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Concentrated Growth Factors vs. Leukocyte-and-Platelet-Rich Fibrin for Enhancing Postextraction Socket Healing. A Longitudinal Comparative Study. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10228256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Platelet concentrates (PCs) have been used for over 20 years in dentistry, as an adjunct to oral surgery procedures, to improve hard and soft tissue healing and control postoperative symptoms. Among various PCs, Leukocyte and Platelet-Rich Fibrin (L-PRF) has become very popular due to its excellent cost-effectiveness ratio, and to the simple preparation protocol, but comparative clinical studies with other PCs are lacking. The aim of this split-mouth cohort study was to evaluate the effect of Concentrated Growth Factors (CGF), a recently introduced PC, as compared to L-PRF for enhancing post-extraction socket healing. Methods: Patients in need of bilateral tooth extractions were included. Each side was treated with either CGF or L-PRF. Pain, socket closure and healing index were the main outcomes. Results: Forty-five patients (24 women), aged 60.52 ± 11.75 years (range 37–87 years) were treated. No significant difference in outcomes was found, except for Pain at day 1 (p < 0.001) and socket closure in the vestibulo-palatal/lingual dimension at day 7 post-extraction (p = 0.04), both in favor of CGF. Conclusions: based on the present results, CGF proved to be as effective and safe as L-PRF, representing a valid alternative option for improving alveolar socket healing and reducing postoperative discomfort.
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102
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Dhingra K, Chaudhari PK, Gupta S. Issues with the conduct and reporting of split-mouth randomized clinical trial. Am J Orthod Dentofacial Orthop 2020; 158:634-635. [PMID: 33131560 DOI: 10.1016/j.ajodo.2020.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/22/2020] [Indexed: 11/16/2022]
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103
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Palma LF, Marcucci M, Remondes CM, Chambrone L. Leukocyte- and platelet-rich fibrin does not provide any additional benefit for tooth extraction in head and neck cancer patients post-radiotherapy: a randomized clinical trial. Med Oral Patol Oral Cir Bucal 2020; 25:e799-e804. [PMID: 32701929 PMCID: PMC7648915 DOI: 10.4317/medoral.23804] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 06/04/2020] [Indexed: 12/14/2022] Open
Abstract
Background One of the most important complications of radiotherapy (RT) for head and neck cancer (HNC) is osteoradionecrosis (ORN) of the jaws, arising mainly from tooth extractions. Thus, the present study aimed to evaluate the efficacy of leukocyte- and platelet-rich fibrin (L-PRF) in preventing ORN following tooth extraction in post-irradiated HNC patients, as well as other postoperative complications.
Material and Methods 23 patients previously submitted to conventionally fractionated 3D-conformational RT for HNC underwent atraumatic tooth extractions with perioperative antibiotic therapy. Besides, they were randomly assigned to receive L-PRF clots to fill and cover the extraction sockets (n=11, Test Group) or not (n=12, Control Group). A visual analog scale was used to quantify postoperative pain on the 3rd and 7th days. For ORN diagnosis, patients were clinically assessed for up to 180 days. Other postoperative complications (edema, alveolitis, suture dehiscence, continuous bleeding, and oroantral communication) were also evaluated within this period.
Results No case of ORN or another surgical complication was observed and there were no differences in the postoperative pain scores between the groups on the 3rd and 7th days.
Conclusions L-PRF did not seem to provide any additional benefits than those achieved by the combination of the surgical and drug protocols used for tooth extractions in the post-irradiated HNC patients. Key words:Radiotherapy, osteoradionecrosis, tooth extraction, head and neck cancer.
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Affiliation(s)
- L-F Palma
- Rua da Moóca, 2518 cj13. 03104-002 São Paulo, SP, Brazil
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104
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Kargarpour Z, Nasirzade J, Panahipour L, Miron RJ, Gruber R. Relative Centrifugal Force (RCF; G-Force) Affects the Distribution of TGF-β in PRF Membranes Produced Using Horizontal Centrifugation. Int J Mol Sci 2020; 21:E7629. [PMID: 33076376 PMCID: PMC7589083 DOI: 10.3390/ijms21207629] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/06/2020] [Accepted: 10/12/2020] [Indexed: 01/03/2023] Open
Abstract
Solid platelet-rich fibrin (PRF) is produced with centrifugation tubes designed to accelerate clotting. Thus, activated platelets may accumulate within the fibrin-rich extracellular matrix even before centrifugation is initiated. It can thus be assumed that platelets and their growth factors such as transforming growth factor-β (TGF-β) are trapped within PRF independent of their relative centrifugal force (RCF), the gravitation or g-force. To test this assumption, we prepared PRF membranes with tubes where clotting is activated by a silicone-coated interior. Tubes underwent 210 g, 650 g and 1500 g for 12 min in a horizontal centrifuge. The respective PRF membranes, either in total or separated into a platelet-poor plasma and buffy coat fraction, were subjected to repeated freeze-thawing to prepare lysates. Gingival fibroblasts were exposed to the PRF lysates to provoke the expression of TGF-β target genes. We show here that the expression of interleukin 11 (IL11) and NADPH oxidase 4 (NOX4), and Smad2/3 signaling were similarly activated by all lysates when normalized to the size of the PRF membranes. Notably, platelet-poor plasma had significantly less TGF-β activity than the buffy coat fraction at both high-speed protocols. In contrast to our original assumption, the TGF-β activity in PRF lysates produced using horizontal centrifugation follows a gradient with increasing concentration from the platelet-poor plasma towards the buffy coat layer.
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Affiliation(s)
- Zahra Kargarpour
- Department of Oral Biology, Medical University of Vienna, 1090 Vienna, Austria; (Z.K.); (J.N.); (L.P.)
| | - Jila Nasirzade
- Department of Oral Biology, Medical University of Vienna, 1090 Vienna, Austria; (Z.K.); (J.N.); (L.P.)
| | - Layla Panahipour
- Department of Oral Biology, Medical University of Vienna, 1090 Vienna, Austria; (Z.K.); (J.N.); (L.P.)
| | - Richard J. Miron
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland;
| | - Reinhard Gruber
- Department of Oral Biology, Medical University of Vienna, 1090 Vienna, Austria; (Z.K.); (J.N.); (L.P.)
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland;
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105
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de Oliveira LA, Borges TK, Soares RO, Buzzi M, Kückelhaus SAS. Methodological variations affect the release of VEGF in vitro and fibrinolysis' time from platelet concentrates. PLoS One 2020; 15:e0240134. [PMID: 33027285 PMCID: PMC7540869 DOI: 10.1371/journal.pone.0240134] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 09/19/2020] [Indexed: 11/26/2022] Open
Abstract
Blood Concentrates (BCs) are autologous non-transfusional therapeutical preparations with biological properties applied in tissue regeneration. These BCs differ in the preparation method, in fibrin network architecture, growth factors release as well as in platelet/cell content. Methodological changes result in distinct matrices that can compromise their clinical effectiveness. The present study evaluated the influence of different g-forces and types of tubes in the release of vascular endothelial growth factor (VEGF) from platelet-rich fibrin (PRF) as a function of time. The PRF-like samples were obtained with three g-forces (200, 400, and 800 x g) for 10 minutes in pure glass tubes or in polystyrene-clot activator tubes. Scanning and Transmission electron microscopy was used to morphometric analyzes of PRF’s specimens and flow cytometry was used to quantify VEGF slow release until 7 days. Our results showed that platelets were intact and adhered to the fibrin network, emitting pseudopods and in degranulation. The fibrin network was rough and twisted with exosomic granulations impregnated on its surface. An increase in the concentration of VEGF in the PRF supernatant was observed until 7 days for all g forces (200, 400 or 800 xg), with the highest concentrations observed with 200 x g, in both tubes, glass or plastic. Morphological analyzes showed a reduction in the diameter of the PRF fibers after 7 days. Our results showed that g-force interferes with the shape of the fibrin network in the PRF, as well as affect the release of VEGF stored into platelets. This finding may be useful in applying PRF to skin lesions, in which the rapid release of growth factors can favor the tissue repair process. Our observations point to a greater clarification on the methodological variations related to obtaining PRF matrices, as they can generate products with different characteristics and degrees of effectiveness in specific applications.
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Affiliation(s)
- Leonel Alves de Oliveira
- Nucleus of Research in Applied Morphology and Immunology, Faculty of Medicine, University of Brasilia, Federal District, Brasilia, Brazil
| | - Tatiana Karla Borges
- Nucleus of Research in Applied Morphology and Immunology, Faculty of Medicine, University of Brasilia, Federal District, Brasilia, Brazil
| | - Renata Oliveira Soares
- Nucleus of Research in Applied Morphology and Immunology, Faculty of Medicine, University of Brasilia, Federal District, Brasilia, Brazil
| | - Marcelo Buzzi
- Innovacorium Inc., Gainesville, Florida, United States of America
| | - Selma Aparecida Souza Kückelhaus
- Nucleus of Research in Applied Morphology and Immunology, Faculty of Medicine, University of Brasilia, Federal District, Brasilia, Brazil
- * E-mail:
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106
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Schuldt L, Bi J, Owen G, Shen Y, Haapasalo M, Häkkinen L, Larjava H. Decontamination of rough implant surfaces colonized by multispecies oral biofilm by application of leukocyte- and platelet-rich fibrin. J Periodontol 2020; 92:875-885. [PMID: 32853401 DOI: 10.1002/jper.20-0205] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/19/2020] [Accepted: 08/10/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Decontamination of biofilm-infected rough implant surfaces is challenging. Platelet rich blood products have been shown to have anti-microbial properties against periodontal pathogens. Our aim was to investigate the effect of a potential biological implant surface disinfectant, leukocyte- and platelet-rich fibrin (L-PRF), on a mature oral multispecies biofilm on a rough titanium surface. METHODS Sandblasted, large grit, acid-etched (SLA) titanium disks were inoculated with subgingival dental plaque and cultured anaerobically for 21 days. The L-PRF membranes were collected from 12 donors in three trials (four donors in each trial). The disks were rinsed with 0.9% NaCl and exposed to the cell-rich portion of the L-PRF membranes for 48 hours followed by scanning electron microscope (SEM) analysis immediately or after rinsing with 0.9% NaCl prior to fixation. The presence of platelet factor-4 in the rinse samples was analyzed by Western blotting. Remaining bacteria were quantified from SEM images of the implant surfaces and their numbers statistically compared. RESULTS The L-PRF-treated samples without rinsing displayed numerous cells with multiple pseudopodia in immediate contact with bacteria that appeared perforated and increased in size. The cells were identified as platelets based on morphological criteria and by positive reaction for platelet factor-4 by Western blotting. After post-treatment rinsing, the L-PRF-treated disks displayed a significant reduction in bacterial counts (in average 92% reduction). CONCLUSION Application of L-PRF significantly reduced bacterial counts on contaminated SLA titanium surface, most likely through anti-microbial action by platelets.
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Affiliation(s)
- Luisa Schuldt
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia
| | - Jiarui Bi
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia
| | - Gethin Owen
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia
| | - Ya Shen
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia
| | - Markus Haapasalo
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia
| | - Lari Häkkinen
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia
| | - Hannu Larjava
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia
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107
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Soares CS, Babo PS, Reis RL, Carvalho PP, Gomes ME. Platelet-Derived Products in Veterinary Medicine: A New Trend or an Effective Therapy? Trends Biotechnol 2020; 39:225-243. [PMID: 32868100 DOI: 10.1016/j.tibtech.2020.07.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 12/20/2022]
Abstract
Platelet-derived products (PDPs) have gained popularity, mainly due to their high concentrations of bioactive molecules such as growth factors and cytokines, which play important roles in tissue healing and regeneration. PDPs are obtained through minimally invasive procedures and their therapeutic effect has been widely recognized. In veterinary medicine, however, the lack of standard protocols to generate PDPs is a major hurdle for assessing the clinical relevance of PDP-based therapies and for their widespread usage. The aim of this review is to analyze the technical and scientific specificities of PDPs in terms of preparation methodologies, classification categorization, nomenclature, and biological proprieties to advance their future biotechnological potential in veterinary contexts.
