment included resection of all necrotic bone and application of Advanced platelet-rich fibrin (A-PRF) clots and membranes. Follow-up and outcome were conducted by clinical measures to assess healing and recurrence (6-month follow-up). Topical treatment with A-PRF demonstrated a reduction in pain and resulted in complete wound healing within 30 days. A-PRF stimulates the release of growth factors and chemotaxis involved in tissue repair mechanisms. This method seemed to be effective in the treatment of MRONJ.
Collapse
Affiliation(s)
| | | | - Maher Sadik Saifo
- Oncology Department‐ Medical Oncology, Faculty of MedicineDamascus UniversityDamascusSyria
| | - Haya A. L. Jabban
- Oral and Maxillofacial Surgery Department, Faculty of DentistryDamascus universityDamascusSyria
| |
Collapse
|
35
|
Bains VK, Mahendra J, Mittal M, Bedi M, Mahendra L. Technical considerations in obtaining platelet rich fibrin for clinical and periodontal research. J Oral Biol Craniofac Res 2023; 13:714-719. [PMID: 37731846 PMCID: PMC10507643 DOI: 10.1016/j.jobcr.2023.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/12/2023] [Accepted: 09/11/2023] [Indexed: 09/22/2023] Open
Abstract
Autologous platelet rich fibrin (PRF), is currently being widely used and investigated across the globe by clinicians and periodontal research. The technical aspect required for the procurement of PRF includes revolution per minute (RPM), relative centrifugal force (RCF) or G-force, rotor radius, rotor angle, stability or vibration in the centrifugal machine and material of test-tube, besides the systemic health of the individual may influence the final outcome. Present technical note intends to compile these aspects for better understanding and appropriate outcome while preparing PRF in varying clinical scenarios.
Collapse
Affiliation(s)
- Vivek Kumar Bains
- Department of Periodontology, Saraswati Dental College & Hospital, Lucknow, India
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Madhukar Mittal
- Department of Endocrinology & Metabolism, AIIMS, Jodhpur, India
| | - Muskan Bedi
- Department of Basic Medical Sciences, Sri Ramachandra Medical College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Little Mahendra
- Maktoum Bin Hamdan Dental University College, Dubai, United Arab Emirates
| |
Collapse
|
36
|
Jang HJ, Tiruneh DM, Ryu H, Yoon JK. Piezoelectric and Triboelectric Nanogenerators for Enhanced Wound Healing. Biomimetics (Basel) 2023; 8:517. [PMID: 37999158 PMCID: PMC10669670 DOI: 10.3390/biomimetics8070517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/22/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
Wound healing is a highly orchestrated biological process characterized by sequential phases involving inflammation, proliferation, and tissue remodeling, and the role of endogenous electrical signals in regulating these phases has been highlighted. Recently, external electrostimulation has been shown to enhance these processes by promoting cell migration, extracellular matrix formation, and growth factor release while suppressing pro-inflammatory signals and reducing the risk of infection. Among the innovative approaches, piezoelectric and triboelectric nanogenerators have emerged as the next generation of flexible and wireless electronics designed for energy harvesting and efficiently converting mechanical energy into electrical power. In this review, we discuss recent advances in the emerging field of nanogenerators for harnessing electrical stimulation to accelerate wound healing. We elucidate the fundamental mechanisms of wound healing and relevant bioelectric physiology, as well as the principles underlying each nanogenerator technology, and review their preclinical applications. In addition, we address the prominent challenges and outline the future prospects for this emerging era of electrical wound-healing devices.
