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Kanani H, Patil R, Khubchandani M, Yeluri R, K R, Pandey R, Suroliya P, Goyal R, Deshkar M. Surgical Approach to Managing an Apical Periodontal Cyst Using Titanium-Activated Platelet-Rich Fibrin (T-PRF) in a Pediatric Patient: A Case Report. Cureus 2024; 16:e63887. [PMID: 39105011 PMCID: PMC11298275 DOI: 10.7759/cureus.63887] [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: 06/19/2024] [Accepted: 07/05/2024] [Indexed: 08/07/2024] Open
Abstract
This case report discusses the surgical management of an apical periodontal cyst in a 14-year-old male patient presenting with pain in the upper anterior jaw. The patient had a history of trauma to the upper anterior teeth, leading to the development of a radicular cyst involving teeth 11 and 12. The treatment plan included initial root canal therapy followed by surgical enucleation of the cyst, apicoectomy, and retrograde filling of the affected teeth. Titanium-activated platelet-rich fibrin (T-PRF) membranes were utilized along with an osseo-bone graft to promote healing and bone regeneration. Post-operative aesthetic rehabilitation was achieved, and the patient showed complete healing upon six months of follow-up. The case highlights the efficacy of combining endodontic therapy with surgical intervention using advanced biomaterials to manage radicular cysts in pediatric patients successfully.
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Affiliation(s)
- Harikishan Kanani
- Pediatric Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rutuja Patil
- Pedodontics and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Monika Khubchandani
- Pediatric Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ramakrishna Yeluri
- Pediatric Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rajanikanth K
- Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ruchika Pandey
- Orthodontics and Dentofacial Orthopedics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Prachi Suroliya
- Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Riya Goyal
- Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Mrunali Deshkar
- Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Ozkal Eminoglu D, Arabaci T, Oztas Sahiner GA. The effect of titanium-platelet rich fibrin on periodontal intrabony defects: A randomized controlled split-mouth clinical study. PLoS One 2024; 19:e0304970. [PMID: 38843242 PMCID: PMC11156295 DOI: 10.1371/journal.pone.0304970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/20/2024] [Indexed: 06/09/2024] Open
Abstract
This study aimed to determine the contribution of titanium prepared platelet-rich fibrin (T-PRF) with open flap debridement (OFD) on clinical, biochemical and radiographic measurements of periodontal regeneration. Twenty periodontitis patients with bilateral intrabony defects and stage III grade A periodontitis were included in the study. A total of 40 defects were randomly selected for OFD alone (control group, n = 20) or combined OFD+ T-PRF (test group, n = 20). Clinical and radiographic parameters (at baseline and nine months after surgery), and growth factor levels in gingival crevicular fluid (at baseline and at two, four, six, and twelve weeks after surgical treatment) were also evaluated. Considering the clinical parameters, alterations in probing pocket depth, gingival marginal level and clinical endpoint in the test regions treated with T-PRF significantly improved (P<0.05). Fibroblast growth factor-2 and platelet-derived growth factor-BB levels between the two groups in the second and fourth weeks were also significantly different (P<0.05). Furthermore, the receptor activator of nuclear factor κB ligand/osteoprotegerin ratio between the groups was significantly different in the second, fourth, sixth, and twelfth weeks (P<0.05). The bone-filling rate was also significantly greater in the test group than in the control group (P <0.001). Compared with OFD alone, combining T-PRF with the procedure was more successful with regards to clinical, radiographic, and biochemical measurements of periodontal regeneration.
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Affiliation(s)
- Didem Ozkal Eminoglu
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Taner Arabaci
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
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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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Bains VK, Mahendra J, Mittal M, Bedi M, Mahendra L. Technical considerations in obtaining platelet rich fibrin for clinical and periodontal research. J Oral Biol Craniofac Res 2023; 13:714-719. [PMID: 37731846 PMCID: PMC10507643 DOI: 10.1016/j.jobcr.2023.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/12/2023] [Accepted: 09/11/2023] [Indexed: 09/22/2023] Open
Abstract
Autologous platelet rich fibrin (PRF), is currently being widely used and investigated across the globe by clinicians and periodontal research. The technical aspect required for the procurement of PRF includes revolution per minute (RPM), relative centrifugal force (RCF) or G-force, rotor radius, rotor angle, stability or vibration in the centrifugal machine and material of test-tube, besides the systemic health of the individual may influence the final outcome. Present technical note intends to compile these aspects for better understanding and appropriate outcome while preparing PRF in varying clinical scenarios.
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Affiliation(s)
- Vivek Kumar Bains
- Department of Periodontology, Saraswati Dental College & Hospital, Lucknow, India
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Madhukar Mittal
- Department of Endocrinology & Metabolism, AIIMS, Jodhpur, India
| | - Muskan Bedi
- Department of Basic Medical Sciences, Sri Ramachandra Medical College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Little Mahendra
- Maktoum Bin Hamdan Dental University College, Dubai, United Arab Emirates
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Bai MY, Vy VPT, Tang SL, Hung TNK, Wang CW, Liang JY, Wong CC, Chan WP. Current Progress of Platelet-Rich Derivatives in Cartilage and Joint Repairs. Int J Mol Sci 2023; 24:12608. [PMID: 37628786 PMCID: PMC10454586 DOI: 10.3390/ijms241612608] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/04/2023] [Accepted: 08/05/2023] [Indexed: 08/27/2023] Open
Abstract
In recent years, several types of platelet concentrates have been investigated and applied in many fields, particularly in the musculoskeletal system. Platelet-rich fibrin (PRF) is an autologous biomaterial, a second-generation platelet concentrate containing platelets and growth factors in the form of fibrin membranes prepared from the blood of patients without additives. During tissue regeneration, platelet concentrates contain a higher percentage of leukocytes and a flexible fibrin net as a scaffold to improve cell migration in angiogenic, osteogenic, and antibacterial capacities during tissue regeneration. PRF enables the release of molecules over a longer period, which promotes tissue healing and regeneration. The potential of PRF to simulate the physiology and immunology of wound healing is also due to the high concentrations of released growth factors and anti-inflammatory cytokines that stimulate vessel formation, cell proliferation, and differentiation. These products have been used safely in clinical applications because of their autologous origin and minimally invasive nature. We focused on a narrative review of PRF therapy and its effects on musculoskeletal, oral, and maxillofacial surgeries and dermatology. We explored the components leading to the biological activity and the published preclinical and clinical research that supports its application in musculoskeletal therapy. The research generally supports the use of PRF as an adjuvant for various chronic muscle, cartilage, and tendon injuries. Further clinical trials are needed to prove the benefits of utilizing the potential of PRF.
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Affiliation(s)
- Meng-Yi Bai
- Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei 10607, Taiwan
- Adjunct Appointment to the Department of Biomedical Engineering, National Defense Medical Center, Taipei 11490, Taiwan
| | - Vu Pham Thao Vy
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan;
- Department of Radiology, Thai Nguyen National Hospital, Thai Nguyen 24000, Vietnam
| | - Sung-Ling Tang
- Department of Pharmacy Practice, Tri-Service General Hospital, Taipei 11490, Taiwan
| | | | - Ching-Wei Wang
- Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei 10607, Taiwan
| | - Jui-Yuan Liang
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Chin-Chean Wong
- Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan;
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11011, Taiwan
- International Ph.D. Program for Cell Therapy and Regenerative Medicine, College of Medicine, Taipei Medical University, Taipei 11011, Taiwan
| | - Wing P. Chan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei 116081, Taiwan
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Choudhary B, Goswami K, J Patel B, R Vaghani A, J D, Grandhi N, Singh Makkad R. Platelet-rich fibrin and titanium-prepared platelet-rich fibrin in endoperio lesion management. Bioinformation 2023; 19:133-137. [PMID: 37720281 PMCID: PMC10504503 DOI: 10.6026/97320630019133] [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] [Received: 01/01/2023] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 09/19/2023] Open
Abstract
Endo-perio lesions involve a variety of therapy choices that will lead to the best possible elimination of infection. Various therapy approaches have been investigated for curing of patients affected by endo-perio abnormalities. One of the second-generation platelet derivatives is plasma enriched with platelet (PRP).They may aid in the healing of wounds. Enhanced with platelets cells and several growth factors, platelet-rich fibrin (PRF) promotes repair and healing and regeneration of tissue at the periapical area. Platelet cell and leukocyte cell enriched fibrin, prepared in conjunction with titanium (T-PRF), is analogous to fibrin made using the traditional PRF process.The current study was undertaken to compare PRF against T-PRF in the therapy of endo-perio abnormalities using the basic information that was available.280 patients of all sexes between the ages of 18 years and 58 years make up the study's participants. They were divided into two categories. In category I study participants PRF was employed to fill the defect created due to pathology and in category II patients, a T-PRF was used, accompanied by suturing. The one walled, two walled, and three-wall walled infrabony abnormalities were quantified on the digital images acquired using the grid. After three months and six months, the probing periodontal pocket depth in mm and level of attachment (RAL) in mm were measured. In category one, mean change at 3 months was 3.21mm accounting for 33.79% change in PPD. On the other hand mean change at 6 months was 3.61mm accounting for 43.79% change in PPD. When there was evaluation in study participants in category two then it was observed that mean change at 3 months was 2.02mm accounting for 34.79% change in PPD. On the other hand mean change at 6 months was 3.62 mm accounting for 44.79% change in PPD. There was reduction of depth of periodontal pocket at both 3 months follow up and 6 months follow in both categories; however there was no statistical significant variation observed between the two categories regarding decrease in the depth of periodontal pocket on analysis of intergroup variations. It was concluded that there was increase in periodontal attachment and decrease in depth of periodontal pocket in both PRF and T-PRF however there was no statistical substantial variation observed between the two categories regarding increase in the attachment level or decrease in depth of periodontal when intergroup variations between PRF and T-PRF were considered.
