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Azangookhiavi H, Habibzadeh S, Zahmatkesh H, Mellati E, Mosaddad SA, Dadpour Y. The effect of platelet-rich fibrin (PRF) versus freeze-dried bone allograft (FDBA) used in alveolar ridge preservation on the peri-implant soft and hard tissues: a randomized clinical trial. BMC Oral Health 2024; 24:693. [PMID: 38877446 PMCID: PMC11179368 DOI: 10.1186/s12903-024-04478-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/12/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND The effectiveness of alveolar ridge preservation on bone regeneration and tissue healing has been thoroughly documented in the literature. This study aimed to evaluate the peri-implant soft and hard tissue changes after alveolar ridge preservation using either platelet-rich fibrin (PRF) or freeze-dried bone allograft (FDBA) over a 12-month period following the prosthetic loading of implants. METHODS In this randomized clinical trial, 40 individuals were recruited for alveolar ridge preservation using (1) FDBA or (2) PRF in incisal/premolar areas. At two follow-up sessions (six- and 12-months post-implant insertion), radiographic imaging and clinical examinations assessed marginal bone loss and soft tissue factors, including gingival recession and bleeding on probing. The differences between study groups were analyzed using Generalized estimating Equations, the Binary logistic regression model, and Cochran's Q test. RESULTS There was a statistically significant difference regarding gingival recession at both follow-up evaluations; values in the PRF group were considerably lower compared to the FDBA group (p < 0.05). The mean values for vertical marginal bone loss and bleeding on probing showed no significant differences between the two study groups (p > 0.05). CONCLUSIONS Except for gingival recession, applying PRF yielded comparable clinical results to FDBA after one year of implant loading and could be recommended as a potential biomaterial for alveolar ridge preservation following tooth extractions. CLINICAL TRIAL REGISTRATION The research protocol was registered in the Protocol Registration and Results System on 13/08/2021, available at https://clinicaltrials.gov/ (NCT05005377).
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Affiliation(s)
- Hassan Azangookhiavi
- Department of Prosthodontics, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Sareh Habibzadeh
- Department of Prosthodontics, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ehsan Mellati
- University of Sydney, Sydney, Australia
- Private Practice, Sydney, Australia
| | - Seyed Ali Mosaddad
- Department of Research Analytics, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Saveetha University, Chennai, India
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
| | - Yalda Dadpour
- Department of Periodontics, International Campus, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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Anis M, Abdelrahman AR, Attia R, Zahran A. Tomographic assessment of bone changes in atrophic maxilla treated by split-crest technique and dental implants with platelet-rich fibrin and NanoBone ® versus platelet-rich fibrin alone: Randomized controlled trial. BMC Oral Health 2024; 24:691. [PMID: 38877464 PMCID: PMC11177399 DOI: 10.1186/s12903-024-04420-5] [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: 02/27/2024] [Accepted: 05/29/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND This study evaluated the clinical benefits of adding NanoBone® with split-crest technique and simultaneous implant placement covered with platelet-rich fibrin membrane in horizontally deficient maxillary ridges in terms of crestal and horizontal bone changes and patient morbidity. METHODS Forty patients indicated for maxillary ridge splitting and simultaneous implant placement were assigned randomly to the study groups: control group (Platelet Rich Fibrin membrane) and test group (Platelet Rich Fibrin membrane + Nanobone®). The Cone Beam Computed Tomography Fusion technique was utilized to assess crestal and horizontal bone changes after five months of the surgical procedure. Patient morbidity was recorded for one week post-surgical. RESULTS Five months post-surgical, buccal crestal bone resorption was 1.26 ± 0.58 mm for the control group and 1.14 ± 0.63 mm for the test group. Lingual crestal bone resorption was 1.40 ± 0.66 mm for the control group and 1.47 ± 0.68 mm for the test group. Horizontal bone width gain was 1.46 ± 0.44 mm for the control group and 1.29 ± 0.73 mm for the test group. There was no significant statistical difference between study groups regarding crestal and horizontal bone changes and patient morbidity. CONCLUSIONS The tomographic assessment of NanoBone® addition in this study resulted in no statistically significant difference between study groups regarding crestal and horizontal bone changes and patient morbidity. More randomized controlled clinical trials on gap fill comparing different bone grafting materials versus no grafting should be conducted. CLINICALTRIALS GOV REGISTRATION NUMBER NCT02836678, 13th January 2017.
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Affiliation(s)
- Maged Anis
- Department of Periodontology, Faculty of Dentistry, Modern Sciences and Arts University, Giza, Egypt
| | - Ahmed Reda Abdelrahman
- Department of Periodontology, Faculty of Dentistry, Modern Sciences and Arts University, Giza, Egypt.
- Department of Periodontology, Faculty of Dentistry, Cairo University, El-Manial, Cairo, 11553, Egypt.
| | - Rasha Attia
- Department of Periodontology, Faculty of Dentistry, Modern Sciences and Arts University, Giza, Egypt
| | - Amr Zahran
- Department of Periodontology, Faculty of Dentistry, Cairo University, El-Manial, Cairo, 11553, Egypt
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Apaza Alccayhuaman KA, Heimel P, Tangl S, Lettner S, Kampleitner C, Panahipour L, Kuchler U, Gruber R. Human versus Rat PRF on Collagen Membranes: A Pilot Study of Mineralization in Rat Calvaria Defect Model. Bioengineering (Basel) 2024; 11:414. [PMID: 38790282 PMCID: PMC11117948 DOI: 10.3390/bioengineering11050414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/03/2024] [Accepted: 04/06/2024] [Indexed: 05/26/2024] Open
Abstract
Platelet-rich fibrin, the coagulated plasma fraction of blood, is commonly used to support natural healing in clinical applications. The rat calvaria defect is a standardized model to study bone regeneration. It remains, however, unclear if the rat calvaria defect is appropriate to investigate the impact of human PRF (Platelet-Rich Fibrin) on bone regeneration. To this end, we soaked Bio-Gide® collagen membranes in human or rat liquid concentrated PRF before placing them onto 5 mm calvarial defects in Sprague Dawley rats. Three weeks later, histology and micro-computed tomography (μCT) were performed. We observed that the collagen membranes soaked with rat PRF show the characteristic features of new bone and areas of mineralized collagen matrix, indicated by a median mineralized volume of 1.5 mm3 (range: 0.9; 5.3 mm3). Histology revealed new bone growing underneath the membrane and hybrid bone where collagen fibers are embedded in the new bone. Moreover, areas of passive mineralization were observed. The collagen membranes soaked with human PRF, however, were devoid of histological features of new bone formation in the center of the defect; only occasionally, new bone formed at the defect margins. Human PRF (h-PRF) caused a median bone volume of 0.9 mm3 (range: 0.3-3.3 mm3), which was significantly lower than what was observed with rat PRF (r-PRF), with a BV median of 1.2 mm3 (range: 0.3-5.9 mm3). Our findings indicate that the rat calvaria defect model is suitable for assessing the effects of rat PRF on bone formation, but caution is warranted when extrapolating conclusions regarding the efficacy of human PRF.
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Affiliation(s)
- Karol Ali Apaza Alccayhuaman
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria; (K.A.A.A.); (L.P.)
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria; (P.H.); (S.T.); (S.L.); (C.K.)
| | - Patrick Heimel
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria; (P.H.); (S.T.); (S.L.); (C.K.)
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria
| | - Stefan Tangl
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria; (P.H.); (S.T.); (S.L.); (C.K.)
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
| | - Stefan Lettner
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria; (P.H.); (S.T.); (S.L.); (C.K.)
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
| | - Carina Kampleitner
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria; (P.H.); (S.T.); (S.L.); (C.K.)
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria
| | - Layla Panahipour
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria; (K.A.A.A.); (L.P.)
| | - Ulrike Kuchler
- Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria;
| | - Reinhard Gruber
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria; (K.A.A.A.); (L.P.)
