Immediately loaded dental implants bioactivated with platelet-rich plasma (PRP) placed in maxillary and mandibular region

BACKGROUND AND AIM

Dental implants have today deeply changed the dental field. In fact, after almost 50 years, the permanent placement of a titanium screw with an attached tooth have, step by step, changed the society's standard toward a permanently replacement of missed or severely damaged teeth. In fact, the host of benefits born from dental implants have affected both patients and dental professionals. The aim of the present study is to report the outcomes of an implant therapy protocol supporting fixed prostheses implanted soon after extractions and loaded with flapless guided surgery by a 3D software planning.

MATERIALS AND METHODS

37 patients, requiring rehabilitation of booth dental arches with a one-to-one technique, were enrolled in a follow-up study plan which established clinical and radiological examinations on the day after surgery, seven months and one year later. Platelet Rich Plasma (PRP), in combination with autogenous bone, organic bone material and organic bone substitutes, was used before implant-prosthetic rehabilitation with an its prompt loading just before the implant insertion phase.

RESULTS

Definitive restorations were delivered at 6-12 months after surgical procedure. One year after loading there were no dropouts and no failure of the definitive prosthesis. Furthermore, the feedback from patients resulted positive.

CONCLUSIONS

Patients resulted satisfied both aesthetically and functionally regarding these types of prosthetic reconstructions made at the time.

Use of platelet rich fibrin and Bio-OSS/SINT-Oss for implant-prosthetic rehabilitation in maxillary atrophy with sinus pathology: A 48-month follow-up

The maxillary sinus floor elevation procedure has gained popularity with predictable results, and is a safe, acceptable technique for bone augmentation, providing a base for dental implant treatment. Faint radiopaque lesions at the base of the maxillary sinus are frequent diagnoses on radiographs and must be identified during dental implant planning. The use of autografts, xenografts, allografts, and alloplasts or a combination between them has been demonstrated to be effective for increasing bone height and bone volume in maxillary sinus. The objective of this study was to evaluate the outcome of subjects with considerable sinus membrane pathology (test group) undergoing maxillary sinus floor augmentation using Platelet Rich Fibrin (PRF) as a filling material, in association with the Bio-Oss and Sint-Oss and simultaneous implant placement in a one-stage surgical procedure. All patients reported no pain to percussion, no sign of tissue suffering to the soft peri-implant tissues, the presence of an optimal primary stability of the inserted implants, and the increase in the peri-implant bone density. No complications were encountered during follow-up periods in these patients, including no negative evolution in the sinusitis and all implants are functioning successfully. In conclusion, the use of PRF and Piezosurgery reduced the healing time, favoring optimal bone regeneration and allowing sinus membrane integrity to be maintained during surgical procedures, according to evidence-based dentistry.

Growth-promoting action and growth factor release by different platelet derivatives

Abstract Platelet derivatives are commonly used in wound healing and tissue regeneration. Different procedures of platelet preparation may differentially affect growth factor release and cell growth. Preparation of platelet-rich fibrin (PRF) is accompanied by release of growth factors, including platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF) and transforming growth factor β1 (TGFβ1), and several cytokines. When compared with the standard procedure for platelet-rich plasma (PRP), PRF released 2-fold less PDGF, but >15-fold and >2-fold VEGF and TGFβ1, respectively. Also, the release of several cytokines (IL-4, IL-6, IL-8, IL-10, IFNγ, MIP-1α, MIP-1β and TNFα) was significantly increased in PRF-conditioned medium (CM), compared to PRP-CM. Incubation of both human skin fibroblasts and human umbilical vein endothelial cells (HUVECs) with PRF-derived membrane (mPRF) or with PRF-CM enhanced cell proliferation by >2-fold (p<0.05). Interestingly, PRP elicited fibroblast growth at a higher extent compared to PRF. At variance, PRF effect on HUVEC growth was significantly greater than that of PRP, consistent with a higher concentration of VEGF in the PRF-CM. Thus, the procedure of PRP preparation leads to a larger release of PDGF, as a possible result of platelet degranulation, while PRF enhances the release of proangiogenic factors.