Collapse
Affiliation(s)
- Hye-Jeong Jang
- Department of Systems Biotechnology, Chung-Ang University, Anseong-si 17546, Gyeonggi-do, Republic of Korea;
| | - Daniel Manaye Tiruneh
- Department of Intelligence Energy and Industry, Chung-Ang University, Seoul 06974, Republic of Korea;
| | - Hanjun Ryu
- Department of Intelligence Energy and Industry, Chung-Ang University, Seoul 06974, Republic of Korea;
- Department of Advanced Materials Engineering, Chung-Ang University, Anseong-si 17546, Gyeonggi-do, Republic of Korea
| | - Jeong-Kee Yoon
- Department of Systems Biotechnology, Chung-Ang University, Anseong-si 17546, Gyeonggi-do, Republic of Korea;
| |
Collapse
|
37
|
Kale AM, Sethi KS, Mahale SA, Karde PA, Kale LM, Choudhary SH. Comparative analysis of platelet-rich fibrin membrane and 0.2% hyaluronic acid gel on healing following gingival depigmentation procedure. J Indian Soc Periodontol 2023; 27:636-641. [PMID: 38434500 PMCID: PMC10906787 DOI: 10.4103/jisp.jisp_291_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 03/05/2024] Open
Abstract
Introduction Platelet-rich fibrin (PRF) accelerates wound healing by promoting faster cicatricial tissue remodeling and excellent neovascularization. Hyaluronic acid (HA) being biocompatible, anti-inflammatory, and proangiogenic leads to improvement in the rate of wound healing. Aim The aim of this study was to compare the effect of PRF membrane and 0.2% HA gel on wounds after gingival depigmentation surgery. Materials and Methods This study was carried out on 30 systemically healthy individuals recruited from the pool of patients who visited the department of periodontology. After depigmentation procedure in every patient, the sites were divided into three even groups. Group A received PRF membrane and periodontal dressing, Group B received 0.2% HA gel application and periodontal dressing, and Group C served as a control group in which only periodontal dressing was placed. The individuals were evaluated for the healing index (HI) and Numerical Rating Scale (NRS) on the 3rd and 5th day. Epithelialization test (ET) was performed on the 5th day. Gingival biotype was reassessed and compared to preoperative value after 3 months. The clinical trial was expressed in terms of mean and standard deviation. Intra-group comparison and inter-group comparison were done through the Kruskal-Wallis ANOVA test. All statistical tests were performed through SPSS version 25.0 (IBM). Results The inter-group statistical analysis concerning NRS, HI, and ET showed statistically significant results in Groups A and B compared to Group C (P < 0.05), while gingival biotype showed statistically significant results in Group A compared to Groups B and C. Conclusion The use of PRF membrane and HA gel to protect the raw wound site of depigmented gingiva proved to be an effective approach, resulting in faster healing.
Collapse
Affiliation(s)
- Aishwarya Madhukar Kale
- Department of Periodontics, MGV’s KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Kunal S. Sethi
- Department of Periodontics, MGV’s KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Swapna A. Mahale
- Department of Periodontics, MGV’s KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Prerna A. Karde
- Department of Periodontics, MGV’s KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Lata Madhukar Kale
- Department of Periodontics, MGV’s KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Sneha H. Choudhary
- Department of Periodontics, MGV’s KBH Dental College and Hospital, Nashik, Maharashtra, India
| |
Collapse
|
38
|
Gowda TM, Jayashri M, Venkatesh UG, Shah R, Kumar ABT, Deepthi M, Priya S. Autologous tooth bone graft block compared with advanced platelet-rich fibrin in alveolar ridge preservation: A clinico-radiographic study. J Indian Soc Periodontol 2023; 27:619-625. [PMID: 38434501 PMCID: PMC10906784 DOI: 10.4103/jisp.jisp_43_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 03/05/2024] Open
Abstract
Objectives To determine the clinico-radiographic efficiency of partially demineralized dentin matrix block (PDDM block), a mixture of PDDM with advanced-platelet-rich fibrin+ (A-PRF+) and injectable platelet-rich fibrin versus A-PRF+ alone in alveolar socket preservation. Materials and Methods Sixteen molar teeth indicated for extraction were randomly assigned into two groups. For the test group, sockets were packed with PDDM block and control group, with A-PRF+ plug alone. Clinical and radiographic cone-beam computed tomography methods were used to assess the horizontal and vertical ridge dimensional changes at baseline and 4 months. Results Clinically, the mid buccal and palatal crestal height (10.25 ± 0.86 and 9.75 ± 0.28 mm) and alveolar ridge width (11.37 ± 0.25 mm) were significantly higher in the test group as compared to the control group, 4 months after tooth extraction (P < 0.01). Radiographically, there was improved apposition and nonsignificant resorption for the test group in ridge height and width, whereas statistically significant higher resorption was seen in the control group at 4 months. Conclusion The application of the PDDM block demonstrated efficacy in maintaining the dimensions of the extraction socket when compared to A-PRF+ alone. This autologous and immune-free regenerative biomaterial is widely obtainable, offering a glimpse into the potential of next-generation biofuels for regeneration.