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
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Gasparro R, Di Lauro AE, Campana MD, Rosiello N, Mariniello M, Sammartino G, Marenzi G. Effectiveness of Autologous Platelet Concentrates in the Sinus Lift Surgery: Findings from Systematic Reviews and Meta-Analyses. Dent J (Basel) 2024; 12:101. [PMID: 38668013 PMCID: PMC11049363 DOI: 10.3390/dj12040101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/20/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Maxillary sinus augmentation is one of the most predictable procedures for the rehabilitation of the posterior maxilla. The current overview aimed to summarize the findings provided by systematic reviews (SRs) and meta-analyses on the effectiveness of autologous platelet concentrates (APCs) in sinus lift and to assess the methodological quality of the included SRs. Three electronic databases have been explored. SRs and meta-analyses addressing the effectiveness of APCs in sinus lift technique were included. Clinical, radiographic and histomorphometric findings were considered for APCs as solely grafting materials and APCs in combination with biomaterials. Outcomes were implant survival rate (ISR), implant stability (IS), implant failure (IF), postoperative complications, histomorphometric findings, radiographic bone gain, bone volume and bone density. The methodological quality of the included SRs was assessed using the updated version of "A Measurement Tool to Assess Systematic Review" (AMSTAR-2). Thirty SRs were included. The methodological quality of the included reviews ranged from critically low (3 studies) to high (9 studies). The included SRs showed favorable clinical outcomes, short-term new bone formation and no biological complications when APCs were used both as solely graft material or in combination with other biomaterials. However, no significant additional effects in the long-term period were observed. APCs did not add any further positive effects compared to the physiological healing derived by the natural blood clot. The current overview of SRs highlighted the need for high-quality SRs evaluating the role of APCs in sinus lift though network meta-analyses, in order to identify the most powerful material for sinus lift augmentation. The use of APCs improves the healing of soft tissues and the postoperative quality of life in the short-term period. Thus, its application can be recommended.
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Affiliation(s)
| | | | | | | | | | - Gilberto Sammartino
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Oral Surgery, University of Naples Federico II, 80131 Naples, Italy; (R.G.); (A.E.D.L.); (M.D.C.); (N.R.); (M.M.); (G.M.)
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Shanbhag S, Al-Sharabi N, Kampleitner C, Mohamed-Ahmed S, Kristoffersen EK, Tangl S, Mustafa K, Gruber R, Sanz M. The use of mesenchymal stromal cell secretome to enhance guided bone regeneration in comparison with leukocyte and platelet-rich fibrin. Clin Oral Implants Res 2024; 35:141-154. [PMID: 37964421 DOI: 10.1111/clr.14205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/25/2023] [Accepted: 11/01/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVES Secretomes of mesenchymal stromal cells (MSC) represent a novel strategy for growth-factor delivery for tissue regeneration. The objective of this study was to compare the efficacy of adjunctive use of conditioned media of bone-marrow MSC (MSC-CM) with collagen barrier membranes vs. adjunctive use of conditioned media of leukocyte- and platelet-rich fibrin (PRF-CM), a current growth-factor therapy, for guided bone regeneration (GBR). METHODS MSC-CM and PRF-CM prepared from healthy human donors were subjected to proteomic analysis using mass spectrometry and multiplex immunoassay. Collagen membranes functionalized with MSC-CM or PRF-CM were applied on critical-size rat calvaria defects and new bone formation was assessed via three-dimensional (3D) micro-CT analysis of total defect volume (2 and 4 weeks) and 2D histomorphometric analysis of central defect regions (4 weeks). RESULTS While both MSC-CM and PRF-CM revealed several bone-related proteins, differentially expressed proteins, especially extracellular matrix components, were increased in MSC-CM. In rat calvaria defects, micro-CT revealed greater total bone coverage in the MSC-CM group after 2 and 4 weeks. Histologically, both groups showed a combination of regular new bone and 'hybrid' new bone, which was formed within the membrane compartment and characterized by incorporation of mineralized collagen fibers. Histomorphometry in central defect sections revealed greater hybrid bone area in the MSC-CM group, while the total new bone area was similar between groups. CONCLUSION Based on the in vitro and in vivo investigations herein, functionalization of membranes with MSC-CM represents a promising strategy to enhance GBR.
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Affiliation(s)
- Siddharth Shanbhag
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Niyaz Al-Sharabi
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Carina Kampleitner
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, The Research Center in Cooperation with AUVA, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Samih Mohamed-Ahmed
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Einar K Kristoffersen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Stefan Tangl
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Kamal Mustafa
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Reinhard Gruber
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mariano Sanz
- ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
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Zahedi L, Mohammadi M, Kalantari M, Arabsolghar M, Ranjbar H. Horizontal ridge augmentation with particulate cortico-cancellous freeze-dried bone allograft alone or combined with injectable-platelet rich fibrin in a randomized clinical trial. Clin Implant Dent Relat Res 2024; 26:127-137. [PMID: 38093400 DOI: 10.1111/cid.13295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 11/08/2023] [Accepted: 11/11/2023] [Indexed: 02/09/2024]
Abstract
OBJECTIVES The objective of this study is to assess the effectiveness of horizontal ridge augmentation using FDBA in combination with injectable-platelet rich fibrin (i-PRF) versus FDBA alone. To fulfill this aim, the radiographic and histomorphometric outcomes are compared. METHOD The study involved 41 patients who had horizontal alveolar ridge defects categorized as either B (2.5-7 mm) or C (0-2.5 mm). The control group received FDBA alone (n = 20), while the test group received FDBA in combination with i-PRF (n = 21). The horizontal dimensions of the alveolar ridge were measured at 0, 2, 4, and 6 mm from the bone crest using CBCT before and 6 months after alveolar ridge augmentation. In the second-stage surgery, 24 biopsies were taken from the augmented bone - 13 from the control group and 11 from the test group, and were examined histologically and histomorphometrically. The data were analyzed using Pearson correlation coefficient, chi-square, paired-t, and two-sample t tests. RESULTS There was no significant difference (p > 0.05) in the increase of mean ridge width between the test group and the control group after 6 months at distances of 0, 2, 4, and 6 mm from the crest, with differences of -0.28, 0.12, 0.52, and 1.04 mm, respectively. However, the amount of newly formed bone and material residues was significantly higher in the FDBA + i-PRF group compared to the FDBA alone group (45.01% and 13.06% vs 54.03% and 8.48%, respectively). There was no significant difference in the amount of soft tissue between the two groups (41.02% and 37.5%, p > 0.05). CONCLUSION The study found that there was no statistically significant difference in the increase of horizontal ridge width between the FDBA + i-PRF group and the FDBA group. However, the histomorphometric analysis revealed that the FDBA + i-PRF group had a higher proportion of newly formed bone, less connective tissue, and fewer residual particles. This suggests a superior quality of bone formation compared to the FDBA group.
