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Wei Y, Cheng Y, Wei H, Wang Y, Zhang X, Miron RJ, Zhang Y, Qing S. Development of a super-hydrophilic anaerobic tube for the optimization of platelet-rich fibrin. Platelets 2024; 35:2316745. [PMID: 38385327 DOI: 10.1080/09537104.2024.2316745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/05/2024] [Indexed: 02/23/2024]
Abstract
Horizontal platelet-rich fibrin (H-PRF) contains a variety of bioactive growth factors and cytokines that play a key role in the process of tissue healing and regeneration. The blood collection tubes used to produce Solid-PRF (plasmatrix (PM) tubes) have previously been shown to have a great impact on the morphology, strength and composition of the final H-PRF clot. Therefore, modification to PM tubes is an important step toward the future optimization of PRF. To this end, we innovatively modified the inner wall surface of the PM tubes with plasma and adjusted the gas environment inside the PM tubes to prepare super-hydrophilic anaerobic plasmatrix tubes (SHAP tubes). It was made anaerobic for the preparation of H-PRF with the aim of improving mechanical strength and bioactivity. The findings demonstrated that an anaerobic environment stimulated platelet activation within the PRF tubes. After compression, the prepared H-PRF membrane formed a fibrous cross-linked network with high fracture strength, ideal degradation characteristics, in addition to a significant increase in size. Thereafter, the H-PRF membranes prepared by the SHAP tubes significantly promoted collagen synthesis of gingival fibroblast and the mineralization of osteoblasts while maintaining excellent biocompatibility, and advantageous antibacterial properties. In conclusion, the newly modified PRF tubes had better platelet activation properties leading to better mechanical strength, a longer degradation period, and better regenerative properties in oral cell types including gingival fibroblast and alveolar osteoblasts. It also improves the success rate of H-PRF preparation in patients with coagulation dysfunction and expands the clinical application scenario.
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Affiliation(s)
- Yan Wei
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yihong Cheng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hongjiang Wei
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yulan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Periodontology, University of Bern, Bern Switzerland
| | - Xiaoxin Zhang
- Department of Periodontology, University of Bern, Bern Switzerland
| | - Richard J Miron
- Department of Dental Implantology, School and Hospital of Stomatology University of Wuhan, Wuhan, China
| | - Yufeng Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Dental Implantology, School and Hospital of Stomatology University of Wuhan, Wuhan, China
| | - Shanglan Qing
- Department of Stomatology Chongqing General Hospital, Chongqing, China
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Anaya-Sampayo LM, García-Robayo DA, Roa NS, Rodriguez-Lorenzo LM, Martínez-Cardozo C. Platelet-rich fibrin (PRF) modified nano-hydroxyapatite/chitosan/gelatin/alginate scaffolds increase adhesion and viability of human dental pulp stem cells (DPSC) and osteoblasts derived from DPSC. Int J Biol Macromol 2024; 273:133064. [PMID: 38866288 DOI: 10.1016/j.ijbiomac.2024.133064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/05/2024] [Accepted: 06/08/2024] [Indexed: 06/14/2024]
Abstract
Bone tissue regeneration strategies have incorporated the use of natural polymers, such as hydroxyapatite (nHA), chitosan (CH), gelatin (GEL), or alginate (ALG). Additionally, platelet concentrates, such as platelet-rich fibrin (PRF) have been suggested to improve scaffold biocompatibility. This study aimed to develop scaffolds composed of nHA, GEL, and CH, with or without ALG and lyophilized PRF, to evaluate the scaffold's properties, growth factor release, and dental pulp stem cells (DPSC), and osteoblast (OB) derived from DPSC viability. Four scaffold variations were synthesized and lyophilized. Then, degradation, swelling profiles, and morphological analysis were performed. Furthermore, PDGF-BB and FGF-B growth factors release were quantified by ELISA, and cytotoxicity and cell viability were evaluated. The swelling and degradation profiles were similar in all scaffolds, with pore sizes ranging between 100 and 250 μm. FGF-B and PDGF-BB release was evidenced after 24 h of scaffold immersion in cell culture medium. DPSC and OB-DPSC viability was notably increased in PRF-supplemented scaffolds. The nHA-CH-GEL-PRF scaffold demonstrated optimal physical-biological characteristics for stimulating DPSC and OB-DPSC cell viability. These results suggest lyophilized PRF improves scaffold biocompatibility for bone tissue regeneration purposes.
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Affiliation(s)
| | | | - Nelly S Roa
- Dental Research Center, School of Dentistry, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Luis Maria Rodriguez-Lorenzo
- Department of Polymeric Nanomaterials and Biomaterials, Institute Science and Technology of Polymers (ICTP-CSIC), Madrid, Spain
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Blanco J, García Alonso A, Hermida-Nogueira L, Castro AB. How to explain the beneficial effects of leukocyte- and platelet-rich fibrin. Periodontol 2000 2024. [PMID: 38923566 DOI: 10.1111/prd.12570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/06/2024] [Accepted: 04/15/2024] [Indexed: 06/28/2024]
Abstract
The survival of an organism relies on its ability to repair the damage caused by trauma, toxic agents, and inflammation. This process involving cell proliferation and differentiation is driven by several growth factors and is critically dependent on the organization of the extracellular matrix. Since autologous platelet concentrates (APCs) are fibrin matrices in which cells, growth factors, and cytokines are trapped and delivered over time, they are able to influence that response at different levels. The present review thoroughly describes the molecular components present in one of these APCs, leukocyte- and platelet-rich fibrin (L-PRF), and summarizes the level of evidence regarding the influence of L-PRF on anti-inflammatory reactions, analgesia, hemostasis, antimicrobial capacity, and its biological mechanisms on bone/soft tissue regeneration.
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Affiliation(s)
- Juan Blanco
- Department of Surgery (Stomatology, Unit of Periodontology), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Angel García Alonso
- Platelet Proteomics Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Santiago de Compostela University, Santiago de Compostela, Spain
| | - Lidia Hermida-Nogueira
- Platelet Proteomics Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Santiago de Compostela University, Santiago de Compostela, Spain
| | - Ana B Castro
- Department of Oral Health Sciences, Section of Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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Cui Y, Mai Y, Liu X, Mu H. Clinical benefits of autologous platelet concentrate in periodontal intrabony defects: A network meta-analysis of randomized controlled trials. Eur J Oral Sci 2024; 132:e12978. [PMID: 38459610 DOI: 10.1111/eos.12978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/20/2024] [Indexed: 03/10/2024]
Abstract
This study aimed to compare clinical benefits of autologous platelet concentrate with other periodontal regenerative approaches in intrabony defects. An electronic and hand search of studies up to December 2022 was conducted. Randomized controlled trials with at least 6 months of follow-up were identified to compare autologous platelet concentrates with enamel matrix derivative, bone graft, guided tissue regeneration, and open-flap debridement. All approaches involved papilla preservation flap surgery. The outcomes included probing depth reduction, clinical attachment level gain, linear bone fill, and safety. A network meta-analysis and meta-regression were performed. Fifty-seven studies were included in five network meta-analyses. Autologous platelets concentrate and its adjunct treatments achieved significantly greater clinical and radiographic parameters than did open-flap debridement, and had comparable or better performance than other regenerative treatments. Platelet-rich fibrin showed superiority over platelet-rich plasma in probing depth reduction at 6-month follow-up. Minimal pain and improved wound healing were observed in the treatments with autologous platelet concentrate. Meta-regression showed that deeper baseline intrabony defects resulted in larger probing depth reductions, while smoking impaired the effectiveness of regenerative surgeries. Minimal invasive flap designs led to less effect of regenerative materials. Autologous platelet concentrate is a promising biomaterial in periodontal regeneration due to its convenience, safety, and biocompatibility characteristics.
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Affiliation(s)
- Yue Cui
- Department of Stomatology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, P.R. China
| | - Yuhe Mai
- Department of Stomatology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, P.R. China
| | - Xuewei Liu
- Department of Stomatology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, P.R. China
| | - Hong Mu
- Department of Stomatology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, P.R. China
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Quirynen M, Siawasch SAM, Yu J, Miron RJ. Essential principles for blood centrifugation. Periodontol 2000 2024. [PMID: 38778518 DOI: 10.1111/prd.12555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/09/2024] [Accepted: 02/05/2024] [Indexed: 05/25/2024]
Abstract
Currently, autologous platelet concentrates (APCs) are frequently used for soft- and hard-tissue regeneration, not only within the oral cavity, but also extra-orally including chronic wounds, burns, joints, dermatological conditions, among others. The benefits of APCs are largely influenced by the treatment strategy but also their preparation. This paper therefore discusses in detail: the physical properties of blood cells, the basic principles of blood centrifugation, the impact of the centrifugation protocol (rotations/revolutions per minute, g-force, variation between centrifuges), the importance of timing during the preparation of APCs, the impact of the inner surface of the blood tubes, the use/nonuse of anticoagulants within APC tubes, the impact of the patient's hematocrit, age, and gender, as well as the important requirements for an optimal centrifugation protocol. All these variables indeed have a significant impact on the clinical outcome of APCs.
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Affiliation(s)
- Marc Quirynen
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Sayed Ahmad Manoetjer Siawasch
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Jize Yu
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
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Qiu Y, Shen K, Wei H, Zhang Y, Wang Y, Bai Y. Novel approach to soft tissue regeneration: in vitro study of compound hyaluronic acid and horizontal platelet-rich fibrin combination. J Appl Oral Sci 2024; 32:e20230294. [PMID: 38747782 PMCID: PMC11093524 DOI: 10.1590/1678-7757-2023-0294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/24/2024] [Accepted: 03/12/2024] [Indexed: 05/19/2024] Open
Abstract
OBJECTIVE This study aims to develop a compound biomaterial to achieve effective soft tissue regeneration. METHODOLOGY Compound hyaluronic acid (CHA) and liquid horizontal-platelet-rich fibrin (H-PRF) were mixed at a ratio of 1:1 to form a CHA-PRF gel. Human gingival fibroblasts (HGFs) were used in this study. The effect of CHA, H-PRF, and the CHA-PRF gel on cell viability was evaluated by CCK-8 assays. Then, the effect of CHA, H-PRF, and the CHA-PRF gel on collagen formation and deposition was evaluated by qRT‒PCR and immunofluorescence analysis. Finally, qRT‒PCR, immunofluorescence analysis, Transwell assays, and scratch wound-healing assays were performed to determine how CHA, H-PRF, and the CHA-PRF gel affect the migration of HGFs. RESULTS The combination of CHA and H-PRF shortened the coagulation time of liquid H-PRF. Compared to the pure CHA and H-PRF group, the CHA-PRF group exhibited the highest cell proliferation at all time points, as shown by the CCK-8 assay. Col1a and FAK were expressed at the highest levels in the CHA-PRF group, as shown by qRT‒PCR. CHA and PRF could stimulate collagen formation and HGF migration, as observed by fluorescence microscopy analysis of COL1 and F-actin and Transwell and scratch healing assays. CONCLUSION The CHA-PRF group exhibited greater potential to promote soft tissue regeneration by inducing cell proliferation, collagen synthesis, and migration in HGFs than the pure CHA or H-PRF group. CHA-PRF can serve as a great candidate for use alone or in combination with autografts in periodontal or peri-implant soft tissue regeneration.
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Affiliation(s)
- Yun Qiu
- Wuhan University, School & Hospital of Stomatology, Hubei Key Laboratory of Stomatology, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Wuhan, China
| | - Kailun Shen
- Stomatological Hospital of Xiamen Medical School, Xiamen, China. University of Wuhan, School and Hospital of Stomatology, Department of Dental Implantology, Wuhan, China
| | - Hongjiang Wei
- Wuhan University, School & Hospital of Stomatology, Hubei Key Laboratory of Stomatology, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Wuhan, China
| | - Yufeng Zhang
- Wuhan University, School & Hospital of Stomatology, Hubei Key Laboratory of Stomatology, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Wuhan, China
- Wuhan University, School of Medicine, Medical Research Institute, Wuhan, China
| | - Yulan Wang
- Wuhan University, School & Hospital of Stomatology, Hubei Key Laboratory of Stomatology, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Wuhan, China
- Wuhan University, School of Medicine, Medical Research Institute, Wuhan, China
| | - Yi Bai
- Wuhan University, School of Medicine, Medical Research Institute, Wuhan, China
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Shrestha S, Pathak R, Jagat GC, Donovan J. Platelet-rich fibrin: A review of its role as a new treatment in androgenetic alopecia. J Cosmet Dermatol 2024. [PMID: 38641925 DOI: 10.1111/jocd.16333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/21/2024] [Accepted: 04/04/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Androgenetic alopecia (AGA) is a major cause of hair loss resulting from a complex interplay between various genes and hormones with the result being follicular miniaturization and altered hair cycle dynamics. Platelet-rich plasma (PRP) has a well-established role as adjunctive therapy in AGA but there are many limitations of it. In an attempt to overcome the shortcomings of PRP, liquid platelet-rich fibrin (PRF) was developed. AIM This article critically reviews the protocol for the preparation and clinical outcomes of PRF. PATIENTS/METHODS The articles published so far in the English language regarding the preparation and clinical outcomes of PRF were reviewed. RESULTS Among five studies analyzing various centrifugation speeds and centrifugation times, three of the studies favored low-speed centrifugation, whereas two studies did not support this methodology. A horizontal centrifuge may be preferred over a fixed-angle centrifuge for PRF. Five clinical studies on the use of PRF showed a significant effect on AGA. CONCLUSION At present, there is no consensus regarding the preparation of PRF. Most studies used fixed-angle centrifugation favored low centrifuge speed and less centrifugation time. Larger studies are needed to determine the optimal centrifugation force and time. A horizontal centrifuge may be preferred over a fixed-angle centrifuge due to the higher yield of platelets, and lesser shear trauma to the cells. In addition, larger, well-designed studies are needed to confirm the benefits of PRF over PRP.