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Affiliation(s)
- Balram Choudhary
- Department of Dentistry, JLN Medical College and Hospital, Ajmer, Rajasthan, India
| | - Komal Goswami
- Department of Dentistry, Kshetrapal Hospital, Ajmer, Rajasthan, India
| | | | | | - Dhurubatha J
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kadapa, AP, India
| | - Nishita Grandhi
- Department of Conservative and Endodontics, New Horizon Dental college and Research institute, Bilaspur, Chhattisgarh, India
| | - Ramanpal Singh Makkad
- Department of Oral Medicine and Radiology, New Horizon Dental college and Research institute, Bilaspur, Chhattisgarh, India
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Evolution and Clinical Advances of Platelet-Rich Fibrin in Musculoskeletal Regeneration. BIOENGINEERING (BASEL, SWITZERLAND) 2023; 10:bioengineering10010058. [PMID: 36671630 PMCID: PMC9854731 DOI: 10.3390/bioengineering10010058] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 01/05/2023]
Abstract
Over the past few decades, various forms of platelet concentrates have evolved with significant clinical utility. The newer generation products, including leukocyte-platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF), have shown superior biological properties in musculoskeletal regeneration than the first-generation concentrates, such as platelet-rich plasma (PRP) and plasma rich in growth factors. These newer platelet concentrates have a complete matrix of physiological fibrin that acts as a scaffold with a three-dimensional (3D) architecture. Further, it facilitates intercellular signaling and migration, thereby promoting angiogenic, chondrogenic, and osteogenic activities. A-PRF with higher leukocyte inclusion possesses antimicrobial activity than the first generations. Due to the presence of enormous amounts of growth factors and anti-inflammatory cytokines that are released, A-PRF has the potential to replicate the various physiological and immunological factors of wound healing. In addition, there are more neutrophils, monocytes, and macrophages, all of which secrete essential chemotactic molecules. As a result, both L-PRF and A-PRF are used in the management of musculoskeletal conditions, such as chondral injuries, tendinopathies, tissue regeneration, and other sports-related injuries. In addition to this, its applications have been expanded to include the fields of reconstructive cosmetic surgery, wound healing in diabetic patients, and maxillofacial surgeries.
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8
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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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Özkan Şen D, Öncü E. Splith mouth randomized control trial comparison of T‐PRF and subepithelial connective tissue graft in the treatment of maxillar multiple gingival recessions. J ESTHET RESTOR DENT 2022; 35:449-456. [PMID: 36433863 DOI: 10.1111/jerd.12986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/20/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022]
Abstract
AIM The aim of this study is to compare the treatment efficacy of the bilateral multiple gingival recession areas with a titanium-platelet-rich-fibrin (T-PRF) and subepithelial connective tissue graft (SCTG) combined with a modified coronal advanced flap (MCAF) and the clinical results. METHOD In the study, 118 maxillary bilateral multiple Miller I recessions were treated. Gingival index, plaque index, probing pocket depth, gingival thickness, recession height, recession width, keratinized gingival width and open root surface area were measured at baseline and at 6 months. Postoperative pain levels Visual Analog Scale, healing status, wound healing index evaluated with. The results of both groups pre and postoperative were compared. RESULTS The initial recession height was 2.15 ± 1.0 mm in the T-PRF group; 2.04 ± 0.80 mm in the SCTG group. After 6 months, the mean root closure rate was 61.77%, 75.31% in T-PRF and SCTG group, respectively. Clinical attachment gain was achieved in both groups compared to baseline. When the results were compared, the gains achieved in the SCTG group were statistically significantly higher. İt was determined that patient satisfaction was higher in T-PRF group and wound healing was faster. CONCLUSION Considering the advantages of T-PRF such as providing effective results in the treatment of defects, patient satisfaction and rapid recovery; It can be applied as an alternative to SCTG. CLINICAL SIGNIFICANCE T-PRF can be an alternative to SCTG in the treatment of gingival recessions.
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Affiliation(s)
- Dilek Özkan Şen
- Department of Periodontology Necmettin Erbakan University Faculty of Dentistry Konya Turkey
| | - Elif Öncü
- Department of Periodontology Lokman Hekim University Faculty of Dentistry Ankara Turkey
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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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Swarnakar R, Rahman H, Venkataraman S. "Platelet-Rich Fibrin Membrane-as a novel biomaterial for pressure injury healing in a person with spinal cord injury: A case report". Spinal Cord Ser Cases 2022; 8:75. [PMID: 35948536 PMCID: PMC9364842 DOI: 10.1038/s41394-022-00540-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Pressure injury (PI) impacts the quality of life, and socioeconomic and psychological well-being negatively in persons with Spinal Cord Injury (SCI). Autologous Platelet Rich Plasma (PRP) and Platelet Rich Fibrin (PRF) showed promising roles in wound healing. PRF is considered a second-generation PRP, contains more growth factors and is more biocompatible than PRP. It possesses an additional favourable impact on wound healing due to its three-dimensional fibrin architecture, and antimicrobial property. There are no studies on PRF membrane use for PI healing in SCI. CASE PRESENTATION A 25-year-old male with operated traumatic T10 American Spinal Injury Association Impairment Scale grade A paraplegia with neurogenic bowel, and bladder and a stage II PI over the left greater trochanter, was admitted for inpatient rehabilitation. The chronic non-healing PI which did not show any improvement following normal saline (0.9%) dressing for the past 3 months, was treated with autologous PRF membrane weekly for four weeks. The PI healed completely and no adverse events were noted. Weekly total scores of the Spinal Cord Impairment Pressure Ulcer Monitoring Tool and Pressure Ulcer Scale for Healing were 6, 6, 5, 2, 0 and 12, 10, 10, 3, and 0 respectively. DISCUSSION To the best of our knowledge, this is the first case report on the healing of PI in SCI with the use of PRF. This novel biomaterial is a safe and effective promising agent for PI management in SCI. But further randomized trials are needed to establish stronger evidence regarding feasibility and effectiveness.
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Affiliation(s)
- Raktim Swarnakar
- Department of Physical Medicine and Rehabilitation (PM&R), All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India.
| | - Hafis Rahman
- Department of Physical Medicine and Rehabilitation (PM&R), All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
- Department of Neurorehabilitation, National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bangalore, India
| | - Srikumar Venkataraman
- Department of Physical Medicine and Rehabilitation (PM&R), All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
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Allen BN, Wang Q, Filali Y, Worthington KS, Kacmarynski DSF. Full-Thickness Oral Mucoperiosteal Defects: Challenges and Opportunities. TISSUE ENGINEERING. PART B, REVIEWS 2022; 28:813-829. [PMID: 34409870 PMCID: PMC9469748 DOI: 10.1089/ten.teb.2021.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/10/2021] [Indexed: 11/12/2022]
Abstract
Regenerative engineering strategies for the oral mucoperiosteum, as may be needed following surgeries, such as cleft palate repair and tumor resection, are underdeveloped compared with those for maxillofacial bone. However, critical-size tissue defects left to heal by secondary intention can lead to complications, such as infection, fistula formation, scarring, and midface hypoplasia. This review describes current clinical practice for replacing mucoperiosteal tissue, including autografts and allografts. Potentially paradigm-shifting experimental regenerative engineering strategies for mucoperiosteal wound healing, such as hybrid grafts and engineered matrices, are also discussed. Throughout the review, the advantages and disadvantages of each replacement or regeneration strategy are outlined in the context of clinical outcomes, quality of life for the patient, availability of materials, and cost of care. Finally, future directions for research and development in the area of mucoperiosteum repair are proposed, with an emphasis on identifying globally available and affordable solutions for promoting mucoperiosteal regeneration. Impact statement Unassisted oral mucoperiosteal wound healing can lead to severe complications such as infection, fistulae, scarring, and developmental abnormalities. Thus, strategies for promoting wound healing must be considered when mucoperiosteal defects are incident to oral surgery, as in palatoplasty or tumor resection. Emerging mucoperiosteal tissue engineering strategies, described in this study, have the potential to overcome the limitations of current standard-of-care donor tissue grafts. For example, the use of engineered mucoperiosteal biomaterials could circumvent concerns about tissue availability and immunogenicity. Moreover, employment of tissue engineering strategies may improve the equity of oral wound care by increasing global affordability and accessibility of materials.
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Affiliation(s)
- Brittany N Allen
- Roy J. Carver Department of Biomedical Engineering, College of Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Qi Wang
- Roy J. Carver Department of Biomedical Engineering, College of Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Yassine Filali
- Roy J. Carver Department of Biomedical Engineering, College of Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Kristan S Worthington
- Roy J. Carver Department of Biomedical Engineering, College of Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Deborah S F Kacmarynski
- Department of Otolaryngology - Head and Neck Surgery, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA
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Varghese J, Rajagopal A, Shanmugasundaram S. Role of Biomaterials Used for Periodontal Tissue Regeneration—A Concise Evidence-Based Review. Polymers (Basel) 2022; 14:polym14153038. [PMID: 35956553 PMCID: PMC9370319 DOI: 10.3390/polym14153038] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/04/2022] [Accepted: 07/06/2022] [Indexed: 12/14/2022] Open
Abstract
Periodontal infections are noncommunicable chronic inflammatory diseases of multifactorial origin that can induce destruction of both soft and hard tissues of the periodontium. The standard remedial modalities for periodontal regeneration include nonsurgical followed by surgical therapy with the adjunctive use of various biomaterials to achieve restoration of the lost tissues. Lately, there has been substantial development in the field of biomaterial, which includes the sole or combined use of osseous grafts, barrier membranes, growth factors and autogenic substitutes to achieve tissue and bone regeneration. Of these, bone replacement grafts have been widely explored for their osteogenic potential with varied outcomes. Osseous grafts are derived from either human, bovine or synthetic sources. Though the biologic response from autogenic biomaterials may be better, the use of bone replacement synthetic substitutes could be practical for clinical practice. This comprehensive review focuses initially on bone graft replacement substitutes, namely ceramic-based (calcium phosphate derivatives, bioactive glass) and autologous platelet concentrates, which assist in alveolar bone regeneration. Further literature compilations emphasize the innovations of biomaterials used as bone substitutes, barrier membranes and complex scaffold fabrication techniques that can mimic the histologically vital tissues required for the regeneration of periodontal apparatus.