Collapse
Affiliation(s)
| | | | - Usha Govindaroy Venkatesh
- Department of Public Health Dentistry, Bapuji Dental College and Hospital, Davanagere, Karnataka, India
| | - Rucha Shah
- Department of Periodontics, Bapuji Dental College and Hospital, Davanagere, Karnataka, India
| | | | - Manjunath Deepthi
- Department of Periodontics, Bapuji Dental College and Hospital, Davanagere, Karnataka, India
| | - Saloni Priya
- Department of Periodontics, Bapuji Dental College and Hospital, Davanagere, Karnataka, India
| |
Collapse
|
39
|
You JS, Jung GW, Oh JS, Moon SY, Lee WP, Jo HH. Volumetric evaluation of effects of platelet-rich fibrin and concentrated growth factor on early bone healing after endodontic microsurgery: a randomized controlled trial. BMC Oral Health 2023; 23:821. [PMID: 37899448 PMCID: PMC10613388 DOI: 10.1186/s12903-023-03530-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/11/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND This randomized controlled clinical trial compared the effects of platelet-rich fibrin (PRF) and concentrated growth factor (CGF) on early bone healing after endodontic microsurgery. METHODS Eighteen patients with an isolated periapical lesion < 10 mm in the maxillary anterior region were randomly assigned to three groups: control, PRF, or CGF. Endodontic microsurgery was performed and PRF or CGF membranes were placed over the bone defects in the experimental groups. The volume of the bone defect at postoperative one week, three months, and six months was evaluated using cone-beam computed tomography and Mimics software. The results were statistically analyzed using the Kruskal-Wallis test and post-hoc Mann-Whitney U test with Bonferroni correction. RESULTS At the three-month follow-up, the PRF and CGF groups showed significantly greater bone healing compared with the control group (p > 0.05). However, no significant difference was observed between the PRF and CGF groups. At the six-month follow-up, no significant differences were observed between the groups. CONCLUSIONS These results suggested that PRF and CGF promote early bone healing after endodontic microsurgery.
Collapse
Affiliation(s)
- Jae-Seek You
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Korea
| | - Gyeo-Woon Jung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Korea
| | - Ji-Su Oh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Korea
| | - Seong-Yong Moon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Korea
| | - Won-Pyo Lee
- Department of Periodontology, School of Dentistry, Chosun University, Gwangju, Korea
| | - Hyoung-Hoon Jo
- Department of Conservative Dentistry, School of Dentistry, Chosun University, 309 Phimun-daero, Dong-gu, Gwangju, 61452, Korea.
| |
Collapse
|
40
|
Salgado-Peralvo ÁO, Kewalramani N, Pérez-Jardón A, Pato-Mourelo J, Castro-Calderón A, Arriba-Fuente L, Pérez-Sayáns M. Understanding Solid-Based Platelet-Rich Fibrin Matrices in Oral and Maxillofacial Surgery: An Integrative Review of the Critical Protocol Factors and Their Influence on the Final Product. Medicina (Kaunas) 2023; 59:1903. [PMID: 38003952 PMCID: PMC10673335 DOI: 10.3390/medicina59111903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/20/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023]
Abstract
Platelet-rich fibrin (PRF) is a second-generation platelet concentrate whose use in clinical practice has been widely disseminated. This has led to the development of several commercial protocols, creating great confusion as to the terminology and implications of each of them. This integrative review aims to identify the critical factors of each of the phases of the solid-based PRF matrix protocol and their possible influence on their macro- and microscopic characteristics. An electronic search of the MEDLINE database (via PubMed), Web of Science, Scopus, LILACS, and OpenGrey was carried out. The search was temporarily restricted from 2001 to 2022. After searching, 43 studies were included that met the established criteria. There were numerous factors to consider in the PRF protocol, such as the material of the blood collection tubes, the duration of phlebotomy, the parameters related to blood centrifugation, the time from centrifugation to dehydration of the fibrin clots and their dehydration into membranes, as well as the time to clinical use. These factors influenced the macro- and microscopic characteristics of the PRF and its physical properties, so knowledge of these factors allows for the production of optimised PRF by combining the protocols and materials.
Collapse
Affiliation(s)
- Ángel-Orión Salgado-Peralvo
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-C.); (L.A.-F.)
| | - Naresh Kewalramani
- Department of Nursery and Stomatology, Rey Juan Carlos University, 28922 Madrid, Spain;
| | - Alba Pérez-Jardón
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.P.-J.); (J.P.-M.)
| | - Jesús Pato-Mourelo
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.P.-J.); (J.P.-M.)
| | - Adriana Castro-Calderón
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-C.); (L.A.-F.)
| | - Lorenzo Arriba-Fuente
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-C.); (L.A.-F.)