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Affiliation(s)
- Samir Shrestha
- Department of Dermatology, Rapti Province Hospital, Dang, Tulsipur, Nepal
| | - Raksha Pathak
- Department of Dermatology, Pokhara Academy of Health Sciences, Pokhara, Nepal
| | - G C Jagat
- Sathi Polyclinic, Dang, Tulsipur, Nepal
| | - Jeff Donovan
- Department of Dermatology, University of British Columbia, Vancouver, British Columbia, Canada
- Donovan Hair Clinic, Whistler, British Columbia, Canada
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Anapu MP, Atluri KR, Chandra Tripuraneni S, Issrani R, Bader AK, Alkhalaf ZA, Sghaireen MG, Prabhu N, Rbea DH Alshammari R, Khalid G, Matab G, Khan FH. Evaluation of effect on stability of implants with and without platelet rich fibrin using a resonance frequency analyzer - An in-vivo study. Heliyon 2024; 10:e27971. [PMID: 38623195 PMCID: PMC11016576 DOI: 10.1016/j.heliyon.2024.e27971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 03/03/2024] [Accepted: 03/08/2024] [Indexed: 04/17/2024] Open
Abstract
Background Although the conventional replacement for lost teeth has been partial or full dentures, the need for a fixed, esthetic, and functional restoration makes dental implants a reliable alternative. Aim To evaluate the initial and final stability of platelet rich fibrin coated implants using resonance frequency analyzer. Method ology: Thirteen patients with two or more missing teeth were informed about the procedure, and a consent form was obtained after cone beam computer tomography evaluation. Blood was drawn from the anticubital area of the patient, which was centrifuged to obtain platelet-rich fibrin. In all, 26 implants were placed, among which 13 were platelet-rich fibrin-coated (test group) and 13 were without platelet-rich fibrin (control group), and implant stability quotient values were recorded. Results The mean age of the patients was 34.4 (SD = 4.28). Majority of the patients were males (9; 69.2%) whereas there were only four (30.8%) female patients. When comparison between overall primary implant stability with and without PRF was done, the mean difference was 5.12 and this difference was not statistically significant (p = 0.221) whereas a statistically significant difference (p = 0.019) was found when comparison between overall secondary implant stability was done with and without PRF. The primary and secondary stability values for the control group were 69.18 ± 7.45 and 73.84 ± 8.21 respectively, and the primary and secondary stability values for the test group were 64.06 ± 12.66 and 81.49 ± 7.61 respectively, which showed statistically significant differences among the groups. The difference in these values signify that primary stability is more in control group whereas secondary stability is more in case group. This signifies that PRF enhances the stability of implant. Conclusion Implants coated with platelet-rich fibrin exhibited better osseointegration than implants without platelet-rich fibrin.
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Affiliation(s)
- Mounica Priya Anapu
- Department of Prosthodontics, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnaoutapalli, India
| | - Kaleswara Rao Atluri
- Department of Prosthodontics, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnaoutapalli, India
| | - Sunil Chandra Tripuraneni
- Department of Prosthodontics, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnaoutapalli, India
| | - Rakhi Issrani
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
| | - Alzarea K. Bader
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
| | - Zainab A. Alkhalaf
- Department of Prosthetic Dental Sciences, Ministry of Health, Kingdom of Saudi Arabia
| | - Mohammed Ghazi Sghaireen
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
| | - Namdeo Prabhu
- Department of Oral & Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | | | - Ghosoun Khalid
- College of Medicine, University of Hail, Hail, Kingdom of Saudi Arabia
| | - Ghada Matab
- College of Medicine, University of Hail, Hail, Kingdom of Saudi Arabia
| | - Farida Habib Khan
- Department of Family and Community Medicine, College of Medicine, University of Hail, Hail, Kingdom of Saudi Arabia
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Guimarães LHDS, Pereira Neto ARL, de Oliveira TL, Kataoka MSDS, Pinheiro JDJV, Alves Júnior SDM. Platelet-rich fibrin stimulates the proliferation and expression of proteins related to survival, adhesion, and angiogenesis in gingival fibroblasts cultured on a titanium nano-hydroxyapatite-treated surface. J Oral Biosci 2024; 66:160-169. [PMID: 38048849 DOI: 10.1016/j.job.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 12/06/2023]
Abstract
OBJECTIVES This in vitro study aimed to evaluate the cell viability and expression of proteins related to angiogenesis, adhesion, and cell survival (vascular endothelial growth factor, paxillin, vinculin, fibronectin, and protein kinase B) in gingival fibroblasts that were cultured on titanium discs treated with or without nanohydroxyapatite and exposed to platelet-rich fibrin (PRF)-conditioned medium. METHODS To obtain the conditioned medium, the PRF membranes were prepared and incubated for 48 h in a culture medium without fetal bovine serum. Analyses were performed at 24 and 48 h for the cells cultured on machined-titanium discs or surfaces treated with nanohydroxyapatite in a control medium or PRF-conditioned medium, resulting in four experimental groups (CT-TI, CT-NANO, PRF-TI, and PRF-NANO). RESULTS A decrease in the viability of the gingival fibroblasts was not observed in any of the experimental groups. The PRF-NANO group showed significantly higher immunoexpression of paxillin and AKT at 24 and 48 h (p < 0.01). The same result was observed for vinculin expression at 24 h (p < 0.001). The expression of fibronectin at 48 h and VEGF at 24 and 48 h was significantly higher when the cells were exposed to the PRF-conditioned medium, regardless of the disc surface (p < 0.05). CONCLUSION Gingival fibroblasts cultured on a nanohydroxyapatite-treated surface and in a PRF-conditioned medium showed a greater expression of proteins modulating adhesion, angiogenesis, and cell survival. Our results may contribute to the understanding of the mechanisms related to peri-implant soft tissue sealing.
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Affiliation(s)
| | | | - Thaianna Lima de Oliveira
- Department of Periodontology, School of Dentistry, Federal University of Pará, Av. Augusto Correa 01, Belém, PA, Brazil.
| | - Maria Sueli da Silva Kataoka
- Department of Oral Pathology, School of Dentistry, Federal University of Pará, Av. Augusto Correa 01, Belém, PA, Brazil.
| | - João de Jesus Viana Pinheiro
- Department of Oral Pathology, School of Dentistry, Federal University of Pará, Av. Augusto Correa 01, Belém, PA, Brazil.
| | - Sérgio de Melo Alves Júnior
- Department of Oral Pathology, School of Dentistry, Federal University of Pará, Av. Augusto Correa 01, Belém, PA, Brazil.
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Lektemur Alpan A, Torumtay Cin G, Kızıldağ A, Zavrak N, Özmen Ö, Arslan Ş, Mutlu D. Evaluation of the effect of injectable platelet-rich fibrin (i-PRF) in wound healing and growth factor release in rats: a split-mouth study. Growth Factors 2024; 42:36-48. [PMID: 38058166 DOI: 10.1080/08977194.2023.2289375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/26/2023] [Indexed: 12/08/2023]
Abstract
This experimental study aimed to evaluate the effects of injectable platelet-rich fibrin (i-PRF) on mucosal healing and the release of growth factors in rats. 40 rats were used; i-PRF was administered in the right buccal area while saline was injected in the left. Cytokeratin, FGF, PDGF, TGF, and VEGF expressions were determined with immunohistochemistry. Gene expressions of EGF, TGF-β, and VEGF were analysed. Epithelialization started on the 3rd day, and connective tissue maturation was more prominent in the i-PRF-applied group. Also, the releases of VEGF, EGF, TGF-β, PDGF, and FGF were higher in the i-PRF group during the 14 days. Gene expression analysis showed that changes in TGF-β at 14 days after i-PRF injection and VEGF after 21 days were statistically significant. The results of this study suggested that autologous i-PRF application enhanced the healing of oral mucosal wounds by increasing the release of growth factors for 21 days.
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Affiliation(s)
- Aysan Lektemur Alpan
- Department of Periodontology, Faculty of Dentistry, Pamukkale University, Denizli, Türkiye
| | - Gizem Torumtay Cin
- Department of Periodontology, Faculty of Dentistry, Pamukkale University, Denizli, Türkiye
| | - Alper Kızıldağ
- Department of Periodontology, Faculty of Dentistry, Pamukkale University, Denizli, Türkiye
| | - Necati Zavrak
- Department of Periodontology, Faculty of Dentistry, Pamukkale University, Denizli, Türkiye
| | - Özlem Özmen
- Department of Pathology, Faculty of Veterinary Medicine, Burdur Mehmet Akif Ersoy University, Burdur, Türkiye
| | - Şevki Arslan
- Department of Biology, Faculty of Science, Pamukkale University, Denizli, Türkiye
| | - Doğukan Mutlu
- Department of Biology, Faculty of Science, Pamukkale University, Denizli, Türkiye
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Miron RJ, Fujioka-Kobayashi M, Sculean A, Zhang Y. Optimization of platelet-rich fibrin. Periodontol 2000 2024; 94:79-91. [PMID: 37681522 DOI: 10.1111/prd.12521] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/25/2023] [Accepted: 08/09/2023] [Indexed: 09/09/2023]
Abstract
The use of platelet-rich fibrin (PRF) has gained tremendous popularity in recent years owing to its ability to speed wound healing postsurgery. However, to date, many clinicians are unaware of methods designed to optimize the technology. This overview article will discuss the advancements and improvements made over the years aimed at maximizing cell and growth factor concentrations. First, a general understanding explaining the differences between RPM and RCF (g-force) is introduced. Then, the low-speed centrifugation concept, fixed angle versus horizontal centrifugation, and methods to maximize platelet concentrations using optimized protocols will be discussed in detail. Thereafter, the importance of chemically modified PRF tubes without the addition of chemical additives, as well as regulation of temperature to induce/delay clotting, will be thoroughly described. This article is a first of its kind summarizing all recent literature on PRF designed to optimize PRF production for clinical treatment.
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Affiliation(s)
- Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Masako Fujioka-Kobayashi
- Department of Oral and Maxillofacial Surgery, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Yufeng Zhang
- Department of Oral Implantology, University of Wuhan, Wuhan, China
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Miron RJ, Gruber R, Farshidfar N, Sculean A, Zhang Y. Ten years of injectable platelet-rich fibrin. Periodontol 2000 2024; 94:92-113. [PMID: 38037213 DOI: 10.1111/prd.12538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 09/07/2023] [Accepted: 10/11/2023] [Indexed: 12/02/2023]
Abstract
The use of platelet-rich fibrin (PRF) has seen widespread advantages over platelet-rich plasma (PRP) in many fields of medicine. However, until 2014, PRF remained clinically available only in its solid clotted form. Modifications to centrifugation protocols and tube technology have led to the development of a liquid injectable version of PRF (i-PRF). This narrative review takes a look back at the technological developments made throughout the past decade and further elaborates on their future clinical applications. Topics covered include improvements in isolation techniques and protocols, ways to further concentrate i-PRF, and the clinical impact and relevance of cooling i-PRF. Next, various uses of i-PRF are discussed, including its use in regenerative periodontology, implantology, endodontics, temporomandibular joint injections, and orthodontic tooth movement. Furthermore, various indications in medicine are also covered, including its use in sports injuries and osteoarthritis of various joints, treatment of diabetic ulcers/wound care, and facial esthetics and hair regrowth. Finally, future applications are discussed, mainly its use as a drug delivery vehicle for small biomolecules, such as growth factors, antibiotics, exosomes, and other medications that may benefit from the controlled and gradual release of biomolecules over time.