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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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Senturk MF, Konuk B. Three-Dimensional evaluation of the effect of platelet-rich fibrin on edema in lower impacted third molar surgery performed with piezosurgery. Niger J Clin Pract 2022; 25:1107-1114. [DOI: 10.4103/njcp.njcp_1700_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Reshma A, Varghese S, Pampadykandathil L. Comparison between the regenerative potential of different types of platelet concentrates in periodontal intrabony defect management: A systematic review. J Indian Soc Periodontol 2022; 26:425-433. [DOI: 10.4103/jisp.jisp_684_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/28/2021] [Accepted: 12/12/2021] [Indexed: 11/04/2022] Open
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Sachdeva SV, Saluja H, Mani A. Novel technique for esthetic root coverage with titanium prepared platelet-rich fibrin. Natl J Maxillofac Surg 2021; 12:418-421. [PMID: 35153442 PMCID: PMC8820295 DOI: 10.4103/njms.njms_276_20] [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: 12/15/2020] [Revised: 03/11/2021] [Accepted: 05/28/2021] [Indexed: 11/23/2022] Open
Abstract
Leukocyte- and platelet-rich fibrin (L-PRF) can be defined as an autologous leukocyte and platelet-rich biomaterial. Unlike other platelet-rich products, this technique does not require an anticoagulant or bovine thrombin. However, it is simply centrifuged blood without any additives, which makes it possible to avoid all of the legal restrictions related to the reimplantation of blood-derived products. L-PRF is composed of a fibrin matrix polymerized in a tetramolecular structure and is involved in the joining of platelets, leukocytes, cytokines, and circulating stem cells. The use of silica- coated test tubes is arising a lot of queries about the safety of L-PRF prepared within these test tubes. So, to avoid the use of silicacoated test tubes, titanium prepared PRF has come in practice now, as titanium is biocompatible metal and has property of histoconduction. The present case report is about successful esthetic root coverage around mandibular anterior teeth with clinical attachment loss of 4–5 mm at baseline. The patient had reduced sensitivity, CAL was 1 mm, and attached gingiva covered denuded root surface after 15 days and after 3-month recall appointment.
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Affiliation(s)
- Shivani V Sachdeva
- Department of Periodontology, Pravara Institute of Medical Sciences, Rural Dental College, Loni, Maharashtra, India
| | - Harish Saluja
- Department of Oral and Maxillofacial Surgery, Pravara Institute of Medical Sciences, Rural Dental College, Loni, Maharashtra, India
| | - Amit Mani
- Department of Periodontology, Pravara Institute of Medical Sciences, Rural Dental College, Loni, Maharashtra, India
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Gummaluri SS, Bhattacharya HS, Kumar G, Chaudhary B, Karthikeyan SSS. Predictable Treatment of Gingival Recession Using Titanium Prepared Platelet-Rich Fibrin in Combination with Coronally Advanced Flap. Contemp Clin Dent 2021; 12:174-178. [PMID: 34220159 PMCID: PMC8237811 DOI: 10.4103/ccd.ccd_297_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/29/2020] [Accepted: 08/10/2020] [Indexed: 11/06/2022] Open
Abstract
Treatment for receding gums is always a challenging task for a periodontist. To fulfill this, many surgical techniques such as free gingival grafts, connective tissue grafts, pedicle flaps, and lateral sliding flaps have been used. For better prevention of relapse of these procedures and to improve the gingival biotype, various biomaterials such as platelet-rich fibrin, collagen matrix, and amnion chorion membranes have been additionally utilized. Due to advancements in preparation of platelet concentrates titanium platelet-rich fibrin, a third-generation platelet concentrate was introduced. Unlike other biomaterials, it has thicker fibrin meshwork with greater cellular entrapment and thicker membrane. Present case reports depict the usage of titanium platelet-rich fibrin as a biomaterial along with coronally advanced flap in the treatment of millers Class-I gingival recessions. Patients were followed up to 6 months after performing recession coverage treatments.
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Affiliation(s)
- Shiva Shankar Gummaluri
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Hirak S Bhattacharya
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Geetika Kumar
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Bharti Chaudhary
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - S S Sai Karthikeyan
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
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Koca-Ünsal RB, Ünsal G, Kasnak G, Fıratlı Y, Özcan İ, Orhan K, Fıratlı E. Ultrasonographic evaluation of the titanium-prepared platelet-rich fibrin effect in free gingival graft procedures. J Periodontol 2021; 93:187-194. [PMID: 34060090 DOI: 10.1002/jper.21-0076] [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: 02/05/2021] [Revised: 04/25/2021] [Accepted: 05/27/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Complications after free gingival graft (FGG) operations are generally related to the donor site. The titanium-prepared, platelet-rich fibrin (T-PRF) placement in the donor site accelerate the wound healing and prevent postoperative complications such as pain and hemorrhage. We aim to evaluate the effect of T-PRF regarding vascularization and tissue thickness and to report the advantages of the ultrasonography (US) in FGG. METHODS Ten individuals were divided into two groups as T-PRF and control. While the T-PRF membrane was placed at the donor site in the T-PRF group, a gelatin sponge was placed in the control group. All patients underwent US examination in terms of vascularization and tissue thickness of left and right donor sites. The correlation between the right and left donor sites was analyzed with the Pearson correlation test. Tissue thicknesses and pulsatility index (PI) were analyzed with independent samples t-test. The results were evaluated statistically at the P <0.05 significance level. RESULTS The T-PRF group showed increased vascularity which can be interpreted to improve healing in soft tissue. However, not a difference, but a positively very high correlation was observed between the right and left tissue thicknesses (P = 0,00; r = +0902). CONCLUSIONS Evaluation of tissue thickness and vascularization density of donor sites with US not only increases clinical success rate but also reduces the risk of complications during surgery and postoperative pain in FGG. Studies evaluating T-PRF membrane as palatal dressing after FGG are only clinical, however, the efficiency of T-PRF was evaluated radiologically in this study for the first time.
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Affiliation(s)
- Revan Birke Koca-Ünsal
- Department of Periodontology, University of Kyrenia, Faculty of Dentistry, Kyrenia, Cyprus
| | - Gürkan Ünsal
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Nicosia, Cyprus.,DESAM Institute, Near East University, Nicosia, Cyprus
| | - Gökhan Kasnak
- Department of Periodontology, Faculty of Dentistry, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Yiğit Fıratlı
- Department of Periodontology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - İlknur Özcan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.,Medical Design Application and Research Center, Ankara University, Ankara, Turkey
| | - Erhan Fıratlı
- Department of Periodontology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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Gusman DJR, Matheus HR, Alves BES, de Oliveira AMP, Britto ACDS, Novaes VCN, Nagata MJH, Batista VEDS, de Almeida JM. Platelet-rich fibrin for wound healing of palatal donor sites of free gingival grafts: Systematic review and meta-analysis. J Clin Exp Dent 2021; 13:e190-e200. [PMID: 33575004 PMCID: PMC7864367 DOI: 10.4317/jced.57451] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/23/2020] [Indexed: 01/08/2023] Open
Abstract
Background Platelet-rich fibrin (PRF) has been referred to as a second-generation platelet concentrate, associated with improvements on the healing of palatal wounds followed by FGG harvesting. The aim of this systematic review and meta-analysis was to assess the complete wound epithelialization and postoperative pain when PRF was used in palatal wounds following free gingival graft (FGG) harvesting.
Material and Methods PubMed (Medline), EMBASE and Scopus were searched by two independent individuals up to and including March 2020 in order to identify controlled and randomized controlled clinical trials on the use of PRF at palatal donor sites of FGG. The outcomes assessed were epithelialization and postoperative pain. The risk of bias of the included studies was evaluated using Cochrane Collaboration’s domain-based two-part tool. Random effects meta-analyses were conducted with 95% confidence intervals.
Results The search strategy identified 555 potentially eligible articles, of which 6 randomized controlled clinical trials were included. In the qualitative analysis, most studies (83.3%) reported lower postoperative pain in treatment groups, while all studies accessing epithelialization demonstrated earlier complete wound closure in groups treated with PRF. The discomfort and complete re-epithelialization were more favorable in groups PRF when compared to control groups (P<0.00001).
Conclusions Within the limits of the present study, it can be concluded that the use of PRF for wound healing of palatal donor sites of FGG may decrease postoperative pain and induce earlier complete wound epithelialization. Key words:Wound healing, oral surgery procedures, pain, postoperative.
