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Quirynen M, Siawasch S, Temmerman A, Cortellini S, Dhondt R, Teughels W, Castro AB. Do autologous platelet concentrates (APCs) have a role in intra-oral bone regeneration? A critical review of clinical guidelines on decision-making process. Periodontol 2000 2023; 93:254-269. [PMID: 37845802 DOI: 10.1111/prd.12526] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 07/05/2023] [Accepted: 08/15/2023] [Indexed: 10/18/2023]
Abstract
In the past decades, personalized regenerative medicine has gained increased attention. Autologous platelet concentrates (APCs) such as PRP, PRGF, and L-PRF, all serving as a source of a large variety of cells and growth factors that participate in hard and soft tissue healing and regeneration, could play a significant role in regenerative periodontal procedures. This narrative review evaluated the relative impact of APCs in alveolar ridge preservation, sinus floor augmentation, and the regeneration of bony craters around teeth, both as a single substitute or in combination with a xenograft. L-PRF has a significant beneficial effect on alveolar ridge preservation ( bone quality). The data for PRGF are less convincing, and PRP is controversial. L-PRF can successfully be used as a single substitute during transcrestal (≥3.5 mm bone gain) as well as 1-stage lateral window sinus floor elevation (>5 mm bone gain). For PRGF and especially PRP the data are very scarce. In the treatment of bony craters around teeth, during open flap debridement, L-PRF as a single substitute showed significant adjunctive benefits (e.g., >PPD reduction, >CAL gain, >crater depth reduction). The data for PRP and PRGF were non-conclusive. Adding PRP or L-PRF to a xenograft during OFD resulted in additional improvements (>PPD reduction, >CAL gain, >bone fill), for PRGF no data were found. Autologous platelet concentrates demonstrated to enhance bone and soft tissue healing in periodontal regenerative procedures. The data for L-PRF were most convincing. L-PRF also has the advantage of a greater simplicity of production, and its 100% autologous character.
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Affiliation(s)
- Marc Quirynen
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Sam Siawasch
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Andy Temmerman
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Simone Cortellini
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Rutger Dhondt
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Anna B Castro
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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Alsi SA, Deshpande S, Pande N. Clinical outcomes of implant-supported prosthetic rehabilitation of severely atrophic maxilla: A systematic review. J Indian Prosthodont Soc 2023; 23:335-346. [PMID: 37861610 DOI: 10.4103/jips.jips_360_23] [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] [Indexed: 10/21/2023] Open
Abstract
Aim The purpose of this systematic review is to evaluate the clinical outcomes for the various methods of rehabilitation of a severely atrophic maxilla with the help of implant-supported fixed prosthesis. Materials and Methods The relevant publications published between 2013 and 2022 and written only in English were identified using an electronic search. The primary research question for this study was developed based on the PICO framework, which stands for population, intervention, control, and outcomes which was "What are the clinical outcomes of implant-supported prosthetic rehabilitation in patients with severely atrophic maxilla?" The relevancy of the articles was confirmed by examining their titles, abstracts, and complete texts to determine whether they satisfied the requirements for inclusion. Utilizing specialized study design-related bias assessment forms, the risk of bias was evaluated. Results The database search resulted in 1568 results; however, 1529 of them were eliminated because of insufficient, duplicate, or missing data. Additionally, manual searching yielded 11 articles. After 50 full-text papers were assessed for eligibility, 17 articles were eliminated. Thus, 33 studies in total are included in the current systematic review. Risk of bias analysis and GRADE evidence analysis were performed. Data were found to be heterogeneous and thus meta-analysis could not be done and narrative synthesis is presented. Conclusion The patient's condition and the clinician's expertise play a role in taking the decision on choice of technique for the fixed implant-supported rehabilitation of the severely atrophic maxilla. A high success and survival rate is produced by the majority of fixed implant-assisted prostheses despite the biologic and prosthetic problems. A single approach cannot be recommended as the gold standard. The choice is dependent on the patient's biological factors as well as the clinician's expertise. The included studies were assessed using GRADE criteria. The quality of evidence is low-medium. Therefore, to better comprehend the clinical effectiveness of the treatment alternatives, more well-designed randomized controlled trials with longer follow-up period are required.
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Affiliation(s)
- Shachi Atul Alsi
- Department of Prosthodontics, VSPM DCRC, Nagpur, Maharashtra, India
| | - Saee Deshpande
- Department of Prosthodontics, VSPM DCRC, Nagpur, Maharashtra, India
| | - Neelam Pande
- Department of Prosthodontics, VSPM DCRC, Nagpur, Maharashtra, India
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3
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Tamer Y. Evaluation of immediate implant placement with osteotome sinus floor elevation without graft material. Niger J Clin Pract 2023; 26:274-279. [PMID: 37056099 DOI: 10.4103/njcp.njcp_1734_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
Background Significant difficulties can be encountered when installing posterior maxillary implants. Osteotome sinus floor elevation (OSFE) enables insertion of implants with insufficient bone height at the posterior maxilla using a special instrument known as the "osteotom." Aim This study aimed to evaluate the implant survival rates and radiographical bone gain data after OSFE with simultaneous implant placement performed without grafting material. Further, we have discussed whether the osteotom tapping distance to sinus floor affects the amount of new bone gain (NBG). Materials and Methods Forty dental implants were inserted in 36 patients (20 women and 16 men) aged between 24 and 80 years (mean = 55.7 years). Residual bone height and NBG were analyzed using a commercially available software program on panoramic films. Results The mean residual bone height at the intended implant sites was 5.4 mm ± 2.2 mm, ranging from 3.5 mm to 6.9 mm. The mean NBG was 1.5 mm ± 0.87 mm, ranging from 0.1 mm to 4 mm. At 64.4 months of follow-up, one implant had been lost in the osseointegration period. The remaining 39 implants were in function, with a survival rate of 97.5%. No significant difference was seen between the osteotome tapping distance to sinus floor and NBG at the implant apex (P = 0.395). Conclusion OSFE without using bone grafts with simultaneous implant installation is a safe and reliable method with successful long-term results for he rehabilitation of edentulous posterior maxillae.