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.P.-J.); (J.P.-M.)
| |
Collapse
|
41
|
Ucer C, Khan RS. Alveolar Ridge Preservation with Autologous Platelet-Rich Fibrin (PRF): Case Reports and the Rationale. Dent J (Basel) 2023; 11:244. [PMID: 37886929 PMCID: PMC10605266 DOI: 10.3390/dj11100244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
In dental implantology, alveolar ridge preservation (ARP) has emerged as a standard technique to address dimensional changes that affect alveolar ridge morphology following tooth loss. Various alternative graft materials, including xenografts, alloplasts, and allografts, have been effectively employed in fresh extraction sites for ARP. Current evidence suggests that these materials primarily serve as bio-scaffolds, which are slowly incorporated, thus necessitating a waiting period of at least 4-6 months before implant placement. Consequently, the ARP technique extends the overall duration of implant treatment by several months. Recently, the incorporation of a form of autologous platelet concentrate, known as platelet-rich fibrin (PRF), has been advocated in conjunction with ARP as a method of bioenhancement of soft- and hard-tissue healing and regeneration. PRF contains platelet-derived growth factors, hormones, and bioactive components like cytokines that have demonstrated the ability to stimulate angiogenesis and tissue regeneration throughout all phases of wound healing. Additionally, the concentration of leukocytes present in the PRF matrix plays a vital role in tissue healing and regeneration as part of the osteoimmune response. The reported advantages of incorporating autogenous PRF platelet concentrates during ARP encompass reduced healing time, improved angiogenesis and bone regeneration, socket sealing through the fibrin matrix, antibacterial properties, and decreased post-extraction pain and infection risk. Therefore, the objective of this paper is to review the existing evidence regarding the application of PRF in alveolar ridge preservation (ARP) following tooth extraction. Two clinical case studies are presented, wherein ARP was enhanced with PRF, followed by implant placement within a relatively short period of 8 weeks. These cases serve as further proof of concept for supporting the adjuvant use of PRF to enhance healing and accelerate implant placement after ARP.
Collapse
Affiliation(s)
| | - Rabia S. Khan
- I.C.E Postgraduate Dental Institute, University of Salford, Manchester M5 4WT, UK;
| |
Collapse
|
42
|
de Lima Barbosa R, Stellet Lourenço E, de Azevedo dos Santos JV, Rodrigues Santiago Rocha N, Mourão CF, Alves GG. The Effects of Platelet-Rich Fibrin in the Behavior of Mineralizing Cells Related to Bone Tissue Regeneration-A Scoping Review of In Vitro Evidence. J Funct Biomater 2023; 14:503. [PMID: 37888168 PMCID: PMC10607127 DOI: 10.3390/jfb14100503] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/12/2023] [Accepted: 10/08/2023] [Indexed: 10/28/2023] Open
Abstract
Platelet-rich fibrin (PRF) is a second-generation blood concentrate that serves as an autologous approach for both soft and hard tissue regeneration. It provides a scaffold for cell interaction and promotes the local release of growth factors. PRF has been investigated as an alternative to bone tissue therapy, with the potential to expedite wound healing and bone regeneration, though the mechanisms involved are not yet fully understood. This review aims to explore the in vitro evidence of PRF's effects on the behavior of mineralizing cells related to bone tissue regeneration. A systematic electronic search was conducted up to August 2023, utilizing three databases: PubMed, Web of Science, and Scopus. A total of 76 studies were selected, which presented in vitro evidence of PRF's usefulness, either alone or in conjunction with other biomaterials, for bone tissue treatment. PRF membranes' influence on the proliferation, differentiation, and mineralization of bone cells is linked to the constant release of growth factors, resulting in changes in crucial markers of bone cell metabolism and behavior. This further reinforces their therapeutic potential in wound healing and bone regeneration. While there are some notable differences among the studies, the overall results suggest a positive effect of PRF on cell proliferation, differentiation, mineralization, and a reduction in inflammation. This points to its therapeutic potential in the field of regenerative medicine. Collectively, these findings may help enhance our understanding of how PRF impacts basic physiological processes in bone and mineralized tissue.