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Affiliation(s)
- David-Jonathan-Rodrigues Gusman
- Department of Diagnostic and Surgery - Periodontics Division. São Paulo State University (UNESP), School of Dentistry, Araçatuba.,Department of periodontics, University of Western Sao Paulo (UNOESTE), Presidente Prudente, Sao Paulo, Brazil
| | - Henrique-Rinaldi Matheus
- Department of Diagnostic and Surgery - Periodontics Division. São Paulo State University (UNESP), School of Dentistry, Araçatuba
| | - Breno-Edson-Sendão Alves
- Department of Diagnostic and Surgery - Periodontics Division. São Paulo State University (UNESP), School of Dentistry, Araçatuba.,Department of periodontics, Maringa University Center (UNINGA), Maringa, Parana, Brazil
| | | | | | | | - Maria-José-Hitomi Nagata
- Department of Diagnostic and Surgery - Periodontics Division. São Paulo State University (UNESP), School of Dentistry, Araçatuba
| | | | - Juliano-Milanezi de Almeida
- Department of Diagnostic and Surgery - Periodontics Division. São Paulo State University (UNESP), School of Dentistry, Araçatuba
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Naik S, Nayak A, Chhatre A, Bhatt A, Paradkar S. Comparative evaluation of platelet count in whole blood and injectable platelet-rich fibrin. DENTISTRY AND MEDICAL RESEARCH 2021. [DOI: 10.4103/dmr.dmr_22_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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22
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Effects of titanium prepared platelet rich fibrin on facial nerve regeneration: an experimental study. Braz J Otorhinolaryngol 2020; 88:867-874. [PMID: 33441277 DOI: 10.1016/j.bjorl.2020.11.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/11/2020] [Accepted: 11/27/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Facial nerve damage is a condition that causes functional, psychological, and cosmetic problems; and treatment methods need to be improved. OBJECTIVE We investigated the efficacy of titanium-prepared platelet-rich fibrin as a healing enhancer at the region of transection of the facial nerve. METHODS Twenty-seven New Zealand male rabbits were used in this study, divided into three experimental groups. Group 1, the sham group (n=7); Group 2, the suture group (n=10); and Group 3, the suture+T-PRF group (n=10). In Group 1, the facial nerve trunk was dissected, and no additional surgical intervention was performed. For Group 2, a transection was made to the facial nerve trunk and the nerve endings were sutured together. In Group 3, nerve endings were sutured after transection, and a titanium-prepared platelet-rich fibrin membrane was wrapped in a tube around the damaged area. All animals were followed up weekly for the presence of corneal reflex, whisker movement and low ears. Bilateral facial electromyography was performed both preoperatively and postoperatively at the 1st, 3rd, 5th, 7th, 10th weeks. Tissue samples obtained at the 10th week were histopathologically examined, and intra-group and inter-group comparisons were performed. RESULTS Subjects in Group showed improvement in whisker movement and ear drop one week earlier than Group 2. In Group 3, the nerve stimulation threshold required to trigger the compound muscle action potential had returned to values similar to the preoperative control values (11.31±2.16V) by 5 weeks postoperatively (12.51±3.97V), (p=0.249). CONCLUSION Titanium-prepared platelet-rich fibrin administration contributed to partial nerve healing both on a functional and an electrophysiological level.
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Ravi S, Santhanakrishnan M. Mechanical, chemical, structural analysis and comparative release of PDGF-AA from L-PRF, A-PRF and T-PRF - an in vitro study. Biomater Res 2020; 24:16. [PMID: 32944280 PMCID: PMC7488539 DOI: 10.1186/s40824-020-00193-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 08/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Platelet concentrates have been popularly used in regenerative periodontal therapy as they are autologous in origin and they provide a supernatural concentration of platelets, growth factors and leukocytes. The release profile of various growth factors is considered important during the various phases of wound healing with the most important being the inflammatory phase where the release of the growth factors help in recruitment of cells and in collagen production. With the more recent modifications of PRF namely A-PRF and T-PRF, the mechanical and chemical degradation properties have also improved. The aim of the present study was to correlate the release profile of PDGF-AA from various forms of platelet concentrates (L-PRF, A-PRF, T-PRF) based on their mechanical and chemical properties. METHODS Blood samples were drawn from 2 male and 3 female systemically healthy patients between 20 and 25 years of age who were about to undergo periodontal regeneration for PRF preparation. The blood sample was immediately centrifuged using a table top centrifuge (Remi R4C) at 1060 rpm (208 x g) for 14 min for A-PRF preparation, 1960 rpm (708 x g) for 12 min for L-PRF preparation and 1960 rpm (708 x g) for 12 min in titanium tubes for T-PRF preparation. Tensile test was performed using universal testing machine. The in vitro degradation test of the prepared PRF membranes were conducted by placing the PRF membrane in 10 ml of pH 7.4 PBS on an orbital shaker set at 50 rpm. SEM evaluation of the PRF membrane was done under both low and high magnification. In order to determine the amount of released growth factor PDGF-AA at 15 min, 60 min, 8 h, 1 day, 3 days, and 10 days, samples were placed into a shaking incubator at 37 °C to allow for growth factor release into the culture media. RESULTS On comparing the three PRF membranes, it was found that T-PRF contained the maximum tensile strength (404.61 ± 5.92 MPa) and modulus of elasticity (151.9 ± 6.92 MPa). Statistically significant differences between the three groups were found on comparing the groups for their mechanical properties. In the degradation test, it was found that the maximum amount of degradation was found in L-PRF (85.75%), followed by A-PRF (84.18%) and the least was found in T-PRF (82.27%). T-PRF released the highest amount of PDGF-AA (6060.4 pg/ml) at early time points when compared to A-PRF (5935.3 pg/ml). While T-PRF had rapid release of PDGF-AA, A-PRF had a sustained release of growth factors released at later time points. CONCLUSION Results from the present study indicate that A-PRF is the most favourable form of platelet concentrate in regenerative periodontal therapy as it has a sustained release of growth factors over time.
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Affiliation(s)
- Shravanthy Ravi
- Department of Peridontology, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, 600116 India
| | - Muthukumar Santhanakrishnan
- Department of Peridontology, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, 600116 India
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KOYUNCUOĞLU CZ, ERCAN E, UZUN B, TUNALI M, FİRATLİ E. Management of Deep Gingival Recessions by Modified Coronally Advanced Tunnel Technique with Titanium Platelet Rich Fibrin Membrane or Connective Tissue Graft: 36 Months Follow-up Clinical Study. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2020. [DOI: 10.33808/marusbed.767457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Use of the Autologous Membrane in Structured Rhinoplasty: An Alternative to Camouflaging and Filling. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3056. [PMID: 32983802 PMCID: PMC7489584 DOI: 10.1097/gox.0000000000003056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 06/24/2020] [Indexed: 11/28/2022]
Abstract
Supplemental Digital Content is available in the text. Rhinoplasty is one of the most challenging procedures in plastic surgery because the surgical modifications should attend to patient expectations and to the need for functional correction allied to aesthetics. Composed of leukocytes and platelet-rich fibrin, an autologous membrane has great potential for tissue repair. The purpose of this study was to assess the use of this membrane (associated or not associated with diced cartilage) as an alternative to techniques such as the camouflage and filling; correction of irregularities of the dorsum, nose tip, soft triangle, and K zone; filling in of dead space; skin camouflage; and an improvement in the healing process in primary or secondary rhinoplasties.
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Jasmine S, Thangavelu A, Krishnamoorthy R, Alshatwi AA. Platelet Concentrates as Biomaterials in Tissue Engineering: a Review. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2020. [DOI: 10.1007/s40883-020-00165-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Agarwal MC, Kumar G, Manjunath RGS, Karthikeyan SSS, Gummaluri SS. Pinhole Surgical Technique - A Novel Minimally Invasive Approach for Treatment of Multiple Gingival Recession Defects: A Case Series. Contemp Clin Dent 2020; 11:97-100. [PMID: 33110318 PMCID: PMC7580744 DOI: 10.4103/ccd.ccd_449_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/14/2020] [Accepted: 03/07/2020] [Indexed: 11/22/2022] Open
Abstract
Gingival recessions are one of the most prevalent periodontal diseases. Hypersensitivity and esthetics are the major concerns associated with recession defects. There are various treatment modalities for its management, but recently, minimally invasive techniques have gained much importance because of lower patient morbidity and comparable results when compared to conventional techniques. This case series represents a 6-month follow-up of a recently introduced pinhole surgical technique where the percentage of root coverage was found to be statistically significant.
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Affiliation(s)
- Manvi Chandra Agarwal
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Geetika Kumar
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - R G Shiva Manjunath
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - S S Sai Karthikeyan
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Shiva Shankar Gummaluri
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
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Gummaluri SS, Bhattacharya HS, Astekar M, Cheruvu S. Evaluation of titanium-prepared platelet-rich fibrin and leucocyte platelet-rich fibrin in the treatment of intra-bony defects: A randomized clinical trial. J Dent Res Dent Clin Dent Prospects 2020; 14:83-91. [PMID: 32908648 PMCID: PMC7464223 DOI: 10.34172/joddd.2020.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 04/25/2020] [Indexed: 12/17/2022] Open
Abstract
Background. Various treatment modalities, such as leucocyte platelet-rich fibrin (L-PRF), bone grafts, and membranes, have been used for the restoration of lost periodontal tissues. Titanium-prepared platelet-rich fibrin (T-PRF) has attracted attention for its proper haemocompatibility, thick fibrin meshwork, and long resorption time. The present study aimed to evaluate the effectiveness of T-PRF and L-PRF in the management of intra-bony defects based on clinical and radiographic criteria. Methods. Twenty-six subjects with 34 intra-bony 3- walled defects were divided into two groups (n=17) and treated with T-PRF or L-PRF. Clinical and radiographic measurements were recorded at baseline and 6- , 3- and 9- month intervals and tabulated on Microsoft Excel spreadsheets. For intra- and intergroup comparisons, paired and unpaired t-tests were performed. P<0.05 was set as statistically significant Results. Intra-group comparisons revealed statistically significant differences (P<0.05) from baseline in both groups regarding clinical measurements. On intergroup comparison, the T-PRF group exhibited a significantly higher defect fill compared to the L-PRF group (P<0.05). Conclusion. Within the limits of the present study, T-PRF seems to be a better alternative to L-PRF in the treatment of intra-bony defects.
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Affiliation(s)
- Shiva Shankar Gummaluri
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Hirak S Bhattacharya
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Madhusudan Astekar
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Shivani Cheruvu
- Department of Periodontology and Implantology, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
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Platelet-Rich Fibrin as a Bone Graft Material in Oral and Maxillofacial Bone Regeneration: Classification and Summary for Better Application. BIOMED RESEARCH INTERNATIONAL 2019; 2019:3295756. [PMID: 31886202 PMCID: PMC6925910 DOI: 10.1155/2019/3295756] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 11/04/2019] [Indexed: 02/06/2023]
Abstract
Platelet-rich fibrin (PRF) is an autologous platelet concentrate that consists of cytokines, platelets, leukocytes, and circulating stem cells. It has been considered to be effective in bone regeneration and is mainly used for oral and maxillofacial bone. Although currently the use of PRF is thought to support alveolar ridge preservation, there is a lack of evidence regarding the application of PRF in osteogenesis. In this paper, we will provide examples of PRF application, and we will also summarize different measures to improve the properties of PRF for achieving better osteogenesis. The effect of PRF as a bone graft material on osteogenesis based on laboratory investigations, animal tests, and clinical evaluations is first reviewed here. In vitro, PRF was able to stimulate cell proliferation, differentiation, migration, mineralization, and osteogenesis-related gene expression. Preclinical and clinical trials suggested that PRF alone may have a limited effect. To enlighten researchers, modified PRF graft materials are further reviewed, including PRF combined with other bone graft materials, PRF combined with drugs, and a new-type PRF. Finally, we will summarize the common shortcomings in the application of PRF that probably lead to application failure. Future scientists should avoid or solve these problems to achieve better regeneration.