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Affiliation(s)
- Y Tamer
- Department of Oral Maxillofacial Surgery, Baskent University Faculty of Dentistry, Adana, Turkey
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4
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Ghasemirad M, Chitsazi MT, Faramarzi M, Roshangar L, Babaloo A, Chitsazha R. Histological examination of the effect of concentrated growth factor (CGF) on healing outcomes after maxillary sinus floor augmentation surgery. J Med Life 2023; 16:267-276. [PMID: 36937478 PMCID: PMC10015573 DOI: 10.25122/jml-2021-0294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 03/28/2022] [Indexed: 03/21/2023] Open
Abstract
A double-blind clinical trial was conducted to examine the effect of concentrated growth factor (CGF), a new generation of platelet derivatives, on the healing outcome of maxillary sinus floor augmentation during maxillary sinus lift surgery. The study included 9 patients referred to the Tabriz University, Faculty of Dentistry, aged 30-80 years, with bilateral posterior partial edentulous or edentulous maxilla who underwent the procedure using a split-mouth technique. After lifting the Schneiderian membrane, bovine xenograft was randomly applied on one side (for example, left maxillary sinus) and CGF on the other side (for example, right maxillary sinus). Results from alizarin red and hematoxylin-eosin staining methods showed that the percentage of bone formed in the CGF group (112.41±26.34% and 96.16±24.49%, respectively) was significantly higher than in the control group (64.99±24.96% and 60.16±16.39%, respectively) (P<0.05). In addition, after 6 months, the amount of residual graft material in the control group (xenograft) was significantly higher than in the CGF group (P<0.05). These findings demonstrate that the use of CGF during open sinus lift surgery is reliable for the placement of dental implants.
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Affiliation(s)
- Mohammad Ghasemirad
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad-Taghi Chitsazi
- Dental and Periodontal Research Center, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
- Corresponding Author: Mohammad-Taghi Chitsazi, Dental and Periodontal Research Center, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran. E-mail:
| | - Masoumeh Faramarzi
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Roshangar
- Department of Anatomical Sciences, Stem Cell Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amirreza Babaloo
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ramtin Chitsazha
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Lombardo G, Signoriello A, Marincola M, Liboni P, Faccioni P, Zangani A, D’Agostino A, Nocini PF. Short and Ultra-Short Implants, in Association with Simultaneous Internal Sinus Lift in the Atrophic Posterior Maxilla: A Five-Year Retrospective Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15227995. [PMID: 36431480 PMCID: PMC9695726 DOI: 10.3390/ma15227995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 05/31/2023]
Abstract
Recent short-term studies suggested the use of short and ultra-short implants in association with a modified osteotome sinus floor elevation (internal sinus lift) technique for the treatment of edentulous resorbed posterior maxilla. The aim of this retrospective study was to investigate this hypothesis in locking-taper implants with a mid-term follow-up of 5 years. Overall, 155 implants (32, 100, and 23 of, respectively, 5.0 mm, 6.0 mm, and 8.0 mm length) were positioned in the atrophic upper maxilla of 79 patients, and 151 implants were loaded with single crowns. Overall implant survival after 5 years was 94.84%. Implant survival for each length group was 93.75%, 94%, and 100% for 5.0, 6.0, and 8.0 mm length, respectively. Preoperative residual crestal bone height of 4.45 (1.3) mm increased to 9.25 (2.13) mm after implant placement and settled at 6.35 (1.73) mm after loading and at 5.25 (1.68) mm at follow-up. Elevation of the Schneiderian membrane was 4.8 (2.46) mm after implant placement, 3.06 (1.3) mm after loading, and 1.46 (1.06) mm at follow-up. Mean variations of peri-implant crestal bone loss and first bone-to-implant contact point were, respectively, -0.36 (1.3) mm and -0.62 (1.15) mm. It can be confirmed that internal sinus lift procedure revealed stable bone gain and negligible resorption at mid-term follow-up for atrophic upper crests with reduced height.
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Affiliation(s)
- Giorgio Lombardo
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Annarita Signoriello
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Mauro Marincola
- Dental Implant Unit, Research Department, Faculty of Dentistry, University of Cartagena, Cartagena 130001, Colombia
| | - Pietro Liboni
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Paolo Faccioni
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Alessandro Zangani
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Antonio D’Agostino
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Pier Francesco Nocini
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
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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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7
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Mijiritsky E, Assaf HD, Kolerman R, Mangani L, Ivanova V, Zlatev S. Autologous Platelet Concentrates (APCs) for Hard Tissue Regeneration in Oral Implantology, Sinus Floor Elevation, Peri-Implantitis, Socket Preservation, and Medication-Related Osteonecrosis of the Jaw (MRONJ): A Literature Review. BIOLOGY 2022; 11:biology11091254. [PMID: 36138733 PMCID: PMC9495871 DOI: 10.3390/biology11091254] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 12/02/2022]
Abstract
Simple Summary Autologous platelet concentrates with high growth factor levels are used in many fields of dentistry. In recent years, the critical role of blood-derived materials in bone and soft tissue engineering has become apparent. After tooth extraction, the alveolar bone is exposed to progressive bone resorption, which can lead to difficulties in implant placement. Hence, many studies have demonstrated that APCs have the potential for soft tissue and bone regeneration. Furthermore, no inflammatory reactions occur, and they may be used alone or in combination with bone grafts, promoting bone growth and maturation. Moreover, the released growth factors and the presence of fibrin structures can induce osteogenesis. This review aims to provide information regarding the applications, indications, advantages, and disadvantages of three APC techniques in hard tissue regeneration. Abstract Over recent years, the usage of autologous platelet concentrates (APCs) has risen in hard tissue regeneration and oral implantology. The purpose of the present review is to offer an overview of the use of three APC techniques in dentistry: platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and concentrated growth factor (CGF). A narrative summary of articles published between January 2011 and April 2022 is provided. The PubMed, Cochrane Library, Scopus, and Embase databases were used to conduct the search. The following keywords were used in the preliminary: “VEGF”, “TGF-b1”, “PRP”, “PRF”, “CGF”, AND “sinus augmentation” OR “implants” OR “peri-implantitis” OR “socket preservation” OR “MRONJ”. A total of 82 articles was finally included. The review then takes into account the application of the three techniques in different areas of treatment—including oral implantology, sinus floor elevation, peri-implantitis, socket preservation, and medication-related osteonecrosis of the jaw (MRONJ)—as well as their advantages and disadvantages.
