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da Silva LMP, Sávio DDSF, de Ávila FC, Vicente RM, Reis GGD, Denardi RJ, da Costa NMM, Silva PHF, Mourão CFDAB, Miron RJ, Messora MR. Comparison of the effects of platelet concentrates produced by high and low-speed centrifugation protocols on the healing of critical-size defects in rat calvaria: a microtomographic and histomorphometric study. Platelets 2022; 33:1175-1184. [PMID: 35591762 DOI: 10.1080/09537104.2022.2071851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The current study evaluated the healing of critical-size defects (CSD) created in rat calvaria treated with platelet concentrates produced by high-speed (Leukocyte- and Platelet-Rich Fibrin - L-PRF) and low-speed (Advanced Platelet-Rich Fibrin - A-PRF) protocols of centrifugation. Twenty-four rats were distributed into three groups: Control, L-PRF, and A-PRF. Five mm diameter CSD were created on the animals' calvaria. The defects of the L-PRF and A-PRF groups were filled with 0.01 ml of L-PRF and A-PRF, respectively. The control group defects were filled with a blood clot only. All animals were euthanized on the 35th postoperative day. Histomorphometric and microtomographic analyses were then performed. The L-PRF and A-PRF groups had significantly higher bone volume and neoformed bone area than those of the control group and lowered bone porosity values (p < .05). No significant differences were observed between A-PRF and L-PRF groups for the analyzed parameters. Therefore, it can be concluded that i) L-PRF and A-PRF potentiated the healing of CSD in rat calvaria; ii) high and low-speed centrifugation protocols did not produce PRF matrices with different biological impacts on the amount of bone neoformation.
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Affiliation(s)
- Lucia Moitrel Pequeno da Silva
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Débora de Souza Ferreira Sávio
- Department of Morphology, Physiology, and Basic Pathology - DMFPB, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP
| | - Felipe Correa de Ávila
- Department of Morphology, Physiology, and Basic Pathology - DMFPB, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP
| | - Raphael Martini Vicente
- Department of Orthopedics and Anesthesiology, Ribeirão Preto Medical School, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Gabriel Guerra David Reis
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ricardo Junior Denardi
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Natacha Malu Miranda da Costa
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Pedro Henrique Felix Silva
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Michel Reis Messora
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Han B, Wang Y, Chen Z, Zheng C, Zhang Z, Liu Y, Liu K, Wang Z, Wang X. Platelet-rich fibrin/anorganic bovine bone mineral complex as grafting materials in endodontic microsurgery with a large lesion size: study protocol for a randomised controlled trial. BMJ Open 2022; 12:e057068. [PMID: 35477884 PMCID: PMC9047977 DOI: 10.1136/bmjopen-2021-057068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Endodontic microsurgery is a treatment of last resort for preserving natural teeth. According to radiographic evaluation, the percentage of complete healing after endodontic microsurgery is only 74.3%. The use of regenerative techniques in endodontic microsurgery for large lesions (>10 mm diameter) is therefore recommended. The most frequently used bone graft in endodontic microsurgery is anorganic bovine bone mineral (ABBM) but this only has an osteoconductive effect. Thus, when platelet-rich fibrin (PRF), a reservoir of growth factors, is used together with ABBM, it increases the regenerative effect. This study is devoted to comparing the clinical outcomes of PRF with/without ABBM as grafting biomaterials in endodontic microsurgery cases with large lesion size to provide some valuable reference data for dentists. METHODS AND ANALYSIS Sixteen patients who are in need of endodontic microsurgery will be recruited. The patients will be randomly assigned to one of two groups: an experimental group, treated with PRF/ABBM complex and collagen membrane, and a control group, treated with ABBM and collagen membrane. Clinical examination including percussion, mobility testing and presence/absence of sinus will be recorded at 7 days, and at 3, 6 and 12 months after endodontic microsurgery. A Visual Analogue Scale will be used by the patients to evaluate pain at 1, 3 and 7 days after endodontic microsurgery. Routine paralleling radiographs will be obtained before and at 3, 6 and 12 months follow-up after endodontic microsurgery. Cone-beam CT (CBCT) scans will be obtained at the 12-month follow-up. Bone formation will be evaluated according to CBCT and paralleling radiographs. The study execute time including follow-ups last from 1 June 2021 to 31 December 2024. ETHICS AND DISSEMINATION This study received approval from the Ethics Committee of Peking University School and Hospital of Stomatology. The results will be disseminated through scientific journals. TRIAL REGISTRATION NUMBER Research data will be registered with the International Clinical Trials Registry Platform (ICTRP), ID: ChiCTR2100046684.
