Platelet-rich fibrin as an autologous biomaterial for bone regeneration: mechanisms, applications, optimization

Orthodontic tooth movement in alveolar bone augmentation area: A systematic review of animal studies

OBJECTIVES

This systematic review aims to evaluate the optimal timing for orthodontic tooth movement (OTM) following alveolar bone augmentation, the types of alveolar bone graft materials used, and the associated animal models.

MATERIAL AND METHODS

A systematic search was conducted across PubMed, Web of Science, Cochrane Library, Scopus, and grey literature databases, covering studies from January 1st, 2014, to November 30th, 2024. Studies addressing combined alveolar bone augmentation and OTM were selected, with outcomes such as OTM rate, bone formation, and root resorption assessed through imaging or histological methods. A control group was required in animal experiments. There were no language restrictions. Article screening and data extraction were performed independently by two reviewers. The SYRCLE risk-of-bias tool was used to evaluate study quality.

RESULTS

Fourteen animal studies were included, with subjects comprising dogs, rats, mice, and rabbits. The graft materials predominantly consisted of allografts, xenografts, and alloplasts. The applied orthodontic force ranged from 10g to 150g, with OTM performed at intervals of 0 to 3months. Methodologies included model measurements, imaging, and histological analyses.

CONCLUSION

OTM can be performed during the bone weaving stage, however, the use of alveolar bone grafts generally impedes OTM. Alloplasts are associated with less root resorption. Animal models should closely mirror human characteristics, considering factors such as sex, age, defect location and size, type of tooth movement, and force magnitude. Overall, the quality of the studies is suboptimal, and further well-designed animal and human studies are needed. This systematic review has been registered with PROSPERO (CRD42025642198).

Accurate Delivery of Mesenchymal Stem Cell Spheroids With Platelet-Rich Fibrin Shield: Enhancing Survival and Repair Functions of Sp-MSCs in Diabetic Wound Healing

Diabetic wound is a significant clinical challenge, and stem cell therapy has shown great potential. This study explores the role of mesenchymal stem cell (MSC) spheroids (Sp-MSCs) in healing diabetic wounds and the use of autologous plasma-rich platelet fibrin (PRF) as a scaffold for Sp-MSCs. Through activation of the coagulation system, PRF offers a protective fibrin shield for Sp-MSCs to promote the rapid recovery migration and proliferation of MSCs while maintaining the activity of Sp-MSCs in an inflammatory overload environment by activating the related genes of Integrin-β1-vascular endothelial growth factor (VEGF), and Wnt/β-catenin pathways. The inclusion of Sp-MSCs accelerates the gelation of PRF and results in improved mechanical strength. Additionally, PRF enhances the repair function of Sp-MSCs, creating a favorable microenvironment for angiogenesis. In the wound model of diabetic mice, the combination of PRF with Sp-MSCs accelerates wound healing. Results show that this combination significantly promotes wound repair and regulates the immune microenvironment. The study suggests that PRF is a promising bio-derived scaffold for stem cell applications in diabetic wounds, offering new directions for stem cell therapy and biomimetic scaffold material development.

Self-Healing Hydrogels: Mechanisms and Biomedical Applications

Hydrogels have emerged as dependable candidates for tissue repair because of their exceptional biocompatibility and tunable mechanical properties. However, conventional hydrogels are vulnerable to damage owing to mechanical stress and environmental factors that compromise their structural integrity and reduce their lifespan. In contrast, self-healing hydrogels with their inherent ability to restore structure and function autonomously offer prolonged efficacy and enhanced appeal. These hydrogels can be engineered into innovative forms including stimulus-responsive, self-degradable, injectable, and drug-loaded variants, thereby enhancing their applicability in wound healing, drug delivery, and tissue engineering. This review summarizes the categories and mechanisms of self-healing hydrogels, along with their biomedical applications, including tissue repair, drug delivery, and biosensing. Tissue repair includes wound healing, bone-related repair, nerve repair, and cardiac repair. Additionally, we explored the challenges that self-healing hydrogels continue to face in tissue repair and presented a forward-looking perspective on their development. Consequently, it is anticipated that self-healing hydrogels will be progressively designed and developed for applications that extend beyond tissue repair to a broader range of biomedical applications.