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Affiliation(s)
- Eitan Mijiritsky
- Head and Neck Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Department of Otolaryngology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 699350, Israel
| | - Haya Drora Assaf
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 9190401, Israel
| | - Roni Kolerman
- Department of Periodontology and Oral Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Luca Mangani
- Department of Translational Medicine and Clinical Science, University of Tor Vegata, 00133 Rome, Italy
| | - Vasilena Ivanova
- Oral Surgery Department, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria
- Correspondence:
| | - Stefan Zlatev
- CAD/CAM Center of Dental Medicine at the Research Institute, Medical University-Plovdiv, 4000 Plovdiv, Bulgaria
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8
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Lv H, Sun X, Wang J, Wang H, Wang L, Zhou Y. Flapless osteotome-mediated sinus floor elevation using platelet-rich fibrin versus lateral approach using deproteinised bovine bone mineral for residual bone height of 2-6 mm: a randomised trial. Clin Oral Implants Res 2022; 33:700-712. [PMID: 35488479 DOI: 10.1111/clr.13934] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 04/15/2022] [Accepted: 04/20/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate patient-reported outcomes and radiographic results of simultaneous implant placement in severely atrophic maxilla using flapless endoscope-assisted osteotome sinus floor elevation with platelet-rich fibrin (PRF), also defined as PESS, and to compare the results with those of lateral sinus floor elevation (LSFE). METHODS Patients with a residual bone height (RBH) of 2-6 mm were included in a randomised controlled trial. PESS was performed with PRF as the sole grafting material. LSFE was performed using deproteinised bovine bone matrix. Patient-reported outcomes were recorded on a visual analogue scale (VAS-pain) and visual rating scale (VRS-swelling and VRS-willingness). Peri-implant bone height (PBH), bone mineral density (BMD), and sinus grafting remodelling index were measured using CBCT immediately postoperatively and 3rd , 6th and 18th months post-surgery. RESULTS The study population consisted of 20 patients in each group. The RBH of two groups averaged 3.35±0.79 mm and 2.92±0.63 mm with no significant difference (p > 0.05). VAS-pain was 18.0 (IR 15.0-22.5) and 35.0 (IR 32.5-37.0) in the PESS and LSFE groups, respectively (p < 0.01). VAS-pain decreased with time in both groups. VRS-swelling was lower in the PESS group than LSFE group. VRS-willingness was higher in the PESS group than LSFE group (p < 0.01). At 18 months post-surgery, the marginal bone loss was 0.60±0.25 mm and 0.69±0.35 mm in the two groups with no significant difference (p = 0.52). CONCLUSIONS Within the limitations of this study, PESS was associated with lower postoperative morbidity and was more tolerable than LSFE. PESS could be a reliable procedure for sinus floor elevation in patients with insufficient RBH.
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Affiliation(s)
- Huixin Lv
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Xiaolin Sun
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Jia Wang
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Hanchi Wang
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Lin Wang
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Yanmin Zhou
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China
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9
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Yin X, Shi H, Poh Hze-Khoong E, Yongjie Hu, Zhang C. Effect of concentrated growth factor on distraction osteogenesis of dental implant distractors. J Oral Maxillofac Surg 2022; 80:889-896. [DOI: 10.1016/j.joms.2021.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 11/29/2022]
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10
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Ma F, Lin Y, Sun F, Jiang X, Wei T. The impact of autologous concentrated growth factors on the alveolar ridge preservation after posterior tooth extraction: A prospective, randomized controlled clinical trial. Clin Implant Dent Relat Res 2021; 23:579-592. [PMID: 34159704 DOI: 10.1111/cid.13026] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/31/2021] [Accepted: 04/22/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Alveolar ridge preservation can effectively decrease alveolar ridge resorption following tooth extraction, but it can be limited by reducing new bone formation and residual bone graft material. Efforts to develop more efficacious approaches are thus an area of active research. PURPOSE To assess the impact of autologous concentrated growth factors (CGF) on alveolar ridge absorption and osteogenesis following posterior tooth extraction. MATERIALS AND METHODS Fifty patients were randomly assigned to have extraction sockets treated with CGF or no treatment. At 10 days, 1 month, and 3 months postextraction, soft tissue color and texture were examined and evaluated with healing score. Cone-beam computed tomography (CBCT) scans were performed before and 3 months after extraction, while radiographic analyses were used to assess vertical and horizontal bone changes. Bone samples were collected from the extraction sockets during implant placement, and micro-computed tomography (micro-CT) scans and histological analysis were performed to evaluate new bone formation. t-Test or Mann-Whitney U test was used to compare data and the level of statistical significance was set at 0.05 for all analyses. RESULTS Forty-six patients completed the trial. Sockets in the experimental group exhibited significantly better healing score on Day 10 postextraction relative to the control group, whereas comparable healing was observed in both groups at 1 and 3 months postextraction. Experimental group exhibited reduced vertical bone changes relative to the control (p < 0.05). Significant reductions were observed in ridge width changes at 1 and 2 mm apical to the crest (p < 0.05), although differences at 3 and 5 mm apical to the crest were not significant. Significant differences of bone mineral density (BMD) and microarchitecture of trabecular bone were observed via micro-CT analyses, and the experimental group had better results. CONCLUSION CGF application following posterior tooth extraction may reduce vertical and horizontal bone resorption and promote new bone formation.