[Mouthwash solutions containing microencapsuled natural extracts: In vitro evaluation of antioxidant properties (dental plaque and gingivitis)]

INTRODUCTION

New mouthwash solutions containing microencapsulated natural extracts were developed to provide both antiseptic activity and in depth treatment of oral tissues, due to their antioxidant and immunoregulatory properties. The objective of this study was to quantify the antioxidant action of the GingiNat solution (LoB5 Foundation, Paris, France) in an in vitro cell model.

MATERIALS AND METHODS

Diluted GingNat solutions (0.12%, 0.06% and 0.012%) were put in contact with Jurkat type human lymphoid cells in basal radical state (cells at rest) and in provoked oxidative stress conditions (after an UVA+UVB irradiation). The lipid peroxidation was quantified by flow cytometry using a fluorescent probe.

RESULTS

The diluted GingNat solutions at 0.12%, 0.06%, and 0.012% showed a significant antioxidant effect with respectively 122.9%, 117.8% and 119.3% on average. The difference was statistically significant compared to controls for the three concentrations without any significant difference among them. This antioxidant effect was even more significant when cells were in oxidative stress with respectively 155.3%, 139.3%, and 132.5% on average. There was a significant difference between the tested concentrations (p<0.01).

DISCUSSION

These first in vitro results confirmed the antioxidant properties of the GingiNat solution. These antioxidant properties are significantly higher at stronger concentrations. Further studies are required to analyze the influence of microencapsulation on these results. Clinical trials are needed to confirm these antioxidant properties.

[Mouthwash solutions containing microencapsulated natural extracts: Clinical results on dental plaque and gingivitis]

INTRODUCTION

New mouthwash solutions containing microencapsulated natural extracts have been developed. Besides antiseptic activity, these solutions have antioxidant and immunoregulatory properties on oral tissues. The objective of this preliminary clinical study was to assess the efficiency of a mouthwash containing microencapsulated natural extracts (GingiNat, LoB5 Foundation, Paris, France) on gingivitis.

PATIENTS AND METHODS

Twenty volunteers (37 + or - 2 years) with significant gingivitis (bleeding when tooth-brushing) used a 6% GingiNat mouthwash solution, two to three times per day (according to oral hygiene habits) for 21 days in addition to their usual oral care. Each volunteer was examined at day 0, 4, 7 and 21. The Löe and Silness Plaque Index, the Russel Periodontal Index, a breath index (halitosis), and oral tissue tolerance were assessed. Finally, each volunteer filled in a daily follow-up form and answered a questionnaire on tolerance and acceptability.

RESULTS

A significant decrease of the dental plaque index was observed on day 4, 7, and 21, in respectively 29, 48 and 71% of volunteers. This decrease reached 18% on day 4 (p=0.014), 32% on day 7 (p=0.002), and 47% on day 21 (p<0.001). A significant decrease of the periodental index was observed on day 4, 7 and 21, in respectively 52, 81 and 95% of volunteers. This decrease reached 30% (p=0.001) on day 4, 49% (p<0.001) on day 7, and 78% (p<0.001) on day 21. A significant improvement of the breath index was noted on day 4, 7, and 21, in respectively 43, 52 and 48% of volunteers. This improvement reached 29% (p=0.004) on day 4, 35% (p=0.001) on day 7, and 32% (p=0.002) on day 21. The mouthwash was well tolerated. The patients liked its effectiveness and organoleptic properties. All patients expressed the wish to continue using this solution.

DISCUSSION

The GingiNat mouthwash solution at 6% had a significant efficiency on plaque, gingivitis, and halitosis after 21 days of use. This makes it a good complementary treatment for gingivitis. Tolerance and acceptability were good despite the long and repeated use. Further studies are needed to have a detailed analysis of its efficiency in the long run and on patients presenting with various forms of periodontitis.