One-Stage Surgical Management of an Asymptomatic Maxillary Sinus Mucocele with Immediate Lateral Sinus Lift and Simultaneous Implant Placement: A Case Report

Background: The relationship between dental implants and sinus mucoceles is an area of growing interest in oral and maxillofacial surgery, as therapeutic approaches for these conditions remain controversial. This case report presents a 48-year-old male with no significant medical history who sought dental care due to recurrent abscesses on the distal abutment of a five-unit maxillary bridge. Clinical and radiographic evaluations, including Cone-Beam Computed Tomography (CBCT), revealed a pathologic lesion associated with the second molar, insufficient alveolar bone height in the posterior maxilla, and a radiopaque mass on the sinus floor. Methods: A one-stage surgical approach was planned, involving the second molar extraction, the sinus cyst removal, sinus floor elevation, and simultaneous implant placement. The prosthetic restoration was completed six months postoperatively. Results: Over an 88-month follow-up period, no prosthetic complications were observed, and the patient reported high satisfaction with the restoration's function and aesthetics. Conclusions: This case highlights a single-stage surgical strategy's feasibility and long-term success in managing asymptomatic maxillary sinus mucoceles while optimizing implant placement and rehabilitation.

Efficacy of Simvastatin in Inhibiting Bone Resorption and Promoting Healing in Delayed Tooth Avulsion: A Case Series

An avulsion is a severe dental injury characterized by the complete displacement of a tooth from its socket, often resulting in a compromised prognosis. One of the key factors influencing the success of reimplantation is the extraoral dry time, which refers to the duration the tooth remains outside of the socket. Prolonged dry time significantly impairs the viability of the periodontal ligament cells, crucial for successful healing and reattachment. Despite various protocols and treatment strategies developed to manage avulsed teeth, no single approach addresses all treatment needs effectively, particularly in cases of delayed reimplantation. Simvastatin, an anti-lipidemic drug, has demonstrated pleiotropic effects that extend beyond cholesterol lowering. These effects include anti-inflammatory properties, promotion of bone regeneration, and enhancement of periodontal ligament cell survival. Such actions suggest that simvastatin may have a beneficial role in improving outcomes following the delayed reimplantation of avulsed teeth. This case series proposes the use of simvastatin as an adjunctive treatment for avulsed teeth along with platelet-rich fibrin and hydroxyapatite, particularly in situations where reimplantation is delayed. By mitigating inflammation and stimulating tissue regeneration, simvastatin may help counteract the damage caused by prolonged extraoral dry time. Its potential to promote periodontal ligament cell survival and enhance healing processes could improve the prognosis of reimplantation, even in cases where traditional treatment alone would be less effective. Given these promising properties, simvastatin may represent a valuable addition to the treatment protocol for avulsed teeth with extended dry times. However, further clinical studies and trials are necessary to validate its efficacy and establish a clear role in the management of delayed reimplantation.

Complication rates of guided bone regeneration using titanium-reinforced PTFE membranes: a retrospective analysis

INTRODUCTION

This study analyzed complication rates of guided bone regeneration (GBR) using titanium-reinforced polytetrafluoroethylene (PTFE) membranes for alveolar ridge augmentation.

MATERIAL AND METHODS

84 patients treated with GBR using titanium-reinforced PTFE membranes (91 sites) were retrospectively analyzed. Complications such as membrane exposure and early removal were analyzed concerning patient age, defect site position, size, simultaneous vs. two-stage implant placement, smoking, and the use of bone grafts (BG) and substitutes (BS).

RESULTS

Early removal due to membrane exposure was necessary in 14/91 sites (15.4%). No correlation was found between early removal and patient age (p = 0.917). Analyzing early removal between the upper and lower jaw and between both jaws' anterior and posterior tooth regions revealed no correlations (p = 0.381 and 0.477, respectively). Defect sites sizes of 5-6 mm exhibited the highest rate of membrane exposure, requiring early removal, accounting for 57.1% of these sites (8/14). No correlation was observed between the defect sites size and early removal (p = 0.660). Comparison of simultaneous (74 sites) vs. two-stage implant placement (16 sites) showed no correlation with early removal (p = 0.706). Membrane exposure incidence was 42.9% among smokers (27 patients, 32.1%) and 57.1% among non-smokers (57 patients, 67.9%), without correlation. No correlation was found between the type of BG and BS and early removal (p = 0.500).