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Affiliation(s)
- Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Reinhard Gruber
- Department of Oral Biology, Medical University of Vienna, Vienna, Austria
| | - Nima Farshidfar
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Yufeng Zhang
- Department of Oral Implantology, University of Wuhan, Wuhan, China
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Schröger SV, Blatt S, Sagheb K, Al-Nawas B, Kämmerer PW, Sagheb K. Platelet-rich fibrin for rehydration and pre-vascularization of an acellular, collagen membrane of porcine origin. Clin Oral Investig 2024; 28:99. [PMID: 38227215 PMCID: PMC10791820 DOI: 10.1007/s00784-023-05485-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/29/2023] [Indexed: 01/17/2024]
Abstract
OBJECTIVES Pre-vascularization of the collagen membranes with autologous platelet concentrates is a standard procedure in oral and maxillofacial surgery. This study analyzed the possible interaction of an acellular collagen membrane of porcine origin (NM) with platelet-rich fibrin (PRF) regarding its rehydration protocol with differences in pH values and effect on angiogenesis. MATERIALS AND METHODS NM was analyzed alone and combined with solid PRF by plotting or co-culturing with injectable PRF. Different media (venous blood, buffer solution with a fixed pH value of 7, saline solution, and injectable PRF) were used to analyze the influence on pH value during rehydration. Chorion allantois membrane assay (CAM) was applied to check pro-angiogenic effects after 24, 48, and 72 h, followed by immunohistochemical analysis. RESULTS Rehydration in injectable PRF showed acidity over time (p < 0.05). A definite pro-angiogenic effect of NM alone was found regarding neo-vessel formation supported by the respective light microscopically analysis without significant differences to PRF alone (p > 0.005). This pro-angiogenic effect could not be exaggerated when NM was combined with liquid/solid PRF (each p > 0.005). CONCLUSIONS Rehydration with liquid PRF of the collagen membrane results in acidity compared to a saline solution or patient's blood. The significant pro-angiogenic potential of the membrane alone resulted in enhanced neo-vessel formation that could not be optimized with the addition of PRF. CLINICAL RELEVANCE STATEMENT Using injectable PRF for rehydration protocol of the collagen membrane leads to acidosis that can ultimately optimize wound healing. Differences in the physio-mechanical interplay of collagen matrices and autologous platelet concentrates must result in clinical algorithms if pre-vascularization can maximize outcomes.
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Affiliation(s)
- Saskia-Vanessa Schröger
- Department of Oral and Maxillofacial Surgery-Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
| | - Sebastian Blatt
- Department of Oral and Maxillofacial Surgery-Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Kawe Sagheb
- Department of Prosthodontics University Medical Center Mainz, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery-Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery-Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery-Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
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Valli Veluri S, Gottumukkala SN, Penmetsa GS, Ramesh K, P MK, Bypalli V, Vundavalli S, Gera D. Clinical and patient-reported outcomes of periodontal phenotype modification therapy using injectable platelet rich fibrin with microneedling and free gingival grafts: A prospective clinical trial. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 125:101744. [PMID: 38128879 DOI: 10.1016/j.jormas.2023.101744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND To evaluate the clinical non-inferiority of injectable platelet-rich fibrin and micro-needling (iPRF+MN) with free gingival grafting (FGG) in periodontal phenotype modification therapy. METHODOLOGY Twenty participants with a gingival thickness (GT)<0.8 mm in the mandibular anterior region were included. The participants were randomly allocated into i-PRF+MN and FGG groups. i-PRF injection was done, and MN was done with the help of a lancet in the i-PRF+MN group. The clinical parameters, i.e., GT and Keratinized tissue width (KTW), were evaluated at baseline, 3 and 6 months post-operatively. Patient-reported outcomes (PROs), i.e., discomfort and esthetic satisfaction, were assessed using the visual analogue score(VAS) at one week and 3 months of re-evaluation, respectively. RESULTS Both groups showed a significant increase in GT and KTW with no intergroup variation (P-0.32, 0.48respectively) at the end of 6 months. However, the i-PRF+ MN group showed better PROs, i.e., less discomfort(1.11±0.60) and better esthetic satisfaction(8.77±0.44). CONCLUSION The non-invasive treatment of i-PRF+MN may lead to non-inferior clinical outcomes after 6 months with better PROs compared to more invasive FGG protocols in phenotype modification therapy.
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Affiliation(s)
- Sathya Valli Veluri
- Department of Periodontics and Implantology, Vishnu Dental College, Vishnupur, Bhimavaram, West Godavari, Andhra Pradesh 534202, India
| | - Sruthima Nvs Gottumukkala
- Department of Periodontics and Implantology, Vishnu Dental College, Vishnupur, Bhimavaram, West Godavari, Andhra Pradesh 534202, India.
| | - Gautami S Penmetsa
- Department of Periodontics and Implantology, Vishnu Dental College, Vishnupur, Bhimavaram, West Godavari, Andhra Pradesh 534202, India
| | - Ksv Ramesh
- Department of Periodontics and Implantology, Vishnu Dental College, Vishnupur, Bhimavaram, West Godavari, Andhra Pradesh 534202, India
| | - Mohan Kumar P
- Department of Periodontics and Implantology, Vishnu Dental College, Vishnupur, Bhimavaram, West Godavari, Andhra Pradesh 534202, India
| | - Vivek Bypalli
- Department of Periodontics and Implantology, Vishnu Dental College, Vishnupur, Bhimavaram, West Godavari, Andhra Pradesh 534202, India
| | - Sravanthi Vundavalli
- Department of Periodontics and Implantology, Vishnu Dental College, Vishnupur, Bhimavaram, West Godavari, Andhra Pradesh 534202, India
| | - Dinesh Gera
- Department of Periodontics and Implantology, Vishnu Dental College, Vishnupur, Bhimavaram, West Godavari, Andhra Pradesh 534202, India
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Li H, Xia T, Zeng H, Qiu Y, Wei Y, Cheng Y, Wang Y, Zhang X, Ke J, Miron R, He Q. Liquid platelet-rich fibrin produced via horizontal centrifugation decreases the inflammatory response and promotes chondrocyte regeneration in vitro. Front Bioeng Biotechnol 2023; 11:1301430. [PMID: 38144541 PMCID: PMC10740190 DOI: 10.3389/fbioe.2023.1301430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
Objective: Recently, liquid platelet-rich fibrin (PRF), a rich source of concentrated platelets and growth factors, has emerged as a promising agent for stimulating tissue regeneration. However, its specific efficacy in chondrocyte proliferation and cartilage regeneration remains underexplored. To address this question, we investigated liquid PRF obtained through horizontal centrifugation and compared its effects with hyaluronic acid (HA), a high molecular weight glucosamine supplement widely used in clinical practice to safeguard against chondral damage. Materials and Methods: Liquid PRF, produced using horizontal centrifugation (liquid H-PRF) at 500 g for 8 min, served as our experimental agent. We conducted cell viability and proliferation assays using PRF-conditioned medium. We assessed the chondrocyte phenotype of ATDC5 cells through toluidine blue and alcian blue staining, real-time polymerase chain reaction (RT-PCR), Western blotting, and immunofluorescence staining. Furthermore, we examined the expression of genes involved in inflammation through RT-PCR and Western blot analysis. Results: Liquid H-PRF exerted notable effects on chondrocytes, influencing proliferation, inflammatory responses, and chondrogenic differentiation. The H-PRF group displayed significantly higher expression of chondrogenic markers, including Col2a1, compared to HA-treated cells, whereas aggrecan expression was significantly higher in the HA group. PRF also demonstrated the ability to reduce inflammatory levels in chondrogenic ATDC5 cells, and this effect was further enhanced when PRF from the buffy coat zone was added. In comparison, chondrocytes cultured in the HA group produced significantly fewer inflammatory factors than those in the PRF group, as confirmed qualitatively by Western blot analysis. Conclusion: Liquid H-PRF emerged as a potent stimulator for chondrogenesis and a regulator of the inflammatory response, achieving levels similar to HA. Moreover, liquid H-PRF exhibited strong potential for enhancing the production of cartilage extracellular matrix and promoting chondrogenic regeneration with notably increased Col2a1 levels. Future research should encompass animal studies and human trials to further evaluate the comparative effectiveness of liquid PRF versus HA, potentially as an alternative or complementary strategy for future clinical applications.
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Affiliation(s)
- Huimin Li
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Ting Xia
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hao Zeng
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yun Qiu
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yan Wei
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yihong Cheng
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yulan Wang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xiaoxin Zhang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jin Ke
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Richard Miron
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Qing He
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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Liu M, Liu Y, Luo F. The role and mechanism of platelet-rich fibrin in alveolar bone regeneration. Biomed Pharmacother 2023; 168:115795. [PMID: 37918253 DOI: 10.1016/j.biopha.2023.115795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/21/2023] [Accepted: 10/26/2023] [Indexed: 11/04/2023] Open
Abstract
Platelet-rich fibrin (PRF), as an autologous blood preparation, has been receiving increasing attention in recent years and has been successfully applied in various clinical treatments for alveolar bone regeneration in the oral field. This review focuses on analyzing and summarizing the role and mechanism of PRF in alveolar bone regeneration. We first provide a brief introduction to PRF, then summarize the mechanisms by which PRF promotes alveolar bone regeneration from three aspects: osteogenesis mechanism, bone induction mechanism, and bone conduction mechanism, involving multiple signaling pathways such as Smad, ERK1/2, PI3K/Akt, and Wnt/β-catenin. We also explore the various roles of PRF as a scaffold, filler, and in combination with bone graft materials, detailing how PRF promotes alveolar bone regeneration and provides a wealth of experimental evidence. Finally, we summarize the current applications of PRF in various oral fields. The role of PRF in alveolar bone regeneration is becoming increasingly important, and its role and mechanism are receiving more and more research and understanding. This article will provide a reference of significant value for research in related fields. The exploration of the role and mechanism of PRF in alveolar bone regeneration may lead to the discovery of new therapeutic targets and the development of more effective and efficient treatment strategies.
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Affiliation(s)
- Ming Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yu Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Feng Luo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
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17
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Cl K, Jeyaraman M, Jeyaraman N, Ramasubramanian S, Khanna M, Yadav S. Antimicrobial Effects of Platelet-Rich Plasma and Platelet-Rich Fibrin: A Scoping Review. Cureus 2023; 15:e51360. [PMID: 38292974 PMCID: PMC10825076 DOI: 10.7759/cureus.51360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2023] [Indexed: 02/01/2024] Open
Abstract
Platelet-rich plasma (PRP), derived from the centrifugation and subsequent separation of whole blood, results in an unusually high concentration of platelets. A newer form of platelet concentrate, platelet-rich fibrin (PRF), has also been developed. There has been significant research into the therapeutic effects of PRP, particularly in enhancing wound healing and preventing infections in surgical wounds. This scoping review aims to thoroughly evaluate preclinical and clinical evidence regarding the antimicrobial effects of PRP and PRF. In conducting this review, 612 records were examined, and 36 articles were selected for inclusion. The studies reviewed include preclinical research, such as in-vitro and in-vivo studies, and clinical trials involving human participants. The current clinical evidence suggests a notable trend towards the antimicrobial capabilities of PRP and PRF, underscoring their potential benefits in treating wounds. The application of PRP and PRF in wound management shows encouraging outcomes, but further investigation is needed to optimize their use as antimicrobial agents. Additional research, particularly randomized controlled trials, is essential to substantiate their antimicrobial effectiveness in specific diseases and types of wounds, considering their potential impact on clinical results.
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Affiliation(s)
- Karan Cl
- Orthopaedics, Sanjay Gandhi Institute of Trauma & Orthopaedics, Bengaluru, IND
| | - Madhan Jeyaraman
- Orthopaedics, ACS Medical College and Hospital, Dr. MGR Educational and Research Institute, Chennai, IND
| | - Naveen Jeyaraman
- Orthopaedics, ACS Medical College and Hospital, Dr. MGR Educational and Research Institute, Chennai, IND
| | | | - Manish Khanna
- Orthopaedics, Autonomous State Medical College, Ayodhya, IND
| | - Sankalp Yadav
- Internal Medicine, Shri Madan Lal Khurana Chest Clinic, New Delhi, IND
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18
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Wu Q, Yu S, Wang Y, Zhang X. Effect of thermal manipulation on the biological and mechanical characteristics of horizontal platelet rich fibrin membranes. BMC Oral Health 2023; 23:956. [PMID: 38041031 PMCID: PMC10693106 DOI: 10.1186/s12903-023-03412-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 09/12/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUD Regardless of application scenarios, proper mechanical characteristics and degradation properties are prerequisites for horizontal platelet rich fibrin (H-PRF) to manifest its ability. Among the methods used to modify PRF, thermal manipulation is promising as it is easy to handle without adding extra additives. Yet there is no consensus on optimal temperature treatment. This study aimed to investigate the effects of heating on the biological and mechanical characteristics of H-PRF and explore the optimum heating temperature for H-PRF thermal treatment. METHODS We employed a series of temperature gradients, room temperature, 50℃, 75℃, 90℃, 105℃. The microstructure and the mechanical properties were recorded by Scanning Electron Microscope (SEM) and tensile strength tests respectively. The degradation rate of H-PRF membranes was examined by digestion assay with plasmin and trypsin. The viability of cells within H-PRF membranes and the proliferation of osteoblasts cultured with extracts from different H-PRF groups was evaluated using CCK-8 assays. RESULTS Compared with the nonheated group, overheated manipulation beyond 90℃ can significantly prolong the degradation properties for up to 3 to 4 weeks and enhance the mass stress of H-PRF membranes. A high-temperature treatment of 105℃ accompanied by the cell activity beneath H-PRF reduced more than half, and thus, the biological effect on human osteoblasts (hFOBs) also reduced dramatically. CONCLUSIONS High thermal manipulation can prolong the degradation properties and enhance the mechanical properties of PRF membranes accompanied by the loss of biological effect.
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Affiliation(s)
- Qian Wu
- Department of Stomatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430079, China
| | - Shimin Yu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Yulan Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Xiaoxin Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China.