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Affiliation(s)
- Leili Zahedi
- Oral and Dental Diseases Research Center, Department of Periodontics, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Mohammadi
- Oral and Dental Diseases Research Center, Department of Periodontics, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahsa Kalantari
- Department of Oral and Maxillofacial Pathology, Oral and Dental Diseases Research Center, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohaddeseh Arabsolghar
- Oral and Dental Diseases Research Center, Department of Periodontics, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
| | - Hadi Ranjbar
- Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
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Chou YH, Chen YJ, Pan CP, Yen WH, Liu PF, Feng IJ, Lin YC, Hu KF. Prevalence of peri-implantitis after alveolar ridge preservation at periodontitis and nonperiodontitis extraction sites: A retrospective cohort study. Clin Implant Dent Relat Res 2023; 25:1000-1007. [PMID: 37424382 DOI: 10.1111/cid.13243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/05/2023] [Accepted: 06/18/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION Periodontitis is the main indication for dental extraction and often leads to peri-implantitis (PI). Alveolar ridge preservation (ARP) is an effective means of preserving ridge dimensions after extraction. However, whether PI prevalence is lower after ARP for extraction after periodontitis remains unclear. This study investigated PI after ARP in patients with periodontitis. MATERIALS AND METHODS This study explored the 138 dental implants of 113 patients. The reasons for extraction were categorized as periodontitis or nonperiodontitis. All implants were placed at sites treated using ARP. PI was diagnosed on the basis of radiographic bone loss of ≥3 mm, as determined through comparison of standardized bitewing radiographs obtained immediately after insertion with those obtained after at least 6 months. Chi-square and two-sample t testing and generalized estimating equations (GEE) logistic regression model were employed to identify risk factors for PI. Statistical significance was indicated by p < 0.05. RESULTS The overall PI prevalence was 24.6% (n = 34). The GEE univariate logistic regression demonstrated that implant sites and implant types were significantly associated with PI (premolar vs. molar: crude odds ratios [OR] = 5.27, 95% confidence intervals [CI] = 2.15-12.87, p = 0.0003; bone level vs. tissue level: crude OR = 5.08, 95% CI = 2.10-12.24; p = 0.003, respectively). After adjustment for confounding factors, the risks of PI were significantly associated with implant sites (premolar vs. molar: adjusted OR [AOR] = 4.62, 95% CI = 1.74-12.24; p = 0.002) and implant types (bone level vs. tissue level: AOR = 6.46, 95% CI = 1.67-25.02; p = 0.007). The reason for dental extraction-that is, periodontitis or nonperiodontitis-was not significantly associated with PI. CONCLUSION ARP reduces the incidence of periodontitis-related PI at extraction sites. To address the limitations of our study, consistent and prospective randomized controlled trials are warranted.
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Affiliation(s)
- Yu-Hsiang Chou
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yan-Jun Chen
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Cheng-Pin Pan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Hsi Yen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Feng Liu
- Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - I-Jung Feng
- Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Ying-Chu Lin
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kai-Fang Hu
- Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Alshamrani AM, Mubarki M, Alsager AS, Alsharif HK, AlHumaidan SA, Al-Omar A. Maxillary Sinus Lift Procedures: An Overview of Current Techniques, Presurgical Evaluation, and Complications. Cureus 2023; 15:e49553. [PMID: 38156177 PMCID: PMC10753870 DOI: 10.7759/cureus.49553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
A maxillary sinus lift procedure is indicated if a dental implant needs to be placed in the posterior maxilla with limited bone available to accommodate a dental implant. Both open and closed sinus lifting procedures are reliable approaches for increasing the bone volume needed to support proper implant positioning. However, these methods can lead to several complications. In addition to the general complications commonly linked to oral surgery, such as swelling or hematoma, the primary complication in open sinus lifting is typically the perforation of the Schneiderian membrane during osteotomy. Detailed and extensive presurgical evaluation is crucial to minimize such complications. The objective of this study was to delineate contemporary trends in sinus lift surgery, with a specific emphasis on different techniques of sinus lift procedure, anatomical and surgical factors, presurgical evaluation, bone grafting, and the practical implications of these factors in implant dentistry cases involving a deficient posterior maxilla. In conclusion, while both osteotome and lateral window techniques can assist clinicians in addressing the complexities of implant placement in a deficient posterior maxilla, bone height before implantation remains a critical factor in determining the success and longevity of implants.
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Affiliation(s)
| | - Mazen Mubarki
- Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
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Smanio Neto H, Moy PK, Martinez EF, Pelegrine AA, Abdalla HB, Clemente-Napimoga JT, Napimoga MH. Sema4D is diminished in leukocyte platelet-rich fibrin and impairs pre-osteoblastic MC3T3-E1 cells' functionality. Arch Oral Biol 2023; 155:105778. [PMID: 37572522 DOI: 10.1016/j.archoralbio.2023.105778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/28/2023] [Accepted: 07/28/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVE Semaphorin 4D (Sema4D) is a coupling factor expressed on osteoclasts that may hinder osteoblast differentiation. Since the leukocyte platelet-rich fibrin (L-PRF) membrane promotes growth factor concentration, this study aims to quantify the amount of Sema4D in L-PRF membranes, and analyze the impact of Sema4D on osteoblast cell function in vitro. DESIGN Enzyme-linked immunosorbent assay (ELISA) was used to quantify the levels of Sema4D in both L-PRF and whole blood (serum). To analyze the impairment of Sema4D on osteoblasts, MC3T3-E1 cells were induced to osteogenic differentiation and exposed to Sema4D ranging from 10 to 500 ng/ml concentrations. The following parameters were assayed: 1) cell viability by MTT assay after 24, 48, and 72 h; 2) matrix mineralization by Alizarin Red staining after 14 days, 3) Runt-related transcription factor 2 (RUNX-2), osteocalcin (OCN), osteonectin (ONC), bone sialoprotein (BSP) and alkaline phosphatase (ALP) gene expression by qPCR. For all data, the significance level was set at 5%. RESULTS The amount of Sema4D in the whole blood (serum) was higher than in L-PRF. Osteoblasts exposed to Sema4D at all tested concentrations exhibited a decrease in matrix mineralization formation as well in RUNX-2, OCN, ONC, BSP, and ALP gene expression (p < 0.05). CONCLUSION The presence of Sema4D, a molecule known for suppressing osteoblast activity, diminishes within L-PRF, enhancing its ability to facilitate bone regeneration.
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Affiliation(s)
- Henrique Smanio Neto
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Implantology, Campinas, SP, Brazil
| | - Peter Karyen Moy
- UCLA, Department of Oral & Maxillofacial Surgery, Los Angeles, CA, USA
| | - Elizabeth Ferreira Martinez
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Oral Pathology and Cell Biology, Campinas, SP, Brazil
| | - André Antonio Pelegrine
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Implantology, Campinas, SP, Brazil
| | - Henrique Ballassini Abdalla
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Neuroimmune Interface of Pain Research Lab, Campinas, SP, Brazil
| | - Juliana Trindade Clemente-Napimoga
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Neuroimmune Interface of Pain Research Lab, Campinas, SP, Brazil
| | - Marcelo Henrique Napimoga
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Neuroimmune Interface of Pain Research Lab, Campinas, SP, Brazil.
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Cirmeni M, Fedele O, Giammarinaro E, Marconcini S, Covani U, Caso G. Immediate implant and socket preservation using sticky bone and leukocyte-platelet-rich fibrin in the anterior maxilla: A 3-year case report. Clin Adv Periodontics 2023; 13:144-148. [PMID: 35581730 DOI: 10.1002/cap.10202] [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: 01/07/2022] [Accepted: 05/12/2022] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Immediate implant in the esthetic area is a challenging procedure. Chronic infection often contributes to extensive bone loss and acute infection often precludes a safe, clean surgery. However, it is quite common to come across failing teeth in the esthetic area, where the patient often demands a faster rehabilitation. CASE PRESENTATION In this clinical case, a fractured upper central incisor was replaced by an immediate implant, and the perimetrical area was filled with heterologous bone blended with patient-derived leukocyte- and platelet-rich fibrin (L-PRF) in the form of sticky bone. A Maryland bridge was bonded to the adjacent teeth with the intent to guarantee minimum esthetic to the patient. After 5 months, the implant was connected to a definitive abutment and crown. The facial and interdental soft tissue was maintained with appreciable success after 2 years. The pre-treatment and 2-year- post-treatment computed tomography scans revealed marginal bone preservation. CONCLUSION The use of sticky bone and L-PRF in immediate implant sites helps prevent hard and soft-tissue collapse and may favor faster and sounder healing. KEY POINTS Why is this case new information? It provides support to the efficacy of immediate implant placement with simultaneous use of L-PRF. What are the keys to successful management of this case? Having L-PRF supporting wound healing. What are the primary limitations to success in this case? Having sufficient bone apical to the existing socket and at adjacent teeth.
