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Jia K, You J, Zhu Y, Li M, Chen S, Ren S, Chen S, Zhang J, Wang H, Zhou Y. Platelet-rich fibrin as an autologous biomaterial for bone regeneration: mechanisms, applications, optimization. Front Bioeng Biotechnol 2024; 12:1286035. [PMID: 38689760 PMCID: PMC11058865 DOI: 10.3389/fbioe.2024.1286035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/22/2024] [Indexed: 05/02/2024] Open
Abstract
Platelet-rich fibrin, a classical autologous-derived bioactive material, consists of a fibrin scaffold and its internal loading of growth factors, platelets, and leukocytes, with the gradual degradation of the fibrin scaffold and the slow release of physiological doses of growth factors. PRF promotes vascular regeneration, promotes the proliferation and migration of osteoblast-related cells such as mesenchymal cells, osteoblasts, and osteoclasts while having certain immunomodulatory and anti-bacterial effects. PRF has excellent osteogenic potential and has been widely used in the field of bone tissue engineering and dentistry. However, there are still some limitations of PRF, and the improvement of its biological properties is one of the most important issues to be solved. Therefore, it is often combined with bone tissue engineering scaffolds to enhance its mechanical properties and delay its degradation. In this paper, we present a systematic review of the development of platelet-rich derivatives, the structure and biological properties of PRF, osteogenic mechanisms, applications, and optimization to broaden their clinical applications and provide guidance for their clinical translation.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Yanmin Zhou
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
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Egle K, Dohle E, Hoffmann V, Salma I, Al-Maawi S, Ghanaati S, Dubnika A. Fucoidan/chitosan hydrogels as carrier for sustained delivery of platelet-rich fibrin containing bioactive molecules. Int J Biol Macromol 2024; 262:129651. [PMID: 38280707 DOI: 10.1016/j.ijbiomac.2024.129651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
Platelet-rich fibrin (PRF), derived from human blood, rich in wound healing components, has drawbacks in direct injections, such as rapid matrix degradation and growth factor release. Marine polysaccharides, mimicking the human extracellular matrix, show promising potential in tissue engineering. In this study, we impregnated the self-assembled fucoidan/chitosan (FU_CS) hydrogels with PRF obtaining PRF/FU_CS hydrogels. Our objective was to analyze the properties of a hydrogel and the sustained release of growth factors from the hydrogel that incorporates PRF. The results of SEM and BET-BJH demonstrated the relatively porous nature of the FU_CS hydrogels. ELISA data showed that combining FU_CS hydrogel with PRF led to a gradual 7-day sustained release of growth factors (VEGF, EGF, IL-8, PDGF-BB, TGF-β1), compared to pure PRF. Histology confirmed ELISA data, demonstrating uniform PRF fibrin network distribution within the FU_CS hydrogel matrix. Furthermore, the FU_CS hydrogels revealed excellent cell viability. The results revealed that the PRF/FU_CS hydrogel has the potential to promote wound healing and tissue regeneration. This would be the first step in the search for improved growth factor release.
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Affiliation(s)
- Karina Egle
- Institute of Biomaterials and Bioengineering, Faculty of Natural Science and Technology, Riga Technical University, LV-1048 Riga, Latvia; Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, LV-1048 Riga, Latvia.
| | - Eva Dohle
- FORM, Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, 60590 Frankfurt am Main, Germany
| | - Verena Hoffmann
- FORM, Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, 60590 Frankfurt am Main, Germany
| | - Ilze Salma
- Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, LV-1048 Riga, Latvia; Institute of Stomatology, Riga Stradins University, LV-1007 Riga, Latvia
| | - Sarah Al-Maawi
- FORM, Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, 60590 Frankfurt am Main, Germany
| | - Shahram Ghanaati
- FORM, Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, 60590 Frankfurt am Main, Germany.
| | - Arita Dubnika
- Institute of Biomaterials and Bioengineering, Faculty of Natural Science and Technology, Riga Technical University, LV-1048 Riga, Latvia; Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, LV-1048 Riga, Latvia.