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Affiliation(s)
- Feifei Ma
- Department of Oral Implantology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China.,First Clinical Division, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Ye Lin
- Department of Oral Implantology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Feng Sun
- First Clinical Division, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xi Jiang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Tai Wei
- First Clinical Division, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
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11
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Lin Y, Zhang M, Zhou L, Chen X, Chen J, Wu D. Promoting effect of rapamycin on osteogenic differentiation of maxillary sinus membrane stem cells. PeerJ 2021; 9:e11513. [PMID: 34141480 DOI: 10.7717/peerj.11513] [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: 06/22/2020] [Accepted: 05/04/2021] [Indexed: 11/20/2022] Open
Abstract
Background Stem cells located in the maxillary sinus membrane can differentiate into osteocytes. Our study aimed to evaluate the effect of rapamycin (RAPA) on the osteogenic differentiation of maxillary sinus membrane stem cells (MSMSCs). Methods Colony-forming unit assay, immunophenotype identification assay, and multi-differentiation assay confirmed characteristics of MSMSCs obtained from SD rats. Transmission electron microscopy (TEM) and flow cytometry (FCM) identified the initial autophagic level of MSMSCs induced by RAPA. Real-time quantitative PCR (qPCR) evaluated subsequent autophagic levels and osteogenic differentiation. Alkaline phosphatase (ALP) activity assay and alizarin red staining (ARS) evaluated subsequent osteogenic differentiation. We performed a histological examination to clarify in vivo osteogenesis with ectopic bone mass from BALB/c nude mice. Results MSMSCs possessed an active proliferation and multi-differentiation capacity, showing a phenotype of mesenchymal stem cells. The autophagic level increased with increasing RAPA (0, 10, 100, 1,000 nM) and decreased over time. ALP activity and calcium nodules forming in four RAPA-treated groups on three-time points (7, 14, 21 d) showed significant differences. Col1a1, Runx2, and Spp1 expressed most in 100 nM RAPA group on 7 and 14 d. Osteogenesis-related genes except for Ibsp expression between four groups tended to be consistent on 21 d. 100 nM and 10 nM RAPA-treated groups showed more bone formation in vivo. Conclusion RAPA can promote osteogenic differentiation of MSMSCs, indicating a possible relationship between osteogenic differentiation and autophagy.
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Affiliation(s)
- Yanjun Lin
- Fujian Key Laboratory of Oral Diseases, Fujian Medical University, Fuzhou, Fujian, China.,Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fuzhou, Fujian, China
| | - Min Zhang
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, Fujian, China.,General Department of Hubin Campus, Hangzhou Stomatology Hospital, Hangzhou, Zhejiang, China
| | - Lin Zhou
- Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fuzhou, Fujian, China
| | - Xuxi Chen
- Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fuzhou, Fujian, China
| | - Jiang Chen
- Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fuzhou, Fujian, China
| | - Dong Wu
- Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fuzhou, Fujian, China
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Mijiritsky E, Assaf HD, Peleg O, Shacham M, Cerroni L, Mangani L. Use of PRP, PRF and CGF in Periodontal Regeneration and Facial Rejuvenation-A Narrative Review. BIOLOGY 2021; 10:317. [PMID: 33920204 PMCID: PMC8070566 DOI: 10.3390/biology10040317] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/03/2021] [Accepted: 04/07/2021] [Indexed: 12/30/2022]
Abstract
Growth factors (GFs) play a vital role in cell proliferation, migration, differentiation and angiogenesis. Autologous platelet concentrates (APCs) which contain high levels of GFs make them especially suitable for periodontal regeneration and facial rejuvenation. The main generations of APCs presented are platelet-rich plasma (PRP), platelet-rich fibrin (PRF) and concentrated growth factor (CGF) techniques. The purpose of this review is to provide the clinician with an overview of APCs' evolution over the past decade in order to give reliable and useful information to be used in clinical work. This review summarizes the most interesting and novel articles published between 1997 and 2020. Electronic and manual searches were conducted in the following databases: Pubmed, Scopus, Cochrane Library and Embase. The following keywords were used: growth factors, VEGF, TGF-b1, PRP, PRF, CGF and periodontal regeneration and/or facial rejuvenation. A total of 73 articles were finally included. The review then addresses the uses of the three different techniques in the two disciplines, as well as the advantages and limitations of each technique. Overall, PRP is mainly used in cases of hard and soft tissue procedures, while PRF is used in gingival recession and the treatment of furcation and intrabony defects; CGF is mainly used in bone regeneration.
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Affiliation(s)
- Eitan Mijiritsky
- Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv 6139001, Israel; (E.M.); (O.P.)
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Haya Drora Assaf
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 9190401, Israel;
| | - Oren Peleg
- Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv 6139001, Israel; (E.M.); (O.P.)
| | - Maayan Shacham
- School of Social Work, Ariel University, Ariel 40700, Israel
| | - Loredana Cerroni
- Department of Translational Medicine and Clinical Science, University of Tor Vergata, 00133 Rome, Italy; (L.C.); (L.M.)
| | - Luca Mangani
- Department of Translational Medicine and Clinical Science, University of Tor Vergata, 00133 Rome, Italy; (L.C.); (L.M.)