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Affiliation(s)
| | | | | | | | - Ugo Covani
- Tuscan Stomatological Institute, Camaiore, Italy
| | - Guerino Caso
- Tuscan Stomatological Institute, Camaiore, Italy
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de Almeida Malzoni CM, Pichotano EC, Freitas de Paula LG, de Souza RV, Okamoto R, Austin RS, Marcantonio E, de Molon RS, Zandim-Barcelos DL. Combination of leukocyte and platelet-rich fibrin and demineralized bovine bone graft enhanced bone formation and healing after maxillary sinus augmentation: a randomized clinical trial. Clin Oral Investig 2023; 27:5485-5498. [PMID: 37580431 DOI: 10.1007/s00784-023-05167-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/13/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND AND OBJECTIVE The resorption of alveolar ridge bone and maxillary sinus pneumatization are challenges to implant-supported prosthetic rehabilitation. Bone regeneration using bone substitutes and growth factors are alternatives for maxillary sinus augmentation (MSA). Therefore, we sought to evaluate the effects of the association between leukocyte and platelet-rich fibrin (L-PRF) and deproteinized bovine bone mineral (DBBM) in MSA procedures. MATERIALS AND METHODS Thirty-six maxillary sinuses from 24 individuals were included in this randomized clinical trial. The maxillary sinuses were randomly grafted with LPRF and DBBM (test group) or grafted only with DBBM (positive control). Dental implants were installed in the test group following two periods of evaluation: after 4 (DBBM+LPRF4) and 8 (DBBM+LPFR8) months of sinus graft healing, while the control group received implants only after 8 months. Cone beam computed tomography (CBCT) was taken 1 week after surgery (T1) and before implant placement (T2). Bone samples were collected during implant placement for histomorphometric and immunohistochemical (IHC) analysis. The primary implant stability was assessed by resonance frequency analysis. RESULTS CBCT analysis demonstrated a significant decrease in bone volume from T1 to T2 in all groups without differences among them. Histologically, the test group showed significantly increase in bone neoformation in both periods of evaluation (LPRF+DBBM4: 44.70±14.01%; LPRF+DBBM8: 46.56±12.25%) compared to the control group (32.34±9.49%). The control group showed the highest percentage of residual graft. IHC analysis showed increased staining intensity of osteocalcin (OCN), vascular endothelial growth factor (VEGF), and runt related transcription factor 2 (RUNX-2) in LPRF+DBBM4 group, and osteopontin (OPN) in the L-PRF+DBBM8. Primary implant stability was successfully achieved (above 60 in implant stability quotient) in all the evaluated groups. CONCLUSION Combination of L-PRF and DBBM increased and accelerated new bone formation allowing early implant placement probably due to the higher protein expression of RUNX2, VEGF, OCN, and OPN. These data suggest that the use of L-PRF might be an interesting alternative to use in combination with DBBM for augment the maxillary sinuses allowing the installation of appropriate length implants in shorter period of time. CLINICAL RELEVANCE This study showed improvement in bone neoformation and accelerated healing when associating L-PRF and DBBM for maxillary sinus augmentation procedures. TRIAL REGISTRATION This study was registered before participant recruitment in Brazilian Registry of Clinical Trials (ReBEC - RBR-95m73t).
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Affiliation(s)
- Carolina Mendonça de Almeida Malzoni
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Elton Carlos Pichotano
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Luiz Guilherme Freitas de Paula
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Ricardo Violante de Souza
- Private practice, School of Medicine of Ribeirão Preto, Sao Paulo University - USP, Ribeirao Preto, Sao Paulo, 14040-904, Brazil
| | - Roberta Okamoto
- Department of Basic Sciences, School of Dentistry at Araçatuba, São Paulo State University - UNESP, Araçatuba, SP, 16015-050, Brazil
| | - Rupert S Austin
- Tissue Engineering and Biophotonics, King's College London Dental Institute, Guy's Hospital, London, UK
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Rafael Scaf de Molon
- Department of Diagnosis and Surgery, School of Dentistry at Araçatuba, Sao Paulo State University - UNESP, Rua Jose Bonifacio, 1193, Vila Mendonça, Araçatuba, SP, 16015-050, Brazil.
| | - Daniela Leal Zandim-Barcelos
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil.
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Al-Sharabi N, Gruber R, Sanz M, Mohamed-Ahmed S, Kristoffersen EK, Mustafa K, Shanbhag S. Proteomic Analysis of Mesenchymal Stromal Cells Secretome in Comparison to Leukocyte- and Platelet-Rich Fibrin. Int J Mol Sci 2023; 24:13057. [PMID: 37685865 PMCID: PMC10487446 DOI: 10.3390/ijms241713057] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/12/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
Secretomes of mesenchymal stromal cells (MSCs) are emerging as a novel growth factor (GF)-based strategy for periodontal and bone regeneration. The objective of this study was to compare the secretome of human bone marrow MSC (BMSC) to that of leukocyte- and platelet-rich fibrin (L-PRF), an established GF-based therapy, in the context of wound healing and regeneration. Conditioned media from human BMSCs (BMSC-CM) and L-PRF (LPRF-CM) were subjected to quantitative proteomic analysis using liquid chromatography with tandem mass spectrometry. Global profiles, gene ontology (GO) categories, differentially expressed proteins (DEPs), and gene set enrichment (GSEA) were identified using bioinformatic methods. Concentrations of selected proteins were determined using a multiplex immunoassay. Among the proteins identified in BMSC-CM (2157 proteins) and LPRF-CM (1420 proteins), 1283 proteins were common. GO analysis revealed similarities between the groups in terms of biological processes (cellular organization, protein metabolism) and molecular functions (cellular/protein-binding). Notably, more DEPs were identified in BMSC-CM (n = 550) compared to LPRF-CM (n = 118); these included several key GF, cytokines, and extracellular matrix (ECM) proteins involved in wound healing. GSEA revealed enrichment of ECM (especially bone ECM)-related processes in BMSC-CM and immune-related processes in LPRF-CM. Similar trends for intergroup differences in protein detection were observed in the multiplex analysis. Thus, the secretome of BMSC is enriched for proteins/processes relevant for periodontal and bone regeneration. The in vivo efficacy of this therapy should be evaluated in future studies.
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Affiliation(s)
- Niyaz Al-Sharabi
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, 5009 Bergen, Norway; (N.A.-S.); (S.M.-A.); (K.M.)
| | - Reinhard Gruber
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria;
- Austrian Cluster for Tissue Regeneration, 1090 Vienna, Austria
- Department of Periodontology, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland
| | - Mariano Sanz
- ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, 28040 Madrid, Spain;
| | - Samih Mohamed-Ahmed
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, 5009 Bergen, Norway; (N.A.-S.); (S.M.-A.); (K.M.)
| | - Einar K. Kristoffersen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, 5021 Bergen, Norway;
- Department of Clinical Science, Faculty of Medicine, University of Bergen, 5021 Bergen, Norway
| | - Kamal Mustafa
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, 5009 Bergen, Norway; (N.A.-S.); (S.M.-A.); (K.M.)
| | - Siddharth Shanbhag
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, 5009 Bergen, Norway; (N.A.-S.); (S.M.-A.); (K.M.)