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Affiliation(s)
- Carla S Soares
- 3Bs Research Group, I3Bs, Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, 4805-017 Barco, Guimarães, Portugal; ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Pedro S Babo
- 3Bs Research Group, I3Bs, Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, 4805-017 Barco, Guimarães, Portugal; ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Rui L Reis
- 3Bs Research Group, I3Bs, Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, 4805-017 Barco, Guimarães, Portugal; ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Pedro P Carvalho
- Vasco da Gama Research Center, CIVG, University School Vasco da Gama, Lordemão, 3020-210 Coimbra, Portugal; Vetherapy, Research and Development in Biotechnology, Coimbra, Portugal.
| | - Manuela E Gomes
- 3Bs Research Group, I3Bs, Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, 4805-017 Barco, Guimarães, Portugal; ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal
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108
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Use of the Autologous Membrane in Structured Rhinoplasty: An Alternative to Camouflaging and Filling. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3056. [PMID: 32983802 PMCID: PMC7489584 DOI: 10.1097/gox.0000000000003056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 06/24/2020] [Indexed: 11/28/2022]
Abstract
Supplemental Digital Content is available in the text. Rhinoplasty is one of the most challenging procedures in plastic surgery because the surgical modifications should attend to patient expectations and to the need for functional correction allied to aesthetics. Composed of leukocytes and platelet-rich fibrin, an autologous membrane has great potential for tissue repair. The purpose of this study was to assess the use of this membrane (associated or not associated with diced cartilage) as an alternative to techniques such as the camouflage and filling; correction of irregularities of the dorsum, nose tip, soft triangle, and K zone; filling in of dead space; skin camouflage; and an improvement in the healing process in primary or secondary rhinoplasties.
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109
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Nivedhitha MS, Jacob B, Ranganath A. Concentrated Growth Factor: A Novel Platelet Concentrate for Revascularization of Immature Permanent Teeth-A Report of Two Cases. Case Rep Dent 2020; 2020:1329145. [PMID: 32879740 PMCID: PMC7448214 DOI: 10.1155/2020/1329145] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/27/2020] [Indexed: 01/08/2023] Open
Abstract
This article elucidates the utilization of a novel platelet concentrate-concentrated growth factor (CGF) for rapid and successful healing outcome in regenerative endodontics. This case report focusses on two cases: 23-year-old and 21-year-old patients with incomplete root formation and periapical lesion. Case 1 and case 2 are classified as stage IV and stage II, respectively, in accordance with Cvek's classification of open apex and had varied outcomes. The extent of open apex, root dentin thickness, and lesion were assessed using periapical radiograph and CBCT. Revascularization procedure was carried out after obtaining patient consent. Following bleeding induction, CGF was prepared, placed, and condensed using pluggers in the root canal space, followed by the placement of mineral trioxide aggregate (MTA) up to the level of CEJ. At 1-year follow-up, apical closure with increased root dentin thickness and reduced periapical radiolucency was evident.
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Affiliation(s)
- M. S. Nivedhitha
- Department of Conservative Dentistry and Endodontics, Saveetha Institute of Medical and Technical Sciences, No. 162, Poonamalle High Road, Chennai, 600077 Tamil Nadu, India
| | - Benoy Jacob
- Department of Conservative Dentistry and Endodontics, Saveetha Institute of Medical and Technical Sciences, No. 162, Poonamalle High Road, Chennai, 600077 Tamil Nadu, India
| | - Aishwarya Ranganath
- Department of Conservative Dentistry and Endodontics, Saveetha Institute of Medical and Technical Sciences, No. 162, Poonamalle High Road, Chennai, 600077 Tamil Nadu, India
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110
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A new insight of Platelet-Rich Fibrin clots morphology and their elemental composition. Tissue Cell 2020; 65:101362. [PMID: 32746996 DOI: 10.1016/j.tice.2020.101362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 12/24/2022]
Abstract
This study analyzed the architecture of Platelet-Rich Fibrin (PRF) clots and assessed their elemental composition in order to provide new insight into this biomaterial. Five surplus PRF clots (2,700 RPM, 12 min.) donated by patients (63.6 ± 12.3 years old) were prepared for use in dental clinical procedures. The internal three-dimensional morphology of the red zones and the thirds of the yellow zones of the clots were analyzed by Variable Pressure Scanning Electron Microscope (VPSEM) after sample preparation by two methods: 1. Fixation (2.5% gluataraldehyde); and 2. Fixation with subsequent partial removal of extracellular elements (8 N, HCl). Semi-quantitative elemental analysis was performed by energy-dispersive X-ray spectrometry (EDX). VPSEM analysis showed erythrocytes in both the red zone and the yellow zone, which consisted mainly of fibrin. Removal of extracellular elements enriched the morphology of both zones; the organization of the fibrin was observed to differ in the thirds of the yellow zone, with increasing density and organization to distal. The elements that compose organic substances (C-Carbon, N-Nitrogen, O-Oxygen, Na-Sodium and P-Phosphorus) and halogens (Cl-Chloride and S-Sulfur) were detected; the highest concentrations were of C, followed by O (p < 0.05), in the proximal region of the fibrin. The results of the present study suggest organization of fibrin in the PRF clot, and also reveal the distribution of the elements present in the different regions of the clot. Improved understanding of these characteristics may favor the use of this biomaterial by increasing its efficiency and functionality.
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111
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The Platelet Concentrates Therapy: From the Biased Past to the Anticipated Future. Bioengineering (Basel) 2020; 7:bioengineering7030082. [PMID: 32751638 PMCID: PMC7552713 DOI: 10.3390/bioengineering7030082] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/25/2020] [Accepted: 07/28/2020] [Indexed: 12/23/2022] Open
Abstract
The ultimate goal of research on platelet concentrates (PCs) is to develop a more predictable PC therapy. Because platelet-rich plasma (PRP), a representative PC, was identified as a possible therapeutic agent for bone augmentation in the field of oral surgery, PRP and its derivative, platelet-rich fibrin (PRF), have been increasingly applied in a regenerative medicine. However, a rise in the rate of recurrence (e.g., in tendon and ligament injuries) and adverse (or nonsignificant) clinical outcomes associated with PC therapy have raised fundamental questions regarding the validity of the therapy. Thus, rigorous evidence obtained from large, high-quality randomized controlled trials must be presented to the concerned regulatory authorities of individual countries or regions. For the approval of the regulatory authorities, clinicians and research investigators should understand the real nature of PCs and PC therapy (i.e., adjuvant therapy), standardize protocols of preparation (e.g., choice of centrifuges and tubes) and clinical application (e.g., evaluation of recipient conditions), design bias-minimized randomized clinical trials, and recognize superfluous brand competitions that delay sound progress. In this review, we retrospect the recent past of PC research, reconfirm our ultimate goals, and discuss what will need to be done in future.
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112
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Lourenço ES, Alves GG, de Lima Barbosa R, Spiegel CN, de Mello-Machado RC, Al-Maawi S, Ghanaati S, de Almeida Barros Mourão CF. Effects of rotor angle and time after centrifugation on the biological in vitro properties of platelet rich fibrin membranes. J Biomed Mater Res B Appl Biomater 2020; 109:60-68. [PMID: 32691512 DOI: 10.1002/jbm.b.34680] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 05/29/2020] [Accepted: 06/16/2020] [Indexed: 01/15/2023]
Abstract
This study evaluated the impact of rotor angle and time of storage after centrifugation on the in vitro biological properties of platelet-rich fibrin (PRF) membranes. Blood samples (n = 9) were processed with a vertical fixed-angle (V) or a swing-out horizontal (H) centrifuge, with 20-60 min of sample storage after centrifugation. Leukocytes, platelets, and red blood cells were counted, and fibrin architecture was observed by scanning electron microscopy (SEM). The release of FGF2, PDGFbb, VEGF, IL-6, and IL-1β was measured after incubation on culture media for 7-21 days. Cell content was equivalent in all experimental groups (p > .05). The fibrin matrix was similar for fixed-angle and horizontal centrifugation. Horizontal centrifugation induced a twofold increase in PDGF and 1.7× increase on FGF release as compared to V samples, while IL-1β was significantly reduced (p < .05). No significant difference was observed on the release of growth factors and cytokines at different times after centrifugation (p < .05). These data suggest that both angles of centrifugation produce PRF membranes with similar structure and cellularity, but horizontal centrifugation induces a higher release of growth factors. Higher times of storage after centrifugation did not impact on cell content and the release of growth factors.
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Affiliation(s)
| | - Gutemberg Gomes Alves
- Department of Molecular and Cell Biology, Institute of Biology, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Renata de Lima Barbosa
- Post-Graduation Program in Science and Biotechnology, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Carolina Nascimento Spiegel
- Department of Molecular and Cell Biology, Institute of Biology, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | | - Sarah Al-Maawi
- Department of Maxillofacial, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt Am Main, Germany
| | - Shahram Ghanaati
- Department of Maxillofacial, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt Am Main, Germany
| | - Carlos Fernando de Almeida Barros Mourão
- Post-Graduation Program in Dentistry, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.,Post-Graduation Program in Science and Biotechnology, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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113
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Nogueira LS, Martinez EF, Peruzzo DC, Joly JC, Napimoga MH. Inflammatory cell profile using different autologous fibrin protocols. Tissue Cell 2020; 67:101407. [PMID: 32835940 DOI: 10.1016/j.tice.2020.101407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 01/02/2023]
Abstract
Autologous fibrin has been widely used in surgical procedures for both soft and hard tissue repair. There are different protocols and devices to obtain this matrix, with varying centrifugal time, gravity force, speed, angle of the sample tube and spinning radius. The aim of this study was to compare three methods of obtaining autologous fibrin: L-PRF using the Intra-Spin L-PRF centrifuge (Dohan protocol), the advanced PRF (A-PRF) using the Intra-Spin L-PRF centrifuge and autologous leukocyte fibrin (ALF), using the Kasvi centrifuge. Venous blood was collected from 7 healthy volunteers, which were submitted to the 3 different methods of centrifugation. The membranes were tissue-processed and evaluated by immunohistochemistry for CD3, CD20, CD68 and CD138. For CD68+, a lower number of cells was immunolabelled in the L-PRF group when compared to the other groups (A-PRF and ALF). For CD3+, a lower number of immunolabellated cells was observed in the ALF group when compared to the remaining groups (p < 0.05). In the A-PRF group, the CD20+ cell count was lower than in the remaining groups. No difference was observed in CD138+ cell counts between the groups. The 3 protocols tested are suitable for obtaining autologous fibrin membranes.
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Affiliation(s)
- Ledson Sampaio Nogueira
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Periodontology, Campinas, SP, Brazil
| | - Elizabeth Ferreira Martinez
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Oral Pathology and Cell Biology, Campinas, SP, Brazil
| | - Daiane Cristina Peruzzo
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Periodontology, Campinas, SP, Brazil
| | - Júlio César Joly
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Periodontology, Campinas, SP, Brazil
| | - Marcelo Henrique Napimoga
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Neuroimmune Interface of Pain Research Lab, Campinas, SP, Brazil.