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Chang YR, Liu C, Yin LH. [Research progress on platelet-rich fibrin derivatives]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:660-665. [PMID: 31875447 DOI: 10.7518/hxkq.2019.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Platelet-rich plasma and platelet-rich fibrin (PRF) are widely used in the field of stomatology. Advance-ments in preparation techniques and basic research have enabled the use of PRF derivatives in oral clinical applications. The evolution, preparation techniques, biological properties, and medical research progress of PRF derivatives are reviewed in this paper.
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Affiliation(s)
- Yao-Ren Chang
- Dept. of Oral Implan-tation, Hospital of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Chun Liu
- Dept. of Oral Implan-tation, Hospital of Stomatology, Lanzhou University, Lanzhou 730000, China
| | - Li-Hua Yin
- Dept. of Oral Implan-tation, Hospital of Stomatology, Lanzhou University, Lanzhou 730000, China;Dept. of Dental Implantation, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai 200011, China
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Arabaci T, Albayrak M. Titanium-prepared platelet-rich fibrin provides advantages on periodontal healing: A randomized split-mouth clinical study. J Periodontol 2019; 89:255-264. [PMID: 29543995 DOI: 10.1002/jper.17-0294] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 09/20/2017] [Accepted: 09/23/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND The aim of this study to evaluate the contributions of titanium-prepared platelet-rich fibrin (T-PRF) combined with open flap debridement (OFD) on biological markers in gingival crevicular fluid (GCF)and periodontal outcomes. METHODS Twenty-nine participants with chronic periodontitis were treated either with autologous T-PRF+OFD or OFD alone. GCF growth factor levels and relative receptor activator nuclear factor kappa-B/osteoprotegerin (RANKL/OPG) ratio at baseline and 2, 4, and 6 weeks postoperatively were analyzed, and clinical parameters such as probing depth (PD), relative attachment level (RAL) and gingival margin level (GML) at baseline and 9 months after surgery were compared. RESULTS The mean PD reduction, RAL gain, and GML change were significantly greater in the OFD+T-PRF sites than in the OFD sites (P = 0.033, P = 0.029, and P = 0.026, respectively). Both groups demonstrated increased growth factor levels at week 2 compared with baseline, followed by reductions at weeks 4 and 6. GCF growth factor levels in the test group were seen at higher concentrations with respect to control group until 6 weeks post-surgery. During this 6-week period, relative RANKL/OPG ratio was found significantly lower in the OFD+T-PRF group compared to the OFD group(P < 0.05). CONCLUSIONS Using T-PRF membrane combined with OFD provided significantly higher concentrations of growth factors and lower RANKL/OPG ratio in GCF for approximately 4 to 6 weeks, and improved periodontal healing compared to conventional flap sites.
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Affiliation(s)
- Taner Arabaci
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Mevlut Albayrak
- Medical Laboratory Department, Health Services Vocational Training School, Ataturk University, Erzurum, Turkey
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Tian J, Cheng LHH, Cui X, Lei XX, Tang JB, Cheng B. Application of standardized platelet-rich plasma in elderly patients with complex wounds. Wound Repair Regen 2019; 27:268-276. [PMID: 30693614 DOI: 10.1111/wrr.12702] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 01/16/2019] [Accepted: 01/23/2019] [Indexed: 02/05/2023]
Abstract
In recent years, autologous platelet-rich plasma (PRP) derivatives have been used widely in the regeneration and repair of tissue, but a standard definition and preparation method for PRP are lacking. We developed a standardized method using platelet indices as quality-control indicators for PRP preparation. Twenty-one elderly patients (9 males, 12 females) with complex wounds were treated with standardized platelet-rich plasma (S-PRP). The platelet count in PRP after the second centrifugation was 1,069-1,436 × 109 /L. We adjusted the platelet concentration in PRP after a second centrifugation to 1,000 × 109 /L according to a formula using platelet-poor plasma (PPP). The standardized preparation method that we developed gave S-PRP with a relatively uniform platelet concentration. The wounds of 21 patients showed accelerated healing after S-PRP treatment, and there were no obvious side effects during treatment. These data suggest that our preparation method of S-PRP, using platelet indices as quality-control indicators with platelet count of 1,000 × 109 /L could be used for the treatment of complex wounds in the elderly. The preparation method of S-PRP proposed in the present study may be a simple and effective method of PRP quality control.
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Affiliation(s)
- Ju Tian
- Department of Plastic Surgery, People's Hospital of Zhongshan City, Zhongshan, Guangdong, China
- Department of Plastic Surgery, General Hospital of Southern Theater Command, PLA, Guangzhou, Guangdong, China
- The Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLA, Guangzhou, Guangdong, China
| | - Liu-Hang-Hang Cheng
- Graduate School, Shantou University Medical College, Shantou, Guangdong, China
| | - Xiao Cui
- Department of Plastic Surgery, General Hospital of Southern Theater Command, PLA, Guangzhou, Guangdong, China
- The Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLA, Guangzhou, Guangdong, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiao-Xuan Lei
- Department of Plastic Surgery, General Hospital of Southern Theater Command, PLA, Guangzhou, Guangdong, China
- The Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLA, Guangzhou, Guangdong, China
| | - Jian-Bing Tang
- Department of Plastic Surgery, General Hospital of Southern Theater Command, PLA, Guangzhou, Guangdong, China
| | - Biao Cheng
- Department of Plastic Surgery, General Hospital of Southern Theater Command, PLA, Guangzhou, Guangdong, China
- The Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLA, Guangzhou, Guangdong, China
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Barbon S, Stocco E, Macchi V, Contran M, Grandi F, Borean A, Parnigotto PP, Porzionato A, De Caro R. Platelet-Rich Fibrin Scaffolds for Cartilage and Tendon Regenerative Medicine: From Bench to Bedside. Int J Mol Sci 2019; 20:ijms20071701. [PMID: 30959772 PMCID: PMC6479320 DOI: 10.3390/ijms20071701] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 03/30/2019] [Accepted: 04/01/2019] [Indexed: 12/22/2022] Open
Abstract
Nowadays, research in Tissue Engineering and Regenerative Medicine is focusing on the identification of instructive scaffolds to address the requirements of both clinicians and patients to achieve prompt and adequate healing in case of injury. Among biomaterials, hemocomponents, and in particular Platelet-rich Fibrin matrices, have aroused widespread interest, acting as delivery platforms for growth factors, cytokines and immune/stem-like cells for immunomodulation; their autologous origin and ready availability are also noteworthy aspects, as safety- and cost-related factors and practical aspects make it possible to shorten surgical interventions. In fact, several authors have focused on the use of Platelet-rich Fibrin in cartilage and tendon tissue engineering, reporting an increasing number of in vitro, pre-clinical and clinical studies. This narrative review attempts to compare the relevant advances in the field, with particular reference being made to the regenerative role of platelet-derived growth factors, as well as the main pre-clinical and clinical research on Platelet-rich Fibrin in chondrogenesis and tenogenesis, thereby providing a basis for critical revision of the topic.
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Affiliation(s)
- Silvia Barbon
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121 Padova, Italy.
- LifeLab Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Via N. Giustiniani 2, 35128 Padova, Italy.
| | - Elena Stocco
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121 Padova, Italy.
- LifeLab Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Via N. Giustiniani 2, 35128 Padova, Italy.
| | - Veronica Macchi
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121 Padova, Italy.
- LifeLab Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Via N. Giustiniani 2, 35128 Padova, Italy.
| | - Martina Contran
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121 Padova, Italy.
| | - Francesca Grandi
- Complex Operative Unit-Pediatric Surgery, Hospital of Bolzano, Via L. Böhler 5, 39100 Bolzano, Italy.
| | - Alessio Borean
- Department of Immunohematology and Transfusion Medicine, San Martino Hospital, 32100 Belluno, Italy.
| | - Pier Paolo Parnigotto
- Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling (T.E.S.) Onlus, 35131 Padua, Italy.
| | - Andrea Porzionato
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121 Padova, Italy.
- LifeLab Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Via N. Giustiniani 2, 35128 Padova, Italy.
| | - Raffaele De Caro
- Department of Neuroscience, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121 Padova, Italy.
- LifeLab Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Via N. Giustiniani 2, 35128 Padova, Italy.
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Gomez TW, Gopal RV, Gaffoor FMA, Kumar STR, Girish CS, Prakash R. Comparative evaluation of angiogenesis using a novel platelet-rich product: An in vitro study. J Conserv Dent 2019; 22:23-27. [PMID: 30820078 PMCID: PMC6385567 DOI: 10.4103/jcd.jcd_216_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: In vivo angiogenesis is normal and vital process in growth and development, wound healing, and formation of granulation tissue wherein new blood vessels form from preexisting vessels as part of revascularization. Platelet-rich products promote wound healing associated with angiogenesis. Biomaterials such as titanium were found to be angiogenic. Unlike in vivo situations, in vitro angiogenesis, study cells, within a controlled environment. Aims: The aim of this study is to evaluate the angiogenic potential of a novel platelet-rich product. Materials and Methods: Blood was drawn from volunteers with informed consent. Blood samples were centrifuged to obtain platelet-rich products. Platelet concentrates prepared were platelet-rich plasma (PRP), platelet-rich fibrin, and a novel platelet-rich product which is titanium-prepared PRP (TPRP), obtained using titanium. The study which compared platelet concentrate was divided into four groups subjected to tissue culture. Phase-contrast microscope was used to determine the rate of growth by cell counting. Statistical Analysis: ANOVA was used for comparison within groups and post hoc for multiple comparisons. Results: TPRP group showed granular ground substance. Group with platelet-rich fibrin (PRF) shows a high rate of growth whereas those with TPRP showed better growth rate when compared to its counterpart, PRP. Conclusions: This is the first study which introduces TPRP. Previous studies have proved that titanium-prepared PRF has better structural quality than its counterpart platelet-rich fibrin. This study concludes that TPRP has better angiogenic potential than its counterpart PRP. Further in vivo studies are needed to promote TPRP as a new generation of platelet products.