Collapse
Affiliation(s)
- Renata de Lima Barbosa
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24033-900, Brazil
- Graduate Program in Science and Biotechnology, Fluminense Federal University, Niteroi 24210-201, Brazil
| | - Emanuelle Stellet Lourenço
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24033-900, Brazil
| | - Julya Vittoria de Azevedo dos Santos
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24033-900, Brazil
- Graduate Program in Science and Biotechnology, Fluminense Federal University, Niteroi 24210-201, Brazil
| | - Neilane Rodrigues Santiago Rocha
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24033-900, Brazil
- Graduate Program in Science and Biotechnology, Fluminense Federal University, Niteroi 24210-201, Brazil
| | - Carlos Fernando Mourão
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | - Gutemberg Gomes Alves
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24033-900, Brazil
- Graduate Program in Science and Biotechnology, Fluminense Federal University, Niteroi 24210-201, Brazil
| |
Collapse
|
43
|
Agrawal P, Nikhade P, Patel A, Bhopatkar J, Suryawanshi T. Pioneering Periapical Healing: The Novel Synergy of Mineral Trioxide Aggregate and Injectable Platelet-Rich Fibrin. Cureus 2023; 15:e46341. [PMID: 37920636 PMCID: PMC10618628 DOI: 10.7759/cureus.46341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/01/2023] [Indexed: 11/04/2023] Open
Abstract
This case report presents a novel non-surgical approach for managing a substantial periapical lesion associated with tooth 12 using a combination of injectable platelet-rich fibrin (i-PRF) and mineral trioxide aggregate (MTA). A 28-year-old male patient presented with pus discharge and intermittent swelling following a history of dental trauma. Clinical and radiographic assessments confirmed a large periapical cyst associated with tooth 12. The treatment involved root canal therapy with calcium hydroxide medication, leading to symptom relief. Subsequently, i-PRF combined with MTA was used as a regenerative material for periapical healing. Follow-up examinations at three, six, and nine months showed complete resolution of symptoms and radiographic evidence of lesion healing. This innovative technique demonstrates the potential of i-PRF and MTA synergy in the non-surgical management of periapical lesions, avoiding the risks associated with surgical interventions and promoting effective tissue healing.
Collapse
Affiliation(s)
- Paridhi Agrawal
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pradnya Nikhade
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aditya Patel
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Jay Bhopatkar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Tejas Suryawanshi
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
44
|
Albatal W, Qasem T, Tolibah YA. Liquid platelet-rich fibrin in root surface biomodification during gingival recession treatment: Randomized, controlled, split-mouth, clinical trial. Clin Exp Dent Res 2023; 9:772-782. [PMID: 37165467 PMCID: PMC10582228 DOI: 10.1002/cre2.747] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/27/2023] [Accepted: 04/28/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Free gingival graft (FGG) has been successfully used in the treatment of gingival recessions, as it is the most predictable technique for increasing the attached gingiva. This study aimed to evaluate the effect of liquid platelet-rich fibrin (PRF) with FGG on root surface coverage as root surface biomodification. MATERIALS AND METHODS The research sample consisted of 32 surgical sites in 16 patients, they had 2 bilateral recessions in the incisor area of the same dental arch, the sample was divided into 2 groups randomly, and liquid PRF was applied in the first group with the FGG (experimental group), and in the second group the FGG was applied alone (control group). Gingival recession depth (RD) and width of attached gingiva (WAG) were measured before starting, after 1, 3, and 6 months. The percentage of root coverage (RC) was calculated after 6 months. Healing Index (HI) was recorded after 1 week, 2 weeks, and 1 month. RESULTS Both groups showed a reduction in gingival RD during all follow-up periods but the difference between both groups was not statistically significant (p > 0.05) at 1 and 3 months, whereas there were significant differences at 6 months (p = 0.001). RC was better in the liquid PRF group than in the control group, but this difference was not statistically significant (p > 0.05). The postoperative 7th and 14th days HI scores of the liquid PRF group were significantly better than the control group (p = 0.000 and p = 0.004, respectively), whereas there were no significant differences in HI scores between both groups at first month (p > 0.05). CONCLUSIONS According to the results, the addition of liquid PRF to the root surface with FGG showed further development in terms of decreasing RD, increasing WAG, and accelerated wound-healing.