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114
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Tarallo F, Mancini L, Pitzurra L, Bizzarro S, Tepedino M, Marchetti E. Use of Platelet-Rich Fibrin in the Treatment of Grade 2 Furcation Defects: Systematic Review and Meta-Analysis. J Clin Med 2020; 9:jcm9072104. [PMID: 32635413 PMCID: PMC7408882 DOI: 10.3390/jcm9072104] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 02/07/2023] Open
Abstract
In periodontitis patients, furcation defects are crucial sites to regenerate due to their complex anatomy. Various modern surgical techniques and use of biomaterials have been suggested in the literature. Among all, platelet-rich fibrin (PRF) has potential in tissue regeneration thanks to its role in the release of growth factors. Therefore, the purpose of this study was to evaluate the beneficial effect of the addition of PRF to open flap debridement (OFD) or as an adjuvant to other biomaterials such as bone grafts in the treatment of grade 2 mandibular furcation defects. Systematic research was carried out on the databases Medline, Scopus, Embase, and Cochrane Library and registered on PROSPERO (CRD42020167662). According to the PICO guidelines by Cochrane, randomized trials and prospective non-randomized trials were evaluated, with a minimum follow-up period of 6 months. The inclusion criteria were the absence of systemic diseases, non-smoking patients, and a population aged from 18 to 65 years. Vertical pocket probing depth (PPD), vertical clinical attachment level (VCAL), and gingival recession (REC) were the primary outcomes. Vertical furcation depth (VFD), and the percentage of bone defect fill (%v-BDF) were considered as secondary outcomes. A meta-analysis of the primary and secondary outcomes was performed. Publication bias was assessed through a funnel plot. Eighty-four articles were initially extracted. Eight randomized clinical trials were analyzed according to the exclusion and inclusion criteria. The Quality assessment instrument (QAI) revealed four articles at low risk of bias, one at moderate, and three at high risk of bias. The metanalysis showed significant data regarding PPD, VCAL, VFD and %v-BDF in the comparison between PRF + OFD vs. OFD alone. The adjunct of PRF to a bone graft showed a significant difference for VCAL and a not statistically significant result for the other involved parameters. In conclusion, the adjunctive use of PRF to OFD seems to enhance the periodontal regeneration in the treatment of grade 2 furcation defects. The combination of PRF and bone graft did not show better clinical results, except for VCAL, although the amount of literature with low risk of bias is scarce. Further well-designed studies to evaluate the combination of these two materials are therefore needed.
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Affiliation(s)
- Francesco Tarallo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 L’Aquila, Coppito, Italy; (L.M.); (E.M.)
- Correspondence:
| | - Leonardo Mancini
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 L’Aquila, Coppito, Italy; (L.M.); (E.M.)
| | - Luciano Pitzurra
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (L.P.); (S.B.)
| | - Sergio Bizzarro
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (L.P.); (S.B.)
| | - Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 L’Aquila, Coppito, Italy;
| | - Enrico Marchetti
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 L’Aquila, Coppito, Italy; (L.M.); (E.M.)
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115
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Brancaccio Y, Antonelli A, Barone S, Bennardo F, Fortunato L, Giudice A. Evaluation of local hemostatic efficacy after dental extractions in patients taking antiplatelet drugs: a randomized clinical trial. Clin Oral Investig 2020; 25:1159-1167. [PMID: 32613433 DOI: 10.1007/s00784-020-03420-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 06/17/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate clinical efficacy of four different local hemostatics in patients taking oral antiplatelet therapy, after multiple dental extractions without discontinuing drugs. MATERIALS AND METHODS Study sample included 102 patients (mean age 64.1 ± 17.4 years) in treatment with oral antiplatelet agents needing multiple dental extractions. After surgery, the sockets were randomly sealing with suture alone (control group), hemostatic plug (HEM), advanced platelet-rich fibrin (A-PRF+), and leukocyte-platelet-rich fibrin (L-PRF). Primary outcomes were post-operative bleeding, wound healing index, and possible complications. Secondary outcomes were correlation between primary outcomes and patient's comorbidities and voluptuous habits. Descriptive statistics, bivariate comparisons, and logistic regression analysis were performed (p < 0.05). RESULTS Both A-PRF+ and L-PRF showed a reduced bleeding risk when compared with suture alone (OR = 0.09, p = 0.001 for A-PRF+; OR = 0.09, p = 0.005 for L-PRF). Only L-PRF showed a reduced risk for incomplete wound healing when compared with the control site (OR = 0.43, p = 0.019). Patients affected by hypertension (OR 3.91, p = 0.015) and diabetes (OR 3.24, p = 0.026) had the highest bleeding risk. Smoking (OR 4.30, p = 0.016) and diabetes (OR 3.79, p = 0.007) interfered with healing process. CONCLUSION L-PRF and A-PRF represent a valid alternative to the traditional hemostatics, reducing post-surgical bleeding and promoting wound healing. CLINICAL RELEVANCE In patients taking antiplatelet drugs, different local hemostatics are useful to control potential post-operative bleeding and to favor wound healing. However, comorbidities and voluptuous habits may increase bleeding risk, interfering with healing process.
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Affiliation(s)
- Ylenia Brancaccio
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Alessandro Antonelli
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Selene Barone
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Francesco Bennardo
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Leonzio Fortunato
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Amerigo Giudice
- Department of Health Sciences, Magna Graecia University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy.
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116
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Miron RJ, Moraschini V, Del Fabbro M, Piattelli A, Fujioka-Kobayashi M, Zhang Y, Saulacic N, Schaller B, Kawase T, Cosgarea R, Jepsen S, Tuttle D, Bishara M, Canullo L, Eliezer M, Stavropoulos A, Shirakata Y, Stähli A, Gruber R, Lucaciu O, Aroca S, Deppe H, Wang HL, Sculean A. Use of platelet-rich fibrin for the treatment of gingival recessions: a systematic review and meta-analysis. Clin Oral Investig 2020; 24:2543-2557. [PMID: 32591868 DOI: 10.1007/s00784-020-03400-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 06/09/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis was to compare the use of platelet-rich fibrin (PRF) with other commonly utilized treatment modalities for root coverage procedures. MATERIALS AND METHODS The eligibility criteria comprised randomized controlled trials (RCTs) comparing the performance of PRF with that of other modalities in the treatment of Miller class I or II (Cairo RT I) gingival recessions. Studies were classified into 5 categories as follows: (1) coronally advanced flap (CAF) alone vs CAF/PRF, (2) CAF/connective tissue graft (CAF/CTG) vs CAF/PRF, (3) CAF/enamel matrix derivative (CAF/EMD) vs CAF/PRF, (4) CAF/amnion membrane (CAF/AM) vs CAF/PRF, and (5) CAF/CTG vs CAF/CTG/PRF. Studies were evaluated for percentage of relative root coverage (rRC; primary outcome), clinical attachment level (CAL), keratinized mucosa width (KMW), and probing depth (PD) (secondary outcomes). RESULTS From 976 articles identified, 17 RCTs were included. The use of PRF statistically significantly increased rRC and CAL compared with CAF alone. No change in KMW or reduction in PD was reported. Compared with PRF, CTG resulted in statistically significantly better KMW and RC. No statistically significant differences were reported between the CAF/PRF and CAF/EMD groups or between the CAF/PRF and CAF/AM groups for any of the investigated parameters. CONCLUSIONS The use of CAF/PRF improved rRC and CAL compared with the use of CAF alone. While similar outcomes were observed between CAF/PRF and CAF/CTG for CAL and PD change, the latter group led to statistically significantly better outcomes in terms of rRC and KTW. In summary, the use of PRF in conjunction with CAF may represent a valid treatment modality for gingival recessions exhibiting adequate baseline KMW. CLINICAL RELEVANCE The data indicate that the use of PRF in conjunction with CAF statistically significantly improves rRC when compared with CAF alone but did not improve KMW. Therefore, in cases with limited baseline KMW, the use of CTG may be preferred over PRF.
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Affiliation(s)
- Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland.
| | - Vittorio Moraschini
- Department of Periodontology, Dental Research Division, School of Dentistry, Veiga de Almeida University, Rio de Janeiro, Brazil
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy.,IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy.,Catholic University of San Antonio de Murcia (UCAM), Murcia, Spain.,Villaserena Foundation for Research, Città Sant'Angelo, PE, Italy
| | | | - Yufeng Zhang
- Department of Oral Implantology, University of Wuhan, Wuhan, China
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, University of Bern, Bern, Switzerland
| | - Benoit Schaller
- Department of Cranio-Maxillofacial Surgery, University of Bern, Bern, Switzerland
| | - Tomoyuki Kawase
- Division of Oral Bioengineering, Institute of Medicine and Dentistry, Niigata University, Niigata, Japan
| | - Raluca Cosgarea
- Department of Prosthetic Dentistry, University Iuliu Hatieganu, Cluj-Napoca, Romania.,Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Soren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Delia Tuttle
- Canyon Lake Dental Office, Lake Elsinore, CA, USA
| | - Mark Bishara
- West Bowmanville Family Dental, Bowmanville, Ontario, Canada
| | | | - Meizi Eliezer
- Department of Periodontology, University of Bern, Bern, Switzerland
| | | | - Yoshinori Shirakata
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Alexandra Stähli
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Reinhard Gruber
- Department of Oral Biology, University of Vienna, Vienna, Austria
| | - Ondine Lucaciu
- Department of Prosthetic Dentistry, University Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Sofia Aroca
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Herbert Deppe
- Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar der TUM, Munich, Germany
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
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Yamaguchi S, Aizawa H, Sato A, Tsujino T, Isobe K, Kitamura Y, Watanabe T, Okudera H, Mourão CF, Kawase T. Concentrated Growth Factor Matrices Prepared Using Silica-Coated Plastic Tubes Are Distinguishable From Those Prepared Using Glass Tubes in Platelet Distribution: Application of a Novel Near-Infrared Imaging-Based, Quantitative Technique. Front Bioeng Biotechnol 2020; 8:600. [PMID: 32612985 PMCID: PMC7310272 DOI: 10.3389/fbioe.2020.00600] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/15/2020] [Indexed: 12/14/2022] Open
Abstract
Platelet-rich fibrin (PRF) matrices were originally prepared using plain glass tubes without the aid of coagulation factors because coagulation factor XII is activated by glass surfaces. Recently, the use of silica-coated plastic tubes as a substitute of glass tubes has been recommended for PRF preparation. This recommendation is owing not only to the shortage of glass tubes for medical use in the market, but also the higher coagulation activity of silica-coated plastic tubes and equal quality of PRF. However, these matrices are not the same. To evaluate the differences, we compared glass- and silica-coated plastic tubes in terms of platelet distribution and quantity in concentrated growth factors (CGF). CGF matrices were immediately prepared from freshly collected blood samples, fixed after red thrombus removal, and divided into two equal pieces sagittally. One piece was used for CD41 detection and the other was applied as an isotype control. Platelet distribution in CGF matrices was examined, without embedding or sectioning, by a novel method using invisible near-infrared imaging. The dehydrated membranous CGF matrix was more transparent. Thus, the fluorescence signal was clearly detectable with less scattering. Platelets were distributed mainly in the distal side of the glass-prepared CGF matrix, but homogeneously in the silica-prepared CGF matrix. Platelet count was positively correlated with fluorescence intensity. Although not yet fully developed, this imaging technique enabled us to recognize the differences in platelet distribution and quantity in CGF matrices by excluding bias caused by the technical limitations of scanning electron microscopy and conventional immunohistochemical methods.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Carlos Fernando Mourão
- Department of Oral Surgery, Dentistry School, Fluminense Federal University, Rio de Janeiro, Brazil
| | - Tomoyuki Kawase
- Division of Oral Bioengineering, Institute of Medicine and Dentistry, Niigata University, Niigata, Japan
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Bouland C, Meuleman N, Widelec J, Keiani-Mothlagh K, Voisin C, Lagneaux L, Philippart P. Case reports of medication-related osteonecrosis of the jaw (MRONJ) treated with uncultured stromal vascular fraction and L-PRF. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 122:212-218. [PMID: 32540361 DOI: 10.1016/j.jormas.2020.05.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 04/22/2020] [Accepted: 05/25/2020] [Indexed: 01/04/2023]
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a challenging affection, considering the absence of a "Gold Standard" treatment. Cell therapy and tissue engineering, using adipose-tissue stromal vascular fraction (SVF) containing mesenchymal stromal cells (MSC) and endothelial progenitor cells (EPC); and a scaffold with healing properties, l-platelet-rich fibrin (L-PRF), could be a therapeutic option. Two cases of MRONJ were treated by tissue engineering. The patients presented respectively a stage-II and a stage-III MRONJ. The protocol consists of SVF injection in the L-PRF applied on the cleaned bone. Patients are followed clinically and by medical imaging (MI) for 18 months. The buccal mucosa was closed within a month. No recurrence was observed during the follow-up. The MI highlighted bone formation. MSC and EPC presence, in the SVF, were confirmed by immunophenotyping. We report the preliminary results of MRONJ patients successfully treated with the association of autologous fresh L-PRF-SVF.