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Affiliation(s)
- Treesa William Gomez
- Department of Conservative and Endodontics, Noorul Islam College of Dental Science, Kerala University of Health Sciences, Thiruvananthapuram, Kerala, India
| | - Rajesh V Gopal
- Department of Conservative and Endodontics, Noorul Islam College of Dental Science, Kerala University of Health Sciences, Thiruvananthapuram, Kerala, India
| | - Faisal M A Gaffoor
- Department of Conservative and Endodontics, Noorul Islam College of Dental Science, Kerala University of Health Sciences, Thiruvananthapuram, Kerala, India
| | - Santhosh T R Kumar
- Department of Biotechnology, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, India
| | - C Sabari Girish
- Department of Conservative and Endodontics, Noorul Islam College of Dental Science, Kerala University of Health Sciences, Thiruvananthapuram, Kerala, India
| | - R Prakash
- Department of Biotechnology, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, India
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Mitra DK, Potdar PN, Prithyani SS, Rodrigues SV, Shetty GP, Talati MA. Comparative study using autologous platelet-rich fibrin and titanium prepared platelet-rich fibrin in the treatment of infrabony defects: An in vitro and in vivo study. J Indian Soc Periodontol 2019; 23:554-561. [PMID: 31849402 PMCID: PMC6906909 DOI: 10.4103/jisp.jisp_562_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: The platelet concentrates had been pioneered to be used in regenerative medicine since above a decade. Aims and Objectives: To compare the autologous platelet rich fibrin (PRF) and titanium prepared platelet rich fibrin (T-PRF) in the treatment of infrabony defects, clinically and radiographically and to compare the histologic difference between PRF and T-PRF by light microscopy and scanning electron microscopy (SEM). Materials and Methods: The present study is a split mouth randomised controlled trial study in which 20 sites were selected and randomly assigned equally into 10 sites each in group A [Test group=T-PRF] and group B [Control group=PRF]. Clinical parameters were evaluated at baseline,3 months and 9 months. Radiographic parameters were evaluated at baseline and 9 months. Histologic differences between light microscopy and SEM for both PRF and T-PRF was studied after sequential processing. Results: There was marked reduction in Probing Pocket depth and gain in Clinical Attachment Level in both the T-PRF and PRF groups from baseline to 9 months in intragroup comparisons. However, on intergroup comparisons, no statistical significance was seen. Radiographically, mean defect depths for both the groups showed statistically significant reduction from baseline values to 9 months on intragroup comparisons but not on intergroup comparisons. In-vitro evaluation, on both light and scanning electron microscopy, T-PRF showed denser fibril meshwork as compared to PRF. Conclusion: The clinical parameters and radiographic outcomes showed marked improvement at 9 months with both PRF and T-PRF in the treatment of infrabony defects from baseline values in intragroup comparison. However, statistically efficacy of T-PRF was not seen to be superior to that of PRF both clinically and radiographically. Histologic evaluation showed T-PRF had denser fibrils as compared to PRF in both light and scanning electron microscopy.
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Affiliation(s)
- Dipika Kalyan Mitra
- Department of Periodontology, T. P. C. T's Terna Dental College, Navi Mumbai, Maharashtra, India
| | | | - Saurabh Suresh Prithyani
- Department of Periodontology, T. P. C. T's Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Silvia Victor Rodrigues
- Department of Periodontology, T. P. C. T's Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Gaurav Prabhakar Shetty
- Department of Periodontology, T. P. C. T's Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Meenakshi Abhay Talati
- Department of Periodontology, T. P. C. T's Terna Dental College, Navi Mumbai, Maharashtra, India
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Ercan E. The Effect of Platelet-Rich Fibrin and Titanium Prepared Platelet-Rich Fibrin on Early Soft Tissue Healing of Extraction Sites. CUMHURIYET DENTAL JOURNAL 2018. [DOI: 10.7126/cumudj.471947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Kizildağ A, Çiçek Y, Arabaci T, Köse O. The effect of leukocyte-platelet-rich fibrin on bone morphogenetic protein-2 and insulin-like growth factor-1 levels in patients with chronic periodontitis: a randomized split mouth clinical trail. Growth Factors 2018; 36:239-245. [PMID: 30624092 DOI: 10.1080/08977194.2018.1551217] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The present study evaluates the effects of leukocyte-platelet-rich fibrin (L-PRF) combined with open flap debridement (OFD) on clinical parameters and growth factors levels (GFL) in chronic periodontitis (CP) patients. This trial was registered at clinicaltrials.gov as NCT02594605. 16 patients (32 sites) with chronic periodontitis who had at least two areas of horizontal bone loss, were treated with OFD alone or L-PRF with OFD (OFD + L-PRF). GFL in gingival crevicular fluid (GCF) were analyzed at baseline, 1 week, 2 weeks and 4 weeks after operation. Probing depth (PD) and clinical attachment level (CAL) were measured at baseline and 6 months postoperatively. PD reduction and CAL gain were significantly higher in the OFD + L-PRF sites than in OFD sites. OFD + L-PRF group showed significantly increased bone morphogenetic protein-2 and insulin-like growth factor-1 at 2 weeks compared with baseline. L-PRF combined with OFD significantly increases GFL and thus, it enhances the periodontal healing on CP patients.
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Affiliation(s)
- Alper Kizildağ
- a Department of Periodontology, Faculty of Dentistry , Pamukkale University , Denizli , Turkey
| | - Yasin Çiçek
- b Department of Periodontology, Faculty of Dentistry , Adıyaman University , Adıyaman , Turkey
| | - Taner Arabaci
- c Department of Periodontology, Faculty of Dentistry , Atatürk University , Erzurum , Turkey
| | - Oğuz Köse
- d Department of Periodontology, Faculty of Dentistry , Recep Tayyip Erdogan University , Rize , Turkey
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Barbon S, Stocco E, Grandi F, Rajendran S, Borean A, Pirola I, Capelli S, Bagno A, Tavano R, Contran M, Macchi V, De Caro R, Parnigotto PP, Porzionato A, Grandi C. Biofabrication of a novel leukocyte-fibrin-platelet membrane as a cells and growth factors delivery platform for tissue engineering applications. J Tissue Eng Regen Med 2018; 12:1891-1906. [PMID: 29956492 DOI: 10.1002/term.2713] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 04/04/2018] [Accepted: 06/01/2018] [Indexed: 12/12/2022]
Abstract
Autologous platelet-rich hemocomponents have emerged as potential biologic tools for regenerative purpose, but their therapeutic efficacy still remains controversial. This work represents the characterization study of an innovative autologous leukocyte-fibrin-platelet membrane (LFPm), which we prepared according to a novel protocol involving multiple cycles of apheresis. The high content in fibrinogen gave to our hemocomponent the appearance of a manipulable and suturable membrane with high elasticity and deformation capacity. Moreover, being highly enriched with platelets, leukocytes, and monocytes/macrophages, the LFPm sustained the local release of bioactive molecules (platelet derived growth factor, vascular endothelial growth factor, interleukin-10, and tumour necrosis factor alpha). In parallel, the evaluation of stemness potential highlighted also that the LFPm contained cells expressing pluripotency and multipotency markers both at the messenger ribonucleic acid (NANOG, SOX2, THY1, NT5E, and ENG) and surface-protein level (CD44high /CD73+ /CD34+ /CD117+ /CD31+ ). Finally, biodegradation analysis interestingly showed a good stability of the membrane for at least 3 weeks in vitro and 1 week in vivo. In both cases, biodegradation was associated with progressive exposure of fibrin scaffold, loss/migration of cellular elements, and release of growth factors. Overall, collected evidence could shed some light on the regenerative effect that LFPms may exert after the autologous implant on a defect site.