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Valentini P, Calciolari E, Monlezun S, Akcalı A, Donos N, Quirynen M. APCs in sinus floor augmentation. Periodontol 2000 2024. [PMID: 38363055 DOI: 10.1111/prd.12554] [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: 09/23/2023] [Revised: 12/18/2023] [Accepted: 01/21/2024] [Indexed: 02/17/2024]
Abstract
After tooth loss in the posterior area of the maxilla, sinus floor elevation is often required to compensate the vertical bone loss due to sinus pneumatization. This narrative review reports on the potential benefits of autologous platelet concentrates (APCs) during this procedure. As for transcrestal approach, APCs have been used as "sole" substitute/graft. However, because of the low number of clinical trials available with PRGF, and even none for PRP, no definitive conclusions can be made regarding their efficacy. The number of studies on the use of L-PRF were outnumbered indicating good feasibility for vertical bone gain, with a high implant survival rate and a low degree of complications. PRP and PRGF have not been studied as a "single/sole" substitute for a one-stage lateral window approach, probably because of the weak physical characteristics of the membranes. L-PRF alone appears to be a predictable grafting material for lateral maxillary sinus grafting and a reduced RBH should not be considered as a risk factor. Compared to a "standard" bone substitute L-PRF shows slightly less vertical bone gain (consider enough membrane application and use of bony window as new sinus floor roof over the implant apices), enhanced early resorption (first 6 months after application), but a similar stable bone gain afterward. For a two-stage lateral window approach, APCs "alone" cannot be recommended, due to their weak withstand to the sinus pneumatization forces. APCs combined with bone substitutes seem to accelerate bone formation, without any additional benefits on the long-term new bone gain. The use of L-PRF membranes for the treatment of perforations appears to be an effective treatment option, but further clinical studies are needed to confirm this. Even though the abovementioned statements are based on large numbers of studies, additional RCTs comparing APCs with different types of grafting procedures for sinus elevation are needed.
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Affiliation(s)
- Pascal Valentini
- Department of Implant Surgery Tattone Hospital, University of Corsica Pasquale Paoli, Institute of Health, Corte, France
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, London, UK
- Dental school, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Sebastien Monlezun
- Department of Implant Surgery Tattone Hospital, University of Corsica Pasquale Paoli, Institute of Health, Corte, France
| | - Aliye Akcalı
- Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, London, UK
- Department of Periodontology, Dental Faculty, University of Dokuz Eylul, Izmir, Turkey
| | - Nikos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, London, UK
| | - Marc Quirynen
- Department of Oral Health Sciences, Katholieke Universiteit Leuven & University Hospitals Leuven, (section Periodontology), Leuven, Belgium
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Masliah J, Samama M. Pre-prosthetic schuchardt osteotomy with sinus floor elevation. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101782. [PMID: 38278442 DOI: 10.1016/j.jormas.2024.101782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/02/2024] [Accepted: 01/21/2024] [Indexed: 01/28/2024]
Abstract
Premature loss of teeth leads to an inevitable egression of opposing teeth. Schuchardt osteotomy is a quick and efficient alternative to create a prosthetic space compatible with prosthetic rehabilitation. During the surgical procedure, it is difficult, if not impossible, to preserve the integrity of the sinus membrane and thus to proceed at the same time with a bone graft in the adjacent sub-sinus area to address a vertical alveolar deficiency. In this technical note, the author describes a new technique by combining a sinus suspension during a Schuchardt osteotomy. This innovative approach allows for the treatment of Schneider's membrane perforation and the simultaneous achievement of sub-sinus bone augmentation during the osteotomy.
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Affiliation(s)
- Julia Masliah
- Resident, Univ, Reims, CHU Reims, Department of Oral Surgery Division, F-51100, France.