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Affiliation(s)
- C Bouland
- Medicine faculty, université Libre de Bruxelles (ULB), 808, route de Lennik, 1070 Brussels, Belgium; Laboratory of clinical cell therapy (LCCT), campus Erasme, bâtiment de transfusion (Level +1), Jules-Bordet institute, université Libre de Bruxelles (ULB), 808, Route de Lennik, 1070 Brussels, Belgium; Stomatology and maxillofacial surgery department, CHU de Saint-Pierre, 322, rue Haute, 1000 Brussels, Belgium.
| | - N Meuleman
- Laboratory of clinical cell therapy (LCCT), campus Erasme, bâtiment de transfusion (Level +1), Jules-Bordet institute, université Libre de Bruxelles (ULB), 808, Route de Lennik, 1070 Brussels, Belgium; Hematology department, Jules-Bordet institute, université Libre de Bruxelles (ULB), 121, boulevard de Waterloo, 1000 Brussels, Belgium
| | - J Widelec
- Radiology department, hôpitaux IRIS SUD, site Molière, 142, Rue Marconi, 1190 Brussels, Belgium
| | - K Keiani-Mothlagh
- Stomatology and maxillofacial surgery department, hôpitaux IRIS SUD, site Bracops, 79, Rue Docteur-Huet, 1070 Brussels, Belgium
| | - C Voisin
- Stomatology and maxillofacial surgery department, hôpitaux IRIS SUD, site Bracops, 79, Rue Docteur-Huet, 1070 Brussels, Belgium; Private practice maxillofacia clos du parnasse Local 3F, 1050 Brussels, Belgium
| | - L Lagneaux
- Laboratory of clinical cell therapy (LCCT), campus Erasme, bâtiment de transfusion (Level +1), Jules-Bordet institute, université Libre de Bruxelles (ULB), 808, Route de Lennik, 1070 Brussels, Belgium
| | - P Philippart
- Medicine faculty, université Libre de Bruxelles (ULB), 808, route de Lennik, 1070 Brussels, Belgium; Radiology department, hôpitaux IRIS SUD, site Molière, 142, Rue Marconi, 1190 Brussels, Belgium
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A Comprehensive Review of Concentrated Growth Factors and Their Novel Applications in Facial Reconstructive and Regenerative Medicine. Aesthetic Plast Surg 2020; 44:1047-1057. [PMID: 31970453 DOI: 10.1007/s00266-020-01620-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/12/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Concentrated growth factors (CGFs) are the latest generation of platelet concentrates. The objective of developing CGF is to increase therapeutic efficacy. However, few studies have supported the superiority of CGF in composition and efficacy. The reconstruction and regeneration process is complicated and long term, whereas bioactivity of CGF is not durable. The purpose of this review is threefold. The first is to recommend more comparative studies between CGF and other platelet concentrates. The second is to constitute a continuous drug delivery system by combining CGF with other biomaterials. Finally, the novel use of CGF in facial regenerative and reconstructive medicine will be highlighted. METHODS A comprehensive review of literature regarding the use of CGF in facial regenerative and reconstructive medicine was performed. Based on the inclusion and exclusion criteria, a total of 135 articles were included. RESULTS The use of CGF involving facial rejuvenation, cartilage grafting, facial bone defects, facial peripheral nerve injury and wounding is reviewed. The reconstructive and regenerative principles lie in firm fibrin scaffolds and continuous in situ delivery of multiple growth factors. CONCLUSIONS CGF represents an advance in personalized medicine concept. However, the current scientific evidences about the use of CGF are limited. More basic and clinical studies should be conducted to understand the characteristics and clinical application of CGF. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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120
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Al-Hamed FS, Hijazi A, Gao Q, Badran Z, Tamimi F. Platelet Concentrate Treatments for Temporomandibular Disorders: A Systematic Review and Meta-analysis. JDR Clin Trans Res 2020; 6:174-183. [PMID: 32464073 DOI: 10.1177/2380084420927326] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES This systematic review compared platelet concentrates (PCs) versus hyaluronic acid (HA) or saline/Ringer's solution injections as treatments of temporomandibular osteoarthritis and disc displacement in terms of pain and maximum mouth opening (MMO). METHODS PubMed, Cochrane, and Scopus were searched up to March 6, 2020. Inclusion criteria were randomized clinical trials (RCTs). Exclusion criteria were case series, observational studies, animal studies, and reviews. The Effective Public Health Practice Project (EPHPP) quality assessment tool was used to assess the risk of bias in the included studies. The weighted mean difference was used to compare the results. RESULTS Nine RCTs were included with a total of 407 patients. The numbers of joints treated were 262, 112, and 112 in the PC, HA, and saline groups, respectively. The quality of studies was rated as strong in 4 studies, moderate in 4 studies, and weak in 1 study. The meta-analysis revealed that PCs decreased pain visual analogue scale (VAS) scores compared to HA by an average of -1.11 (CI, -1.62 to -0.60; P < 0.0001) and -0.57 (CI, -1.55 to 0.41; P = 0.26) at 3 and 12 mo follow-up respectively. Also, the average decrease in pain scores with PC compared to saline was -1.33 (CI, -2.61 to -0.06; P = 0.04), -2.07 (CI, -3.46 to -0.69; P = 0.003), and -2.71 (CI, -4.69 to -0.72; P = 0.008) at 3, 6, and 12 mo, respectively. Regarding MMO measurements, PC was comparable to HA, but it was significantly better than saline after 3 and 6 mo [2.9 mm (CI,1.47 to 4.3; P < 0.0001), and 1.69 mm (CI, 0.13 to 3.25; P = 0.03) respectively]. CONCLUSION PC reduces pain VAS scores compared to HA during the first 3 m after treatment, and when compared to saline, it reduces pain and increases MMO for longer durations. However, due to differences between groups regarding PC preparation protocols and study heterogeneity, further standardized RCTs are required. KNOWLEDGE TRANSFER STATEMENT This study provides researchers and clinicians with quantitative and qualitative analyses of the current evidence regarding the clinical outcomes of platelet concentrate injections in the treatment of temporomandibular joint osteoarthritis and disc displacement in terms of pain control and maximum mouth opening.
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Affiliation(s)
- F S Al-Hamed
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - A Hijazi
- Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Q Gao
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Z Badran
- Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Department of Periodontology, Faculty of Dental Surgery, University of Nantes, Nantes, France
| | - F Tamimi
- Faculty of Dentistry, McGill University, Montreal, QC, Canada.,College of Dental Medicine, Qatar University, Doha, Qatar
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121
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Bi J, Intriago MFB, Koivisto L, Jiang G, Häkkinen L, Larjava H. Leucocyte‐ and platelet‐rich fibrin regulates expression of genes related to early wound healing in human gingival fibroblasts. J Clin Periodontol 2020; 47:851-862. [DOI: 10.1111/jcpe.13293] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/03/2020] [Accepted: 04/11/2020] [Indexed: 01/30/2023]
Affiliation(s)
- Jiarui Bi
- Faculty of Dentistry Department of Oral Biological and Medical Sciences University of British Columbia Vancouver BC Canada
| | - Maria Fernanda Barona Intriago
- Faculty of Dentistry Department of Oral Biological and Medical Sciences University of British Columbia Vancouver BC Canada
| | - Leeni Koivisto
- Faculty of Dentistry Department of Oral Biological and Medical Sciences University of British Columbia Vancouver BC Canada
| | - Guoqiao Jiang
- Faculty of Dentistry Department of Oral Biological and Medical Sciences University of British Columbia Vancouver BC Canada
| | - Lari Häkkinen
- Faculty of Dentistry Department of Oral Biological and Medical Sciences University of British Columbia Vancouver BC Canada
| | - Hannu Larjava
- Faculty of Dentistry Department of Oral Biological and Medical Sciences University of British Columbia Vancouver BC Canada
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122
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Mariani E, Roffi A, Cattini L, Pulsatelli L, Assirelli E, Krishnakumar GS, Cenacchi A, Kon E, Filardo G. Release kinetic of pro- and anti-inflammatory biomolecules from platelet-rich plasma and functional study on osteoarthritis synovial fibroblasts. Cytotherapy 2020; 22:344-353. [PMID: 32327304 DOI: 10.1016/j.jcyt.2020.02.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 02/24/2020] [Accepted: 02/24/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND AIMS This study evaluated the release kinetics of numerous representative and less studied platelet-rich plasma (PRP) cytokines/chemokines with regard to the effects of various cellular compositions and incubation times. In addition, the biological effects of different PRPs on osteoarthritis synovial fibroblasts in vitro were tested. METHODS Peripheral whole blood was collected from healthy donors, and pure platelet-rich plasma (P-PRP), leukocyte-rich platelet-rich plasma (L-PRP) and platelet-poor plasma (PPP) were prepared for the analysis of the following biomolecules: IL-1β, IL-4, IL-6, IL-10, IL-17a, IL-22, MIP-1α/CCL-3, RANTES/CCL-5, MCP-3/CCL-7, Gro-α/CXCL-1, PF-4/CXCL-4, ENA-78/CXCL-5, NAP-2/CXCL-7, IL-8/CXCL-8, Fractalkine/CX3CL-1, s-CD40L P-PRP, L-PRP and PPP. Their effect on osteoarthritis synovial fibroblasts in vitro was tested by analyzing changes induced in both gene expression on a panel of representative molecules involved in physiopathology of joint environment and synthesis of IL-1β, IL-8 and hyaluronic acid. RESULTS This study demonstrated that among the 16 analyzed biomolecules, four were undetectable, whereas most of the detected biomolecules were more concentrated in L-PRP even when concentrations were normalized to platelet number. Despite the pro-inflammatory boost, the various PRP preparations did not alter synovial fibroblast gene expression of specific factors that play a pivotal role in joint tissue homeostasis and are able to induce anti-inflammatory (TIMP-1) biomolecules. DISCUSSION This study provides a set of reference data on the concentration and release kinetics of some less explored biomolecules that could represent potential specific effectors in the modulation of inflammatory processes and in tissue repair after treatment with PRP.