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Affiliation(s)
- Silvia Barbon
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy.,Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling (TES) ONLUS, Padua, Italy
| | - Elena Stocco
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy.,Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling (TES) ONLUS, Padua, Italy
| | - Francesca Grandi
- Department of Women's and Children's Health, Pediatric Surgery, University of Padua, Padua, Italy
| | - Senthilkumar Rajendran
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | - Alessio Borean
- Department of Immunohematology and Transfusion Medicine, San Martino Hospital Belluno, Belluno, Italy
| | - Ivan Pirola
- Department of Immunohematology and Transfusion Medicine, San Martino Hospital Belluno, Belluno, Italy
| | - Stefano Capelli
- Department of Immunohematology and Transfusion Medicine, San Martino Hospital Belluno, Belluno, Italy
| | - Andrea Bagno
- Department of Industrial Engineering, University of Padua, Padua, Italy
| | - Regina Tavano
- Department of Biomedical Sciences, University of Padua, Padova, Italy
| | - Martina Contran
- Department of Neurosciences, Section of Human Anatomy, University of Padua, Padua, Italy
| | - Veronica Macchi
- Department of Neurosciences, Section of Human Anatomy, University of Padua, Padua, Italy
| | - Raffaele De Caro
- Department of Neurosciences, Section of Human Anatomy, University of Padua, Padua, Italy
| | - Pier Paolo Parnigotto
- Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling (TES) ONLUS, Padua, Italy
| | - Andrea Porzionato
- Department of Neurosciences, Section of Human Anatomy, University of Padua, Padua, Italy
| | - Claudio Grandi
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
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Olgun E, Ozkan SY, Atmaca HT, Yalim M, Hendek MK. Comparison of the clinical, radiographic, and histological effects of titanium-prepared platelet rich fibrin to allograft materials in sinus-lifting procedures. ACTA ACUST UNITED AC 2018; 9:e12347. [DOI: 10.1111/jicd.12347] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/19/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Ebru Olgun
- Department of Periodontology; Faculty of Dentistry; Kirikkale University; Kirikkale Turkey
| | | | | | - Mehmet Yalim
- Department of Periodontology; Faculty of Dentistry; Gazi University; Ankara Turkey
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Yu P, Zhai Z, Jin X, Yang X, Qi Z. Clinical Application of Platelet-Rich Fibrin in Plastic and Reconstructive Surgery: A Systematic Review. Aesthetic Plast Surg 2018; 42:511-519. [PMID: 29396591 DOI: 10.1007/s00266-018-1087-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 01/14/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Platelet-rich fibrin (PRF) has been applied in the clinical field for more than a decade, but largely in oral surgery and implant dentistry. Its utilization in plastic and reconstructive surgery is limited and lacking a comprehensive review. Hence, this article focuses on the various clinical applications of PRF pertaining to the plastic and reconstructive field through a systematic review. METHODS In this review, articles describing the clinical application of PRF in plastic and reconstructive surgery were screened using predetermined inclusion and exclusion criteria. The articles were summarized and divided into groups based on the utilization of PRF. The effects and complications of PRF were analyzed and concluded. RESULTS Among the 634 articles searched, 7 articles describing 151 cases are eligible. PRF was applied on 116 (76.8%) wounds to facilitate tissue healing, and the complete wound closure rate was 91.4% (106/116). Otherwise, PRF was applied in 10 (6.6%) cases of zygomaticomaxillary fracture to reconstruct orbital floor defects and in 25 (16.6%) cases of facial autologous fat grafts to increase the fat retention rate successfully. There is no report of PRF-related complications. CONCLUSIONS PRF could facilitate wound healing, including the healing of soft tissues and bony tissues, and facilitate fat survival rate. Further studies are needed to test the mechanism of PRF and expand its scope of application in plastic and reconstructive surgery. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Effectiveness and predictability of titanium-prepared platelet-rich fibrin for the management of multiple gingival recessions. Clin Oral Investig 2017; 22:1345-1354. [DOI: 10.1007/s00784-017-2211-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 09/11/2017] [Indexed: 11/26/2022]
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Agrawal AA. Evolution, current status and advances in application of platelet concentrate in periodontics and implantology. World J Clin Cases 2017; 5:159-171. [PMID: 28560233 PMCID: PMC5434315 DOI: 10.12998/wjcc.v5.i5.159] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 12/06/2016] [Accepted: 03/02/2017] [Indexed: 02/05/2023] Open
Abstract
Platelet concentrates (PC) [platelet-rich plasma (PRP) and platelet-rich fibrin (PRF)] are frequently used for surgical procedures in medical and dental fields, particularly in oral and maxillofacial surgery, plastic surgery and sports medicine. The objective of all these technologies is to extract all the elements from a blood sample that could be used to improve healing and promote tissue regeneration. Although leukocyte rich and leukocyte poor PRP’s have their own place in literature, the importance of non-platelet components in a platelet concentrate remains a mystery. PC have come a long way since its first appearance in 1954 to the T-PRF, A-PRF and i-PRF introduced recently. These PC find varied applications successfully in periodontics and implant dentistry as well. However, the technique of preparation, standing time, transfer process, temperature of centrifuge, vibration, etc., are the various factors for the mixed results reported in the literature. Until the introduction of a proper classification of terminologies, the PC were known by different names in different countries and by different commercial companies which also created a lot of confusion. This review intends to clarify all these confusion by briefing the exact evolution of PC, their preparation techniques, recent advances and their various clinical and technical aspects and applications.
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Arabacı T, Kose O, Albayrak M, Cicek Y, Kizildag A. Advantages of Autologous Platelet-Rich Fibrin Membrane on Gingival Crevicular Fluid Growth Factor Levels and Periodontal Healing: A Randomized Split-Mouth Clinical Study. J Periodontol 2017; 88:771-777. [PMID: 28452623 DOI: 10.1902/jop.2017.160485] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND This study evaluates contributions of platelet-rich fibrin (PRF) combined with conventional flap surgery on growth factor levels in gingival crevicular fluid (GCF) and periodontal healing. METHODS Twenty-six patients (52 sites) with chronic periodontitis were treated either with autologous PRF with open flap debridement (OFD+PRF) or OFD alone. Growth factor levels in GCF at baseline and 2, 4, and 6 weeks after surgery were analyzed, and clinical parameters such as probing depth (PD), relative clinical attachment level (rCAL), and gingival margin level (GML) at baseline and 9 months after surgery were measured. RESULTS Mean PD reduction and rCAL gain were significantly greater in OFD+PRF sites than in OFD sites. Mean GML change was -0.38 + 0.10 mm in OFD sites and 0.11 + 0.08 mm in the test group; difference between the two groups was statistically significant (P <0.05). Both groups demonstrated increased expression levels of fibroblast growth factor-2, transforming growth factor-β1, and platelet-derived growth factor-BB at 2 weeks compared with baseline, followed by reductions at 4 and 6 weeks. The OFD+PRF group showed significantly higher growth factor levels compared with the OFD group at 2 and 4 weeks. CONCLUSION PRF membrane combined with OFD provides significantly higher GCF concentrations of angiogenic biomarkers for ≈2 to 4 weeks and better periodontal healing in terms of conventional flap sites.
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Affiliation(s)
- Taner Arabacı
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Oguz Kose
- Department of Periodontology, Faculty of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Mevlut Albayrak
- Medical Laboratory Department, Health Services Vocational Training School, Atatürk University
| | - Yasin Cicek
- Department of Periodontology, Faculty of Dentistry, Adıyaman University, Adıyaman, Turkey
| | - Alper Kizildag
- Department of Periodontology, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
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Wang X, Li G, Guo J, Yang L, Liu Y, Sun Q, Li R, Yu W. Hybrid composites of mesenchymal stem cell sheets, hydroxyapatite, and platelet-rich fibrin granules for bone regeneration in a rabbit calvarial critical-size defect model. Exp Ther Med 2017; 13:1891-1899. [PMID: 28565782 PMCID: PMC5443196 DOI: 10.3892/etm.2017.4199] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 01/13/2017] [Indexed: 12/15/2022] Open
Abstract
The reconstruction of large bone defects remains a major clinical challenge, and tissue engineering is a promising technique for resolving this problem. Many attempts have been made to optimize bone tissue engineering protocols. The aim of the present study was to develop a process incorporating mesenchymal stem cell (MSC) sheets with nanoscale hydroxyapatite (nano-HA) and autologous platelet-rich fibrin (PRF) granules for enhanced bone formation within a critical-sized rabbit cranial defect. MSC sheets and PRF were prepared prior to in vivo experiments. The osteogenic differentiation ability of MSCs and the ultrastructure of PRF were also studied. A total of 15 New Zealand white rabbits were used in the current study and critical-size defects (CSDs) were surgically introduced in the cranium (diameter, 15 mm). The surgical defects were treated with MSC/PRF composites, MSC composites or left empty. Animals were euthanized at week 8 post-surgery. Iconography, histological and histomorphometric analysis were performed to assess de novo bone formation. The percentage of new bone in the MSC/PRF group (35.7±5.1%) was significantly higher than that in the MSC (18.3±3.2%; P<0.05) and empty defect groups (4.7±1.5%; P<0.05). The results of the present study suggest that combined application of an MSC sheet with nano-HA and granular PRF enhances bone regeneration in a rabbit calvarial CSD model, and provides a novel insight into bone tissue regeneration for large bone defects.
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Affiliation(s)
- Xi Wang
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Guanghui Li
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Jia Guo
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Lei Yang
- Department of Orthodontics, Beijing Ruitai Dental Hospital, Beijing 100107, P.R. China
| | - Yiming Liu
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Qiang Sun
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Rui Li
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Weiwei Yu
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
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Chatterjee A, Debnath K, Ali MM, Babu C, Gowda PL. Comparative histologic evaluation of titanium platelet-rich fibrin and platelet-rich fibrin in hypertensive and smoker participants: A cell cytology study. J Indian Soc Periodontol 2017; 21:195-200. [PMID: 29440785 PMCID: PMC5803874 DOI: 10.4103/jisp.jisp_137_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction In recent years, a growing interest has emerged with the use of platelet-rich products for the treatment of many clinical conditions in dentistry. Objective The present study aimed to define the structural characteristics of titanium platelet-rich fibrin (TPRF) and PRF in hypertensive and smoker participants. Materials and Methods Ten milliliters of blood samples was drawn using a syringe form ninety participants (healthy, hypertensive, and smokers). Five milliliters of blood was transferred to each of dry glass tube and titanium tube. The clot obtained after centrifugation from each tube was processed for light microscopy analysis. Results The TPRF samples have demonstrated a highly organized and thicker fibrin network with continuous integrity as compared to PRF in healthy participants. The hypertensive and smokers showed less prominent fibrin border between the cellular structures in both the platelet concentrates, but sufficient fibrin mesh network was found in TPRF clot as compared to PRF clot in the test participants. Conclusion This is the first human histologic study to define the fibrin meshwork in both TPRF and PRF clots in hypertensive and smokers. The platelet activation by titanium offered high characteristics to fibrin network.