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Affiliation(s)
- Bing Han
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yuhan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Zhibin Chen
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Chunyan Zheng
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Zhichun Zhang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yingyi Liu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Kaining Liu
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Zuhua Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Plasma Rich in Growth Factors in the Treatment of Endodontic Periapical Lesions in Adult Patients: A Narrative Review. Pharmaceuticals (Basel) 2021; 14:ph14101041. [PMID: 34681265 PMCID: PMC8539488 DOI: 10.3390/ph14101041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 10/12/2021] [Indexed: 02/07/2023] Open
Abstract
Platelet concentrates have been widely used in regenerative medicine, including endodontics. The aim of this manuscript was to assess critically the efficacy of PRF in the treatment of endodontic periapical lesions in adult patients on the basis of the literature. The PICO approach was used to properly develop literature search strategies. The PubMed database was analyzed with the keywords: "((PRP) OR (PRF) OR (PRGF) OR (CGF)) AND (endodontic) AND ((treatment) OR (therapy))". After screening of 155 results, 14 articles were included in this review. Different types of platelet concentrates are able to stimulate the processes of proliferation and differentiation of mesenchymal stem cells. Platelet rich fibrin (PRF) releases growth factors for at least 7 days at the application site. Growth factors and released cytokines stimulate the activity of osteoblasts. Moreover, the release of growth factors accelerates tissue regeneration by increasing the migration of fibroblasts. It was not possible to assess the efficacy of PRF supplementation in the treatment of endodontic periapical lesions in permanent, mature teeth with closed apexes, due to the lack of well-designed scientific research. Further studies are needed to analyze the effect of PRF on the healing processes in the periapical region.
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Plasma Rich in Growth Factors in the Treatment of Endodontic Periapical Lesions in Adult Patients: Case Reports. Int J Mol Sci 2021; 22:ijms22179458. [PMID: 34502364 PMCID: PMC8431603 DOI: 10.3390/ijms22179458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/19/2021] [Accepted: 08/30/2021] [Indexed: 12/17/2022] Open
Abstract
Platelet-rich fibrin (PRF) is an autologous blood concentrate obtained without anticoagulants by centrifugation of patients’ peripheral venous blood. PRF is considered to enhance the formation of new bone. The aim of this manuscript was to present two case reports of permanent teeth with closed apexes with periapical lesions, treated endodontically with the use of PRF. The root canals were mechanically cleaned and shaped with NiTi files and irrigated with 5.25% sodium hypochlorite (NaOCl), 40% citric acid (CA), and triple distillated water. Before the canal systems were obturated, A-PRF was used as a scaffold and was placed below the cementodentinal junction with hand pluggers. Cone beam computerized tomography (CBCT) was used to assess the resolutions of periapical radiolucencies. After 6 months, the measurements of both periapical lesions were significantly reduced. Although the performed root canal treatments (RCTs) can definitely be recognized as successful, it must be emphasized that mechanical shaping and cleaning of the root canals with special disinfecting solutions significantly affect the clinical efficacy of RCT. It seems impossible to state that PRF played a leading role in the healing process of the presented periapical lesions. Further studies must be performed to assess whether RCT of mature teeth with an additional PRF application is superior to RCT performed alone.