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Affiliation(s)
- Erminia Mariani
- Laboratorio di Immunoreumatologia e rigenerazione tissutale, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy; Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum-Università di Bologna, Bologna, Italy.
| | - Alice Roffi
- Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Luca Cattini
- Laboratorio di Immunoreumatologia e rigenerazione tissutale, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Lia Pulsatelli
- Laboratorio di Immunoreumatologia e rigenerazione tissutale, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Elisa Assirelli
- Laboratorio di Immunoreumatologia e rigenerazione tissutale, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Gopal Shankar Krishnakumar
- Department of Biotechnology, Bannari Amman Institute of Technology, Sathyamangalam, Erode, Tamil Nadu, India
| | - Annarita Cenacchi
- Servizio di Immunoematologia e Medicina trasfusionale, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Elizaveta Kon
- Humanitas University Department of Biomedical Sciences, Humanitas Clinical and Research Center, Milan, Italy
| | - Giuseppe Filardo
- Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Chandra RV, Vaishnavi V, S Chakravarthy YSH. Regenerative Capacity of Leukocyte-rich and Platelet-rich Fibrin in Indirect Sinus Elevation Procedure May be Dependent on Model-Specific Modification of the Centrifugation Cycle. Contemp Clin Dent 2020; 10:433-439. [PMID: 32308316 PMCID: PMC7150577 DOI: 10.4103/ccd.ccd_715_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Context: To compare optical density (OD) and fibrinogen content of leukocyte-rich and platelet-rich fibrin (L-PRF) generated by standard protocol (2700 rotations per minute [RPM] for 12 min) versus relative centrifugal force (RCF)-adjusted protocol across two widely used laboratory centrifuges with swing-out rotors. Aims: Centrifuges for PRF production generate forces in excess of 800 g. The study aimed to evaluate OD, fibrinogen content and effectiveness in bone-added osteotome sinus floor elevation (BAOSFE) of leukocyte-rich and platelet-rich fibrin (L-PRF) generated by the standard protocol (2700 RPM for 12 min) versus a RCF-adjusted protocol to generate precisely 400 g of force across two centrifuges with swing-out rotors. The outcomes were compared to a standard centrifuge configured to generate L-PRF as per the original Choukroun guidelines. Settings and Design: Sample size for the present study was calculated using proportional power calculation. A minimum sample size of 8 per group was needed to detect a bone height difference of 2 mm when the power of the test is 0.80 at a significance level of 0.05. Subjects and Methods: Based on the centrifuge and protocol used to generate L-PRF, 10 participants were assigned to each of the following groups are as follows: D group, fixed angle centrifuge (DUO Quattro®) at default setting. R-O group: Swing-out centrifuge (Remi 8C®) + standard protocol. R-A group: Remi 8C® centrifuge + RCF-adjusted protocol. C-O group: Swing-out centrifuge (Remi C854®) + standard protocol. and C-A group: Remi C854® + RCF-adjusted protocol. OD, fibrinogen content, and gain in bone fill and bone height after BAOSFE were the evaluated outcomes. Statistical Analysis Used: Data were analyzed using GraphPad Prism® Software version 6.0 (GraphPad Software Inc., La Jolla, USA) and SAS Software® version 9.3 versions (SAS, New Delhi, India). Data were summarized by mean ± standard deviation for continuous data and median ± inter-quartile range for the score data. The comparison between different time points was done by analysis of one-way repeated measures test, followed by post hoc test for score data. The comparison between two groups for repeated data was made by analysis of two-way repeated measures test and followed by post hoc test. Spearman's Rho correlation test was used to test the correlation between prognosis and the other variables. Results: L-PRF from the Remi C854® centrifuge with RCF-adjusted protocol showed OD (P = 0.152) and fibrinogen content (P = 0.232) identical to those from the DUO Quattro® centrifuge. L-PRF from Remi 8C® centrifuge with the RCF-adjusted protocol resulted in maximum postoperative bone height gain (7.01 ± 1.44 mm) and bone fill (13.50 ± 4.51 mm2) which was higher than that of the outcomes from the DUO Quattro® centrifuge (6.82 ± 2.92 mm and 12.32 ± 5.31 mm2). Conclusions: A reduction in RCF resulted in a less dense clot and had a positive influence on the regenerative potential of L-PRF in BAOSFE procedure.
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Affiliation(s)
- Rampalli Viswa Chandra
- Department of Periodontics, SVS Institute of Dental Sciences, Mahbubnagar, Telangana, India
| | - Varanasi Vaishnavi
- Department of Periodontics, SVS Institute of Dental Sciences, Mahbubnagar, Telangana, India
| | - Y S H S Chakravarthy
- Department of Periodontics, SVS Institute of Dental Sciences, Mahbubnagar, Telangana, India
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Ondur E, Bolukbasi Balcioglu N, Soluk Tekkesin M, Guzel O, Ersanli S. Effects of Platelet-Rich Fibrin on Hard Tissue Healing: A Histomorphometric Crossover Trial in Sheep. MATERIALS 2020; 13:ma13071695. [PMID: 32260464 PMCID: PMC7178662 DOI: 10.3390/ma13071695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 11/16/2022]
Abstract
Bone defects lead to aesthetic and functional losses, causing dental rehabilitation to be more difficult. The objective of this work is to histologically assess the hard tissue healing of bone defects filled with platelet-rich fibrin (PRF) alone or as an adjuvant for mixing with and covering anorganic bovine bone (ABB), compared to ABB covered with a resorbable collagen membrane (CM). This study was designed as a crossover animal study. Four 5-mm tibia defects, 5 mm apart from each other, were surgically created on the tibias of 6 sheep. The defects were randomly filled with ABB + CM; PRF alone; ABB+PRF; or were left empty. The animals were euthanized on days 10, 20, and 40 post-operatively. No group showed any signs of bone necrosis. Inflammation was observed in 2 control and 3 test defects with no statistically significant difference between groups at each time point. The ABB + CM and ABB + PRF groups experienced the highest bone regeneration ratios. No differences between the empty-defect and PRF groups were observed in regard to bone regeneration. No statistical difference was observed between the ABB+PRF and ABB + CM groups in regard to bone regeneration and the amount of residual graft material at each time point. The use of PRF should be preferred due to its autogenous origin, low cost, and ease of use.
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Affiliation(s)
- Esra Ondur
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Istanbul 34093, Turkey; (E.O.); (S.E.)
| | - Nilufer Bolukbasi Balcioglu
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Istanbul 34093, Turkey; (E.O.); (S.E.)
- Correspondence: or
| | - Merva Soluk Tekkesin
- Department of Tumor Pathology, Institute of Oncology, Istanbul University, Istanbul 34093, Turkey;
| | - Ozlem Guzel
- Department of Surgery, Veterinary Faculty, Istanbul University Cerrahpasa, Istanbul 34320, Turkey;
| | - Selim Ersanli
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Istanbul 34093, Turkey; (E.O.); (S.E.)
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125
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Rodas MAR, Paula BLD, Pazmiño VFC, Lot Vieira FFDS, Junior JFS, Silveira EMV. Platelet-Rich Fibrin in Coverage of Gingival Recession: A Systematic Review and Meta-Analysis. Eur J Dent 2020; 14:315-326. [PMID: 32221958 PMCID: PMC7296445 DOI: 10.1055/s-0040-1701907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This systematic review and meta-analysis sought to evaluate the efficacy of platelet-rich fibrin (PRF) membranes versus subepithelial connective tissue grafts (SCTGs) in the coverage of Miller class I and II gingival recessions. After the inclusion and exclusion criteria were applied, the quality of seven articles (Cohen's Kappa = 0.9) was evaluated using the Jadad scale. The MEDLINE/PubMed, Cochrane, and Web of Science databases were consulted, and manual searches were performed in the most popular periodontics journals. The studies included considered a total of 122 patients, 203 surgical fields on which SCTGs were used, and 205 surgical fields on which PRF was used. The parameters analyzed were probing depth, clinical attachment level, gingival recession, and keratinized mucosa. The minimum follow-up period accepted was 6 months. A statistically significant difference between the SCTG and PRF groups was found only in the case of keratinized mucosa. However, gingival recession, clinical attachment level, and probing depth parameters in the PRF group were found to be statistically equal to those of the SCTG group (the gold standard) (p ≥0.05). PRF membranes were determined to be a promising alternative to autogenous gingival grafts in the treatment of Miller class I and II gingival recessions.
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Affiliation(s)
| | | | - Victor Fabrizio Cabrera Pazmiño
- Department of prosthesis, Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), University of São Paulo (USP), Bauru, São Paulo, Brazil
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126
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Talon I, Schneider A, Ball V, Hemmerlé J. Functionalization of PTFE Materials Using a Combination of Polydopamine and Platelet-Rich Fibrin. J Surg Res 2020; 251:254-261. [PMID: 32179278 DOI: 10.1016/j.jss.2019.11.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 10/01/2019] [Accepted: 11/03/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND The diaphragm, which forms a physical barrier between the thoracic and the abdominal cavities, is also the major part of the respiratory system. Congenital diaphragmatic hernia (CDH) is a malformation of that partition muscle. Expanded polytetrafluoroethylene (e-PTFE), a synthetic nondegradable biomaterial, is currently used for the repair of diaphragm defects. Indeed, this hydrophobic biomaterial does not promote rapid and dense cell colonization. Surface modifications are needed to favor or even guide cellular responses. MATERIALS AND METHODS In this context, we present here a practical and effective way of functionalization of the e-PTFE material. We investigated, by using electron microscopy, the coating with PRF (Platelet-Rich Fibrin) of PDA (Polydopamine) treated e-PTFE implant material. RESULTS We demonstrate that this straightforward chemical functionalization with PDA increases the hydrophilicity of e-PTFE and thus improves tissue integration. Then, we demonstrated that whatever the contact time between PRF and e-PTFE and the centrifugation speed, the PDA coating on the e-PTFE biomaterial promotes further biological events like cell adhesion and spreading. CONCLUSIONS Our findings clearly show that this composite coating (chemically by using PDA + biologically by using PRF) method of e-PTFE is a simple, interesting and promising way to favor tissular integration of such biomaterials.
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Affiliation(s)
- Isabelle Talon
- Institut National de la Santé et de la Recherche Médicale, UMR_S 1121, Strasbourg, France; Hôpitaux Universitaires de Strasbourg, Service de Chirurgie Pédiatrique, Strasbourg, France.
| | - Anne Schneider
- Institut National de la Santé et de la Recherche Médicale, UMR_S 1121, Strasbourg, France; Hôpitaux Universitaires de Strasbourg, Service de Chirurgie Pédiatrique, Strasbourg, France
| | - Vincent Ball
- Institut National de la Santé et de la Recherche Médicale, UMR_S 1121, Strasbourg, France
| | - Joseph Hemmerlé
- Institut National de la Santé et de la Recherche Médicale, UMR_S 1121, Strasbourg, France
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de Almeida Barros Mourão CF, de Mello-Machado RC, Javid K, Moraschini V. The use of leukocyte- and platelet-rich fibrin in the management of soft tissue healing and pain in post-extraction sockets: A randomized clinical trial. J Craniomaxillofac Surg 2020; 48:452-457. [PMID: 32201062 DOI: 10.1016/j.jcms.2020.02.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 01/28/2020] [Accepted: 02/24/2020] [Indexed: 01/05/2023] Open
Abstract
This study aimed to evaluate the clinical effect of leukocyte- and platelet-rich fibrin (L-PRF) to improve epithelialization and decrease postoperative pain in post-extraction sockets. Thirty two participants requiring extractions of posterior teeth were randomized into two groups: 1) extractions and socket filling with L-PRF membrane (test group) and 2) extraction with spontaneous healing (control group). One week after extraction, an assessment of soft tissue healing around the sockets was performed using the healing index. Also, postoperative pain by visual analog scale (VAS) and number of consumed analgesic tablets were recorded. In the first week, the sockets of the test group presented a significantly (mean of 3.81 ± 0.54; p = 0.0138) higher level of healing when compared to the sockets of the control group (mean of 3.18 ± 0.65). The participants of control group reported a significantly (mean of 5.12 ± 1.08; p = 0.0128) higher level of postoperative pain when compared to the test group (mean of 4 ± 1.15). Also, the control group consumed a greater number of analgesics (mean of 1.75 ± 0.85; p = 0.0136) when compared to the test group (mean of 1 ± 1.15). The results of the present study demonstrate that whenever improved healing of the extraction socket is needed, the use of L-PRF should be considered. In addition, the use of L-PRF decreases postoperative pain and discomfort.