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, 5021 Bergen, Norway;
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Caponio VCA, Baca-González L, González-Serrano J, Torres J, López-Pintor RM. Effect of the use of platelet concentrates on new bone formation in alveolar ridge preservation: a systematic review, meta-analysis, and trial sequential analysis. Clin Oral Investig 2023; 27:4131-4146. [PMID: 37439800 PMCID: PMC10415431 DOI: 10.1007/s00784-023-05126-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/20/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVES To investigate the histomorphometric changes occurring in alveolar ridge preservation (ARP) based on the use of different plasma concentrates (PCs) in randomized clinical trials (RCT). There is controversy whether the placement of PCs in ARP is effective in the formation of new bone. MATERIALS AND METHODS A systematic review search was conducted in PubMed, Scopus, Web of Science, and Cochrane Database to answer the PICO question: In patients undergoing tooth extraction followed by ARP, do PCs alone in the post-extraction socket in comparison with spontaneous healing improve new vital bone formation percentage in histomorphometric analysis after more than 10 weeks? The risk of bias was assessed and a meta-analysis was conducted. RESULTS Of 3809 results, 8 studies were considered suitable for inclusion. A total of 255 teeth were extracted in 250 patients. Regarding the PCs used, ARP was performed with platelet- and leukocyte-rich fibrin (L-PRF) in 120 sockets, and with pure platelet-rich plasma (P-PRP) in 31 sockets and 104 sockets were controlled. PCs improved new bone formation in ARP with respect to the spontaneous healing group (SMD = 1.77, 95%C.I. = 1.47-2.06, p-value < 000.1). There were no differences between the different PCs (L-PRF and P-PRP). CONCLUSION The results of this meta-analysis support the efficacy of the use of PCs in new bone formation in ARP. With respect to the different types of PCs studied, no differences were observed. CLINICAL RELEVANCE When planning implant surgery after tooth extraction, treatment with PCs should be considered for ARP. Any PC increases new bone formation compared to spontaneous healing.
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Affiliation(s)
- Vito Carlo Alberto Caponio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Laura Baca-González
- Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - José González-Serrano
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain.
- Departamento de Especialidades Clínicas Odontológicas, Facultad de Odontología, Plaza Ramón y Cajal S/N, 28040, Madrid, Spain.
| | - Jesús Torres
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Rosa María López-Pintor
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
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Idiri K, Bandiaky O, Soueidan A, Verner C, Renard E, Struillou X. The Effectiveness of the Addition of Platelet-Rich Fibrin to Bovine Xenografts in Sinus and Bone Ridge Augmentation: A Systematic Review. J Funct Biomater 2023; 14:389. [PMID: 37504884 PMCID: PMC10381281 DOI: 10.3390/jfb14070389] [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: 06/27/2023] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 07/29/2023] Open
Abstract
Dental implants sometimes need bone augmentation to recreate an adequate bone height and volume. Numerous bone augmentation techniques have been described, and, currently, the most commonly used bone graft procedure is xenografts with deproteinized bovine bone mineral (DBBM). The addition of platelet-rich fibrin (PRF) to DBBM has already shown better performance than DBBM alone in restoring intrabony periodontal defects, but the role of PRF in preimplantation bone grafts is still not clear. The objective of this systematic review was to evaluate the efficacy of the adjunction of PRF or L-PRF to DBBM in bone ridge augmentation procedures. Clinical randomized controlled studies using PRF associated with DBBM were included. In April 2023, three electronic databases (PubMed, Cochrane, and Web of Science) were searched. The search strategy was performed according to PRISMA guidelines. The risk of bias assessments were performed using the Cochrane Collaboration tool. A total of seven articles were included and analyzed. The results show no statistically significant effect of PRF added to DBBM compared to DBBM alone in the sinus lift procedure but do show an effect in the reduction in bone graft resorption in one study of mandibular guided bone regeneration.
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Affiliation(s)
- Katia Idiri
- Faculté de Chirurgie Dentaire, CHU Nantes, Service Odontologie Restauratrice et Chirurgicale, Nantes Université, 44035 Nantes, France
| | - Octave Bandiaky
- Faculté de Chirurgie Dentaire, CHU Nantes, Service Odontologie Restauratrice et Chirurgicale, Nantes Université, 44035 Nantes, France
- Oniris, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, Nantes Université, UMR 1229, F-44000 Nantes, France
| | - Assem Soueidan
- Faculté de Chirurgie Dentaire, CHU Nantes, Service Odontologie Restauratrice et Chirurgicale, Nantes Université, 44035 Nantes, France
- Oniris, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, Nantes Université, UMR 1229, F-44000 Nantes, France
| | - Christian Verner
- Faculté de Chirurgie Dentaire, CHU Nantes, Service Odontologie Restauratrice et Chirurgicale, Nantes Université, 44035 Nantes, France
| | - Emmanuelle Renard
- Faculté de Chirurgie Dentaire, CHU Nantes, Service Odontologie Restauratrice et Chirurgicale, Nantes Université, 44035 Nantes, France
- Oniris, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, Nantes Université, UMR 1229, F-44000 Nantes, France
| | - Xavier Struillou
- Faculté de Chirurgie Dentaire, CHU Nantes, Service Odontologie Restauratrice et Chirurgicale, Nantes Université, 44035 Nantes, France
- Oniris, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, Nantes Université, UMR 1229, F-44000 Nantes, France
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Júnior JAG, Nóbrega F, Oliveira PG, Bergamo ET, Cadore U, Gomes MZDV, Kjellin P, Chaushu L, Bezerra F, Ghiraldini B, Scombatti de Souza S. Evaluation of Implant Surface Modification with Nanohydroxyapatite Associated with the Use of L-PRF: In Vivo Study in Rats. J Funct Biomater 2023; 14:370. [PMID: 37504865 PMCID: PMC10381410 DOI: 10.3390/jfb14070370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/17/2023] [Accepted: 07/10/2023] [Indexed: 07/29/2023] Open
Abstract
Leukocyte-platelet-rich fibrin (L-PRF) contains growth factors that stimulate bone regeneration. This study evaluated the bone repair in a tibia rat model around two implant surfaces in combination or not with L-PRF by assessing microtomographic and histomorphometric parameters. A total of 48 female rats were used in the study, in which 24 received implants with two types of surface treatments (dual acid etched-DAE or nanohydroxyapatite-nanoHA), and the other 24 received the same mini implants with L-PRF, which was collected by cardiac puncture, centrifugated, and inserted in the bone bed. The animals were euthanized 7 and 30 days after implant placement, and the retrieved samples were prepared for microtomographic and histomorphometric (bone-to-implant contact-BIC; and Bone Area Fraction Occupancy-BAFO) analyses. The adhesion of the nanoHA surface onto the implant surface was investigated by insertion and removal in simulated bone medium (Sawbones). The adhesion evaluation revealed that the loss of nanoHA after this procedure (as measured with SEM) from the implant surface was less than 1%. Overall, the nanoHA surface presented more bone in contact and in proximity to the implant, a higher bone surface/tissue volume fraction, a higher number of bone trabeculae, as well as trabecular separation relative to the DAE surface. Such results were more evident when the nanoHA surface was combined with L-PRF and after 30 days in vivo. The nanoHA surface presented higher BAFO when compared to DAE, with or without association with L-PRF. Therefore, implants with a nanoHA surface potentially benefit from the association to L-PRF.