| | - Mickaël Samama
- Stomatologist and Oral Surgeon, private pratice in 5 rue Dupont des Loges, Paris 75007, and Clinique Saint Jean de Dieu Paris 7, France; Sorbonne Universite, APHP, Hopital Pitie-Salpetriere, Service de Stomatologie et Chirurgie Maxillo-faciale, 75013 Paris, France; Consultant at Gustave Roussy Institute in Paris, Department of Head and Neck ENT Surgery, France
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Hosny OH, Abd-Elkareem M, Ali MM, Ahmed AF. Advanced platelet-rich fibrin promotes healing of induced corneal ulcer in donkeys (Equus asinus). Sci Rep 2023; 13:21824. [PMID: 38071242 PMCID: PMC10710484 DOI: 10.1038/s41598-023-48933-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023] Open
Abstract
Ulcerative keratitis is a common disease in horses which may cause blindness. To prevent secondary bacterial and fungal infections and promote quick re-growth of the epithelial layer, different treatment approaches have been employed. This study aimed to examine the effects of advanced platelet-rich fibrin (A-PRF) gel on the healing process of experimentally induced corneal ulcers in donkeys. Nine healthy adult donkeys were used for the study. The donkeys were divided into two groups: the control group, where no medication was applied to the corneal ulcer, and the A-PRF gel group, where A-PRF gel was applied once a day on specific days after ulcer induction. The healing process was evaluated through various examinations and analyses. The results demonstrated that the A-PRF gel group showed significant improvement in the corneal ulcer area, with epithelial and stromal regeneration. At day 35, about 60% of the A-PRF group showed negative fluorescein uptake. Additionally, fewer complications were observed during the healing process compared to the control group. In conclusion, A-PRF gel is an important and safe therapeutic option for controlling ocular surface infection and promoting corneal healing. We recommend using A-PRF gel as an alternative approach, avoiding eyelid suturing, and minimizing corneal irritation.
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Affiliation(s)
- Omar H Hosny
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt.
| | - Mahmoud Abd-Elkareem
- Department of Cell and Tissues, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
| | - Magda M Ali
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
| | - Ahmed F Ahmed
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
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The Adjunctive Use of Leucocyte- and Platelet-Rich Fibrin in Periodontal Endosseous and Furcation Defects: A Systematic Review and Meta-Analysis. MATERIALS 2022; 15:ma15062088. [PMID: 35329540 PMCID: PMC8953320 DOI: 10.3390/ma15062088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/06/2022] [Accepted: 03/07/2022] [Indexed: 02/04/2023]
Abstract
The aim of this systematic review of randomized controlled trials was to evaluate the adjunctive use of leucocyte- and platelet-rich fibrin (L-PRF) in periodontal endosseous and furcation defects, as compared without L-PRF. The endosseous defect group was subclassified into: L-PRF/open flap debridement (L-PRF/OFD) versus OFD, L-PRF/osseous graft (L-PRF/OG) versus OG, L-PRF/Emdogain (L-PRF/EMD) versus EMD, and L-PRF/guided tissue regeneration (L-PRF/GTR) versus GTR. The furcation defect group was subclassified into L-PRF/OFD versus OFD, and L-PRF/OG versus OG. Mean difference, 95% confidence intervals and forest plots were calculated for probing pocket depth (PPD), clinical attachment level (CAL) and radiographic defect depth (DD). Nineteen studies concerning systemically healthy non-smokers were included. The results of this systematic review and meta-analysis showed in two- and/or three-wall endosseous defects that the adjunctive use of L-PRF to OFD or OG was significantly beneficial for PPD reduction, CAL gain and DD reduction, as compared without L-PRF. Furthermore, the data showed that for two- and/or three-wall endosseous defects, the adjunctive use of L-PRF to GTR was significantly beneficial for CAL and DD improvement, whereas adding L-PRF to EMD had no significant effect, and that for class II furcation defects, the addition of L-PRF to OFD was significantly beneficial for PPD, CAL and DD improvement, whereas the addition of L-PRF to OG was significantly clinically beneficial. In conclusion, this systematic review and meta-analysis found that there was significant clinical and radiographic additive effectiveness of L-PRF to OFD and to OG in two- and/or three-wall periodontal endosseous defects of systemically healthy non-smokers, as compared without L-PRF.