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Albahrawy M, Abass M, Mosbah E, Karrouf G, Awadin W, Zaghloul A. Reinforcement of colon anastomosis healing with leukocyte platelet-rich fibrin in rabbit model. Life Sci 2023; 333:122146. [PMID: 37802197 DOI: 10.1016/j.lfs.2023.122146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/25/2023] [Accepted: 10/03/2023] [Indexed: 10/08/2023]
Abstract
AIM This study investigated the regenerative efficacy of leukocyte platelet-rich fibrin (L-PRF) on colon anastomotic healing in rabbits. MAIN METHODS Thirty-six healthy male white New Zealand rabbits were subjected to complete transactions of the ascending colon. The rabbits were equally divided into two groups: the control group, where the transected colon ends were anastomosed by a simple interrupted suture pattern, and the L-PRF-treated group, in which L-PRF was wrapped entirely around the anastomotic line. The postoperative acute pain scale was assessed using the Bristol Rabbit Pain Scale before surgery and at each four-hour interval post-operatively. After euthanizing the rabbits, the adhesion degree score, anastomotic bursting pressure, and stenosis degree of the anastomotic colon were assessed, and histopathological examination at the 7th, 14th, and 28th days postoperatively. KEY FINDINGS Rabbits in both groups showed a significant increase in pain scores compared to baseline. Postoperatively, the L-PRF group exhibited significantly lower pain scores, adhesion scores, and stenosis degrees than the control group. However, the anastomotic bursting pressure was significantly higher in the L-PRF group. Re-epithelialization, polymorphonuclear neutrophil infiltration, granulation tissue formation, and collagen deposition scores were improved considerably in the L-PRF group compared to the control group. Immunostaining of growth factor expression was significantly lower in the control than in the L-PRF group. SIGNIFICANCE The L-PRF can augment collagen deposition, re-epithelialize the mucosa, promote angiogenesis, reduce adhesions, and diminish the stenosis degree scores. Therefore, it can be considered a promising aid in healing bowel anastomoses.
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Affiliation(s)
- Mohammed Albahrawy
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Marwa Abass
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt.
| | - Esam Mosbah
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Gamal Karrouf
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Walaa Awadin
- Department of Pathology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Adel Zaghloul
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
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Salgado-Peralvo ÁO, Kewalramani N, Pérez-Jardón A, Pato-Mourelo J, Castro-Calderón A, Arriba-Fuente L, Pérez-Sayáns M. Understanding Solid-Based Platelet-Rich Fibrin Matrices in Oral and Maxillofacial Surgery: An Integrative Review of the Critical Protocol Factors and Their Influence on the Final Product. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1903. [PMID: 38003952 PMCID: PMC10673335 DOI: 10.3390/medicina59111903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/20/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023]
Abstract
Platelet-rich fibrin (PRF) is a second-generation platelet concentrate whose use in clinical practice has been widely disseminated. This has led to the development of several commercial protocols, creating great confusion as to the terminology and implications of each of them. This integrative review aims to identify the critical factors of each of the phases of the solid-based PRF matrix protocol and their possible influence on their macro- and microscopic characteristics. An electronic search of the MEDLINE database (via PubMed), Web of Science, Scopus, LILACS, and OpenGrey was carried out. The search was temporarily restricted from 2001 to 2022. After searching, 43 studies were included that met the established criteria. There were numerous factors to consider in the PRF protocol, such as the material of the blood collection tubes, the duration of phlebotomy, the parameters related to blood centrifugation, the time from centrifugation to dehydration of the fibrin clots and their dehydration into membranes, as well as the time to clinical use. These factors influenced the macro- and microscopic characteristics of the PRF and its physical properties, so knowledge of these factors allows for the production of optimised PRF by combining the protocols and materials.
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Affiliation(s)
- Ángel-Orión Salgado-Peralvo
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-C.); (L.A.-F.)
| | - Naresh Kewalramani
- Department of Nursery and Stomatology, Rey Juan Carlos University, 28922 Madrid, Spain;
| | - Alba Pérez-Jardón
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.P.-J.); (J.P.-M.)
| | - Jesús Pato-Mourelo
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.P.-J.); (J.P.-M.)
| | - Adriana Castro-Calderón
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-C.); (L.A.-F.)
| | - Lorenzo Arriba-Fuente
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-C.); (L.A.-F.)
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.P.-J.); (J.P.-M.)
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21
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Ucer C, Khan RS. Alveolar Ridge Preservation with Autologous Platelet-Rich Fibrin (PRF): Case Reports and the Rationale. Dent J (Basel) 2023; 11:244. [PMID: 37886929 PMCID: PMC10605266 DOI: 10.3390/dj11100244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
In dental implantology, alveolar ridge preservation (ARP) has emerged as a standard technique to address dimensional changes that affect alveolar ridge morphology following tooth loss. Various alternative graft materials, including xenografts, alloplasts, and allografts, have been effectively employed in fresh extraction sites for ARP. Current evidence suggests that these materials primarily serve as bio-scaffolds, which are slowly incorporated, thus necessitating a waiting period of at least 4-6 months before implant placement. Consequently, the ARP technique extends the overall duration of implant treatment by several months. Recently, the incorporation of a form of autologous platelet concentrate, known as platelet-rich fibrin (PRF), has been advocated in conjunction with ARP as a method of bioenhancement of soft- and hard-tissue healing and regeneration. PRF contains platelet-derived growth factors, hormones, and bioactive components like cytokines that have demonstrated the ability to stimulate angiogenesis and tissue regeneration throughout all phases of wound healing. Additionally, the concentration of leukocytes present in the PRF matrix plays a vital role in tissue healing and regeneration as part of the osteoimmune response. The reported advantages of incorporating autogenous PRF platelet concentrates during ARP encompass reduced healing time, improved angiogenesis and bone regeneration, socket sealing through the fibrin matrix, antibacterial properties, and decreased post-extraction pain and infection risk. Therefore, the objective of this paper is to review the existing evidence regarding the application of PRF in alveolar ridge preservation (ARP) following tooth extraction. Two clinical case studies are presented, wherein ARP was enhanced with PRF, followed by implant placement within a relatively short period of 8 weeks. These cases serve as further proof of concept for supporting the adjuvant use of PRF to enhance healing and accelerate implant placement after ARP.
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Affiliation(s)
| | - Rabia S. Khan
- I.C.E Postgraduate Dental Institute, University of Salford, Manchester M5 4WT, UK;
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Albatal W, Qasem T, Tolibah YA. Liquid platelet-rich fibrin in root surface biomodification during gingival recession treatment: Randomized, controlled, split-mouth, clinical trial. Clin Exp Dent Res 2023; 9:772-782. [PMID: 37165467 PMCID: PMC10582228 DOI: 10.1002/cre2.747] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/27/2023] [Accepted: 04/28/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Free gingival graft (FGG) has been successfully used in the treatment of gingival recessions, as it is the most predictable technique for increasing the attached gingiva. This study aimed to evaluate the effect of liquid platelet-rich fibrin (PRF) with FGG on root surface coverage as root surface biomodification. MATERIALS AND METHODS The research sample consisted of 32 surgical sites in 16 patients, they had 2 bilateral recessions in the incisor area of the same dental arch, the sample was divided into 2 groups randomly, and liquid PRF was applied in the first group with the FGG (experimental group), and in the second group the FGG was applied alone (control group). Gingival recession depth (RD) and width of attached gingiva (WAG) were measured before starting, after 1, 3, and 6 months. The percentage of root coverage (RC) was calculated after 6 months. Healing Index (HI) was recorded after 1 week, 2 weeks, and 1 month. RESULTS Both groups showed a reduction in gingival RD during all follow-up periods but the difference between both groups was not statistically significant (p > 0.05) at 1 and 3 months, whereas there were significant differences at 6 months (p = 0.001). RC was better in the liquid PRF group than in the control group, but this difference was not statistically significant (p > 0.05). The postoperative 7th and 14th days HI scores of the liquid PRF group were significantly better than the control group (p = 0.000 and p = 0.004, respectively), whereas there were no significant differences in HI scores between both groups at first month (p > 0.05). CONCLUSIONS According to the results, the addition of liquid PRF to the root surface with FGG showed further development in terms of decreasing RD, increasing WAG, and accelerated wound-healing.
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Affiliation(s)
- Wajeha Albatal
- Department of Periodontology, Faculty of DentistryDamascus UniversityDamascusSyria
| | - Tarek Qasem
- Department of Periodontology, Faculty of DentistryDamascus UniversityDamascusSyria
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23
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Quirynen M, Siawasch S, Temmerman A, Cortellini S, Dhondt R, Teughels W, Castro AB. Do autologous platelet concentrates (APCs) have a role in intra-oral bone regeneration? A critical review of clinical guidelines on decision-making process. Periodontol 2000 2023; 93:254-269. [PMID: 37845802 DOI: 10.1111/prd.12526] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 07/05/2023] [Accepted: 08/15/2023] [Indexed: 10/18/2023]
Abstract
In the past decades, personalized regenerative medicine has gained increased attention. Autologous platelet concentrates (APCs) such as PRP, PRGF, and L-PRF, all serving as a source of a large variety of cells and growth factors that participate in hard and soft tissue healing and regeneration, could play a significant role in regenerative periodontal procedures. This narrative review evaluated the relative impact of APCs in alveolar ridge preservation, sinus floor augmentation, and the regeneration of bony craters around teeth, both as a single substitute or in combination with a xenograft. L-PRF has a significant beneficial effect on alveolar ridge preservation ( bone quality). The data for PRGF are less convincing, and PRP is controversial. L-PRF can successfully be used as a single substitute during transcrestal (≥3.5 mm bone gain) as well as 1-stage lateral window sinus floor elevation (>5 mm bone gain). For PRGF and especially PRP the data are very scarce. In the treatment of bony craters around teeth, during open flap debridement, L-PRF as a single substitute showed significant adjunctive benefits (e.g., >PPD reduction, >CAL gain, >crater depth reduction). The data for PRP and PRGF were non-conclusive. Adding PRP or L-PRF to a xenograft during OFD resulted in additional improvements (>PPD reduction, >CAL gain, >bone fill), for PRGF no data were found. Autologous platelet concentrates demonstrated to enhance bone and soft tissue healing in periodontal regenerative procedures. The data for L-PRF were most convincing. L-PRF also has the advantage of a greater simplicity of production, and its 100% autologous character.
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Affiliation(s)
- Marc Quirynen
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Sam Siawasch
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Andy Temmerman
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Simone Cortellini
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Rutger Dhondt
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Anna B Castro
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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Baadsgaard Bruun L, Waskiw Hardon TA, Havnsøe Krogh AK, Qvortup K, Heegaard S, Thuri Kristensen A, Henriksen MDL. The use of a "horizontal centrifugation protocol" to prepare autologous platelet-rich fibrin membranes for corneal reconstruction surgery in dogs with complicated corneal ulcerations: A case series. Vet Ophthalmol 2023. [PMID: 37721981 DOI: 10.1111/vop.13148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE The purpose of this case series was to describe the effect of autologous PRF membrane for corneal reconstruction surgery in dogs. PRF membranes made from two healthy dogs unrelated to the current case series were used for PRF histologic analyses. ANIMALS Seven dogs with complicated corneal ulcerations. PROCEDURE A complete ophthalmic examination, hematology, and fibrinogen analysis were performed pre-surgery. A PRF clot was made from autologous blood in a serum tube after centrifugation in a horizontal Bio-PRF® Centrifuge at 700 × g for 8 min. The PRF clot was processed in a PRF-Box® into a PRF membrane. The PRF membrane was sutured to the corneal ulcer bed. Each dog had a follow-up at days 5-7, 12-14, and 30-40 post-surgery. A final long-term follow-up was performed as well. RESULTS A positive outcome with healing and a "good" quality PRF membrane was seen in six out of seven dogs. One dog had a fibrinogen level below normal range and the PRF membrane was of "poor" quality. This dog developed a descemetocele 13 days post-surgery and needed rescue surgery. Mean healing time for all dogs was 9 ± 5.5 days. Minimal scarring, corneal pigmentation, and vascularization were observed at the final long-term follow-up 288 ± 44 days post-surgery. CONCLUSION PRF membrane was successful as graft material for corneal ulceration reconstruction surgery. Low fibrinogen appeared to have negative effect on the quality of the PRF membrane, showing the importance for the surgeon to evaluate the quality of the PRF membrane prior to surgery.