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Affiliation(s)
- Carlos Fernando de Almeida Barros Mourão
- Department of Oral Surgery, School of Dentistry, Fluminense Federal University, Rio de Janeiro, Brazil; South Bay Dental Institute, Los Angeles, CA, United States
| | | | - Kayvon Javid
- South Bay Dental Institute, Los Angeles, CA, United States
| | - Vittorio Moraschini
- Department of Oral Surgery, School of Dentistry, Fluminense Federal University, Rio de Janeiro, Brazil.
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Abstract
Currently, in the field of dentistry literature, one of most active research topics is clearly related to implants, bone materials, and regenerative strategies for the reconstruction of different oral tissues. Biomaterials and related technologies used with these purposes could only be derived from the integration of the knowledge of different disciplines, which together are skilled in generating innovation and research development, with extensive support of basic sciences and intense international cooperation. The combination of these resources, associated with the greater need for increasingly comprehensive and predictable therapeutic protocols, brings a substantial change in the treatment of oral rehabilitations.
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129
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Mariani E, Pulsatelli L. Platelet Concentrates in Musculoskeletal Medicine. Int J Mol Sci 2020; 21:ijms21041328. [PMID: 32079117 PMCID: PMC7072911 DOI: 10.3390/ijms21041328] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/29/2020] [Accepted: 02/06/2020] [Indexed: 12/02/2022] Open
Abstract
Platelet concentrates (PCs), mostly represented by platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are autologous biological blood-derived products that may combine plasma/platelet-derived bioactive components, together with fibrin-forming protein able to create a natural three-dimensional scaffold. These types of products are safely used in clinical applications due to the autologous-derived source and the minimally invasive application procedure. In this narrative review, we focus on three main topics concerning the use of platelet concentrate for treating musculoskeletal conditions: (a) the different procedures to prepare PCs, (b) the composition of PCs that is related to the type of methodological procedure adopted and (c) the clinical application in musculoskeletal medicine, efficacy and main limits of the different studies.
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Affiliation(s)
- Erminia Mariani
- Laboratorio di Immunoreumatologia e rigenerazione tissutale, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy;
- Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum-University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
- Correspondence: ; Tel.: +39-051-6366803
| | - Lia Pulsatelli
- Laboratorio di Immunoreumatologia e rigenerazione tissutale, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy;
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130
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Evaluation of New Bone Formation Using Autogenous Tooth Bone Graft Combined with Platelet-Rich Fibrin in Calvarial Defects. J Craniofac Surg 2020; 30:1662-1666. [PMID: 30939548 DOI: 10.1097/scs.0000000000005413] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of the present study was to evaluate the contributions of autogenous tooth bone graft (ATBG) combined with platelet-rich fibrin (PRF) on new bone formation and bone morphogenetic protein (BMP)-2 in rabbit calvarial defects. Twelve male New Zealand rabbits were used in this study. Three circular bone defects were prepared in each rabbit with a drill. These defects were divided into 3 groups: control, treated with ATBG, and treated with ATBG+PRF. The animals were sacrificed at 28 days. Samples were evaluated by histomorphometric analyses and total augmented area, new bone area and bone density were calculated. In addition, expression of BMP-2 was determined by immunohistochemical staining. The total augmented area, new bone area and bone density were significantly greater in the ATBG group than in the control group (P <0.05). Also, these values were significantly higher in the ATBG+PRF group than the ATBG group (P <0.05). Test groups demonstrated significantly increased BMP-2 levels compared with the control group (P <0.05). The present study suggested that ATBG combined with PRF significantly increased the new bone formation and enhanced bone healing in cranial defects.
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131
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Effects of Platelet Rich Fibrin on Full Thickness Skin Grafts in the Rat Model-Planimetry Results. CURRENT HEALTH SCIENCES JOURNAL 2020; 45:278-284. [PMID: 32042455 PMCID: PMC6993764 DOI: 10.12865/chsj.45.03.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 09/29/2019] [Indexed: 11/20/2022]
Abstract
Platelets play a crucial role in wound healing as they are reservoirs of growth factors and cytokines which play a fundamental role in homeostasis and tissue remodeling. Recently, fields such as dermatology and plastic and reconstructive surgery have become interested in the tissue regenerative properties of these compounds, especially since it promotes wound healing, improves scar outcomes and has rejuvenating effects on the skin and other tissues. We evaluated the effects of Platelet Rich Fibrin (PRF) in full thickness skin graft healing. Our study included 40 male Wistar rats. Skin grafts were assessed macroscopically using planimetry. The full thickness skin grafts in the test group, displayed a lower necrosis rate compared to the control group. Our study displays the potential benefits of using Platelet Rich compounds to facilitate wound healing and integration of full thickness skin grafts.
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132
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Biofunctionalization of porcine-derived collagen matrices with platelet rich fibrin: influence on angiogenesis in vitro and in vivo. Clin Oral Investig 2020; 24:3425-3436. [DOI: 10.1007/s00784-020-03213-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 01/15/2020] [Indexed: 02/07/2023]
Abstract
Abstract
Objectives
Porcine-derived collagen matrices (CM) can be used for oral tissue regeneration, but sufficient revascularization is crucial. The aim of this study was to analyze the influence of platelet-rich fibrin (PRF) on angiogenesis of different CM in vitro and in vivo.
Materials and methods
Three different CM (mucoderm, jason, collprotect) were combined with PRF in a plotting process. Growth factor release (VEGF, TGF-β) was measured in vitro via ELISA quantification after 1,4 and 7 days in comparison to PRF alone. In ovo yolk sac (YSM) and chorion allantois membrane (CAM) model, angiogenic potential were analyzed in vivo with light- and intravital fluorescence microscopy after 24 h, then verified with immunohistochemical staining for CD105 and αSMA.
Results
Highest growth factor release was seen after 24 h for all three activated membranes in comparison to the native CM (VEGF 24 h: each p < 0.05; TGF-β: each p < 0.001) and the PRF (no significant difference). All activated membranes revealed a significantly increased angiogenic potential in vivo after 24 h (vessels per mm2: each p < 0.05; branching points per mm2: each p < 0.01; vessel density: each p < 0.05) and with immunohistochemical staining for CD105 (each p < 0.01) and αSMA (each p < 0.05).
Conclusions
PRF improved the angiogenesis of CM in vitro and in vivo.
Clinical relevance
Bio-functionalization of CM with PRF could easily implemented in the clinical pathway and may lead to advanced soft tissue healing.
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133
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Nasirzade J, Kargarpour Z, Hasannia S, Strauss FJ, Gruber R. Platelet-rich fibrin elicits an anti-inflammatory response in macrophages in vitro. J Periodontol 2020; 91:244-252. [PMID: 31376159 PMCID: PMC7065136 DOI: 10.1002/jper.19-0216] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 05/31/2019] [Accepted: 06/17/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Platelet-rich fibrin (PRF) serves as a reservoir of bioactive molecules to support wound healing and bone regeneration. The beneficial action of PRF might involve macrophage polarization from proinflammatory M1 toward pro-resolving M2 phenotypes. This study aims to evaluate the effect of PRF on macrophage polarization. METHODS Murine primary macrophages and RAW 264.7 cells were exposed to saliva and lipopolysaccharides (LPS) with and without PRF lysates obtained by repeated freeze-thawing or the secretome of PRF membranes, termed PRF conditioned medium. The expression of the M1 marker genes interleukin 1β (IL1β) and interleukin 6 (IL6) along with the M2 markers arginase-1 and chitinase-like 3 (Chil3 or YM1) were evaluated by real time polymerase chain reaction. Immunoassay and immunofluorescence staining were performed for IL6 and p65 translocation, a subunit nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB), respectively. RESULTS We report here that PRF lysates and PRF conditioned medium, the latter containing the secretome, greatly decreased the proinflammatory response of primary macrophages and RAW 264.7 cells as indicated by the expression of IL1β and IL6. The anti-inflammatory activity of PRF lysates was further confirmed by IL6 immunoassay. Moreover, PRF lysates suppressed the translocation of p65 from the cytoplasm into the nucleus after incubation with saliva. In support of M2 polarization, PRF lysates and PRF conditioned medium enhanced the expression of arginase-1 and YM1 in primary macrophages. CONCLUSION Our results indicate that PRF holds an anti-inflammatory activity and shifts the macrophage polarization from an M1 toward an M2 phenotype.
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Affiliation(s)
- Jila Nasirzade
- Department of Oral BiologyMedical University of ViennaViennaAustria
- Department of BiochemistryFaculty of Biological SciencesTarbiat Modares UniversityTehranIran
| | - Zahra Kargarpour
- Department of Oral BiologyMedical University of ViennaViennaAustria
- Department of BiochemistryFaculty of Biological SciencesTarbiat Modares UniversityTehranIran
| | - Sadegh Hasannia
- Department of BiochemistryFaculty of Biological SciencesTarbiat Modares UniversityTehranIran
| | - Franz Josef Strauss
- Department of Oral BiologyMedical University of ViennaViennaAustria
- Department of Conservative DentistrySchool of DentistryUniversity of ChileSantiagoChile
| | - Reinhard Gruber
- Department of Oral BiologyMedical University of ViennaViennaAustria
- Department of PeriodontologySchool of Dental MedicineUniversity of BernBernSwitzerland
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134
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Verboket RD, Anbar B, Söhling N, Kontradowitz K, Marzi I, Ghanaati S, Henrich D. Changes in platelet-rich fibrin composition after trauma and surgical intervention. Platelets 2020; 31:1069-1079. [DOI: 10.1080/09537104.2020.1714575] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- René D. Verboket
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Bechir Anbar
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Nicolas Söhling
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Kerstin Kontradowitz
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Ingo Marzi
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Shahram Ghanaati
- Clinic for Maxillofacial and Plastic Surgery, FORM, Frankfurt Oral Regenerative Medicine, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | - Dirk Henrich
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
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The Effect of Warfarin on the Fibrin Architecture of Platelet-Rich Fibrin. J Craniofac Surg 2020; 31:e13-e18. [DOI: 10.1097/scs.0000000000005808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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136
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Systematic Comparison of the Effect of Four Clinical-Grade Platelet Rich Hemoderivatives on Osteoblast Behaviour. Int J Mol Sci 2019; 20:ijms20246243. [PMID: 31835696 PMCID: PMC6941155 DOI: 10.3390/ijms20246243] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/09/2019] [Accepted: 12/09/2019] [Indexed: 02/07/2023] Open
Abstract
Hemoderivatives have utilized in an empirical manner, driven by clinical considerations, leading to the development of a plethora of manufacturing protocols. The purpose of this study was to investigate the composition and bioactivity of four common clinical-grade hemoderivates prepared using standardised methods. Four different hemoderivatives were obtained from sheep blood and divided into two groups: A-PRF/i-PRF (fresh) and P-PRP/L-PRP (anticoagulated). Thrombus (CLOT) was used as a control. Thrombocyte quantification, growth factor composition (IGF-I, VEGF, PDGF-BB, BMP-2), cell viability, migration and mineralization assay were evaluated. Platelet recovery was superior for L-PRP followed by P-PRP. A significant cumulative release of IGF-I and PDGF-BB was noted for A-PRF and L-PRP groups at early time points. Similar release profiles of BMP-2 and VEGF were noted in all protocols. Cell viability and migration assay have demonstrated a detrimental effect when the concentration was ≥60%. Moreover, at Day 21, i-PRF have demonstrated superior mineralisation properties when compared to all groups. A negative impact of A-PRF was demonstrated at high concentrations. Despite its low content in growth factors, i-PRF was the best performing blood product for inducing osteoblast mineralisation, and therefore could be the candidate of choice for utilisation in bone tissue engineering applications.