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Yüce MO, Adalı E, Işık G. The effect of concentrated growth factor (CGF) in the surgical treatment of medication-related osteonecrosis of the jaw (MRONJ) in osteoporosis patients: a randomized controlled study. Clin Oral Investig 2021; 25:4529-4541. [PMID: 33392802 DOI: 10.1007/s00784-020-03766-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 12/21/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The purpose of this present study was to evaluate the efficiency of the growth factors delivered by concentrated growth factor (CGF) on the healing process of osteoporotic patients with medication-related osteonecrosis of the jaws (MRONJ). METHODS This randomized controlled study was composed of osteoporotic female patients who were treated with oral bisphosphonates (BPs) and diagnosed with MRONJ. For the CGF group, each patient was treated with a local application of CGF at the surgical site after removing the necrotic bone, while the surgical area was primarily closed as traditional surgical therapy for the control group. The patients underwent clinical examinations for 6 months postoperatively to check the presence of infection and dehiscence. RESULTS Complete healing was achieved in 19 patients of 28 patients (mean age: CGF group, 73.57 ± 5.1; control group, 73.64 ± 5.49) diagnosed with MRONJ. There was no significant difference in post-op healing data between groups during healing periods (p > 0.05). In the CGF group (n = 14) in three cases, bone exposure without infection was detected, and one of them showed a recurrent infection. In the control group (n = 14) in six cases, bone exposure without infection was detected, and three of them also showed recurrent infection. CONCLUSION Although our results were not statistically significant, our findings suggest that the local application of CGF appears to be an effective approach to the surgical treatment of MRONJ in osteoporosis patients by improving tissue regeneration. CLINICAL RELEVANCE A specific treatment protocol to manage MRONJ is still controversial. This study justifies that CGF can be used in combination with surgical treatment.
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Affiliation(s)
- Meltem Ozden Yüce
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Emine Adalı
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Izmir Democracy University, Izmir, Turkey.
| | - Gözde Işık
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ege University, Izmir, Turkey
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Alauddin MS, Ramli H. Management of Membrane Exposure Utilizing Concentrated Growth Factor (CFG) in Guided Bone Regeneration: A Clinical Report. Open Dent J 2020. [DOI: 10.2174/1874210602014010763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
This is a clinical case of a healthy woman with a missing upper right central incisor (#8) who requested a permanent prosthetic replacement due to endodontic failure. Clinically, she was presented with thin edentulous ridges and fibrous gingival tissue and minimal or compromised alveolar bone segment on the buccal profile as detected on cone-beam computed tomography (CBCT).
Case Report:
The conventional treatment approach is to add pink porcelain; however, rarely does the prosthetic gingiva substitute blend well with the existing oral profile. Therefore,Guided Bone Regeneration (GBR) was done instead on #8 using the allograft [RegenOss, Neobiotech] and PTFE membrane. Upon examination, membrane exposure was detected, and the size was found to be increased in follow-up visits. The membrane was replaced with a Concentrated Growth Factor [CGF] and sutured at the site of the defect. After 12 months, a vertical and horizontal bone with adequate soft tissue emergence profile was achieved clinically, radiographically, and digitally. The delayed removal of the exposed membrane provided more time for initial bone regeneration in GBR. The replacement barrier of an exposed membrane using CGF is considered an innovative procedure with the cellular content providing vascularization and regeneration.
Conclusion:
This case concludes that CGF can be a viable alternative material to enhance GBR outcome in replacing exposed membranes.
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BOLAT A, GÜLTEKİN Y. Investigation of the contribution of concentrated growth factor (CGF) and processed lipoaspirate (PLA) to wound healing in diabetic rats. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2020. [DOI: 10.32322/jhsm.804331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Chen J, Wan Y, Lin Y, Jiang H. Considerations for Clinical Use of Concentrated Growth Factor in Maxillofacial Regenerative Medicine. J Craniofac Surg 2020; 32:1316-1321. [PMID: 33055562 DOI: 10.1097/scs.0000000000007182] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Different strategies have been utilized to facilitate mineralized/soft tissues. Concentrated growth factor (CGF) emerges as a promising biomaterial for regenerative therapy due to high levels of platelets, growth factors, and nucleated cells entrapped in the fibrin scaffold. This review aimed to collect extensive studies on CGF used in maxillofacial regenerative medicine, discussing current obstacles, and expressing some considerations of CGF use. Articles were retrieved systematically without time limitation. In total, 27 human studies were included and separated accordingly. In general, CGF has been most evaluated in implant related therapy and maxillofacial bone regeneration where a majority of articles have revealed favorable outcomes. Little studies have supported the effects on improving probing periodontal depth reductions and clinical attachment level gains for intrabony and furcation defect regeneration. Very little data with high-level evidence was available directly to investigate its effects on the soft tissue regeneration and postoperative complications reduction. The evidence supporting the clinical efficacy of CGF in maxillofacial regenerative medicine is limited. Some conflicting results are worrisome. In addition, the characterization of CGF preparation protocols and CGF's components was not performed in most studies. Further studies should make a consensus on standardized end-product of CGF including characterization of protocols and optimal ratio of CGF' components. Defined algorithms and evidence-based protocols for the clinical use of CGF should be also available.