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Affiliation(s)
- Louise Baadsgaard Bruun
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Anicura Aarhus Veterinary Hospital, Aarhus, Denmark
| | - Tommy A Waskiw Hardon
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Haslev Veterinary Clinic, Haslev, Denmark
| | - Anne K Havnsøe Krogh
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Qvortup
- Departmnent of Biomedical Science, Core Facility for Integrated Microscopy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Heegaard
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Annemarie Thuri Kristensen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michala de Linde Henriksen
- Comparative Ophthalmology, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
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25
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Yu S, Bd YT, Bd YW, Bd MF, BMed SL, BMed GT, BMed ZY, Miron RJ, Zhang Y, Yang Z, Wang Y. Early tissue and healing responses after maxillary sinus augmentation using horizontal platelet rich fibrin bone blocks. BMC Oral Health 2023; 23:589. [PMID: 37620826 PMCID: PMC10463479 DOI: 10.1186/s12903-023-03228-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/14/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND The effects of horizontal platelet-rich fibrin (H-PRF) bone block on the healing and immune response during sinus augmentation have not been fully investigated histologically at early time points. METHODS Eighteenth male New Zealand white rabbits underwent bilateral sinus augmentation and were divided into two groups: deproteinized bovine bone mineral (DBBM) alone and H-PRF + DBBM (H-PRF bone block) group. Maxilla samples were collected at 3, 7 and 14 days post sinus augmentation procedures and analyzed using histological staining for the number of inflammatory cells, new blood vessels and evidence for early osteoclast bone turnover/remodeling. Furthermore, the effects of H-PRF bone blocks on the migration of osteoblasts and THP-1 macrophages were evaluated using a Transwell assay in vitro. RESULTS A higher number of immune cells were found in the H-PRF bone block group at 3 and 7 days post-surgery when compared to the DBBM alone group,most notably in the regions close to the mucosal lining and bone plates. Furthermore, a significantly greater number of new blood vessel formations and early signs of osteoclast development were found in the H-PRF bone block group at 14 days. The in vitro transwell assay further confirmed that culture medium from H-PRF bone block markedly promote the migration of osteoblasts and THP-1 macrophages. CONCLUSIONS The findings from this study have shown that H-PRF bone block is capable of increasing early immune cell infiltration leading to the acceleration of neovascularization and speeding the process of bone metabolism in vivo following maxillary sinus grafting with DBBM.
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Affiliation(s)
- Shimin Yu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Yinping Tian Bd
- Department of Stomatology, The Central Hospital of Enshi Tujia and Miao Autonomous Perfecture, Enshi, 445000, China
| | - Yan Wei Bd
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Mengge Feng Bd
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Sensen Li BMed
- Department of Stomatology, The Central Hospital of Enshi Tujia and Miao Autonomous Perfecture, Enshi, 445000, China
| | - Guoyong Tong BMed
- Department of Stomatology, The Central Hospital of Enshi Tujia and Miao Autonomous Perfecture, Enshi, 445000, China
| | - Zhouqing Yu BMed
- Department of Stomatology, The Central Hospital of Enshi Tujia and Miao Autonomous Perfecture, Enshi, 445000, China
| | - Richard J Miron
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Yufeng Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
- Medical Research Institute, School of Medicine, Wuhan University, Wuhan, 430071, China
| | - Zaibo Yang
- Department of Stomatology, The Central Hospital of Enshi Tujia and Miao Autonomous Perfecture, Enshi, 445000, China.
| | - Yulan Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China.
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26
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Hunger S, Krennmair S, Krennmair G, Otto S, Postl L, Nadalini DM. Platelet-rich fibrin vs. buccal advancement flap for closure of oroantral communications: a prospective clinical study. Clin Oral Investig 2023; 27:2713-2724. [PMID: 36607489 PMCID: PMC10264294 DOI: 10.1007/s00784-022-04846-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/26/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The primary aim was to evaluate the success of the defect closure (tight or open) of oroantral communications (OAC) after treatment with platelet-rich fibrin (PRF) clots or a buccal advancement flap (BAF). Secondary outcome measurements were the evaluation of the wound healing, the displacement of the mucogingival border (MGB), and the pain level. MATERIAL AND METHODS Fifty eligible patients with an OAC defect larger than 3 mm were randomly assigned to either PRF (test group, n = 25) or BAF (control group, n = 25) for defect closure. In a prospective follow-up program of 21 days, the defect closure healing process, the wound healing course using Landry's wound healing index (score: 0-5), the displacement of the MGB, and the postoperative pain score were evaluated. RESULTS Five patients in each group were lost to follow-up resulting in 40 patients (20 in each group) for continuous evaluation. On postoperative day 21 (study endpoint), no difference regarding success rate (defined as closure of OAC) was noticed between the test (90%; 18/20) and control group (90%; 18/20). A univariate analysis showed significant differences for age and defect size/height for the use of PRF between successful-tight and open-failed defect healing. At the final evaluation, a significantly (p = 0.005) better wound healing score, a lower displacement of the MGB as well as lower pain-score were seen for the use of PRF. CONCLUSIONS Based on the findings of the current study, the use of platelet-rich fibrin represents a reliable and successful method for closure of oroantral communications. The use of PRF clots for defect filling is associated with lowered pain levels and less displacement of the mucogingival border. CLINICAL RELEVANCE The defect size should be taken into account when choosing the number and size of PRF plugs.
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Affiliation(s)
- Stefan Hunger
- Medical Faculty, Johannes Kepler University Linz, Altenberger Strasse 69, 4040, Linz, Austria
- Clinic of Oral and Maxillofacial Surgery, Kepler University Hospital, Johannes Kepler University, Krankenhausstraße 7a, Linz, Austria
| | - Stefan Krennmair
- Medical Faculty, Johannes Kepler University Linz, Altenberger Strasse 69, 4040, Linz, Austria
- NumBioLab, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Gerald Krennmair
- Head of Department of Prosthodontics, Sigmund Freud University Vienna, Freudplatz 1, 1020, Vienna, Austria
| | - Sven Otto
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University Munich, Lindwurmstr. 2a, 80337, Munich, Germany
| | - Lukas Postl
- Medical Faculty, Johannes Kepler University Linz, Altenberger Strasse 69, 4040, Linz, Austria.
- NumBioLab, Ludwig-Maximilians University of Munich, Munich, Germany.
| | - Danilo-Marc Nadalini
- Clinic of Oral and Maxillofacial Surgery, Kepler University Hospital, Johannes Kepler University, Krankenhausstraße 7a, Linz, Austria
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Albatal W, Qasem T, Tolibah YA. Evaluation of the Effect of Injectable Platelet-rich Fibrin on Palatal Wound Healing: A Two-arm Randomized Controlled Clinical Trial. J Contemp Dent Pract 2023; 24:214-220. [PMID: 37469259 DOI: 10.5005/jp-journals-10024-3496] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
AIM This study aimed to evaluate the effect of injectable platelet-rich fibrin (i-PRF) as a potential catalyst for the acceleration of palatal wound healing after subepithelial connective tissue graft (SCTG) harvesting. MATERIALS AND METHODS Referred patients to the Department of Periodontology with the complication of the gingival recession were examined. Thirty participants were chosen for root coverage surgeries with SCTGs, and randomly distributed into two groups; the study group (n = 15) with i-PRF was applied, and the control group (n = 15) without i-PRF. The wound healing index was evaluated on the 7th, 14th, and 30th days of the treatment. Palatal tissue thickness was measured before the treatment and at the 1st, 2nd, and 3rd months after the treatment. RESULTS The study group improved significantly the early healing over the control group on days 7 and 14 (p < 0.01), whereas no difference in the first month (p > 0.05) between the groups. Moreover, the study group showed higher tissue thickness mean in the first and second month (p < 0.01), but in the third month, there were no significant differences (p > 0.05) between both groups. CONCLUSION The i-PRF has favorable effects on the healing process by enhancing wound healing and increasing the tissue thickness in the palate after SCTG harvesting. CLINICAL SIGNIFICANCE For clinicians, it is important to know that we can use biological materials to accelerate healing in general, such as i-PRF. In this study, we used it in the palate, which may accelerate the healing so that we can repeatedly use the same area of the patient's palate for more than one occasion faster.
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Affiliation(s)
- Wajeha Albatal
- Department of Periodontology, Faculty of Dentistry, Damascus, University, Damascus, Syria
| | - Tarek Qasem
- Department of Periodontology, Faculty of Dentistry, Damascus, University, Damascus, Syria
| | - Yasser Alsayed Tolibah
- Department of Pediatric Dentistry, Faculty of Dentistry, Damascus, University, Damascus, Syria, Phone: +00963988812044, e-mail: yasseralsayedtolibah@gmail, Orcid: https://orcid.org/0000-0001-5498-9991
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28
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Alshoiby MM, Fawzy El-Sayed KM, Elbattawy W, Hosny MM. Injectable platelet-rich fibrin with demineralized freeze-dried bone allograft compared to demineralized freeze-dried bone allograft in intrabony defects of patients with stage-III periodontitis: a randomized controlled clinical trial. Clin Oral Investig 2023:10.1007/s00784-023-04954-y. [DOI: 10.1007/s00784-023-04954-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/17/2023] [Indexed: 04/03/2023]
Abstract
Abstract
Aim
The current randomized controlled clinical trial assessed the effect of injectable platelet-rich fibrin (I-PRF) combined with demineralized freeze-dried bone allograft (DFDBA) compared to DFDBA alone in the management of intrabony defects of stage-III periodontitis patients.
Methodology
Following sample size calculation, twenty stage-III periodontitis patients with ≥ 5 mm clinical attachment level (CAL)-loss and ≥ 3 mm intrabony defects were randomized into test (I-PRF + DFDBA; n = 10) and control (DFDBA; n = 10) groups. CAL (primary outcome), periodontal probing depth (PPD), gingival recession depth (GRD), full-mouth plaque scores (FMPS), full-mouth bleeding scores (FMBS), radiographic linear defect depth (RLDD), and bone fill (secondary outcomes) were examined at baseline, 3, 6, and 9 months post-surgically.
Results
I-PRF + DFDBA and DFDBA independently demonstrated significant intragroup CAL-gain, PPD-, and RLDD-reduction at 3, 6, and 9 months (p < 0.05), with no significant intergroup differences observed (p > 0.05). CAL-gain (mean ± SD) of 2.40 ± 0.70 mm and 2.50 ± 0.85 mm and PPD-reduction of 3.50 ± 1.18 mm and 2.80 ± 0.42 mm were demonstrated for I-PRF + DFDBA and DFDBA at 9 months respectively. Both groups showed significant intragroup RLDD improvement, with a RLDD of 3.58 ± 0.66 mm and 3.89 ± 1.57 mm for I-PRF + DFDBA and DFDBA at 9 months respectively. Stepwise linear regression analysis revealed that baseline RLDD and bone fill at 9 months were significant predictors of CAL (p < 0.05).
Conclusion
Within the present study’s limitations, DFDBA with or without I-PRF resulted in significant improvement in clinical and radiographic periodontal parameters in the surgical treatment of periodontal intrabony defects of stage-III periodontitis patients. Addition of I-PRF to DFDBA does not appear to significantly enhance the DFDBA’s reparative/regenerative outcomes.
Clinical relevance
Within the current study’s limitations, routinely adding I-PRF to DFDBA cannot be recommended to significantly improve DFDBA’s treatment outcomes in intrabony defects.
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Kosmidis K, Ehsan K, Pitzurra L, Loos B, Jansen I. An in vitro study into three different PRF preparations for osteogenesis potential. J Periodontal Res 2023; 58:483-492. [PMID: 36942454 DOI: 10.1111/jre.13116] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/21/2023] [Accepted: 03/01/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVE To investigate the effect of Advanced Platelet-Rich Fibrin (A-PRF+), Leukocyte Platelet-Rich Fibrin (L-PRF), and injectable Platelet-Rich Fibrin (i-PRF) on osteogenesis of a human osteoblast-like cell line in vitro. BACKGROUND Different PRF protocols are used in clinical dentistry in the last years. Recent literature documented the positive impact of PRF derivatives in vivo and in vitro, on different types of cells. However, hardly any literature comparing the new protocols for PRF (the A-PRF+ and i-PRF) with the original protocol of PRF (L-PRF) is present for osteoblast-like cells. MATERIALS AND METHODS A-PRF+, L-PRF, and i-PRF were prepared from six male donors and pre-cultured with 10 mL culture medium for 6 days. 5 x 103 cells/ml osteoblasts from the osteoblast cell line (U2OS) were seeded and cultured either with conditioned medium derived from the different PRF conditions or with regular culture medium. At five different time points (0, 7, 14, 21, 28 days), the osteogenic capacity of the cells was assessed with Alizarin Red S to visualize mineralization. Also in these cells, the calcium concentration and alkaline phosphatase activity were investigated. Using qPCR, the expression of alkaline phosphatase, osteocalcin, osteonectin, ICAM-1, RUNX-2, and collagen 1a was assessed. RESULTS In osteoblast-like cells cultured with conditioned medium, the A-PRF+ conditioned medium induced more mineralization and calcium production after 28 days of culturing compared with the control (p < .05). No significant differences were found in the extent of cell proliferation between the different conditions. RUNX-2 and osteonectin mRNA expression in the cells were lower in all PRF-stimulated cultures compared with control at different time points. The i-PRF-conditioned medium induced more ALP activity (p < .05) compared with control and osteoblasts-like cells differentiated more compared with osteoblasts cultured with L-PRF. CONCLUSIONS The three PRF preparations seem to have the capacity to increase the osteogenic potential of osteoblast-like cells. A-PRF+ seems to have the highest potential for mineralization, while i-PRF seems to have the potential to enhance early cell differentiation.