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137
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New Biomaterials and Regenerative Medicine Strategies in Periodontology, Oral Surgery, Esthetic and Implant Dentistry 2018. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1363581. [PMID: 31915677 PMCID: PMC6935461 DOI: 10.1155/2019/1363581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 12/06/2018] [Indexed: 11/23/2022]
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138
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Chang YR, Liu C, Yin LH. [Research progress on platelet-rich fibrin derivatives]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:660-665. [PMID: 31875447 DOI: 10.7518/hxkq.2019.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Platelet-rich plasma and platelet-rich fibrin (PRF) are widely used in the field of stomatology. Advance-ments in preparation techniques and basic research have enabled the use of PRF derivatives in oral clinical applications. The evolution, preparation techniques, biological properties, and medical research progress of PRF derivatives are reviewed in this paper.
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Affiliation(s)
- Yao-Ren Chang
- Dept. of Oral Implan-tation, Hospital of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Chun Liu
- Dept. of Oral Implan-tation, Hospital of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Li-Hua Yin
- Dept. of Oral Implan-tation, Hospital of Stomatology, Lanzhou University, Lanzhou 730000, China;Dept. of Dental Implantation, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai 200011, China
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139
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Pitzurra L, Jansen IDC, de Vries TJ, Hoogenkamp MA, Loos BG. Effects of L-PRF and A-PRF+ on periodontal fibroblasts in in vitro wound healing experiments. J Periodontal Res 2019; 55:287-295. [PMID: 31782171 PMCID: PMC7154757 DOI: 10.1111/jre.12714] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 10/28/2019] [Accepted: 11/12/2019] [Indexed: 02/06/2023]
Abstract
Objective To determine whether leukocyte‐platelet‐rich fibrin (L‐PRF) and advanced platelet‐rich fibrin (A‐PRF+) differ in their in vitro capacity to induce proliferation and migration of periodontal fibroblasts. Background L‐PRF and A‐PRF + are autologous materials used in periodontal regenerative surgery. They derive from blood from patients, but have different characteristics. The literature is controversial regarding the effects of the two PRF preparations on periodontal tissue fibroblasts. Materials and methods L‐PRF and A‐PRF + membranes were prepared from eight patients and incubated in 3 mL of culture medium for 2 days. Gingival fibroblasts (G‐F) and periodontal ligament fibroblast (PDL‐F) primary cells were retrieved from 7 donors. These cells were pre‐cultured for 1 day in wound healing experiment plates leaving a gap of 500 ± 50 µm in a concentration of 3.3 x 105 cells/mL. 70 µL of the cell suspension was placed in each half of the well. Thereafter, the pre‐cultured L‐PRF and A‐PRF + supernatants were added to the experimental plates, and the fibroblasts were incubated for another 24 h. Medium alone (NEG) and fibroblast growth factor II (FGF) were used as controls. Subsequently, cell migration was registered for 24 h with live cell imaging in a time frame microscope at 5% CO2 in air at 37°C. Images were analyzed using ImageJ. Cell proliferation and cell viability were measured. Results L‐PRF and A‐PRF + induced higher cell proliferation than FGF and NEG. Both A‐PRF + and L‐PRF induced significant faster artificial wound closure than controls. Both PRF conditioned media induced faster cell migration in the initial phase (P < .01), but in the stoppage phase, the induced migration was higher for the A‐PRF+, compared with L‐PRF (P < .01). Conclusion L‐PRF and A‐PRF + have a stimulatory effect on migration and proliferation of periodontal fibroblasts, and artificial wound closure was longer sustained by A‐PRF + than L‐PRF.
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Affiliation(s)
- Luciano Pitzurra
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ineke D C Jansen
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Teun J de Vries
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Michel A Hoogenkamp
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Univeristeit Amsterdam, Amsterdam, The Netherlands
| | - Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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140
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Lei L, Yu Y, Han J, Shi D, Sun W, Zhang D, Chen L. Quantification of growth factors in advanced platelet‐rich fibrin and concentrated growth factors and their clinical efficacy as adjunctive to the GTR procedure in periodontal intrabony defects. J Periodontol 2019; 91:462-472. [DOI: 10.1002/jper.19-0290] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/01/2019] [Accepted: 08/11/2019] [Indexed: 01/27/2023]
Affiliation(s)
- Lihong Lei
- Department of PeriodonticsSecond Affiliated HospitalSchool of MedicineZhejiang University Hangzhou China
| | - Yuanyuan Yu
- Department of PeriodonticsSecond Affiliated HospitalSchool of MedicineZhejiang University Hangzhou China
| | - Jiayin Han
- Department of PeriodonticsSecond Affiliated HospitalSchool of MedicineZhejiang University Hangzhou China
| | - Danhui Shi
- Department of PeriodonticsSecond Affiliated HospitalSchool of MedicineZhejiang University Hangzhou China
| | - Weilian Sun
- Department of PeriodonticsSecond Affiliated HospitalSchool of MedicineZhejiang University Hangzhou China
| | - Diya Zhang
- Dental DepartmentSir Run Run Shaw HospitalSchool of MedicineZhejiang University Hangzhou China
| | - Lili Chen
- Department of PeriodonticsSecond Affiliated HospitalSchool of MedicineZhejiang University Hangzhou China
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141
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Ghaznavi D, Babaloo A, Shirmohammadi A, Zamani ARN, Azizi M, Rahbarghazi R, Ghaznavi A. Advanced platelet-rich fibrin plus gold nanoparticles enhanced the osteogenic capacity of human mesenchymal stem cells. BMC Res Notes 2019; 12:721. [PMID: 31685012 PMCID: PMC6827227 DOI: 10.1186/s13104-019-4750-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/18/2019] [Indexed: 01/14/2023] Open
Abstract
Objectives There is still insufficient clinical evidence of platelet-rich fibrin beneficial effects on bone regeneration. Gold nanoparticles have been shown to enhance osteogenic differentiation and bone mineralization. The purpose of this study was to investigate the effect of advanced-platelet-rich fibrin modified by gold nanoparticles on the osteoblastic differentiation of human mesenchymal stem cells. Results MTT assay revealed 0.0125 mM gold nanoparticles had no cytotoxic effects on stem cells after 7 days. The addition of 0.0125 mM gold nanoparticle to advanced-platelet-rich fibrin clot increased cell viability compared to the non-treated control group (p < 0.05). 7-day incubation of stem cells with advanced-platelet-rich fibrin modified by gold nanoparticles conditioned media was shown to promote alkaline phosphatase activity compared to the control cells and group treated with advanced-platelet-rich fibrin condition media (p < 0.05). By using Alizarin Red S staining, red-colored calcium deposits were observed in the group treated with advanced-platelet-rich fibrin and gold nanoparticles conditioned media in comparison with non-treated cells (p < 0.05). Advanced-platelet-rich fibrin conditioned medium was unable to promote calcium deposition compared to the combination of advanced-platelet-rich fibrin and gold nanoparticles (p < 0.05). Adding gold nanoparticles to advanced-platelet-rich fibrin and fibrin and platelet byproducts could be an alternative strategy to improve osteogenic capacity of stem cells.
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Affiliation(s)
- Dara Ghaznavi
- Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Periodontics, Dental Faculty, Tabriz University of Medical Sciences, Golgasht Ave, Tabriz, 5166/15731, Iran
| | - Amirreza Babaloo
- Department of Periodontics, Dental Faculty, Tabriz University of Medical Sciences, Golgasht Ave, Tabriz, 5166/15731, Iran.
| | - Adileh Shirmohammadi
- Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Periodontics, Dental Faculty, Tabriz University of Medical Sciences, Golgasht Ave, Tabriz, 5166/15731, Iran
| | | | - Mehdi Azizi
- Department of Medical Nanotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Rahbarghazi
- Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Applied Cell Sciences Department, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Aisan Ghaznavi
- Department of Oral and Maxillofacial Radiology, Dental Faculty, Urmia University of Medical Sciences, Urmia, Iran
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142
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Comparison Effects of Platelet-Rich Fibrin on Macrofat and Shuffling Fat Grafting. J Craniofac Surg 2019; 30:2332-2336. [DOI: 10.1097/scs.0000000000005745] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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143
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Zhang Z, Li X, Zhao J, Jia W, Wang Z. Effect of autogenous growth factors released from platelet concentrates on the osteogenic differentiation of periodontal ligament fibroblasts: a comparative study. PeerJ 2019; 7:e7984. [PMID: 31687282 PMCID: PMC6825745 DOI: 10.7717/peerj.7984] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 10/02/2019] [Indexed: 12/21/2022] Open
Abstract
Background Platelet concentrates have been used in tissue regeneration. The purpose of this study was to examine effects of growth factors released from leukocyte- and platelet-rich fibrin (L-PRF) and concentrated growth factor (CGF) on the osteogenic differentiation of periodontal ligament fibroblasts (PDLFs). Methods Leukocyte- and platelet-rich fibrins, CGFs and PDLFs were obtained from New Zealand rabbits. The release of basic fibroblast growth factor (bFGF), bone morphogenetic protein 2 (BMP-2) and transforming growth factor β1 (TGF-β1) from L-PRFs and CGFs was measured at 5 h and 1, 3, 5, 7 days, using the enzyme linked immunosorbent assay. The PDLFs were treated with exudates of L-PRF or CGF. After the treatment, cell counting kit-8 assay was performed at day 1, 3, 5 and 7. Alkaline phosphatase (ALP) assay and Western blotting were applied at day 7. Three blocking antibodies were used to neutralize the proteins of bFGF, BMP-2 and TGF-β1. Results Leukocyte- and platelet-rich fibrin and CGF showed different growth factor release pattern, but similar accumulated concentration of these growth factors. PDLFs proliferation was significantly promoted by both L-PRF and CGF at day 1, 3 and 7, and CGF group was superior to L-PRF group at day 1 and 3. Both L-PRF and CGF significantly enhanced PDLFs ALP activity and protein expression of osteogenic markers. The osteopontin level was higher in CGF group than in L-PRF group, but no significant differences were found between two groups for ALP activity. Three blocking antibodies significantly downregulated both L-PRF and CGF induced osteogenic markers expression. Conclusion Both CGF and L-PRF can promote the proliferation and osteogenic differentiation of PDLFs. The bFGF, BMP-2 and TGF-β1 are involved in both L-PRF and CGF induced osteogenic differentiation of PDLFs.