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Affiliation(s)
- José Augusto Gabarra Júnior
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of Sao Paulo, Ribeirão Preto 14040-904, SP, Brazil
| | - Fernando Nóbrega
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of Sao Paulo, Ribeirão Preto 14040-904, SP, Brazil
| | - Paula Gabriela Oliveira
- Department of Periodontology, School of Dentistry, University Center of State of Para, Belem 66060-575, PA, Brazil
| | - Edmara Tatiely Bergamo
- Department of Periodontology and Prosthodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru 17012-901, SP, Brazil
| | - Uislen Cadore
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of Sao Paulo, Ribeirão Preto 14040-904, SP, Brazil
| | | | - Per Kjellin
- Promimic AB, AstraZeneca BioventureHub, 481 83 Mölndal, Sweden
| | - Liat Chaushu
- Department of Periodontology and Implant Dentistry, School of Dentistry, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Fabio Bezerra
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of Sao Paulo, Ribeirão Preto 14040-904, SP, Brazil
| | - Bruna Ghiraldini
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of Sao Paulo, Ribeirão Preto 14040-904, SP, Brazil
| | - Sergio Scombatti de Souza
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of Sao Paulo, Ribeirão Preto 14040-904, SP, Brazil
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Dewan H, Jain S, Tushar, Gupta MK, Billing RK, Tejaswi CK. Assessment of the Effect of Phototherapy and PRP on the Immediate Implants: An Original Research. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S156-S160. [PMID: 37654295 PMCID: PMC10466601 DOI: 10.4103/jpbs.jpbs_443_22] [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: 10/03/2022] [Revised: 10/23/2022] [Accepted: 11/02/2022] [Indexed: 09/02/2023] Open
Abstract
Immediate implants have been gaining popularity in recent times. There are many adjuvant techniques that are followed before implant placement, which have recently shown hopeful results. For this reason, the current comparative study analyzes the effectiveness of platelet-rich plasma (PRP) and photofunctionalization (PF) at a tertiary care dental hospital. In the current clinical trial, 30 subjects were grouped equally to receive immediate dental implants, with one group in which pretreatment of the extraction site was done with the auto-PRP and PF, while the control group received no pretreatment. For 12 months after the placement of the implant, the subjects were observed for alterations in the parameters. The variables analyzed were survival, esthetics, biological integration, and finally the success of the implants in each group. Values were noted and compared using the appropriate statistical tools, while keeping the level of significance at P < 0.05. For the variables of esthetics and survival, no substantial differences were observed in the PRP and PF groups. There was no difference between these experimental groups and the control group. However, there were significant differences for the biological variable as there was more marginal bone loss in the experimental groups. On the whole, the success was greater for the experimental groups than the control group, though not significant. The pretreatment protocols using PRP and PF have shown to improve some characteristics of the immediate implants in the anterior regions. However, further studies are suggested.
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Affiliation(s)
- Harisha Dewan
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Shailesh Jain
- Department of Prosthodontics Crown and Bridge, School of Dental Sciences, Sharda University, Greater Noida, UP, India
| | - Tushar
- Department of Prosthodontics and Crown and Bridge Dental College, RIMS, Ranchi, Jharkhand, India
| | - Manoj Kumar Gupta
- Department of Pathology and Blood Bank, Government Medical College, Ambedkar Nagar, India
| | | | - C. Krishna Tejaswi
- Department of Prosthodontics, Crown and Bridge, Dhanalakshmi Srinivasan Dental College and Hospital, Perambalur, Tamil Nadu, India
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Madi M, Almindil I, Alrassasi M, Alramadan D, Zakaria O, Alagl AS. Cone-Beam Computed Tomography and Histological Findings for Socket Preservation Techniques Using Different Grafting Materials: A Systematic Review. J Funct Biomater 2023; 14:jfb14050282. [PMID: 37233391 DOI: 10.3390/jfb14050282] [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: 04/07/2023] [Revised: 05/06/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE Socket preservation techniques have been used to maintain the ridge dimension following tooth extraction. The materials used influence the quality and quantity of newly formed bone. Therefore, the aim of this article was to systematically review the literature reporting both histological and radiographic outcomes of socket preservation techniques after tooth extraction in human subjects. MATERIAL AND METHOD A systematic electronic search was performed in the electronic databases. English language clinical studies that were published between 2017 and 2022 and included both histological and radiographic findings for the test and control groups. Our primary search produced 848 articles, and of these, 215 were duplicate studies. A total of 72 articles were then eligible for full-text reading. RESULTS The review included eight studies that met its inclusion criteria. Three outcomes were compared in the included studies. The percentage of newly formed bone ranged from 21.34 ± 9.14% to more than 50% of new bone formation. The materials that showed more than 50% of newly formed bone formation were demineralized dentin graft, platelet-rich fibrin, freeze-dried bone allograft, corticocancellous porcine, and autogenous bone. Four Studies did not report the percentage of the residual graft materials, while those who reported showed a variable range of a minimum 1.5% to more than 25%. One study did not report the changes in horizontal width at the follow-up period, while other studies ranged from 0.6 mm to 10 mm. CONCLUSION Socket preservation represents an efficient technique to preserve the ridge contour with satisfactory newly formed bone in the augmented site and maintaining the vertical and horizontal dimensions of the ridge.
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Affiliation(s)
- Marwa Madi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
| | - Ibrahim Almindil
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
| | - Maria Alrassasi
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
| | - Doha Alramadan
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
| | - Osama Zakaria
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
| | - Adel S Alagl
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
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Shetty NR, Menaka KB. Effect of platelet concentrates on the treatment outcome of peri implantitis: A systematic review. J Indian Soc Periodontol 2023; 27:140-145. [PMID: 37152466 PMCID: PMC10159101 DOI: 10.4103/jisp.jisp_622_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 06/13/2022] [Accepted: 07/10/2022] [Indexed: 05/09/2023] Open
Abstract
Platelet concentrates (PCs) are biological agents known to promote soft as well as hard tissue healing. The review aimed at evaluating the effectiveness of PCs for treating peri-implantitis (PI). Five electronic databases were systematically reviewed followed by a handsearch of relevant journals. The selected studies focused on the predetermined primary and secondary outcomes. The primary outcomes were bleeding on probing, probing depth, marginal bone level. RevMan 5.4.1 software was used for risk bias analysis. The search retrieved 12 articles, and only one study compared PC and open flap debridement. Other three studies with different control arms were included to evaluate the overall effect of different PCs in treatment of PI. High heterogeneity was found regarding study design, sample size, surgical techniques, and methods for preparing PCs. The use of platelet-rich fibrin for PI over conventional therapy was beneficial in improving clinical parameters. In addition, PC when combined with graft materials provided a significant improvement in parameters assessed. The preliminary data regarding the use of different PC in treatment of PI seem to be promising. However, due to lack of comparative randomized controlled trials, future clinical research is necessary to comment on the role of PCs for treating PI.
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Affiliation(s)
- Nikitha Ravindra Shetty
- Department of Periodontics, KAHER'S KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
| | - K B Menaka
- Department of Periodontics, KAHER'S KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
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Park JY, Hong KJ, Ko KA, Cha JK, Gruber R, Lee JS. Platelet-rich fibrin combined with a particulate bone substitute versus guided bone regeneration in the damaged extraction socket: An in vivo study. J Clin Periodontol 2023; 50:358-367. [PMID: 36330669 DOI: 10.1111/jcpe.13742] [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: 04/21/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
AIM It has been proposed that platelet-rich fibrin (PRF) can be used to support bone regeneration during alveolar ridge augmentation. The aim of this study was to determine whether an approach utilizing PRF provides similar performance to the established guided bone regeneration (GBR) procedure. MATERIALS AND METHODS Two-wall defects were surgically created in beagle dogs and treated in three experimental groups: (i) a sticky bone (SB) substitute prepared using liquid PRF and deproteinized porcine bone mineral (DPBM); (ii) SB covered with solid PRF compressed into a membrane; and (iii) GBR performed using DPBM covered by a collagen membrane. Quantitative reverse-transcription polymerase chain reaction was applied to the specimen after 1 week of healing, and microcomputed tomography (micro-CT) and histological outcomes were analysed after 8 weeks of healing. RESULTS Compared with GBR, PRF resulted in a moderate increase in the expression levels of osteoblast and osteoclast markers, osteocalcin, and calcitonin receptor. Moreover, PRF modestly increased angiogenesis and the inflammation markers vascular endothelial growth factor (VEGF) and IL-6. Micro-CT and histological analyses confirmed the expected increased alveolar ridge area, with no significant differences between the three groups. Consistently, graft consolidation, as indicated by new bone formation at the defect site, did not differ significantly between groups. CONCLUSIONS The present results demonstrate that PRF-based approaches perform comparably to the established GBR procedure in terms of the consolidation of DPBM in two-wall alveolar defects.