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Affiliation(s)
- Kostantinos Kosmidis
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Karishma Ehsan
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Luciano Pitzurra
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bruno Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ineke Jansen
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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30
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Manasa B, Baiju KV, Ambili R. Efficacy of injectable platelet-rich fibrin (i-PRF) for gingival phenotype modification: a split-mouth randomized controlled clinical trial. Clin Oral Investig 2023:10.1007/s00784-023-04943-1. [PMID: 36920546 DOI: 10.1007/s00784-023-04943-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/06/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVES Gingival phenotype is decisive in periodontal health, aesthetics, and function and is a predictor of treatment outcomes. Injectable platelet-rich fibrin is a recently proposed method of gingival augmentation due to its enhanced regenerative potential. The objective of the present study was to evaluate the efficacy of injectable platelet-rich fibrin for gingival phenotype modification. MATERIALS AND METHODS In this split-mouth study, 30 healthy volunteers with thin gingival biotypes in either maxillary or mandibular incisors were included. iPRF was prepared using 64 g relative centrifugal force for 3 min. i-PRF was injected into the attached gingiva using a 27-gauge disposable needle in relation to the test sites (n = 360), and contralateral sites were kept as control. Re-evaluation was done at the end of 3 and 6 months. Post-operative complications and patient-reported experience measures were also recorded. Statistical analysis was done using paired t-test and analysis of covariance. RESULTS Statistically significant increase in gingival thickness was found in the test group at the individual site and tooth level. An overall increase in gingival thickness of 26.56% after 3 months and 29% after 6 months compared to baseline was noticed in the test group. No significant difference was found in the width of keratinized gingiva in any of the comparisons. CONCLUSION The non-surgical application of i-PRF is promising for enhancing gingival thickness. Future well-controlled studies with long-term follow-up in different patient populations can provide more evidence. CLINICAL RELEVANCE Gingival phenotype modification is a useful therapy to prevent the occurrence of gingival recession in patients with thin phenotypes. TRIAL REGISTRATION Clinical Trial Registration Number: CTRI/2021/04/032650.
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Affiliation(s)
- Budhan Manasa
- Department of Periodontics, PMS College of Dental Sciences and Research, Trivandrum, Kerala, India
| | - K V Baiju
- Department of Statistics, Government College for Women, Trivandrum, Kerala, India
| | - R Ambili
- Department of Periodontics, PMS College of Dental Sciences and Research, Trivandrum, Kerala, India.
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31
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Ye L, Mashrah MA, Ge L, Fang Y, Guo X, Ge Q, Wang L. Network meta-analysis of platelet-rich fibrin in periodontal intrabony defects. J Oral Pathol Med 2023; 52:206-215. [PMID: 36793244 DOI: 10.1111/jop.13409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/08/2023] [Accepted: 01/23/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVES To evaluate the effect of platelet-rich fibrin alone or in combination with different biomaterials for the treatment of periodontal intra-bony defect. METHODS Up to April 2022, Cochrane library, Medline, EMBASE, and Web of Science databases were searched for randomized clinical trials. The outcomes of interest were probing pocket depth reduction, clinical attachment level gain, bone gain, and bone defect depth reduction. Bayesian network meta-analysis with 95% credible intervals was calculated. RESULTS Thirty-eight studies with 1157 participants were included. Platelet-rich fibrin alone or platelet-rich fibrin +biomaterials showed a statistically significant difference when compared with open flap debridement (p < 0.05, low to high certainty evidence). Neither biomaterials alone nor platelet-rich fibrin +biomaterials showed a statistically significant difference when compared to platelet-rich fibrin alone (p > 0.05, very low to high certainty evidence). Platelet-rich fibrin +biomaterials showed insignificant differences as compared to biomaterials alone (p > 0.05, very low to high certainty evidence). Allograft +collagen membrane ranked the best in probing pocket depth reduction while platelet-rich fibrin +hydroxyapatite ranked the best in bone gain. CONCLUSION It seems that (1) platelet-rich fibrin with/without biomaterials were more effective than open flap debridement. (2) Platelet-rich fibrin alone provides a comparable effect to biomaterials alone and platelet-rich fibrin +biomaterials. (3) Platelet-rich fibrin +biomaterials provide a comparable effect to biomaterials alone. Although allograft +collagen membrane and platelet-rich fibrin +hydroxyapatite ranked the best in terms of probing pocket depth reduction and bone gain respectively, the difference between different regenerative therapies remains insignificant, and therefore, further studies are still needed to confirm these results.
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Affiliation(s)
- Lianmei Ye
- Department of Oral Implant, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
- Department of Stomatology, Dongguan TungWah Hospital, Dongguan, Guangdong, China
| | - Mubarak Ahmed Mashrah
- Department of Oral Implant, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Linhu Ge
- Department of Oral Implant, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Ying Fang
- Department of Oral Implant, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Xueqi Guo
- Department of Oral Implant, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Qing Ge
- Department of Oral Implant, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Liping Wang
- Department of Oral Implant, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
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Torkzaban P, Rabienejad N, Cheraghi Z, Lahoorpoor K. Effectiveness of using platelet-rich fibrin to increase keratinized tissue around the tooth in the modified apical reposition flap method: A split-mouth, randomized controlled trial. Clin Exp Dent Res 2023; 9:36-44. [PMID: 36424485 PMCID: PMC9932240 DOI: 10.1002/cre2.693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 09/12/2022] [Accepted: 11/03/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES One of the simplest methods to increase keratinized gingiva is the modified apically repositioned flap (MARF) technique. In this method, the periosteum remains exposed, which may lead to postoperative pain and discomfort. In the presence of bone dehiscence, bone resorption and gingival recession may occur. Hence, this study aims to use platelet-rich fibrin (PRF) to promote wound healing in the MARF technique and overcome its disadvantages. MATERIAL AND METHODS In this randomized controlled trial study, 10 patients (six males and four females with a mean age of 33.9 ± 11.13) with less than 2 mm of attached gingiva bilaterally were treated by the MARF + PRF membrane (test group), on the one hand, whereas, on the other hand, it was treated only by MARF (control group). Clinical parameters of keratinized gingiva include thickness, width, and vestibule depth before and 8 weeks after the intervention were measured. RESULTS The attached gingival width increased significantly in both groups (1.7 mm in the MARF and 2.3 mm in the PRF) and this was greater in the PRF group (p < .05). Gingival thickness in the PRF method was significantly higher than in the control group (p < .05). Probe depth, vestibular depth, and postoperative pain were not different in both groups. Wound shrinkage in the MARF group (51%) was significantly higher than in the PRF group (30%) (p < .05). CONCLUSION Using PRF with the MARF method significantly increased the width and thickness of the gingiva and reduced shrinkage compared to MARF only. Postoperative pain and vestibular depth changes were similar in both groups.
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Affiliation(s)
- Parviz Torkzaban
- Department of Periodontology, Faculty of DentistryHamadan University of Medical SciencesHamadanIran
| | - Nazli Rabienejad
- Department of Periodontology, Faculty of DentistryHamadan University of Medical SciencesHamadanIran
| | - Zahra Cheraghi
- Department of EpidemiologyHamadan University of Medical ScienceHamadanIran
| | - Kamran Lahoorpoor
- Department of Periodontology, Faculty of DentistryHamadan University of Medical SciencesHamadanIran
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Michels R, Magrin GL, Cruz ACC, Magini RS, Benfatti CAM. Functionalization of a Volume-Stable Collagen Matrix Using Liquid Platelet-Rich Fibrin: A Case Report Presenting a New Approach for Root Coverage. Case Rep Dent 2023; 2023:3929269. [PMID: 37006702 PMCID: PMC10060066 DOI: 10.1155/2023/3929269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/29/2023] [Accepted: 02/04/2023] [Indexed: 04/04/2023] Open
Abstract
This case report presents a novel approach for root coverage of multiple gingival recessions with a volume-stable collagen matrix functionalized with injectable platelet-rich fibrin (i-PRF). A patient with multiple gingival recessions in the anterior maxilla was submitted to root coverage by coronally advanced flap with split-full-split incisions. Blood collection was performed before surgery and i-PRF was obtained after centrifugation (relative centrifugal force (RCF) 400 g, 2700 rpm, 3 minutes). A volume-stable collagen matrix was soaked with i-PRF and applied as a substitute for autogenous connective tissue graft. A mean root coverage of 83% was observed after a 12-month follow-up period, and only slight modifications were detected in a 30-month follow-up consultation. The association of a volume-stable collagen matrix with i-PRF successfully treated multiple gingival recessions with reduced morbidity since a connective tissue collection was avoided.
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Affiliation(s)
- Roberta Michels
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Gabriel Leonardo Magrin
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - ACC Cruz
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - RS Magini
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Cesar Augusto Magalhães Benfatti
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
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Feng M, Wei Y, Wei H, Wang Y, Zhang Y, Miron RJ, Wang Y. Effect of relative centrifugal force on the biological properties of liquid platelet-rich fibrin produced via horizontal centrifugation. Clin Oral Investig 2023; 27:399-409. [PMID: 36242639 DOI: 10.1007/s00784-022-04745-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 10/01/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVES Platelet-rich fibrin (PRF) in liquid form has shown advantages in tissue engineering including acting as injectable fillers and drug carriers. However, few studies have investigated the best relative centrifugal force (RCF) for preparing liquid PRF. The aim of the present study was to find out optimal centrifugation force for preparing liquid PRF. MATERIALS AND METHODS Liquid PRF was prepared using horizontal centrifugation (liquid H-PRF) with RCF ranging from 100 g, 300 g, 500 g, to 700 g for 8 min. The volume, weight, solidification time, and tensile properties were subsequently investigated. Scanning electron microscopy (SEM) and rheologic tests were carried out to investigate the microstructure and rheologic properties of liquid H-PRF after natural polymerization. The total number, concentration, and distribution of cells within each liquid H-PRF was evaluated by complete blood count (CBC) analysis and hematoxylin-eosin staining. RESULTS As RCF values increased, the volume and weight of liquid H-PRF both increased accordingly. SEM images revealed that as the centrifugal force increased, the fibrin bundles became thinner with a denser fibrin network, and rheologic tests revealed improved mechanical properties. CBC analysis demonstrated that 500 g group had the highest number of leukocytes and neutrophils, whereas 100 g group yielded the highest concentration of leukocytes and platelets. Furthermore, histological analysis suggests that cells obtained by 500 g for 8 min were most evenly distributed in liquid H-PRF. CONCLUSIONS In summary, the present study provided insights into the contents of liquid H-PRF prepared at different centrifugation forces, enabling clinicians to choose proper centrifugation forces based on their needs. CLINICAL RELEVANCE The present findings provide theoretical basis for clinical choice of liquid H-PRF protocol from mechanical, cell contents, and histological aspects.
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Affiliation(s)
- Mengge Feng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yan Wei
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hongjiang Wei
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yunxiao Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yufeng Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Medical Research Institute, School of Medicine, Wuhan University, Wuhan, 430071, China
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Yulan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
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Palaiologou A, Keeling F. Autologous blood products: Usage and preparation protocols. Clin Adv Periodontics 2022; 12:287-293. [PMID: 35906935 DOI: 10.1002/cap.10221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/26/2022] [Indexed: 11/08/2022]
Abstract
FOCUSED CLINICAL QUESTION What are the appropriate preparation protocols for autologous blood products to support their clinical utilization? SUMMARY Autologous blood products provide a unique clinical benefit. Their popularity among the professions is growing. However, as this is a rapidly evolving field, multiple modalities are presented within the literature. Frequently there is no demonstrated superiority to previous iterations. This brief review attempts to offer a concise chronology on their evolution, preparation, and where possible, evidence to support their clinical utilization. CONCLUSIONS The field of autologous blood products is expanding rapidly. These products appear to yield variable clinical benefits in specific indications. However, evidence supporting their universal application is scant, and the superiority of one formulation versus another is yet to be demonstrated.
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Affiliation(s)
- Archontia Palaiologou
- Department of Periodontics, University of Texas Health San Antonio School of Dentistry, San Antonio, Texas, USA
| | - Francis Keeling
- Department of Periodontics, University of Texas Health San Antonio School of Dentistry, San Antonio, Texas, USA
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The application of injectable platelet-rich fibrin in regenerative dentistry: A systematic scoping review of In vitro and In vivo studies. JAPANESE DENTAL SCIENCE REVIEW 2022; 58:89-123. [PMID: 35368368 PMCID: PMC8971935 DOI: 10.1016/j.jdsr.2022.02.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 01/24/2022] [Accepted: 02/20/2022] [Indexed: 02/07/2023] Open
Abstract
Background Ongoing research in the dental field has begun to focus on the use of injectable platelet-rich fibrin (I-PRF) as a regenerative tool with the potential to prompt tissue regeneration. In this regard, this systematic scoping review aimed to collect, map, and appraise the in vitro and in vivo studies regarding the role of I-PRF in or soft and hard tissue regeneration in relation to oral and maxillofacial structures. Methods A systematic electronic search of Medline, Scopus, Web of Science, and Embase databases was performed from 2000 to December 2021 using a combination of keywords. All in vitro and in vivo studies, written in English and concerning the potential role of I-PRF in regenerative dentistry were considered. Results In total, 18 in vitro studies, 5 animal studies, 6 case reports, and 31 clinical studies have evaluated the effect of I-PRF on oral and maxillofacial soft and hard tissue regeneration. The investigated studies verified the anti-inflammatory, anti-microbial efficacy and the positive effects of I-PRF application for wound, periodontal, bone, cartilage, and pulp regeneration, as well as acceleration in tooth movement during orthodontic treatment. Conclusions Current literature approves the feasibility of I-PRF application as a promising regenerative adjunct to dental procedures.