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Clearance of Bone Substitute in Gel Form Accidentally Dispersed into the Sinus Cavity during Transcrestal Maxillary Sinus Floor Elevation: Two-Case Report. SINUSITIS 2021. [DOI: 10.3390/sinusitis5020014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Sinus membrane perforation is the most frequent intraoperative complication occurring during maxillary sinus floor elevation. Although numerous techniques for perforation management are present, grafting material dissemination may still occur, representing a potential trigger factor leading to acute or chronic sinusitis. This case report describes two cases of xenogeneic bone substitute in gel form accidentally dispersed into the sinus cavity during maxillary sinus floor elevation with a transcrestal approach. In both cases, immediately postoperative radiographic imaging showed an important amount of gel graft dislodged into the sinus cavity as a consequence of hidden perforations that remained undetected during surgery. Patients were monitored for 6 months after surgery and reported no signs or symptoms related to possible sinus disease. Control radiographs showed no sinus membrane hypertrophy and/or presence of residual disseminated gel, confirming complete clearance of the accidentally dispersed graft through the ostiomeatal complex. In order to minimize postoperative complications, bone substitutes in gel form could represent an interesting alternative to granular grafts for their easier clearance from the maxillary sinus cavity in case of accidental dissemination during sinus augmentation procedures.
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de Almeida Malzoni CM, Nícoli LG, da Col Dos Santos Pinto G, Pigossi SC, Zotesso VA, Verzola MHA, Marcantonio C, Gonçalves V, Zandim-Barcelos DL, Marcantonio E. The Effectiveness of L-PRF in the Treatment of Schneiderian Membrane Large Perforations: Long-Term Follow-Up of a Case Series. J ORAL IMPLANTOL 2021; 47:31-35. [PMID: 32662834 DOI: 10.1563/aaid-joi-d-20-00044] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The perforation of the Schneiderian membrane (SM) is a common surgical complication during the sinus floor augmentation (SFA) procedure. Different approaches have been proposed to completely closer the SM perforation and to avoid graft contamination or migration and postoperative sinus infection. In this context, the leukocyte and platelet-rich fibrin (L-PRF) membranes have been proposed for SM perforation treatment because of their natural adhesive property and resistance. Thus, this case series aims to evaluate the effectiveness of L-PRF in the treatment of SM large perforations during SFA. A total of 9 SM perforations were treated in this case series. The L-PRF membranes were interposed on the perforated SM until the rupture could not be visualized. The maxillary sinus cavities were filled with deproteinized bovine mineral bone (Bio-oss, Geistlich, Switzerland), and a collagen membrane was positioned to cover the lateral access window. After 8 months, 13 implants were placed, achieving satisfactory primary stability. The osseointegration of all implants and absence of infection signs/mucus in the maxillary sinus were observed in cone beam computed tomography or panoramic radiography qualitative analysis after 3-5 years of follow-up. It can be concluded that the use of L-PRF can be considered a viable alternative for the repair of large SM perforations.
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Affiliation(s)
| | - Lélis Gustavo Nícoli
- Department of Clinic and Surgery, School of Dentistry, Alfenas Federal University (Unifal-MG), Alfenas, Minas Gerais, Brazil
| | - Gustavo da Col Dos Santos Pinto
- Department of Clinic and Surgery, School of Dentistry, Alfenas Federal University (Unifal-MG), Alfenas, Minas Gerais, Brazil
| | - Suzane Cristina Pigossi
- Department of Clinic and Surgery, School of Dentistry, Alfenas Federal University (Unifal-MG), Alfenas, Minas Gerais, Brazil
| | | | | | - Cláudio Marcantonio
- Dental Graduate Program, Universidade de Araraquara-UNIARA, Araraquara, SP, Brazil
| | - Victor Gonçalves
- Department of Diagnosis and Surgery, School of Dentristry at Araraquara, São Paulo Sate University-UNESP, Araraquara, SP, Brazil
| | - Daniela Leal Zandim-Barcelos
- Department of Diagnosis and Surgery, School of Dentristry at Araraquara, São Paulo Sate University-UNESP, Araraquara, SP, Brazil
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, School of Dentristry at Araraquara, São Paulo Sate University-UNESP, Araraquara, SP, Brazil