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Affiliation(s)
- Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, South Korea
| | - Kyu-Jin Hong
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Kyung-A Ko
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, South Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, South Korea
| | - Reinhard Gruber
- Department of Oral Biology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, South Korea
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20
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Reçica B, Bukleta D, Popovska M, Tefiku U, Ahmedi J, Stubljar D. Comparative analysis of the effect of 4MATRIX with and without PRF on regeneration of infrabony periodontal pockets. Saudi Dent J 2023; 35:244-250. [PMID: 37091276 PMCID: PMC10114591 DOI: 10.1016/j.sdentj.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/29/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
Aim The aim was to compare the effect in improvement of periodontal pocket depth (PPD) and clinical attachment level (CAL) between application of 4MATRIX and 4 MATRIX combined with PRF in advanced periodontal disease during follow-up of 6, 12 and 18 months. Methods Thirty patients of both genders aged 25-50 years were included. The patients were clinically and radiologically diagnosed with generalized advanced chronic periodontitis with the presence of periodontal pockets with a depth of ≥ 5 mm bilaterally in the upper jaw. Both sides were treated with a flap intervention in all patients. On one side a bone substitute 4MATRIX was applied, and the other side was treated with an application 4MATRIX and PRF. The clinical assessment and measurements were performed in four stages, immediately before the intervention, and then 6, 12 and 18 months after the intervention. PPD and CAL were determined in all four timepoints. Results PPD was the highest at zero time before the surgery for both groups and was 5.56 ± 0.28 mm. In the postoperative follow-up period, the PPD value decreased gradually with the lowest average value of 5.10 ± 0.18 mm after 18 months in Group I and 4.67 ± 0.13 mm in Group II (p < 0.001, respectively). Moreover, comparing the values of PPD at 6, 12 and 18 months after the surgery, a significant difference was found between the patients from the 4MATRIX vs 4MATRIX + PRF (p < 0.001 respectively). The postoperative follow-up period showed a decrease in CAL value with the lowest value after 18 months. A significant difference in CAL was found between the four measurement times (p < 0.001, respectively). The average level of CAL was the highest before surgical treatment in both groups. The intergroup analysis of CAL after 18 months in group I (4MATRIX) was 5.27 ± 0.17 mm and in group II 4.10 ± 0.14 mm (p < 0.001). Conclusion Treatment of adult patients with advanced chronic periodontitis with periodontal pockets of ≥ 5 mm bilaterally in the upper jaw using 4MATRIX and 4MATRIX + PRF showed improvement of PPD and lower CAL loss after 18 months of the treatment. In the group treated with 4MATRIX + PRF patients showed the highest improvement in PPD and CAL loss. The analysis of treatment with 4MATRIX and 4MATRIX + PRF showed the lowest values after 18 months of the treatment.
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Affiliation(s)
- Bylbyl Reçica
- Department of Oral Surgery, College of Medical Sciences Rezonanca, Prishtina, Republic of Kosovo
| | - Dashnor Bukleta
- Department of Oral Surgery, College of Medical Sciences Rezonanca, Prishtina, Republic of Kosovo
| | - Mirjana Popovska
- Department of Periodontology and Oral Pathology, University Dental Clinical Centre ”Ss. Cyril and Methodius University”, Skopje, The Former Yugolav Republic of Macedonia
| | - Urim Tefiku
- Dental Clinic DentaMed, Prishtina, Republic of Kosovo
| | - Jehona Ahmedi
- Department of Oral Surgery, Dental School, Faculty of Medicine, University of Prishtina, Republic of Kosovo
- Corresponding author.
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21
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Guan S, Xiao T, Bai J, Ning C, Zhang X, Yang L, Li X. Clinical application of platelet-rich fibrin to enhance dental implant stability: A systematic review and meta-analysis. Heliyon 2023; 9:e13196. [PMID: 36785817 PMCID: PMC9918761 DOI: 10.1016/j.heliyon.2023.e13196] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 12/23/2022] [Accepted: 01/20/2023] [Indexed: 01/27/2023] Open
Abstract
Objective To investigate the effect of platelet-rich fibrin application on implant stability. Study design Five databases, namely, PubMed, Embase, Web of Science, Wiley, and China National Knowledge Infrastructure, were searched for reports published up to November 20, 2022. Randomized controlled trials (RCT), including parallel RCTs and split-mouth RCTs, with at least 10 patients/sites were considered for inclusion. Results After screening based on the inclusion criteria, ten RCTs were included. Low heterogeneity was observed in study characteristics, outcome variables, and estimation scales (I2 = 27.2%, P = 0.19). The qualitative and meta-analysis results showed that PRF increased the effect of implant stabilizers after implant surgery. Conclusions The results of the present systematic review and meta-analysis suggest that PRF can increase implant stability after implant surgery. PRF may also have a role in accelerating bone healing and tends to promote new bone formation at the implant site.
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Affiliation(s)
- Shuai Guan
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University and Hebei Key Laboratory of Stomatology, Shijiazhuang, 050017, PR China
| | - Tiepeng Xiao
- The Second Affiliated Hospital of Hebei Medical University, Shijiazhuang, 050000, PR China
| | - Jiuping Bai
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University and Hebei Key Laboratory of Stomatology, Shijiazhuang, 050017, PR China
| | - Chunliu Ning
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University and Hebei Key Laboratory of Stomatology, Shijiazhuang, 050017, PR China
| | - Xingkui Zhang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University and Hebei Key Laboratory of Stomatology, Shijiazhuang, 050017, PR China
| | - Lei Yang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Key Laboratory of Environment and Human Health, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Xiangjun Li
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University and Hebei Key Laboratory of Stomatology, Shijiazhuang, 050017, PR China,Corresponding author.
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22
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Suárez-López Del Amo F, Monje A. Efficacy of biologics for alveolar ridge preservation/reconstruction and implant site development: An American Academy of Periodontology best evidence systematic review. J Periodontol 2022; 93:1827-1847. [PMID: 35841608 PMCID: PMC10092438 DOI: 10.1002/jper.22-0069] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/02/2022] [Accepted: 04/04/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The use of biologics may be indicated for alveolar ridge preservation (ARP) and reconstruction (ARR), and implant site development (ISD). The present systematic review aimed to analyze the effect of autologous blood-derived products (ABPs), enamel matrix derivative (EMD), recombinant human platelet-derived growth factor-BB (rhPDGF-BB), and recombinant human bone morphogenetic protein-2 (rhBMP-2), on the outcomes of ARP/ARR and ISD therapy (i.e., alveolar ridge augmentation [ARA] and maxillary sinus floor augmentation [MSFA]). METHODS An electronic search for eligible articles published from January 2000 to October 2021 was conducted. Randomized clinical trials evaluating the efficacy of ABPs, EMD, rhBMP-2, and rhPDGF-BB for ARP/ARR and ISD were included according to pre-established eligibility criteria. Data on linear and volumetric dimensional changes, histomorphometric findings, and a variety of secondary outcomes (i.e., clinical, implant-related, digital imaging, safety, and patient-reported outcome measures [PROMs]) were extracted and critically analyzed. Risk of bias assessment of the selected investigations was also conducted. RESULTS A total of 39 articles were included and analyzed qualitatively. Due to the high level of heterogeneity across studies, quantitative analyses were not feasible. Most studies in the topic of ARP/ARR revealed that the use of biologics rendered similar results compared with conventional protocols. However, when juxtaposed to unassisted healing or socket filling using collagen sponges, the application of biologics did contribute to attenuate post-extraction alveolar ridge atrophy in most investigations. Additionally, histomorphometric outcomes were positively influenced by the application of biologics. The use of biologics in ARA interventions did not yield superior clinical or radiographic outcomes compared with control therapies. Nevertheless, ABPs enhanced new bone formation and reduced the likelihood of early wound dehiscence. The use of biologics in MSFA interventions did not translate into superior clinical or radiographic outcomes. It was observed, though, that the use of some biologics may promote bone formation during earlier stages of healing. Only four clinical investigations evaluated PROMs and reported a modest beneficial impact of the use of biologics on pain and swelling. No severe adverse events in association with the use of the biologics evaluated in this systematic review were noted. CONCLUSIONS Outcomes of therapy after post-extraction ARP/ARR and ARA in edentulous ridges were comparable among different therapeutic modalities evaluated in this systematic review. Nevertheless, the use of biologics (i.e., PRF, EMD, rhPDGF-BB, and rhBMP-2) in combination with a bone graft material generally results into superior histomorphometric outcomes and faster wound healing compared with control groups.