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Affiliation(s)
- Zheng Zhang
- Department of Periodontology, Tianjin Stomatological Hospital, Hospital of Stomatology, Nankai University, Tianjin, China
| | - Xinyue Li
- Department of Periodontology, Tianjin Stomatological Hospital, Hospital of Stomatology, Nankai University, Tianjin, China
| | - Jing Zhao
- Department of Periodontology, Tianjin Stomatological Hospital, Hospital of Stomatology, Nankai University, Tianjin, China
| | - Wenjun Jia
- Department of Periodontology, Tianjin Stomatological Hospital, Hospital of Stomatology, Nankai University, Tianjin, China
| | - Zuomin Wang
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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144
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Feigin K, Shope B. Use of Platelet-Rich Plasma and Platelet-Rich Fibrin in Dentistry and Oral Surgery: Introduction and Review of the Literature. J Vet Dent 2019; 36:109-123. [DOI: 10.1177/0898756419876057] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Platelet concentrates, mostly represented by platelet-rich plasma and platelet-rich fibrin, have gained significant interest in various medical and oral disciplines because of their potential to stimulate and boost regeneration of hard and soft tissues. Prepared from the patient’s own blood, they have been tested and used in various different surgical fields including oral and maxillofacial surgery. The effects of these biomaterials are described to be a result of the large concentration of platelets which contain a wide range of growth factors. The aim of this article is to introduce the principle and function of these platelet concentrates, to review their preparation, and to provide a comprehensive examination of the published oral and maxillofacial literature on this subject.
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145
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Fibrin as a Multipurpose Physiological Platform for Bone Tissue Engineering and Targeted Delivery of Bioactive Compounds. Pharmaceutics 2019; 11:pharmaceutics11110556. [PMID: 31661853 PMCID: PMC6920828 DOI: 10.3390/pharmaceutics11110556] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/18/2019] [Accepted: 10/18/2019] [Indexed: 12/14/2022] Open
Abstract
Although bone graft is still considered as the gold standard method, bone tissue engineering offers promising alternatives designed to mimic the extracellular matrix (ECM) and to guide bone regeneration process. In this attempt, due to their similarity to the ECM and their low toxicity/immunogenicity properties, growing attention is paid to natural polymers. In particular, considering the early critical role of fracture hematoma for bone healing, fibrin, which constitutes blood clot, is a candidate of choice. Indeed, in addition to its physiological roles in bone healing cascade, fibrin biochemical characteristics make it suitable to be used as a multipurpose platform for bioactive agents’ delivery. Thus, taking advantage of these key assets, researchers and clinicians have the opportunity to develop composite systems that might further improve bone tissue reconstruction, and more generally prevent/treat skeletal disorders.
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146
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Striking Differences in Platelet Distribution between Advanced-Platelet-Rich Fibrin and Concentrated Growth Factors: Effects of Silica-Containing Plastic Tubes. J Funct Biomater 2019; 10:jfb10030043. [PMID: 31533279 PMCID: PMC6787607 DOI: 10.3390/jfb10030043] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/13/2019] [Accepted: 09/15/2019] [Indexed: 12/15/2022] Open
Abstract
Compared with platelet-rich plasma, the preparation of platelet-rich fibrin (PRF) is simple and has not been overly modified. However, it was recently demonstrated that centrifugation conditions influence the composition of PRF and that silica microparticles from silica-coated plastic tubes can enter the PRF matrix. These factors may also modify platelet distribution. To examine these possibilities, we prepared PRF matrices using various types of blood-collection tubes (plain glass tubes and silica-containing plastic tubes) and different centrifugation speeds. The protocols of concentrated growth factors and advanced-PRF represented high- and low-speed centrifugation, respectively. Platelet distribution in the PRF matrix was examined immunohistochemically. Using low-speed centrifugation, platelets were distributed homogeneously within the PRF matrix regardless of tube types. In high-speed centrifugation, platelets were distributed mainly on one surface region of the PRF matrix in glass tubes, whereas in silica-coated tubes, platelet distribution was commonly more diffusive than in glass tubes. Therefore, both blood-collection tube types and centrifugal conditions appeared to influence platelet distribution in the PRF matrix. Platelets distributed in the deep regions of the PRF matrix may contribute to better growth factor retention and release. However, clinicians should be careful in using silica-coated tubes because their silica microparticles may be a health hazard.
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147
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Caruana A, Savina D, Macedo JP, Soares SC. From Platelet-Rich Plasma to Advanced Platelet-Rich Fibrin: Biological Achievements and Clinical Advances in Modern Surgery. Eur J Dent 2019; 13:280-286. [PMID: 31509878 PMCID: PMC6777161 DOI: 10.1055/s-0039-1696585] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
In the past 20 years, the platelet concentrates have evolved from first-generation products, i.e., platelet-rich plasma (PRP) and plasma rich in growth factors to the second-generation products such as leukocyte-platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF). These autologous products with a higher leukocyte inclusion and flexible fibrin mesh act as a scaffold to increase cellular migration in the angiogenic, osteogenic, and antimicrobial potential of these biomaterials in tissue regeneration. In the second-generation platelet concentrates, the protocols are easier, cheaper, and faster with an entire physiological fibrin matrix, resulting in a tridimensional mesh, not as rigid as one of the first generations. This allows the slow release of molecules over a longer period of time and triggers the healing and regenerative process at the site of injury. The potential of A-PRF to mimic the physiology and immunology of wound healing is also due to the high concentration of growth factors released as follows: vascular endothelial growth factor, platelet-derived growth factor, transforming growth factor-β, and anti-inflammatory cytokines that stimulate tissue cicatrization, vessels formation, and bone cell proliferation and differentiation. Furthermore, the number of neutrophils and monocytes/macrophages is higher releasing important chemotactic molecules such as chemokine ligand-5 and eotaxin. Thus, L-PRF and A-PRF have been used, especially in implantology, periodontology, and maxillofacial surgery. Future clinical applications include tissue regeneration/grafts, ulcers/skin necrosis in the diabetic patient and others, plastic surgery, and even musculoskeletal lesions.
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Affiliation(s)
- Andrea Caruana
- Faculty of Health Sciences, School of Dentistry, Fernando Pessoa University, Porto, Portugal
| | - Daniele Savina
- Faculty of Health Sciences, School of Dentistry, Fernando Pessoa University, Porto, Portugal
| | - José Paulo Macedo
- Faculty of Health Sciences, School of Dentistry, Fernando Pessoa University, Porto, Portugal
| | - Sandra Clara Soares
- Biomedical Research Center, Fernando Pessoa Energy, Environment and Health Research Unit, Faculty of Health Sciences, Fernando Pessoa University, Porto, Portugal
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148
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Al-Hamed FS, Mahri M, Al-Waeli H, Torres J, Badran Z, Tamimi F. Regenerative Effect of Platelet Concentrates in Oral and Craniofacial Regeneration. Front Cardiovasc Med 2019; 6:126. [PMID: 31552270 PMCID: PMC6733887 DOI: 10.3389/fcvm.2019.00126] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/12/2019] [Indexed: 01/11/2023] Open
Abstract
Platelet concentrates (PCs) are biological autologous products derived from the patient's whole blood and consist mainly of supraphysiologic concentration of platelets and growth factors (GFs). These GFs have anti-inflammatory and healing enhancing properties. Overall, PCs seem to enhance bone and soft tissue healing in alveolar ridge augmentation, periodontal surgery, socket preservation, implant surgery, endodontic regeneration, sinus augmentation, bisphosphonate related osteonecrosis of the jaw (BRONJ), osteoradionecrosis, closure of oroantral communication (OAC), and oral ulcers. On the other hand, no effect was reported for gingival recession and guided tissue regeneration (GTR) procedures. Also, PCs could reduce pain and inflammatory complications in temporomandibular disorders (TMDs), oral ulcers, and extraction sockets. However, these effects have been clinically inconsistent across the literature. Differences in study designs and types of PCs used with variable concentration of platelets, GFs, and leucocytes, as well as different application forms and techniques could explain these contradictory results. This study aims to review the clinical applications of PCs in oral and craniofacial tissue regeneration and the role of their molecular components in tissue healing.
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Affiliation(s)
| | - Mohammed Mahri
- Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Haider Al-Waeli
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Jesus Torres
- Faculty of Dentistry, Universidad Complutense, Madrid, Spain
| | - Zahi Badran
- Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Department of Periodontology (CHU/Rmes Inserm U1229/UIC11), Faculty of Dental Surgery, University of Nantes, Nantes, France
| | - Faleh Tamimi
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
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149
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Takahashi A, Tsujino T, Yamaguchi S, Isobe K, Watanabe T, Kitamura Y, Okuda K, Nakata K, Kawase T. Distribution of platelets, transforming growth factor‐β1, platelet‐derived growth factor‐BB, vascular endothelial growth factor and matrix metalloprotease‐9 in advanced platelet‐rich fibrin and concentrated growth factor matrices. ACTA ACUST UNITED AC 2019; 10:e12458. [DOI: 10.1111/jicd.12458] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/04/2019] [Indexed: 12/26/2022]
Affiliation(s)
| | | | | | | | - Taisuke Watanabe
- Division of Anatomy and Cell Biology of the Hard Tissue, Institute of Medicine and Dentistry Niigata University Niigata Japan
| | - Yutaka Kitamura
- Department of Oral and Maxillofacial Surgery Matsumoto Dental University Shiojiri Japan
| | - Kazuhiro Okuda
- Division of Periodontology, Institute of Medicine and Dentistry Niigata University Niigata Japan
| | - Koh Nakata
- Bioscience Medical Research Center Niigata University Medical and Dental Hospital Niigata Japan
| | - Tomoyuki Kawase
- Division of Oral Bioengineering, Institute of Medicine and Dentistry Niigata University Niigata Japan
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150
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Chen YT, Chang YC. Use of platelet-rich fibrin and surgical approach for combined treatment of osteoradionecrosis: a case report. J Int Med Res 2019; 47:3998-4003. [PMID: 31354001 PMCID: PMC6726788 DOI: 10.1177/0300060519862468] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Osteoradionecrosis (ORN) is a complication of radiation therapy for which several treatment options have been reported. The use of platelet‐rich fibrin (PRF), a second-generation platelet concentrate, has been promoted in refractory wounds. A 53-year-old man underwent concurrent chemoradiotherapy for squamous cell carcinoma in the right side of the tongue. Subsequently, he exhibited pus discharge around the right maxillary first molar. Intraoral examination showed mobility and probing depths of >10 mm in teeth 15 and 16. Computed tomography revealed poorly defined osteolytic changes in teeth 15 to 17, indicative of oroantral fistula. Teeth 15 to 17 were extracted and the socket was debrided. Primary closure was achieved after PRF dressing. The wound healed within 2 weeks. The patient returned because of spontaneous loss of tooth 46 and numbness over the right lower lip. Pus was present in premolar areas and in the tooth 46 socket. Radiographic examination showed moth-eaten destruction in right mandibular teeth and better trabecular quality in the right maxilla. A provisional diagnosis of ORN was made. Debridement and primary closure after PRF dressing were performed. The mucosa healed within 3 weeks. Our findings suggest that PRF combined with a surgical approach might be useful for treatment of ORN.
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Affiliation(s)
- Yi-Tzu Chen
- School of Dentistry, Chung Shan Medical University, Department of Oral and Maxillofacial Surgery, Chung Shan Medical University Hospital, Taichung City
| | - Yu-Chao Chang
- School of Dentistry, Chung Shan Medical University, Department of Oral and Maxillofacial Surgery, Chung Shan Medical University Hospital, Taichung City
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