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Affiliation(s)
- Jianguo Chen
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Yingying Wan
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yan Lin
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Haiyue Jiang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
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Adalı E, Yüce MO, Günbay T, Günbay S. Does Concentrated Growth Factor Used With Allografts in Maxillary Sinus Lifting Have Adjunctive Benefits? J Oral Maxillofac Surg 2020; 79:98-108. [PMID: 32866488 DOI: 10.1016/j.joms.2020.07.217] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/23/2020] [Accepted: 07/26/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE Recent studies have shown that the use of platelet concentration products alone, or in combination with variable graft materials, accelerates the new bone formation associated with sinus augmentation. The aim of this study was to measure the adjunctive effects of concentrated growth factor (CGF) used with allograft on new bone formation and augmentation stability in sinus lifting. MATERIALS AND METHODS This randomized controlled study included patients who presented for dental implant placement in atrophic posterior maxilla at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ege University, and who needed maxillary sinus augmentation. All patients were treated with a 2-stage surgical technique using sinus lifting bilaterally and implant placement 6 months later. During sinus lifting surgery, one side was grafted with allograft (group 1) and the other side with allograft mixed CGF (group 2). Cone-beam computed tomography was carried out immediately postoperatively and also 6 months after the augmentation to evaluate vertical bone height and percentage of resorption. Bone specimens were obtained at the time of implant placement and evaluated histomorphometrically to analyze the percentage of new bone formation and residual graft particle. Statistical comparisons were conducted between groups for all these measurements. RESULTS A total of 10 patients (2 females and 8 males) with a mean age of 57 years (range, 39 to 72) were enrolled in the study. Cone-beam computed tomography analysis revealed a significantly higher percentage of bone height resorption at the sixth month in group 1 (median, 9.32%) compared with group 2 (median, 6.37%) (P < .05). According to the histomorphometric examination, the percentage of new bone formation in group 2 (median, 36.41%) was higher than group 1 (median, 35.49%), but this difference did not reach statistical significance. CONCLUSIONS Using CGF with allografts supports the stabilization of gained vertical bone height after sinus augmentation, but further research is needed to determine the accelerating effects of CGF on new bone formation.
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Affiliation(s)
- Emine Adalı
- Assistant Professor, Department Head, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Izmir Democracy University, Izmir, Turkey.
| | - Meltem Ozden Yüce
- Research Assistant, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Tayfun Günbay
- Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Sevtap Günbay
- Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ege University, Izmir, Turkey
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Chandra RV, Vaishnavi V, S Chakravarthy YSH. Regenerative Capacity of Leukocyte-rich and Platelet-rich Fibrin in Indirect Sinus Elevation Procedure May be Dependent on Model-Specific Modification of the Centrifugation Cycle. Contemp Clin Dent 2020; 10:433-439. [PMID: 32308316 PMCID: PMC7150577 DOI: 10.4103/ccd.ccd_715_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Context: To compare optical density (OD) and fibrinogen content of leukocyte-rich and platelet-rich fibrin (L-PRF) generated by standard protocol (2700 rotations per minute [RPM] for 12 min) versus relative centrifugal force (RCF)-adjusted protocol across two widely used laboratory centrifuges with swing-out rotors. Aims: Centrifuges for PRF production generate forces in excess of 800 g. The study aimed to evaluate OD, fibrinogen content and effectiveness in bone-added osteotome sinus floor elevation (BAOSFE) of leukocyte-rich and platelet-rich fibrin (L-PRF) generated by the standard protocol (2700 RPM for 12 min) versus a RCF-adjusted protocol to generate precisely 400 g of force across two centrifuges with swing-out rotors. The outcomes were compared to a standard centrifuge configured to generate L-PRF as per the original Choukroun guidelines. Settings and Design: Sample size for the present study was calculated using proportional power calculation. A minimum sample size of 8 per group was needed to detect a bone height difference of 2 mm when the power of the test is 0.80 at a significance level of 0.05. Subjects and Methods: Based on the centrifuge and protocol used to generate L-PRF, 10 participants were assigned to each of the following groups are as follows: D group, fixed angle centrifuge (DUO Quattro®) at default setting. R-O group: Swing-out centrifuge (Remi 8C®) + standard protocol. R-A group: Remi 8C® centrifuge + RCF-adjusted protocol. C-O group: Swing-out centrifuge (Remi C854®) + standard protocol. and C-A group: Remi C854® + RCF-adjusted protocol. OD, fibrinogen content, and gain in bone fill and bone height after BAOSFE were the evaluated outcomes. Statistical Analysis Used: Data were analyzed using GraphPad Prism® Software version 6.0 (GraphPad Software Inc., La Jolla, USA) and SAS Software® version 9.3 versions (SAS, New Delhi, India). Data were summarized by mean ± standard deviation for continuous data and median ± inter-quartile range for the score data. The comparison between different time points was done by analysis of one-way repeated measures test, followed by post hoc test for score data. The comparison between two groups for repeated data was made by analysis of two-way repeated measures test and followed by post hoc test. Spearman's Rho correlation test was used to test the correlation between prognosis and the other variables. Results: L-PRF from the Remi C854® centrifuge with RCF-adjusted protocol showed OD (P = 0.152) and fibrinogen content (P = 0.232) identical to those from the DUO Quattro® centrifuge. L-PRF from Remi 8C® centrifuge with the RCF-adjusted protocol resulted in maximum postoperative bone height gain (7.01 ± 1.44 mm) and bone fill (13.50 ± 4.51 mm2) which was higher than that of the outcomes from the DUO Quattro® centrifuge (6.82 ± 2.92 mm and 12.32 ± 5.31 mm2). Conclusions: A reduction in RCF resulted in a less dense clot and had a positive influence on the regenerative potential of L-PRF in BAOSFE procedure.