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Tiwari UO, Chandra R, Tripathi S, Jain J, Jaiswal S, Tiwari RK. Comparative analysis of platelet-rich fibrin, platelet-rich fibrin with hydroxyapatite and platelet-rich fibrin with alendronate in bone regeneration: A cone-beam computed tomography analysis. J Conserv Dent 2021; 23:348-353. [PMID: 33623234 PMCID: PMC7883795 DOI: 10.4103/jcd.jcd_228_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/28/2020] [Accepted: 07/16/2020] [Indexed: 11/04/2022] Open
Abstract
Aim This clinical study was designed to evaluate the volumetric healing of periapical (PA) bone defect after PA surgery, using platelet-rich fibrin (PRF), and its combination with hydroxyapatite and alendronate. Subjects and Methods Twenty male patients of age between 25 and 35 years, having PA pathology (>5 mm on intraoral periapical radiograph (IOPA)) with intraoral sinus opening, were included in this study. Cone-beam computed tomography (CBCT) imaging of all patients was done. Root canal treatment with PA surgery was done. Patients were divided into four groups (5 in each group), on the basis of material placed in PA bone defect. After 1 year, CBCT imaging was done. Linear measurement of maximal dimensions in all three orthogonal planes was done in both pre- and post-CBCT image. These measurements were used to estimate the volume of the lesion healed after 1 year of surgery. Statistical Analysis Analysis of variance and Post hoc Tukey's test were used for statistical analysis. Results Change in volume were significantly different between Group 1 vs Group 3; Group 2 vs Group 3 and Group 3 vs Group 4. The Group Order for change in volume 1 year post surgery Group 3> Group 4 ≈ Group 2> Group 1. Conclusions PA bone healing after surgery is enhanced by placing combination of bone regenerative materials. PRF with hydroxyapatite provides best healing outcomes in comparison to PRF with alendronate or PRF alone.
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Affiliation(s)
- Urvashi Ojha Tiwari
- Department of Conservative Dentistry and Endodontics, Career Post Graduate Institute of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Ramesh Chandra
- Department of Conservative Dentistry and Endodontics, Career Post Graduate Institute of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Supratim Tripathi
- Department of Conservative Dentistry and Endodontics, Career Post Graduate Institute of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Jyoti Jain
- Department of Conservative Dentistry and Endodontics, Career Post Graduate Institute of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Sanjay Jaiswal
- Department of Conservative Dentistry and Endodontics, Career Post Graduate Institute of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Rahul Kumar Tiwari
- Department of Radiodiagnosis, King George Medical University, Lucknow, Uttar Pradesh, India
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Impact of Platelet-rich Plasma in the Healing of Through-and-through Periapical Lesions Using 2-dimensional and 3-dimensional Evaluation: A Randomized Controlled Trial. J Endod 2020; 46:1167-1184. [DOI: 10.1016/j.joen.2020.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/28/2020] [Accepted: 06/07/2020] [Indexed: 12/11/2022]
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Multi-modular bone healing assessment in a randomized controlled clinical trial of root-end surgery with the use of leukocyte- and platelet-rich fibrin and an occlusive membrane. Clin Oral Investig 2020; 24:4439-4453. [DOI: 10.1007/s00784-020-03309-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 04/23/2020] [Indexed: 01/24/2023]
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Torabinejad M, Parirokh M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part II: other clinical applications and complications. Int Endod J 2017; 51:284-317. [PMID: 28846134 DOI: 10.1111/iej.12843] [Citation(s) in RCA: 201] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/22/2017] [Indexed: 12/16/2022]
Abstract
Mineral trioxide aggregate (MTA) is a dental material used extensively for vital pulp therapies (VPT), protecting scaffolds during regenerative endodontic procedures, apical barriers in teeth with necrotic pulps and open apices, perforation repairs as well as root canal filling and root-end filling during surgical endodontics. A number of bioactive endodontic cements (BECs) have recently been introduced to the market. Most of these materials have calcium and silicate in their compositions; however, bioactivity is a common property of these cements. These materials include the following: BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, Neo MTA Plus, Ortho MTA, Quick-Set, Retro MTA, Tech Biosealer, and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA but without the drawbacks. In Part I of this review, the available information on the chemical composition of the materials listed above was reviewed and their applications for VPT was discussed. In this article, the clinical applications of MTA and other BECs will be reviewed for apexification, regenerative endodontics, perforation repair, root canal filling, root-end filling, restorative procedures, periodontal defects and treatment of vertical and horizontal root fractures. In addition, the literature regarding the possible drawbacks of these materials following their clinical applications is reviewed. These drawbacks include their discolouration potential, systemic effects and retreatability following use as a root filling material. Based on selected keywords, all publications were searched regarding the use of MTA as well as BECs for the relevant clinical applications. Numerous publications were found regarding the use of BECs for various endodontic applications. The majority of these investigations compared BECs with MTA. Despite promising results for some materials, the number of publications using BECs for various clinical applications was limited. Furthermore, most studies had several methodological shortcomings and low levels of evidence.