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Xin L, Yuan S, Mu Z, Li D, Song J, Chen T. Histological and Histomorphometric Evaluation of Applying a Bioactive Advanced Platelet-Rich Fibrin to a Perforated Schneiderian Membrane in a Maxillary Sinus Elevation Model. Front Bioeng Biotechnol 2020; 8:600032. [PMID: 33324626 PMCID: PMC7726256 DOI: 10.3389/fbioe.2020.600032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/23/2020] [Indexed: 01/15/2023] Open
Abstract
Background Schneiderian membrane (SM) perforation is a major complication of maxillary sinus elevation with simultaneous bone grafting, yet under this scenario there is no standard biomaterial that maximizes favorable tissue healing and osteogenic effects. Purpose To compare the effect of advanced platelet-rich fibrin (A-PRF) and collagen membrane (CM) on a perforated SM with simultaneous bone grafting in a maxillary sinus elevation model. Materials and Methods After perforation of the SM was established, 24 animals were randomly divided into two groups: (i) group CM: CM and deproteinized bovine bone mineral (DBBM) (n = 12), (ii) group A-PRF: A-PRF and DBBM (n = 12). Radiographic and histological evaluations were performed at 1 and 4 weeks post-operation. Results At 1 week, an intact SM was found in group A-PRF. At each time point, the number of inflammatory cells at the perforated site was higher in group CM, and the area of new osteoid formation was significantly greater in group A-PRF (p < 0.0001). At 4 weeks, the osteogenic pattern was shown as from the periphery to the center of the sinus cavity in group A-PRF. Conclusion The higher elasticity, matching degradability, and plentiful growth factors of A-PRF resulted in a fully repaired SM, which later ensured the two osteogenic sources from the SM to generate significant new bone formation. Thus, A-PRF can be considered to be a useful bioactive tissue-healing biomaterial for SM perforation with simultaneous bone grafting.
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Affiliation(s)
- Liangjing Xin
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Shuai Yuan
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Zhixiang Mu
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Dize Li
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Jinlin Song
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Tao Chen
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
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Kim S, Chung JH, Shin SY, Shin SI, Hong JY, Lim HC. Collagenated Synthetic Bone Substitute Material for Sinus Floor Elevation at Sites with a Perforated Schneiderian Membrane. J Clin Med 2020; 9:jcm9113764. [PMID: 33266417 PMCID: PMC7700135 DOI: 10.3390/jcm9113764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 12/29/2022] Open
Abstract
Schneiderian membrane perforation (SMP) is the most common complication during sinus floor elevation (SFE). Conventional methods to repair SMP, such as using a collagen barrier, may be clinically demanding. The aim of the present study was to compare the effects of collagenated bone substitute materials with and without a collagen barrier to repair SMP during SFE in terms of new bone formation and dimensional stability. In 12 rabbits, intentional SMP was made during bilateral SFE. The rabbits were randomly assigned under two groups: the control group, in which the sinus was repaired with a collagen barrier, and the test group, in which the sinus was repaired without a collagen barrier. Collagenated bone substitute material was grafted in both groups. Healing periods of 2 weeks and 4 weeks were provided in both groups. There were no adverse clinical events. Histology revealed that the Schneiderian membrane had atrophied with loss of cilia and serous glands in both groups at 4 weeks. Histomorphometry revealed that the newly formed bone (test: 0.42 ± 0.17 mm2, control: 0.36 ± 0.18 mm2 at 2 weeks; test: 1.21 ± 0.36 mm2, control: 1.23 ± 0.55 mm2 at 4 weeks) or total augmented area did not significantly differ between the two groups at either time points (p > 0.05). In conclusion, collagenated bone substitute material without a collagen barrier demonstrated similar new bone formation and dimensional stability as that with a collagen barrier in repairing SMP.
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Affiliation(s)
- Sangyup Kim
- Department of Periodontology, Graduate School, Kyung Hee University, Seoul 02447, Korea;
| | - Jong-Hyuk Chung
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul 02447, Korea; (J.-H.C.); (S.-Y.S.); (J.-Y.H.)
| | - Seung-Yun Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul 02447, Korea; (J.-H.C.); (S.-Y.S.); (J.-Y.H.)
| | - Seung-Il Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul 02447, Korea; (J.-H.C.); (S.-Y.S.); (J.-Y.H.)