CONCLUSION

GBR using titanium-reinforced PTFE membranes is effective for alveolar ridge augmentation and has favorable long-term outcomes.

CLINICAL RELEVANCE

Careful surgical technique and postoperative care can minimize the notable risk of PTFE membrane exposure.

Investigating the Biological Efficacy of Albumin-Enriched Platelet-Rich Fibrin (Alb-PRF): A Study on Cytokine Dynamics and Osteoblast Behavior

The development of effective biomaterials for tissue regeneration has led to the exploration of blood derivatives such as leucocyte- and platelet-rich fibrin (L-PRF). A novel variant, Albumin-Enriched Platelet-Rich Fibrin (Alb-PRF), has been introduced to improve structural stability and bioactivity, making it a promising candidate for bone regeneration. This study aimed to evaluate Alb-PRF's capacity for cytokine and growth factor release, along with its effects on the proliferation, differentiation, and mineralization of human osteoblasts in vitro. Alb-PRF membranes were analyzed using histological, scanning electron microscopy, and fluorescence microscopy techniques. Cytokine and growth factor release was quantified over seven days, and osteoinductive potential was evaluated with MG-63 osteoblast-like cells. Structural analysis showed Alb-PRF as a biphasic, highly cellularized material that releases lower levels of inflammatory cytokines and higher concentrations of platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) compared to L-PRF. Alb-PRF exhibited higher early alkaline phosphatase activity and in vitro mineralization (p < 0.05) and significantly increased the OPG/RANKL mRNA ratio (p < 0.05). These results indicate that Alb-PRF has promising potential as a scaffold for bone repair, warranting further in vivo and clinical assessments to confirm its suitability for clinical applications.

Comparison Between Autologous Albumin Gel and Liquid Platelet-Rich Fibrin Mixture Versus Connective Tissue Graft to Modify the Gingival Phenotype: A Randomized Controlled Trial

Objectives To assess changes in gingival thickness (GTH) and the width of keratinized gingival tissue (KTW) following treatment with either connective tissue graft (CTG) or an albumin gel-platelet-rich fibrin mixture (Alb-PRF). Materials and methods Twenty treatment sites were included in a split-mouth design involving 10 patients with a thin gingival phenotype in the mandibular anterior region. The sample was randomly divided into two groups, with the Alb-PRF applied to the experimental group and CTG used for the control group. GTH and KTW were measured at baseline and after one, three, and six months. Results GTH increased in both groups during all follow-up periods. However, no statistically significant differences (p > 0.05) between the groups were observed at baseline and six months. At three months, the experimental group exhibited significantly higher GTH (p < 0.001). Additionally, at three and six months, the CTG group showed a superior increase in KTW (p < 0.05). Conclusion Within the constraints of this study, Alb-PRF application for modifying thin gingival phenotypes proved to be an effective therapeutic option, potentially serving as an alternative to CTGs. Although Alb-PRF resulted in thicker gingiva, CTG demonstrated a greater enhancement in KTW.

Platelet-rich fibrin in dentistry

OBJECTIVES

To review the progress of Platelet Rich Fibrin (PRF) as a biomaterial in dentistry and to highlight its promising application as a safe and biocompatible autologous platelet concentrate. Publications were searched in GeenMedical, X-mol, GoogleScholar, and PubMed from October 2024 with no language restrictions. The literature was searched for relevant databases and journals on the use of PRFs in dentistry up to October 2024, and the inclusion criteria included randomized controlled trials, clinical trials, case series, and systematic reviews.

CONCLUSION

PRF is a second-generation platelet concentrate that is sourced from oneself, has fewer adverse effects, and is simple and safe to prepare. These materials include growth factors and fibrin scaffolds, which are extensively utilized in regenerative medicine. By outlining PRF, we found that good results can be achieved when PRF is used to treat these conditions.

CLINICAL SIGNIFICANCE

The application of PRF in dentistry is widespread, particularly in periodontal soft and hard tissue regeneration, oral lichen planus, and pulpal regeneration. This article reviews the background, classification, and preparation methods of PRFs, along with their dental applications. We anticipate further research on various PRF derivatives in the future, which will significantly improve the utilization of PRF in oral applications and offer fresh insights for diagnosing and treating oral diseases.