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Sun J, Hu Y, Fu Y, Zou D, Lu J, Lyu C. Emerging roles of platelet concentrates and platelet-derived extracellular vesicles in regenerative periodontology and implant dentistry. APL Bioeng 2022; 6:031503. [PMID: 36061076 PMCID: PMC9439711 DOI: 10.1063/5.0099872] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/08/2022] [Indexed: 11/14/2022] Open
Abstract
Platelet concentrates (PCs) are easily obtained from autogenous whole blood after centrifugation and have evolved through three generations of development to include platelet-rich plasma, platelet-rich fibrin, and concentrated growth factor. Currently, PCs are widely used for sinus floor elevation, alveolar ridge preservation, periodontal bone defects, guided bone regeneration, and treatment of gingival recession. More recently, PCs have been leveraged for tissue regeneration to promote oral soft and hard tissue regeneration in implant dentistry and regenerative periodontology. PCs are ideal for this purpose because they have a high concentration of platelets, growth factors, and cytokines. Platelets have been shown to release extracellular vesicles (P-EVs), which are thought to be essential for PC-induced tissue regeneration. This study reviewed the clinical application of PCs and P-EVs for implant surgery and periodontal tissue regeneration.
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Affiliation(s)
- Jiayue Sun
- Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Yinghan Hu
- Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Yinxin Fu
- Wuhan Fourth Hospital, Wuhan, Hubei 430032, China
| | - Derong Zou
- Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Jiayu Lu
- Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Chengqi Lyu
- Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
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Arthroscopic Meniscal Repair With Second-Generation Platelet-Rich Fibrin Clot Augmentation. Arthrosc Tech 2022; 11:e1569-e1575. [PMID: 36185123 PMCID: PMC9519935 DOI: 10.1016/j.eats.2022.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/01/2022] [Indexed: 02/03/2023] Open
Abstract
Meniscal tears are among the most common injuries in the knee, and partial as well as total meniscectomy has been advocated as the treatment for meniscal injury. Over the years, the role of the meniscus as a shock absorber, load transmitter, and secondary anterior stabilizer, along with its proprioceptive and lubrication role, has been well established, and meniscal repair is recommended, especially in younger individuals. Factors such as tear location, pattern, chronicity, size, and extent; repair technique; and patient age and habits can influence meniscal repair, and to enhance meniscal healing, a variety of augmentation techniques have been introduced. These include needling, trephination, synovial abrasion, and the use of adjuvants such as platelet-rich plasma, platelet clots, fibrin clots, bone marrow clots, and stem cells. A second-generation platelet derivative called "platelet-rich fibrin" (PRF) has predictable platelet, growth factor, and cell mediator concentrations without using any anticoagulants. We describe a reproducible and simple way to harvest PRF and create and use a PRF clot, along with detailed instructions on how to integrate the clot with a meniscal repair arthroscopically.
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Clinical and radiographic evaluation of low-speed platelet-rich fibrin (PRF) for the treatment of intra-osseous defects of stage-III periodontitis patients: a randomized controlled clinical trial. Clin Oral Investig 2022; 26:6671-6680. [PMID: 35876893 PMCID: PMC9643252 DOI: 10.1007/s00784-022-04627-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/12/2022] [Indexed: 12/04/2022]
Abstract
Aim The current randomized controlled trial assessed for the first time the effect of a low-speed platelet-rich fibrin (PRF) with open flap debridement (OFD) versus OFD alone in the treatment of periodontal intra-osseous defects of stage-III periodontitis patients. Methods Twenty-two periodontitis patients with ≥ 6 mm probing depth (PD) and ≥ 3 mm intra-osseous defects were randomized into test (PRF + OFD; n = 11) and control (OFD; n = 11) groups. Clinical attachment level (CAL)–gain (primary outcome), PD-reduction, gingival recession depth (GRD), full-mouth bleeding scores (FMBS), full-mouth plaque scores (FMPS), radiographic linear defect depth (RLDD), and radiographic bone fill (secondary-outcomes) were examined over 9 months post-surgically. Results Low-speed PRF + OFD and OFD demonstrated significant intra-group CAL-gain and PD- and RLDD-reduction at 3, 6, and 9 months (p < 0.01). Low-speed PRF + OFD exhibited a significant CAL-gain of 3.36 ± 1.12 mm at 6 months (2.36 ± 0.81 mm for the control group; p < 0.05), and a significantly greater PD-reduction of 3.36 ± 1.12 mm at 3 months, of 3.64 ± 1.12 mm at 6 months and of 3.73 ± 1.19 mm at 9 months (2.00 ± 0.89 mm, 2.09 ± 1.04 mm, and 2.18 ± 1.17 mm in the control group respectively; p < 0.05). No significant differences were notable regarding GRD, FMPS, FMBS, RLDD, or bone fill between both groups (p > 0.05). Conclusions Within the current clinical trial’s limitations, the use of low-speed PRF in conjunction with OFD improved CAL and PD post-surgically, and could provide a cost-effective modality to augment surgical periodontal therapy of intra-osseous defects of stage-III periodontitis patients. Clinical relevance Low-speed PRF could provide a cost-effective modality to improve clinical attachment gain and periodontal probing depth reduction with open flap debridement approaches.
Supplementary Information The online version contains supplementary material available at 10.1007/s00784-022-04627-2.
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Puri K, Khatri M, Bansal M, Kumar A, Rehan M, Gupta A. A novel injectable platelet-rich fibrin reinforced papilla reconstruction technique. J Indian Soc Periodontol 2022; 26:412-417. [PMID: 35959300 PMCID: PMC9362817 DOI: 10.4103/jisp.jisp_441_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 12/10/2021] [Accepted: 01/15/2022] [Indexed: 11/27/2022] Open
Abstract
Formation of black triangles due to the loss of interdental papilla is one of the utmost perplexing esthetic problems of the periodontium. Many surgical and nonsurgical treatment options have been researched upon to obtain complete papillary fill, but minimally invasive procedures have always been the choice of treatment both for the operator as well as the patient. This article describes the use of injectable platelet-rich fibrin (i-PRF) as a novel nonsurgical technique for the reconstruction of deficient interdental papilla. This is probably the first article that describes the use of i-PRF for the nonsurgical treatment of black triangles. Six sites with the presence of deficient interdental papilla in four patients were selected for this case series. After completion and reevaluation of scaling and root planing, autologous i-PRF was injected at the base of the interdental papilla using the insulin syringe. Photographs obtained before the treatment and at 1, 3, and 6 months after the intervention were assessed by Image J software along with clinical measurements. The use of novel nonsurgical injectable PRF technique allows clinician to successfully treat deficient interdental papilla.
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Affiliation(s)
- Komal Puri
- Department of Periodontology, Institute of Dental Studies & Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India
| | - Manish Khatri
- Department of Periodontology, Institute of Dental Studies & Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India
| | - Mansi Bansal
- Department of Periodontology, Institute of Dental Studies & Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India
| | - Ashish Kumar
- Department of Periodontology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Mohd Rehan
- Department of Periodontology, Institute of Dental Studies & Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India
| | - Aneesha Gupta
- Department of Periodontology, Institute of Dental Studies & Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India
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Efficacy of concentrated growth factor versus collagen membrane in reconstructive surgical therapy of peri-implantitis: 3-year results of a randomized clinical trial. Clin Oral Investig 2022; 26:5247-5260. [PMID: 35618961 PMCID: PMC9381616 DOI: 10.1007/s00784-022-04493-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
Objectives To compare the 3-year clinical and radiographic outcomes of two different reconstructive surgical management of peri-implantitis using a bone substitute in combination with either concentrated growth factor (CGF) or collagen membrane (CM). Material and methods Fifty-one patients who had at least one implant presenting peri-implantitis with an intrabony defect were filled with a xenogenic bone grafting material and covered either CGF or CM. Clinical and radiographic assessments were carried out at baseline and postoperative years 1 and 3. Three different composite outcomes were defined to evaluate treatment success at a 3-year follow-up. The effects of possible prognostic indicators on treatment success were identified by using multilevel regression analysis. Results The changes in probing depth (PD) and radiographic vertical defect depth (VDD) between baseline and year 1 and baseline and year 3 presented significantly greater decreases for the CM group in comparison with the CGF group (p < 0.05). No significant differences between the two treatment modalities were demonstrated regarding treatment success outcomes. History of periodontitis, VDD at baseline, and the number of intrabony defect walls revealed significant impacts on treatment success (p = 0.033; OR = 3.50, p = 0.039; OR = 0.975, and p = 0.024; OR = 7.0 and p = 0.019;OR = 6.0, respectively). Conclusions CM in combination with a bone substitute seems to have slightly better outcomes compared to the CGF membranes in reconstructive surgical therapy of peri-implantitis. The history of periodontitis, baseline VDD, and peri-implant bone defect configuration could be possible predictors influencing treatment success. Trial registration ClinicalTrials.gov NCT04769609. Clinical relevance For the reconstruction of peri-implant bone defects, using a bone substitute in combination with a collagen membrane may show more favorable outcomes.
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Blood Clots versus PRF: Activating TGF-β Signaling and Inhibiting Inflammation In Vitro. Int J Mol Sci 2022; 23:ijms23115897. [PMID: 35682575 PMCID: PMC9180540 DOI: 10.3390/ijms23115897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 02/01/2023] Open
Abstract
The preparation of platelet-rich fibrin (PRF) requires blood centrifugation to separate the yellow plasma from the red erythrocyte fraction. PRF membranes prepared from coagulated yellow plasma are then transferred to the defect sites to support tissue regeneration. During natural wound healing, however, it is the unfractionated blood clot (UBC) that fills the defect site. It is unclear whether centrifugation is necessary to prepare a blood-derived matrix that supports tissue regeneration. The aim of the present study was to compare lysates prepared from PRF and UBC based on bioassays and degradation of the respective membranes. We report here that lysates prepared from PRF and UBC membranes similarly activate TGF-β signaling, as indicated by the expression of interleukin 11 (IL-11), NADPH oxidase 4 (NOX-4) and proteoglycan 4 (PRG4) in gingival fibroblasts. Consistently, PRF and UBC lysates stimulated the phosphorylation and nuclear translocation of Smad3 in gingival fibroblasts. We further observed that PRF and UBC lysates have comparable anti-inflammatory activity, as shown by the reduction in lipopolysaccharide (LPS)-induced IL-6, inducible nitric oxidase synthase (iNOS) and cyclooxygenase 2 (COX-2) expression in RAW264.7 cells. Moreover, inflammation induced by Poly (1:C) HMW and FSL-1, which are agonists of Toll-like receptor (TLR) 3 and 2/6, respectively, was reduced by both PRF and UBC. PRF and UBC lysates reduced the nuclear translocation of p65 in LPS-induced RAW264.7 cells. In contrast to the similar activity observed in the bioassays, UBC membranes lack the structural integrity of PRF membranes, as indicated by the rapid and spontaneous disintegration of UBC membranes. We show here that the lysates prepared from PRF and UBC possess robust TGF-β and anti-inflammatory activity. However, visual inspection of the PRF and UBC membranes confirmed the negative impact of erythrocytes on the structural integrity of membranes prepared from whole blood. The data from the present study suggest that although both UBC and PRF have potent TGF-β and anti-inflammatory activity, UBC does not have the strength properties required to be used clinically to prepare applicable membranes. Thus, centrifugation is necessary to generate durable and clinically applicable blood-derived membranes.
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da Silva LMP, Sávio DDSF, de Ávila FC, Vicente RM, Reis GGD, Denardi RJ, da Costa NMM, Silva PHF, Mourão CFDAB, Miron RJ, Messora MR. Comparison of the effects of platelet concentrates produced by high and low-speed centrifugation protocols on the healing of critical-size defects in rat calvaria: a microtomographic and histomorphometric study. Platelets 2022; 33:1175-1184. [PMID: 35591762 DOI: 10.1080/09537104.2022.2071851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The current study evaluated the healing of critical-size defects (CSD) created in rat calvaria treated with platelet concentrates produced by high-speed (Leukocyte- and Platelet-Rich Fibrin - L-PRF) and low-speed (Advanced Platelet-Rich Fibrin - A-PRF) protocols of centrifugation. Twenty-four rats were distributed into three groups: Control, L-PRF, and A-PRF. Five mm diameter CSD were created on the animals' calvaria. The defects of the L-PRF and A-PRF groups were filled with 0.01 ml of L-PRF and A-PRF, respectively. The control group defects were filled with a blood clot only. All animals were euthanized on the 35th postoperative day. Histomorphometric and microtomographic analyses were then performed. The L-PRF and A-PRF groups had significantly higher bone volume and neoformed bone area than those of the control group and lowered bone porosity values (p < .05). No significant differences were observed between A-PRF and L-PRF groups for the analyzed parameters. Therefore, it can be concluded that i) L-PRF and A-PRF potentiated the healing of CSD in rat calvaria; ii) high and low-speed centrifugation protocols did not produce PRF matrices with different biological impacts on the amount of bone neoformation.