- Correspondence: (S.-I.S.); (H.-C.L.); Tel.: +82-2-2228-3185 (S.-I.S. & H.-C.L. ); Fax: +82-2-392-0398 (S.-I.S. & H.-C.L. )
| | - Ji-Youn Hong
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul 02447, Korea; (J.-H.C.); (S.-Y.S.); (J.-Y.H.)
| | - Hyun-Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul 02447, Korea; (J.-H.C.); (S.-Y.S.); (J.-Y.H.)
- Correspondence: (S.-I.S.); (H.-C.L.); Tel.: +82-2-2228-3185 (S.-I.S. & H.-C.L. ); Fax: +82-2-392-0398 (S.-I.S. & H.-C.L. )
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Tabrizi R, Mirmohammad Sadeghi H, Bakhshaei P, Ozkan BT. Does platelet-rich fibrin increase stability of the maxilla following Le Fort I osteotomy? A single-blind clinical trial study. J Craniomaxillofac Surg 2020; 48:531-535. [PMID: 32402496 DOI: 10.1016/j.jcms.2020.04.007] [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: 12/14/2019] [Revised: 03/20/2020] [Accepted: 04/18/2020] [Indexed: 01/15/2023] Open
Abstract
This single-blind clinical trial study aimed to assess the efficacy of platelet-rich fibrin (PRF) in increasing stability following Le Fort I osteotomy for maxillary advancement. Patients who underwent Le Fort I osteotomy for maxillary advancement were assigned randomly into two groups: in group 1 (the study group, n = 22) PRF was placed in the osteotomy sites following fixation, while no PRF was used in group 2 (the control group, n = 22). Lateral cephalograms obtained preoperatively (T0), immediately after surgery (T1), and 1 year after surgery (T2) were compared between the two groups, and the amount of relapse was determined. The amount of maxillary change (relapse) at the A point in relation to the x-axis was 0.45 ± 0.67 mm in group 1 and 1.86 ± 0.56 mm in group 2. There was a significant difference in mean relapse in relation to the x-axis between the two groups 12 months after osteotomy (p < 0.001). The mean maxillary change (relapse) in relation to the y-axis was 0.77 ± 1.15 mm in group 1 and 2.25 ± 1.22 mm in group 2. Analysis of the data demonstrated a significant difference in mean relapse in relation to the y-axis between the two groups (p < 0.001). PRF may enhance the stability of the maxilla following Le Fort I osteotomy. Based on the results of this study the administration of PRF should be considered whenever possible.
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Affiliation(s)
- Reza Tabrizi
- Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Mirmohammad Sadeghi
- Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pedram Bakhshaei
- Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Birkan Taha Ozkan
- Oral and Maxillofacial Surgery, Toros University, Institute of Health Science, Toros, Turkey
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Barbu HM, Iancu SA, Jarjour Mirea I, Mignogna MD, Samet N, Calvo-Guirado JL. Management of Schneiderian Membrane Perforations during Sinus Augmentation Procedures: A Preliminary Comparison of Two Different Approaches. J Clin Med 2019; 8:jcm8091491. [PMID: 31546766 PMCID: PMC6780245 DOI: 10.3390/jcm8091491] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 09/09/2019] [Accepted: 09/12/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The aim of this study was to retrospectively analyze two different sealing techniques for sinus membrane perforations produced during sinus floor augmentation by a lateral approach. METHODS A total of 172 lateral-approach sinus floor augmentation surgeries were performed on 130 patients. Sixty-one membrane perforations (35%) were reported. Most of the perforations were caused by accidental membrane tearing and 16 (26%) were caused by deliberate incision for mucocele removal. In 31 perforation cases (51%), the Schneiderian membrane was sealed by suturing, while the remaining 30 cases (49%) were sealed using a low-resorption collagen membrane coverage. RESULTS Out of the 31 cases treated with a suture-sealing techniques, 26 (84%) were successful, presenting graft integration. Failure occurred in the other five (16%) cases. Out of the 30 perforations sealed with low-resorption collagen membranes, 28 (93%) presented successful graft integration, while two (7%) failed. CONCLUSIONS Both surgical techniques yielded therapeutic success.