Collapse
Affiliation(s)
- Wajeha Albatal
- Department of Periodontology, Faculty of DentistryDamascus UniversityDamascusSyria
| | - Tarek Qasem
- Department of Periodontology, Faculty of DentistryDamascus UniversityDamascusSyria
| | | |
Collapse
|
45
|
Quirynen M, Siawasch S, Temmerman A, Cortellini S, Dhondt R, Teughels W, Castro AB. Do autologous platelet concentrates (APCs) have a role in intra-oral bone regeneration? A critical review of clinical guidelines on decision-making process. Periodontol 2000 2023; 93:254-269. [PMID: 37845802 DOI: 10.1111/prd.12526] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 07/05/2023] [Accepted: 08/15/2023] [Indexed: 10/18/2023]
Abstract
In the past decades, personalized regenerative medicine has gained increased attention. Autologous platelet concentrates (APCs) such as PRP, PRGF, and L-PRF, all serving as a source of a large variety of cells and growth factors that participate in hard and soft tissue healing and regeneration, could play a significant role in regenerative periodontal procedures. This narrative review evaluated the relative impact of APCs in alveolar ridge preservation, sinus floor augmentation, and the regeneration of bony craters around teeth, both as a single substitute or in combination with a xenograft. L-PRF has a significant beneficial effect on alveolar ridge preservation ( bone quality). The data for PRGF are less convincing, and PRP is controversial. L-PRF can successfully be used as a single substitute during transcrestal (≥3.5 mm bone gain) as well as 1-stage lateral window sinus floor elevation (>5 mm bone gain). For PRGF and especially PRP the data are very scarce. In the treatment of bony craters around teeth, during open flap debridement, L-PRF as a single substitute showed significant adjunctive benefits (e.g., >PPD reduction, >CAL gain, >crater depth reduction). The data for PRP and PRGF were non-conclusive. Adding PRP or L-PRF to a xenograft during OFD resulted in additional improvements (>PPD reduction, >CAL gain, >bone fill), for PRGF no data were found. Autologous platelet concentrates demonstrated to enhance bone and soft tissue healing in periodontal regenerative procedures. The data for L-PRF were most convincing. L-PRF also has the advantage of a greater simplicity of production, and its 100% autologous character.
Collapse
Affiliation(s)
- Marc Quirynen
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Sam Siawasch
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Andy Temmerman
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Simone Cortellini
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Rutger Dhondt
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Anna B Castro
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| |
Collapse
|
46
|
Krishnegowda R, Pradhan SN, Belgaumkar VA. A Split-Face Study to Evaluate Efficacy of Autologous Injectable Platelet-Rich Fibrin With Microneedling Against Microneedling With Normal Saline (Placebo Control) in Atrophic Acne Scars. Dermatol Surg 2023; 49:938-942. [PMID: 37584506 DOI: 10.1097/dss.0000000000003893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
BACKGROUND Acne scars cause significant psychosocial stress. Despite a wide armamentarium, there is a constant search for an effective modality. Autologous injectable platelet-rich fibrin (i-PRF) is a promising novel option in the management of atrophic scars. OBJECTIVE To compare efficacy of autologous i-PRF with microneedling against microneedling alone in atrophic acne scars. MATERIALS AND METHODS A split-face prospective interventional study was conducted on 40 patients with atrophic acne scars. Autologous i-PRF and normal saline were injected into each scar on right (study) and left (control) sides, respectively, followed by microneedling on both sides. Four sessions were performed at monthly intervals with follow-up at 2 months. For assessment, Goodman and Baron (GB) scale, physician subjective score, and patient satisfaction scores were used. RESULTS Mean baseline GB grade on each side was 3.45. At 24 weeks, mean GB grade was significantly reduced on the study side (1.47, SD 0.56) than control side (3.33, SD 0.53). Mean patient satisfaction score was significantly higher on the right side (5.95) compared with the left side (5.35). Rolling scars responded the best followed by boxcar and ice-pick scars. CONCLUSION Autologous i-PRF and microneedling act synergistically to improve acne scars.