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Affiliation(s)
- Lucia Moitrel Pequeno da Silva
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Débora de Souza Ferreira Sávio
- Department of Morphology, Physiology, and Basic Pathology - DMFPB, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP
| | - Felipe Correa de Ávila
- Department of Morphology, Physiology, and Basic Pathology - DMFPB, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP
| | - Raphael Martini Vicente
- Department of Orthopedics and Anesthesiology, Ribeirão Preto Medical School, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Gabriel Guerra David Reis
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ricardo Junior Denardi
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Natacha Malu Miranda da Costa
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Pedro Henrique Felix Silva
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Michel Reis Messora
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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The effect of resting and compression time post-centrifugation on the characteristics of platelet rich fibrin (PRF) membranes. Clin Oral Investig 2022; 26:5281-5288. [PMID: 35451655 DOI: 10.1007/s00784-022-04496-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/13/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the effect of resting and compression time after centrifugation on the physical properties of platelet rich fibrin (PRF) membranes, and to provide optimal guidance regarding the clinical preparation of PRF. MATERIALS AND METHODS A total of 12 volunteers enrolled in this study divided into 2 groups equally. For each volunteer, 6 tubes of 10 mL venous whole blood was drawn. To evaluate the influence of resting time after centrifugation, PRF clots were taken out 0, 1, 3, 5, 7, and 10 min from tubes following centrifugation, and then the weight, size, maximum stress, and maximum strain of each group were measured. To evaluate the influence of compression time on the preparation of PRF membranes, the weight ratio of PRF membranes to PRF clots was calculated by compression for 10 s, 30 s, 60 s, 90 s, 120 s, and 180 s, respectively. Scanning electron microscopy was performed to observe the cross-linking of the fibers within membranes, and the maximum stress and strain of PRF membranes were tested followed by stress-strain curve analysis. RESULTS The weight and volume of PRF clots and PRF membranes increased in size and weight reached the top at 3 min, followed by a decrease after 7-min resting. The maximum strain of the PRF membranes after 10 min decreased significantly compared to the 3-min and 5-min groups. The maximum stress was found at 3 min followed by a statistical decrease when resting time went on. Scanning electron microscopy demonstrated that the internal fibrous structure of the PRF membranes was looser when the compression time was less than 60 s when comparing the 90-s group. The maximum stress of PRF membranes was shown using a wait period of 3 min post-centrifugation followed by compression for 120 s. CONCLUSION The findings from the present study demonstrate that the time post-centrifugation of PRF membranes showed a maximum weight, volume, and mechanical properties after resting for 3-5 min in the tube post-centrifugation followed by a compression time of 120 s. CLINICAL RELEVANCE Although research to date has focused primarily on centrifugation protocols, this study revealed for the first time that the resting time post-centrifugation greatly affected the mechanical properties of PRF. This study demonstrated that the resting and compression time after centrifugation influences the mechanical strength of PRF membranes, which might explain differences in PRF characteristics prepared by different clinicians that may provide a standard guide for preparation of PRF membranes.
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Simões-Pedro M, Tróia PMBPS, dos Santos NBM, Completo AMG, Castilho RM, de Oliveira Fernandes GV. Tensile Strength Essay Comparing Three Different Platelet-Rich Fibrin Membranes (L-PRF, A-PRF, and A-PRF+): A Mechanical and Structural In Vitro Evaluation. Polymers (Basel) 2022; 14:polym14071392. [PMID: 35406263 PMCID: PMC9002533 DOI: 10.3390/polym14071392] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 01/28/2023] Open
Abstract
Predictable outcomes intended by the application of PRF (platelet-rich fibrin) derivative membranes have created a lack of consideration for their consistency and functional integrity. This study aimed to compare the mechanical properties through tensile strength and analyze the structural organization among the membranes produced by L-PRF (leukocyte platelet-rich fibrin), A-PRF (advanced platelet-rich fibrin), and A-PRF+ (advanced platelet-rich fibrin plus) (original protocols) that varied in centrifugation speed and time. L-PRF (n = 12), A-PRF (n = 19), and A-PRF+ (n = 13) membranes were submitted to a traction test, evaluating the maximum and average traction. For maximum traction, 0.0020, 0.0022, and 0.0010 N·mm−2 were obtained for A-PRF, A-PRF+, and L-PRF, respectively; regarding the average resistance to traction, 0.0012, 0.0015, and 0.006 N·mm−2 were obtained, respectively (A-PRF+ > A-PRF > L-PRF). For all groups studied, significant results were found. In the surface morphology observations through SEM, the L-PRF matrix showed a highly compact surface with thick fibers present within interfibrous areas with the apparent destruction of red blood cells and leukocytes. The A-PRF protocol showed a dense matrix composed of thin and elongated fibers that seemed to follow a preferential and orientated direction in which the platelets were well-adhered. Porosity was also evident with a large diameter of the interfibrous spaces whereas A-PRF+ was the most porous platelet concentrate with the greatest fiber abundance and cell preservation. Thus, this study concluded that A-PRF+ produced membranes with significant and higher maximum traction results, indicating a better viscoelastic strength when stretched by two opposing forces.
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Affiliation(s)
- Mara Simões-Pedro
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3515-320 Viseu, Portugal; (M.S.-P.); (P.M.B.P.S.T.); (N.B.M.d.S.)
| | - Pedro Maria B. P. S. Tróia
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3515-320 Viseu, Portugal; (M.S.-P.); (P.M.B.P.S.T.); (N.B.M.d.S.)
| | - Nuno Bernardo Malta dos Santos
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3515-320 Viseu, Portugal; (M.S.-P.); (P.M.B.P.S.T.); (N.B.M.d.S.)
| | - António M. G. Completo
- Centre for Mechanical Technology and Automation, TEMA—University of Aveiro, 3810-549 Aveiro, Portugal;
| | - Rogerio Moraes Castilho
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI 48104, USA;
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Fibrinogen Concentrations in Liquid PRF Using Various Centrifugation Protocols. Molecules 2022; 27:molecules27072043. [PMID: 35408442 PMCID: PMC9000261 DOI: 10.3390/molecules27072043] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/18/2022] [Accepted: 03/18/2022] [Indexed: 02/06/2023] Open
Abstract
Liquid platelet-rich fibrin (PRF) is produced by fractionation of blood without additives that initiate coagulation. Even though liquid PRF is frequently utilized as a natural source of fibrinogen to prepare sticky bone, the concentration of fibrinogen and the overall amount of "clottable PRF" components have not been evaluated. To this aim, we prepared liquid PRF at 300, 700, and 2000 relative centrifugal force (RCF), for 8 min and quantified the fibrinogen levels by immunoassay. We report here that, independent of the RCF, the fibrinogen concentration is higher in the platelet-poor plasma (PPP) compared to the buffy coat (BC) fraction of liquid PRF and further decreases in the remaining red fraction. We then determined the weight of the clotted PRF fractions before and after removing the serum. The PPP and BC fractions consist of 10.2% and 25.3% clottable matrix suggesting that more than half of the weight of clottable BC is caused by cellular components. Our data provide insights into the distribution of fibrinogen in the different fractions of liquid PRF. These findings suggest that PPP is the main source of clottable fibrinogen, while the BC is more a cell source when it comes to the preparation of sticky bone.
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Farshidfar N, Amiri MA, Jafarpour D, Hamedani S, Niknezhad SV, Tayebi L. The feasibility of injectable PRF (I-PRF) for bone tissue engineering and its application in oral and maxillofacial reconstruction: From bench to chairside. BIOMATERIALS ADVANCES 2022; 134:112557. [DOI: https:/doi.org/10.1016/j.msec.2021.112557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Feng M, Wang Y, Wei Y, Zhang X, Xiao L, Gong Z, Fujioka-Kobayashi M, Sculean A, Miron RJ, Froum S, Zhang Y. Preparation, characterization and biological properties of a novel bone block composed of platelet rich fibrin and a deproteinized bovine bone mineral. FUNDAMENTAL RESEARCH 2022; 2:321-328. [PMID: 38933158 PMCID: PMC11197745 DOI: 10.1016/j.fmre.2021.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/17/2021] [Accepted: 08/08/2021] [Indexed: 01/12/2023] Open
Abstract
Alveolar bone defects caused by tooth loss often lead to challenges in implant dentistry, with a need for development of optimal bone biomaterials to predictably rebuild these tissues. To address this problem, we fabricated a novel bone block using platelet-rich fibrin (PRF) and Deproteinized Bovine Bone Mineral (DBBM), and characterized their mechanical and biological properties. The bone block was prepared by mixing DBBM, Liquid-PRF, and Solid-PRF fragments in various combinations as follows: (1) BLOCK-1 made with Solid-PRF fragments + DBBM, (2) BLOCK-2 made with Liquid-PRF + DBBM, (3) BLOCK-3 made with Solid-PRF fragments + Liquid-PRF + DBBM. The time for solidification and the degradation properties were subsequently recorded. Scanning electron microscopy (SEM) and tensile tests were carried out to investigate the microstructure and mechanical properties of each block. The bioactivity of the three groups towards osteoblast differentiation was also evaluated by culturing cells with the conditioned medium from each of the three groups including cell proliferation assay, cell migration assay, alkaline phosphatase (ALP) staining, and alizarin red staining (ARS), as well as by real-time PCR for genes encoding runt-related transcription factor 2 (RUNX2), ALP, collagen type I alpha1(COL1A1) and osteocalcin (OCN). BLOCK-3 made with Solid-PRF fragments + Liquid-PRF + DBBM had by far the fastest solidification period (over a 10-fold increase) as well as the most resistance to degradation. SEM and tensile tests also revealed that the mechanical properties of BLOCK-3 were superior in strength when compared to all other groups and further induced the highest osteoblast migration and osteogenic differentiation confirmed by ALP, ARS and real-time PCR. PRF bone blocks made through the combination of Solid-PRF fragments + Liquid-PRF + DBBM had the greatest mechanical and biological properties when compared to either used alone. Future clinical studies are warranted to further support the clinical application of PRF bone blocks in bone regeneration procedures.
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Affiliation(s)
- Mengge Feng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430071, China
| | - Yulan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430071, China
| | - Yan Wei
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430071, China
| | - Xiaoxin Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430071, China
| | - Leyi Xiao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430071, China
| | - Zijian Gong
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430071, China
| | - Masako Fujioka-Kobayashi
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Scott Froum
- Clinical Assistant Professor State University of New York, Stony Brook Department of Periodontology, Private Practice New York, New York, USA
| | - Yufeng Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430071, China
- Medical Research Institute, School of Medicine, Wuhan University, Wuhan 430071, China
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Farshidfar N, Amiri MA, Jafarpour D, Hamedani S, Niknezhad SV, Tayebi L. The feasibility of injectable PRF (I-PRF) for bone tissue engineering and its application in oral and maxillofacial reconstruction: From bench to chairside. BIOMATERIALS ADVANCES 2022; 134:112557. [PMID: 35527147 PMCID: PMC9295636 DOI: 10.1016/j.msec.2021.112557] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 12/18/2022]
Abstract
Among all the biomaterials introduced in the field of bone tissue engineering, injectable platelet-rich fibrin (I-PRF) has recently gained considerable attention. I-PRF, as a rich source of biologically active molecules, is a potential candidate which can be easily obtained in bedside and constitutes several biological factors which can result in higher anti-bacterial, anti-inflammatory and regenerative capabilities. According to the studies evaluating the osteogenic efficacy of I-PRF, this biomaterial has exhibited favorable outcomes in terms of adhesion, differentiation, migration, proliferation and mineralization potential of stem cells. In addition, the injectability and ease-of-applicability of this biomaterial has led to its various clinical applications in the oral and maxillofacial bone regeneration such as ridge augmentation, sinus floor elevation, cleft palate reconstruction and so on. Furthermore, to enhance the clinical performance of I-PRF, albumin gel-PRF as a long-lasting material for long-term utilization has been recently introduced with a gradual increase in growth factor release pattern. This review provides a comprehensive approach to better evaluate the applicability of I-PRF by separately appraising its performance in in-vitro, in-vivo and clinical situations. The critical approach of this review toward the different production protocols and different physical and biological aspects of I-PRF can pave the way for future studies to better assess the efficacy of I-PRF in bone regeneration.
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Affiliation(s)
- Nima Farshidfar
- Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammad Amin Amiri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Dana Jafarpour
- Faculty of Dentistry, McGill University, Montreal, Canada
| | - Shahram Hamedani
- Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyyed Vahid Niknezhad
- Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Lobat Tayebi
- Marquette University School of Dentistry, Milwaukee, WI, USA.
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Amiri MA, Farshidfar N, Hamedani S. The prospective relevance of autologous platelet concentrates for the treatment of oral mucositis. Oral Oncol 2021. [DOI: https://doi.org/10.1016/j.oraloncology.2021.105549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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