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Affiliation(s)
- Horia Mihail Barbu
- Oral Implantology Department, Titu Maiorescu University, 031593 Bucharest, Romania.
| | | | | | - Michele Davide Mignogna
- Head & Neck Clinical Section, Department of Neuroscience, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80138 Naples, Italy.
| | - Nachum Samet
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA.
| | - José Luis Calvo-Guirado
- Department of Oral and Implant Surgery, Universidad Católica of Murcia, 30107 Murcia, Spain.
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Karayürek F, Kadiroğlu ET, Nergiz Y, Coşkun Akçay N, Tunik S, Ersöz Kanay B, Uysal E. Combining platelet rich fibrin with different bone graft materials: An experimental study on the histopathological and immunohistochemical aspects of bone healing. J Craniomaxillofac Surg 2019; 47:815-825. [DOI: 10.1016/j.jcms.2019.01.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/26/2018] [Accepted: 01/14/2019] [Indexed: 12/12/2022] Open
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14
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Effectiveness of Platelet-Rich Fibrin as an Adjunctive Material to Bone Graft in Maxillary Sinus Augmentation: A Meta-Analysis of Randomized Controlled Trails. BIOMED RESEARCH INTERNATIONAL 2019; 2019:7267062. [PMID: 31008111 PMCID: PMC6441530 DOI: 10.1155/2019/7267062] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 02/08/2019] [Accepted: 02/25/2019] [Indexed: 12/11/2022]
Abstract
Purpose To date, it remains unknown whether the addition of platelet-rich fibrin (PRF) to bone grafts actually improves the effectiveness of maxillary sinus augmentation. This study aimed to perform a meta-analysis to evaluate the efficacy of PRF in sinus lift. Materials and Methods PubMed, Embase, and the Cochrane Library were searched. Randomized controlled studies were identified. The risk of bias was evaluated using the Cochrane Collaboration tool. Results Five RCTs were included in our meta-analysis. Clinical, radiographic, and histomorphometric outcomes were considered. No implant failure or graft failure was detected in all included studies within the follow-up period. The percentage of contact length between newly formed bone substitute and bone in the PRF group was lower but lacked statistical significance (3.90%, 95% CI, -2.91% to 10.71%). The percentages of new bone formation (-1.59%, 95% CI, -5.36% to 2.18%) and soft-tissue area (-3.73%, 95% CI, -10.11% to 2.66%) were higher in the PRF group but were not significantly different. The percentage of residual bone graft was not significant in either group (4.57%, 95% CI, 0% to 9.14%). Conclusions Within the limitations of this review, it was concluded that there were no statistical differences in survival rate, new bone formation, contact between newly formed bone and bone substitute, percentage of residual bone graft (BSV/TV), and soft-tissue area between the non-PRF and PRF groups. Current evidence supporting the necessity of adding PRF to bone graft in sinus augmentation is limited.
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15
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Successful Use of Leukocyte Platelet-Rich Fibrin in the Healing of Sinus Membrane Perforation: A Case Report. IMPLANT DENT 2018; 27:375-380. [PMID: 29461999 DOI: 10.1097/id.0000000000000731] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this case report was to demonstrate the repair of a large sinus membrane perforation related to a sinus floor augmentation procedure, using leukocyte platelet-rich fibrin (L-PRF), for subsequent rehabilitation of a partially edentulous patient. MATERIALS AND METHODS The patient presented the absence of teeth numbers 18, 17, and 16, associated with insufficient bone height because of the maxillary sinus pneumatization. A maxillary inlay bone graft was proposed, however, during the sinus floor augmentation procedure, a large portion of the sinus membrane was ruptured. To avoid interruption of the surgical procedure, membrane mending was proposed using L-PRF and collagen membranes. RESULTS After 8 months, 2 external hexagon connection dental implants were placed in the 16 and 17 teeth regions, and a screw-retained implant-supported prosthesis was installed. CONCLUSION The use of L-PRF associated with collagen membrane was efficient for the sealing of the sinus membrane perforation and enabled bone formation for subsequent implant installation.
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