Collapse
|
47
|
Smoczer C, Yuth KR, Askar MA, Young LA, Paurazas SB. Growth Factors Released from Advanced Platelet-Rich Fibrin in the Presence of Calcium-Based Silicate Materials and Their Impact on the Viability and Migration of Stem Cells of Apical Papilla. Dent J (Basel) 2023; 11:220. [PMID: 37754340 PMCID: PMC10530054 DOI: 10.3390/dj11090220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 09/28/2023] Open
Abstract
Advanced platelet-rich fibrin (A-PRF) provides the scaffold and growth factors necessary for stem cells to proliferate and differentiate in successful regenerative endodontic procedures. This study investigates the release of transforming growth factor-β1 (TGF-β1), platelet-derived growth factor (PDGF), and vascular endothelial growth factor (VEGF) from A-PRF in cell culture media in the presence and absence of mineral trioxide aggregate (MTA) or Biodentine. Additionally, this research assesses the viability and migration of stem cells of the apical papilla (SCAP) in previously conditioned media. A-PRF obtained from 14 participants were incubated for 7 days in cell culture media alone or via layering with MTA or Biodentine discs and the release of selected growth factors in the media was evaluated using ELISA. The viability of SCAP grown in conditioned media was measured using the CCK8 assay, while SCAP migration was assessed via a transwell assay by counting migrated cells. The release of TGF-β1, PDGF, and VEGF was significantly higher in media with A-PRF alone than in the presence of either calcium-based silicate material (p < 0.05), which showed no difference from the no-A-PRF control (p < 0.05). None of the tested growth factors released in the A-PRF-conditioned media correlated with clot weight. A-PRF-conditioned media, both with and without calcium-based silicate materials, did not impact SCAP viability and migration (p > 0.05). This study shows that SCAP behavior is not impacted by the decrease in growth factor released in the presence of calcium-based silicate materials and that their role in REPs warrants further investigation.
Collapse
Affiliation(s)
- Cristine Smoczer
- Division of Integrated Biomedical Sciences, University of Detroit Mercy School of Dentistry, Detroit, MI 48208, USA; (C.S.)
| | - Kenneth R. Yuth
- Graduate Endodontics, University of Detroit Mercy School of Dentistry, Detroit, MI 48208, USA (M.A.A.)
| | - Mazin A. Askar
- Graduate Endodontics, University of Detroit Mercy School of Dentistry, Detroit, MI 48208, USA (M.A.A.)
| | - Laura A. Young
- Division of Integrated Biomedical Sciences, University of Detroit Mercy School of Dentistry, Detroit, MI 48208, USA; (C.S.)
| | - Susan B. Paurazas
- Graduate Endodontics, University of Detroit Mercy School of Dentistry, Detroit, MI 48208, USA (M.A.A.)
| |
Collapse
|
48
|
Skurska A, Chwiedosik M, Ślebioda Z. Adjunctive use of platelet-rich fibrin in surgical treatment of furcation defects: A systematic review. Adv Med Sci 2023; 68:366-371. [PMID: 37757664 DOI: 10.1016/j.advms.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/20/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023]
Abstract
Periodontitis is an infectious disease characterized by the inflammatory destruction of the tooth supporting tissues. In multi-rooted teeth, this process leads to periodontal destruction within furcations creating defects demanding in terms of treatment. Regeneration of class II furcation involvement, although possible, is considered an unpredictable procedure, especially in terms of the bone fill. The interest in wound healing improvement by additional use of autologous concentrates of growth factors remains high in many fields of dentistry. Platelet-rich fibrin (PRF) is a second-generation platelet concentrate and biomaterial. PRF forms a solid fibrin matrix, which is slowly remodeled comparable to the natural blood clot. Its utilization is associated with release of growth factors and glycoproteins over a long period of time. PRF activates alkaline phosphates, which show osteoblastic activity and this activation influences the bone formation. The aim of this review of randomized controlled trials (RCTs) was to evaluate the adjunctive use of platelet-rich fibrin in surgical treatment of furcation defects.
Collapse
Affiliation(s)
- Anna Skurska
- Department of Integrated Dentistry, Medical University of Bialystok, Poland.