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Affiliation(s)
- Anirban Chatterjee
- Department of Periodontology and Implantology, Oxford Dental College, Bengaluru, Karnataka, India
| | - Koel Debnath
- Department of Periodontology and Implantology, Oxford Dental College, Bengaluru, Karnataka, India
| | - Mohd Mustafa Ali
- Department of Periodontology and Implantology, Oxford Dental College, Bengaluru, Karnataka, India
| | - Chaitanya Babu
- Department of Periodontology and Implantology, Oxford Dental College, Bengaluru, Karnataka, India
| | - Pratibha Laxman Gowda
- Department of Periodontology and Implantology, Oxford Dental College, Bengaluru, Karnataka, India
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Miron RJ, Fujioka-Kobayashi M, Bishara M, Zhang Y, Hernandez M, Choukroun J. Platelet-Rich Fibrin and Soft Tissue Wound Healing: A Systematic Review. TISSUE ENGINEERING PART B-REVIEWS 2016; 23:83-99. [PMID: 27672729 DOI: 10.1089/ten.teb.2016.0233] [Citation(s) in RCA: 225] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The growing multidisciplinary field of tissue engineering aims at predictably regenerating, enhancing, or replacing damaged or missing tissues for a variety of conditions caused by trauma, disease, and old age. One area of research that has gained tremendous awareness in recent years is that of platelet-rich fibrin (PRF), which has been utilized across a wide variety of medical fields for the regeneration of soft tissues. This systematic review gathered all the currently available in vitro, in vivo, and clinical literature utilizing PRF for soft tissue regeneration, augmentation, and/or wound healing. In total, 164 publications met the original search criteria, with a total of 48 publications meeting inclusion criteria (kappa score = 94%). These studies were divided into 7 in vitro, 11 in vivo, and 31 clinical studies. In summary, 6 out of 7 (85.7%) and 11 out of 11 (100%) of the in vitro and in vivo studies, respectively, demonstrated a statistically significant advantage for combining PRF to their regenerative therapies. Out of the remaining 31 clinical studies, a total of 8 reported the effects of PRF in a randomized clinical trial, with 5 additional studies (13 total) reporting appropriate controls. In those clinical studies, 9 out of the 13 studies (69.2%) demonstrated a statistically relevant positive outcome for the primary endpoints measured. In total, 18 studies (58% of clinical studies) reported positive wound-healing events associated with the use of PRF, despite using controls. Furthermore, 27 of the 31 clinical studies (87%) supported the use of PRF for soft tissue regeneration and wound healing for a variety of procedures in medicine and dentistry. In conclusion, the results from the present systematic review highlight the positive effects of PRF on wound healing after regenerative therapy for the management of various soft tissue defects found in medicine and dentistry.
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Affiliation(s)
- Richard J Miron
- 1 Department of Periodontology, Nova Southeastern University , Fort Lauderdale, Florida
| | - Masako Fujioka-Kobayashi
- 1 Department of Periodontology, Nova Southeastern University , Fort Lauderdale, Florida.,2 Cranio-Maxillofacial Surgery, Bern University Hospital , Inselspital, Bern, Switzerland .,3 Department of Oral Surgery, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School , Tokushima, Japan
| | - Mark Bishara
- 4 West Bowmanville Family Dental , Ontario, Canada
| | - Yufeng Zhang
- 5 Department of Oral Implantology, University of Wuhan , Wuhan, China
| | - Maria Hernandez
- 1 Department of Periodontology, Nova Southeastern University , Fort Lauderdale, Florida
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Ustaoğlu G, Ercan E, Tunali M. The role of titanium-prepared platelet-rich fibrin in palatal mucosal wound healing and histoconduction. Acta Odontol Scand 2016; 74:558-564. [PMID: 27538770 DOI: 10.1080/00016357.2016.1219045] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE We aimed to determine the clinical effects of titanium-prepared, platelet-rich fibrin (T-PRF) on human palatal mucosal wound healing (PMWH) and to identify its effect on time-dependent changes in palatal soft-tissue thickness (PSTT) in terms of histoconduction, which is a new concept. MATERIALS AND METHODS Free gingival graft (FGG) donor sites were treated with T-PRF and compared with an untreated control group. The results of colour match and H2O2-bubbling tests for complete wound epithelization (CWE) were recorded on days 3, 7, 14 and 21. Pain level, number of analgesics used and bleeding status were recorded for the first 7 days. PSTT was measured at baseline and after 1 and 6 months. RESULTS Colour match scores of the test group were significantly higher than those of the control group at 7 and 14 days. CWE was observed at a higher frequency in the test group than in the control group on day 14. Post-operative bleeding prevalence was lower in the test group than in the control group for the first 2 days. A time-dependent decrease in PSTT was observed at 1 and 6 months in the control group compared with baseline (baseline, 4.23 ± 0.62 mm; 1 month, 4.01 ± 0.68 mm; and 6 months, 3.93 ± 0.69 mm). However, no significant difference was found in the test group (baseline, 4.29 ± 0.64 mm; 1 month, 4.61 ± 0.51 mm; and 6 months, 4.51 ± 0.58 mm). CONCLUSION The T-PRF membrane exhibited positive effects on PMWH. T-PRF, which is a promising autogenous matrix for histoconduction, may also be preferred as an autogenous alternative to connective tissue grafts in the treatment of gingival recessions and peri-implant mucosal recessions.
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Chatterjee A, Pradeep AR, Garg V, Yajamanya S, Ali MM, Priya VS. Treatment of periodontal intrabony defects using autologous platelet-rich fibrin and titanium platelet-rich fibrin: a randomized, clinical, comparative study. ACTA ACUST UNITED AC 2016; 8. [PMID: 27477110 DOI: 10.1111/jicd.12231] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 05/25/2016] [Indexed: 11/30/2022]
Abstract
AIM The aim of the present study was to compare the effectiveness of open flap debridement (OFD) alone and OFD with either autologous platelet-rich fibrin (PRF) or titanium PRF (TPRF) in the treatment of intrabony defects (IBD). METHODS The study was conducted on patients reporting to the Department of Periodontics, The Oxford Dental College and Hospital, Bangalore, India. Thirty-eight patients with 90 periodontal IBD of moderate-severe periodontitis were selected and assigned to the OFD alone group (group I), the OFD with autologous PRF group (group II), or the OFD with TPRF group (group III). In each patient, a minimum number of two sextants were present, with probing pocket depths (PPD) ≥5 mm in at least three teeth. RESULTS At 9 months' postoperatively, upon comparing the PPD reduction, defect depth reduction, and clinical attachment level gains, it was noted that groups II and III showed statistically-significant improvements compared with group I, but no statistically-significant difference was noted between groups II and III. CONCLUSION The present study demonstrated that marked improvements in the clinical parameters and radiographic outcomes were noted with both autologous PRF and TPRF in the treatment of IBD.
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Affiliation(s)
- Anirban Chatterjee
- Department of Periodontics, The Oxford Dental College & Hospital, Bangalore, Karnataka, India
| | - Avani R Pradeep
- Department of Periodontology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Vibhuti Garg
- Department of Periodontology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Shravanthi Yajamanya
- Department of Periodontics, The Oxford Dental College & Hospital, Bangalore, Karnataka, India
| | - Mohammed M Ali
- Department of Periodontics, The Oxford Dental College & Hospital, Bangalore, Karnataka, India
| | - V Sneha Priya
- Department of Periodontics, The Oxford Dental College & Hospital, Bangalore, Karnataka, India
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A novel platelet concentrate: titanium-prepared platelet-rich fibrin. BIOMED RESEARCH INTERNATIONAL 2014; 2014:209548. [PMID: 24563860 PMCID: PMC3915853 DOI: 10.1155/2014/209548] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 11/02/2013] [Indexed: 11/17/2022]
Abstract
We developed a new product called titanium-prepared platelet-rich fibrin (T-PRF). The T-PRF method is based on the hypothesis that titanium may be more effective in activating platelets than the silica activators used with glass tubes in Chouckroun's leukocyte- and platelet-rich fibrin (L-PRF) method. In this study, we aimed to define the structural characteristics of T-PRF and compare it with L-PRF. Blood samples were collected from 10 healthy male volunteers. The blood samples were drawn using a syringe. Nine milliliters was transferred to a dry glass tube, and 9 mL was transferred to a titanium tube. Half of each clot (i.e., the blood that was clotted using T-PRF or L-PRF) was processed with a scanning electron microscope (SEM). The other half of each clot was processed for fluorescence microscopy analysis and light microscopy analysis. The T-PRF samples seemed to have a highly organized network with continuous integrity compared to the other L-PRF samples. Histomorphometric analysis showed that T-PRF fibrin network covers larger area than L-PRF fibrin network; also fibrin seemed thicker in the T-PRF samples. This is the first human study to define T-PRF as an autogenous leukocyte- and platelet-rich fibrin product. The platelet activation by titanium seems to offer some high characteristics to T-PRF.
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Naik B, Karunakar P, Jayadev M, Marshal VR. Role of Platelet rich fibrin in wound healing: A critical review. J Conserv Dent 2013; 16:284-93. [PMID: 23956527 PMCID: PMC3740636 DOI: 10.4103/0972-0707.114344] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 03/21/2013] [Accepted: 04/22/2013] [Indexed: 02/02/2023] Open
Abstract
AIM The aim is to review and discuss the strategies available for use of platelet rich fibrin as healing aid in dentistry. BACKGROUND Platelet rich fibrin (PRF) is a fibrin matrix in which platelet cytokines, growth factors, and cells are trapped and may be released after a certain time and that can serve as a resorbable membrane. Choukroun and his associates were amongst the pioneers for using PRF protocol in oral and maxillofacial surgery to improve bone healing in implant dentistry. Autologous PRF is considered to be a healing biomaterial, and presently, studies have shown its application in various disciplines of dentistry. MATERIALS AND METHODS By using specific keywords, electronic search of scientific papers was carried out on the entire PubMed database with custom range of 5 years. The electronic search yielded 302 papers; based on inclusion and exclusion criteria which were specifically predetermined, 72 papers were identified as suitable to the inclusion criteria and the remaining 230 papers were excluded. After adding three more selected papers through hand search, full text of all the articles retrieved and review was done. By pooling the extracted data from selected papers, the reviewed data was synthesized. CONCLUSION Recently by showing good promising results with use of the PRF, it has proved to have a good prospect for its use as healing aid in various aspects of the dentistry.
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Affiliation(s)
- Balaram Naik
- Department of Conservative Dentistry and Endodontics, Sri Dharmasthala Manjunatheshwara College of Dental Sciences, Dharwad, Karnataka, India
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