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Affiliation(s)
- Rampalli Viswa Chandra
- Department of Periodontics, SVS Institute of Dental Sciences, Mahbubnagar, Telangana, India
| | - Varanasi Vaishnavi
- Department of Periodontics, SVS Institute of Dental Sciences, Mahbubnagar, Telangana, India
| | - Y S H S Chakravarthy
- Department of Periodontics, SVS Institute of Dental Sciences, Mahbubnagar, Telangana, India
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Guo T, Gulati K, Shen Z, Han P, Fan Z. Therapeutic outcomes of non-grafted and platelet concentrations-grafted transcrestal maxillary sinus elevation (TSFE): a systematic review and meta-analysis. Sci Rep 2020; 10:5935. [PMID: 32245996 PMCID: PMC7125188 DOI: 10.1038/s41598-020-62407-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 03/11/2020] [Indexed: 12/28/2022] Open
Abstract
To evaluate and compare the stability, quantity and quality of bone augmentation at maxillary sinus elevation sites by non-grafted transcrestal sinus floor elevation (TSFE) and platelet concentration grafted transcrestal sinus floor elevation (PC-TSFE). A complete literature search was performed up to April 2019. Clinical controlled trials, retrospective cohort studies, and prospective cohort studies were selected based on inclusion criteria. The clinical outcomes were implant survival rate (ISR), marginal/crestal bone loss (MBL/CBL) and endo-sinus bone gain (ESBG). Meta‐analysis was conducted on these 1-year based values. Furthermore, another meta-analysis on 1-year ISR value was conducted among studies with different residual bone heights (RBH) within the non-grafted TSFE group. A total of 18 studies were included: 13 in TSFE group and 5 in PC-TSFE group. No significant differences were displayed between the 1-year ISR of TSFE (97%, 95%CI = 0.96–0.99) and PC-TSFE group (99%, 95%CI = 0.97–1.00). Among the various studies with different RBH within TSFE group, no significant differences in 1-year ISR were displayed. The 1-year MBL/CBL value of PC-TSFE group (0.73 mm, 95%CI = 0.43–1.13 mm) did not show significant difference as compared to TSFE group (0.60 mm, 95%CI = 0.10–1.10 mm). Furthermore, no significant enhancement was observed on 1-year ESBG value on PC-TSFE group (3.51 mm, 95%CI = 2.31–4.71 mm) in comparison with the TSFE group (2.87 mm, 95%CI = 2.18m–3.55 mm). Grafting platelet concentrations around dental implants at TSFE sites did not significantly enhance the adjacent bone regeneration. Moreover, TSFE was shown to be a reliable therapeutic option for implant sites that need simultaneous maxillary sinus augmentation, even under limited RBH.
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Affiliation(s)
- Tianqi Guo
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia
| | - Karan Gulati
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia
| | - Ziyun Shen
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, 200072, PR China.,Department of Oral Implant, School and Hospital of Stomatology, Tongji University, Shanghai, 200072, PR China
| | - Pingping Han
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia
| | - Zhen Fan
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, 200072, PR China. .,Department of Oral Implant, School and Hospital of Stomatology, Tongji University, Shanghai, 200072, PR China.
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Torul D, Omezli MM, Kahveci K. Evaluation of the effects of concentrated growth factors or advanced platelet rich-fibrin on postoperative pain, edema, and trismus following lower third molar removal: A randomized controlled clinical trial. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:646-651. [PMID: 32068167 DOI: 10.1016/j.jormas.2020.02.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/06/2020] [Accepted: 02/06/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of this study was to investigate the effects of concentrated growth factors (CGF) and advanced platelet-rich fibrin (A-PRF) on edema, pain, and trismus after mandibular third molar surgery. MATERIAL AND METHODS Patients were randomly divided into A-PRF, CGF and control groups. After extraction of the third molars, A-PRF and CGF were prepared and applied to the extraction sockets in study groups, while nothing was applied to the control group. Edema was measured from 5 reference points, including tragus, labial commissure, soft tissue pogonion, lateral corner of the eye/lateral canthus and angulus mandible. Trismus measured as the distance between the right lower and upper central incisors. Trismus and edema were measured preoperatively, and on postoperative 2nd and 7th days. Pain evaluated using the visual analogue scale (VAS) between 6th hour and 7th day after surgery. RESULTS A total of 75 patients, 25 in each group, were included in the study. The change in tragus to labial commissure measurements showed a significant difference between baseline-7th days among control and CGF groups (P=0.038). Significant differences observed between the tragus to pogonion measurements at baseline-7th days among the control-CGF groups (P=0.014), and A-PRF-CGF groups (P=0.038). Secondary outcome variables trismus, pain, and analgesic consumption showed no significant differences among the groups (P>0.05). CONCLUSIONS Based on the results of this study, it can be concluded that A-PRF and CGF seem to have no positive effects on pain, edema, and trismus after third molar surgery.
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Affiliation(s)
- D Torul
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ordu University, Ordu, Turkey.
| | - M M Omezli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | - K Kahveci
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ordu University, Ordu, Turkey
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Lokwani BV, Gupta D, Agrawal RS, Mehta S, Nirmal NJ. The use of concentrated growth factor in dental implantology: A systematic review. J Indian Prosthodont Soc 2020; 20:3-10. [PMID: 32089593 PMCID: PMC7008628 DOI: 10.4103/jips.jips_375_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/25/2019] [Accepted: 12/27/2019] [Indexed: 12/31/2022] Open
Abstract
In the era of evidence based dentistry, a well-documented consolidated data about improvements in dentistry is a necessity. Concentrated growth factor (CGF) is an emerging trend in periodontology and now in implant dentistry. Various studies have been published in the literature evaluating the effect of CGF on implant osseointegration, implant stability, survival rate, sinus augmentation, and peri-implant defects. However, no systematic review has yet been documented. The present systematic review, being first of its kind, aimed to evaluate the potential outcomes of employing CGF in implant treatment. A literature search was carried out in PubMed and Google scholar for articles published between 2001 and 2019, with various keywords such as "CGF," "dental implant," "bone regeneration," "CGF," and "osseointegration." The screening of studies was done according to PRISMA guidelines. A total of eleven studies were included in this review. Majority of the included studies pointed toward the beneficial effects of CGF in implant treatment. CGF was seen to promote osseointegration and enhance bone regeneration. Although more clinical studies are required to validate the potential merits of CGF in the long run, the preliminary results seem promising.