| | | | - Zuzanna Ślebioda
- Department of Oral Surgery, Periodontology and Oral Mucosa Diseases, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
49
|
Wang XL. Comparison of Platelet-Rich Fibrin and Iodoform Gauze in the Treatment of Localized Alveolitis. J Oral Maxillofac Surg 2023; 81:1155-1160. [PMID: 37364857 DOI: 10.1016/j.joms.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/28/2023]
Abstract
PURPOSE Iodoform gauze is commonly used to treat patients with localized alveolitis; however, saliva can easily dilute the iodoform concentration. This study aimed to compare the efficacies of platelet-rich fibrin (PRF) and iodoform gauze in treating localized alveolitis. METHODS This prospective randomized controlled trial enrolled patients with localized alveolitis who received treatment at our hospital from January 2018 to July 2021. They were randomly assigned to the control (treated with iodoform gauze) or experimental (treated with PRF) groups. Treatment method was the predictor variable. The primary outcome variable was clinical efficacy, defined as symptom resolution 1 week after treatment. Secondary outcome variables included granulation tissue (GT) quantitative score, analgesic drug dosage, and pain score determined using a visual analog scale (VAS). Patient demographics were used as covariates. Data analysis was performed by carrying out the χ2 and Mann-Whitney rank sum tests; P values <.05 indicated statistical significance. RESULTS This study included 60 patients, equally and randomly divided into the control and PRF groups (n = 30 each). There were no significant differences in demographic characteristics of patients between the 2 groups. One week after treatment, the PRF group showed a higher healing rate (93.3% vs 60.0%) and better GT quantitative score (3.13 ± 0.63 vs 1.70 ± 0.75) than the control group (P < .05). Moreover, the number of analgesic tablets consumed within 1 week postoperatively was lesser in the PRF group than in the control group (3.93 ± 1.53 vs 9.67 ± 3.16, P < .05). The PRF group exhibited significantly lower VAS pain scores than those of the control group on the 3rd day (1.10 ± 1.03 vs 4.17 ± 1.49) and 7th day (0.30 ± 0.60 vs 1.73 ± 1.44, P < .05) postoperatively. CONCLUSIONS Compared with iodoform gauze, PRF is associated with higher healing rate, faster promotion of GT growth in the extraction socket, better relief of alveolar pain, and lower intake of analgesic drugs when treating localized alveolitis.
Collapse
Affiliation(s)
- Xiao-Lin Wang
- Resident, Department of Stomatology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
| |
Collapse
|
50
|
Sindhusha VB, Ramamurthy J. Comparison of Antimicrobial Activity of Injectable Platelet-Rich Fibrin (i-PRF) and Leukocyte and Platelet-Rich Fibrin (l-PRF) Against Oral Microbes: An In Vitro Study. Cureus 2023; 15:e46196. [PMID: 37905284 PMCID: PMC10613344 DOI: 10.7759/cureus.46196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
Aim Injectable platelet-rich fibrin (i-PRF) and leukocyte and platelet-rich fibrin (l-PRF) are both blood-derived products used in regenerative medicine and dentistry. They contain platelets, growth factors, and leukocytes, which can have antimicrobial properties to some extent, but their primary purpose is tissue regeneration and wound healing. i-PRF and l-PRF may have some indirect antimicrobial properties due to their composition and ability to enhance tissue healing and immune responses, and they are primarily used in dentistry for their regenerative and wound healing capabilities rather than as standalone antimicrobial agents. This study aims to compare the anti-microbial activity of i-PRF and l-PRF against oral microbes. Methodology This study included 30 patients who were selected using G*Power software version 3.1 (Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany) calculation with the population size. The plaque samples were collected from the subjects using area-specific Gracey curettes used for scaling and root planing to remove plaque and calculus from the teeth and root surfaces. The collected plaque samples were transferred to a tube containing 5 ml of saline (sterile saltwater). The purpose of using saline is to preserve the microbial content of the plaque sample without altering the microbial composition. To obtain a uniform solution, the samples in the saline-containing tube were vortexed for 5 minutes. After vertexing, a small amount of the suspension (0.1 ml) was taken for further analysis. The 0.1 ml suspension was used to plate blood agar using the streak method. A loop or needle is used to streak the sample back and forth across the surface of the agar, leading to the dilution and separation of the bacteria. Results Results state that i-PRF has a maximum zone of inhibition (2.19±0.47 mm) when compared with metronidazole (0.14±0.09 mm). It can be stated that platelet concentrates demonstrate better antimicrobial activity due to their higher oxygen metabolites which help in the aggregation and internalization of microorganisms, which enhances the clearance of pathogens from the bloodstream. Paired t-test has been used for the comparison between the two groups, and the p-value is >0.05 stating that the difference is statistically significant. Conclusion The present study states that i-PRF demonstrated better antimicrobial efficacy as compared to l-PRF. Hence, i-PRF helps in reducing microbial load at the periodontally infected sites when compared with l-PRF.
Collapse
Affiliation(s)
- Vyshnavi B Sindhusha
- Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Jaiganesh Ramamurthy
- Periodontics, Saveetha Dental College and Hospitals, Saveetha institute of medical and technical sciences, Saveetha University, Chennai, IND
| |
Collapse
|