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Affiliation(s)
- M Torabinejad
- Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - M Parirokh
- Endodontology Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Meschi N, Castro AB, Vandamme K, Quirynen M, Lambrechts P. The impact of autologous platelet concentrates on endodontic healing: a systematic review. Platelets 2016; 27:613-633. [PMID: 27658056 DOI: 10.1080/09537104.2016.1226497] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The current literature was reviewed to determine the impact of autologous platelet concentrates (APCs) on endodontic healing. All types of clinical study designs concerning any kind of endodontic treatment involving the application of APCs were included. Two independent reviewers searched three databases (PubMed, Embase, and Cochrane Library) for studies, complemented by hand search, until 16/1/2016. From the 423 identified records, 48 articles met the inclusion criteria. Selected randomized controlled clinical trials (RCTs) underwent Cochrane Collaboration's risk-of-bias assessment and data extraction. Only two RCTs showed low risk of bias. There was considerable heterogeneity between the RCTs with regard to the type of therapy, type of APCs, assessment method, and study quality, and therefore the data could not be analyzed quantitatively. The included case reports/series and non-randomized comparative studies underwent qualitative analysis with the revised Methodological Index for Non-Randomized Studies (MINORS) and data extraction. The two comparative non-randomized studies scored qualitatively high, though the MINORS-scores of the case series and reports were dispersed. APCs were involved in five endodontic treatment modalities, namely apexification, regenerative endodontic procedures, pulpotomy, apical surgery, and treatment of endo-perio/perio-endo lesions. APCs seem to accelerate postoperative bone healing, augment the patients' postoperative quality of life, aid further root development, and support maintenance/regaining of pulp vitality. No adverse events were reported. APCs in endodontic treatments seem to contribute to the healing of soft and hard tissues, though there is a lack of long-term high quality clinical trials and standardized treatment protocols.
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Affiliation(s)
- Nastaran Meschi
- a Department of Oral Health Sciences, Endodontology , KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Ana B Castro
- b Department of Oral Health Sciences , Periodontology, KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Katleen Vandamme
- c Department of Oral Health Sciences , Restorative Dentistry, KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Marc Quirynen
- b Department of Oral Health Sciences , Periodontology, KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Paul Lambrechts
- a Department of Oral Health Sciences, Endodontology , KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
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Application of platelet-rich fibrin in endodontic surgery: a pilot study. GIORNALE ITALIANO DI ENDODONZIA 2015. [DOI: 10.1016/j.gien.2015.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Rodella LF, Bonazza V. Platelet preparations in dentistry: How? Why? Where? When? World J Stomatol 2015; 4:39-55. [DOI: 10.5321/wjs.v4.i2.39] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 04/08/2015] [Accepted: 04/30/2015] [Indexed: 02/06/2023] Open
Abstract
The aim of this article is to review the outcomes of platelet preparations in dentistry. A structured electronic search discovered 348 articles, which described the use of autologous platelet concentrates with a relevance to clinical dentistry. Among these articles, 220 articles investigated platelet rich plasma, 99 investigated platelet rich fibrin, 22 investigated plasma rich in growth factors and 7 investigated the use of concentrated growth factors. Several studies reported beneficial treament outcomes in terms of enhanced bone and soft tissue regeneration.
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