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Affiliation(s)
| | - Deeksha Gupta
- Department of Prosthodontics, Manubhai Patel Dental College, Vadodara, Gujarat, India
| | - Reema Sarvesh Agrawal
- Department of Public Health Dentistry, Manubhai Patel Dental College, Vadodara, Gujarat, India
| | - Sonal Mehta
- Department of Prosthodontics, Manubhai Patel Dental College, Vadodara, Gujarat, India
| | - Narendra J Nirmal
- Department of Prosthodontics, Manubhai Patel Dental College, Vadodara, Gujarat, India
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Lei L, Yu Y, Han J, Shi D, Sun W, Zhang D, Chen L. Quantification of growth factors in advanced platelet‐rich fibrin and concentrated growth factors and their clinical efficacy as adjunctive to the GTR procedure in periodontal intrabony defects. J Periodontol 2019; 91:462-472. [DOI: 10.1002/jper.19-0290] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/01/2019] [Accepted: 08/11/2019] [Indexed: 01/27/2023]
Affiliation(s)
- Lihong Lei
- Department of PeriodonticsSecond Affiliated HospitalSchool of MedicineZhejiang University Hangzhou China
| | - Yuanyuan Yu
- Department of PeriodonticsSecond Affiliated HospitalSchool of MedicineZhejiang University Hangzhou China
| | - Jiayin Han
- Department of PeriodonticsSecond Affiliated HospitalSchool of MedicineZhejiang University Hangzhou China
| | - Danhui Shi
- Department of PeriodonticsSecond Affiliated HospitalSchool of MedicineZhejiang University Hangzhou China
| | - Weilian Sun
- Department of PeriodonticsSecond Affiliated HospitalSchool of MedicineZhejiang University Hangzhou China
| | - Diya Zhang
- Dental DepartmentSir Run Run Shaw HospitalSchool of MedicineZhejiang University Hangzhou China
| | - Lili Chen
- Department of PeriodonticsSecond Affiliated HospitalSchool of MedicineZhejiang University Hangzhou China
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Autologous Bone Marrow Concentrates and Concentrated Growth Factors Accelerate Bone Regeneration After Enucleation of Mandibular Pathologic Lesions. J Craniofac Surg 2018; 29:992-997. [DOI: 10.1097/scs.0000000000004371] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Beneficial Effects of Concentrated Growth Factors and Resveratrol on Human Osteoblasts In Vitro Treated with Bisphosphonates. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4597321. [PMID: 29862271 PMCID: PMC5976957 DOI: 10.1155/2018/4597321] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/19/2018] [Accepted: 04/05/2018] [Indexed: 12/20/2022]
Abstract
Bisphosphonates are primary pharmacological agents against osteoclast-mediated bone loss and widely used in the clinical practice for prevention and treatment of a variety of skeletal conditions, such as low bone density and osteogenesis imperfecta, and pathologies, such as osteoporosis, malignancies metastatic to bone, Paget disease of bone, multiple myeloma, and hypercalcemia of malignancy. However, long-term bisphosphonate treatment is associated with pathologic conditions including osteonecrosis of the jaw, named BRONJ, which impaired bone regeneration process. Clinical management of BRONJ is controversy and one recent approach is the use of platelet concentrates, such as Concentrated Growth Factors, alone or together with biomaterials or antioxidants molecules, such as resveratrol. The aim of the present study was to investigate the in vitro effects of Concentrated Growth Factors and/or resveratrol on the proliferation and differentiation of human osteoblasts, treated or not with bisphosphonates. Human osteoblasts were stimulated for 3 days in complete medium and for 21 days in mineralization medium. At the end of the experimental period, the in vitro effect on osteoblast proliferation and differentiation was evaluated using different techniques such as MTT, ELISA for the quantification/detection of osteoprotegerin and bone morphogenetic protein-2, immunohistochemistry for sirtuin 1 and collagen type I, and the Alizarin Red S staining for the rate of mineralization. Results obtained showed that Concentrated Growth Factors and/or resveratrol significantly increased osteoblast proliferation and differentiation and that the cotreatment with Concentrated Growth Factors and resveratrol had a protective role on osteoblasts treated with bisphosphonates. In conclusion, these data suggest that this approach could be promised in the clinical management of BRONJ.
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Bonazza V, Borsani E, Buffoli B, Castrezzati S, Rezzani R, Rodella LF. How the different material and shape of the blood collection tube influences the Concentrated Growth Factors production. Microsc Res Tech 2016; 79:1173-1178. [DOI: 10.1002/jemt.22772] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 07/29/2016] [Accepted: 08/23/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Veronica Bonazza
- Division of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences; University of Brescia; Brescia 25123 Italy
| | - Elisa Borsani
- Division of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences; University of Brescia; Brescia 25123 Italy
- Interdipartimental University Center of Research “Adaption and Regeneration of Tissues and Organs-(ARTO)”, University of Brescia; Brescia 25123 Italy
| | - Barbara Buffoli
- Division of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences; University of Brescia; Brescia 25123 Italy
- Interdipartimental University Center of Research “Adaption and Regeneration of Tissues and Organs-(ARTO)”, University of Brescia; Brescia 25123 Italy
| | - Stefania Castrezzati
- Division of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences; University of Brescia; Brescia 25123 Italy
| | - Rita Rezzani
- Division of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences; University of Brescia; Brescia 25123 Italy
- Interdipartimental University Center of Research “Adaption and Regeneration of Tissues and Organs-(ARTO)”, University of Brescia; Brescia 25123 Italy
| | - Luigi Fabrizio Rodella
- Division of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences; University of Brescia; Brescia 25123 Italy
- Interdipartimental University Center of Research “Adaption and Regeneration of Tissues and Organs-(ARTO)”, University of Brescia; Brescia 25123 Italy
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