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Affiliation(s)
| | - Alberto Monje
- Department of Periodontology, International University of Catalonia (UIC), Barcelona, Spain.,Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Division of Periodontology, CICOM-MONJE Institute, Badajoz, Spain.,Department of Periodontics, University of Bern, Bern, Switzerland
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23
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Platelet-Rich Fibrin Reduces IL-1β Release from Macrophages Undergoing Pyroptosis. Int J Mol Sci 2022; 23:ijms23158306. [PMID: 35955441 PMCID: PMC9368224 DOI: 10.3390/ijms23158306] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/20/2022] [Accepted: 07/24/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Pyroptosis is a catabolic process relevant to periodontal disorders for which interleukin-1β (IL-1β) inflammation is central to the pathophysiology of the disease. Despite platelet-rich fibrin (PRF) anti-inflammatory properties and its application to support periodontal regeneration, the capacity of PRF to modulate pyroptosis, specifically the production and release of IL-1β, remains unknown. The question arises whether PRF could regulate IL-1β release from macrophages in vitro. Methods: To answer this question, RAW 264.7 macrophages and primary macrophages obtained from murine bone marrow were primed with PRF before being challenged by lipopolysaccharide (LPS). Cells were then analysed for the pyroptosis signalling components by gene expression analyses and IL-1β secretion at the protein level. The release of mitochondrial reactive oxygen species (ROS) was also detected. Results: PRF lowered the LPS-induced expression of IL-1β and NLRP3 inflammasome, caspase-11 and IL-18 in primary macrophages, and IL-1β and caspase-11 in RAW 264.7 cells. Additionally, PRF diminished the secretion of IL-1β at the protein level in LPS-induced RAW 264.7 cells. This was shown through immunoassays performed with the supernatant and further confirmed by analysing the lysates of permeabilised cells. Furthermore, PRF reduced the ROS release provoked by LPS in RAW 264.7 cells. Finally, to enhance IL-1β release from the LPS-primed macrophages, we introduced a second signal with adenosine triphosphate (ATP). In this setting, PRF significantly reduced IL-1β release in RAW 264.7 cells and a trend to diminish IL-1β release in primary macrophages. Conclusion: These findings suggest that PRF can reduce IL-1β release and, at least in part, inhibit pyroptosis-related factors in LPS-challenged macrophages.
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24
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Efficacy of concentrated growth factor versus collagen membrane in reconstructive surgical therapy of peri-implantitis: 3-year results of a randomized clinical trial. Clin Oral Investig 2022; 26:5247-5260. [PMID: 35618961 PMCID: PMC9381616 DOI: 10.1007/s00784-022-04493-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
Objectives To compare the 3-year clinical and radiographic outcomes of two different reconstructive surgical management of peri-implantitis using a bone substitute in combination with either concentrated growth factor (CGF) or collagen membrane (CM). Material and methods Fifty-one patients who had at least one implant presenting peri-implantitis with an intrabony defect were filled with a xenogenic bone grafting material and covered either CGF or CM. Clinical and radiographic assessments were carried out at baseline and postoperative years 1 and 3. Three different composite outcomes were defined to evaluate treatment success at a 3-year follow-up. The effects of possible prognostic indicators on treatment success were identified by using multilevel regression analysis. Results The changes in probing depth (PD) and radiographic vertical defect depth (VDD) between baseline and year 1 and baseline and year 3 presented significantly greater decreases for the CM group in comparison with the CGF group (p < 0.05). No significant differences between the two treatment modalities were demonstrated regarding treatment success outcomes. History of periodontitis, VDD at baseline, and the number of intrabony defect walls revealed significant impacts on treatment success (p = 0.033; OR = 3.50, p = 0.039; OR = 0.975, and p = 0.024; OR = 7.0 and p = 0.019;OR = 6.0, respectively). Conclusions CM in combination with a bone substitute seems to have slightly better outcomes compared to the CGF membranes in reconstructive surgical therapy of peri-implantitis. The history of periodontitis, baseline VDD, and peri-implant bone defect configuration could be possible predictors influencing treatment success. Trial registration ClinicalTrials.gov NCT04769609. Clinical relevance For the reconstruction of peri-implant bone defects, using a bone substitute in combination with a collagen membrane may show more favorable outcomes.
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25
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Duan DH, Wang EB, Zhang JY, Yuan Q, Wang HL. A three-in-one alveolar process reconstruction protocol for maxillary molar sites with severe residual bone height deficiency: A proof-of-concept pilot study. Clin Implant Dent Relat Res 2022; 24:414-423. [PMID: 35557025 DOI: 10.1111/cid.13096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/25/2022] [Accepted: 04/19/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Implant placement in maxillary molar sites with severe height deficiency often requires multiple surgeries, which was time-consuming, invasive, and subject to serious postoperative complications. PURPOSE To introduce and assess a three-in-one technique (extraction, alveolar ridge preservation [ARP], and sinus elevation) for augmenting deficiency maxillary molar alveolar ridges. MATERIAL AND METHODS Fourteen patients with severe posterior maxillary ridge height deficiency underwent extraction, sinus elevation via an intrasocket window and ARP using sticky bone and then covered with acellular dermal matrix (ADM). Primary closure was intentionally not obtained. Cone-beam computed tomography and periapical radiography were used to measure dimensional ridge changes over time. Bone biopsies were taken at implant placement 7-21 months after surgery, which proceeded without additional grafting. Peri-implant soft tissue was assessed after 8-12 months of functional loading. RESULTS Maxillary molar sites (13 first molars, 1 second molar) with a mean sinus floor height of 1.73 ± 0.86 mm and mean buccal plate thickness of 1.62 ± 1.15 mm were elevated and grafted. Immediately after surgery, the mean sinus floor height was 14.03 ± 1.97 mm and the alveolar thickness at virtual implant platform level was 12.99 ± 1.88 mm. After 5-9 months healing, those measurements decreased by 2.45 ± 1.73 mm (p = 0.000) and 3.88 ± 3.95 mm (p = 0.006), respectively. Healed ridges were composed of 18.74% ± 4.34% mean vital bone and 19.08% ± 9.10% mean residual graft. After 8-12 months of functional loading, the peri-implant tissue appeared healthy, and there was a mean marginal bone loss of 0.12 ± 0.11 mm. CONCLUSIONS For maxillary first molar sites with severe sinus floor height deficiency, this minimally invasive three-in-one treatment allows for uncomplicated implant placement and short-term functional stability.
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Affiliation(s)
- Deng-Hui Duan
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - En-Bo Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jian-Yun Zhang
- Department of Oral and Maxillofacial Pathology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Qiao Yuan
- Department of Periodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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26
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Feng M, Wang Y, Wei Y, Zhang X, Xiao L, Gong Z, Fujioka-Kobayashi M, Sculean A, Miron RJ, Froum S, Zhang Y. Preparation, characterization and biological properties of a novel bone block composed of platelet rich fibrin and a deproteinized bovine bone mineral. FUNDAMENTAL RESEARCH 2022; 2:321-328. [PMID: 38933158 PMCID: PMC11197745 DOI: 10.1016/j.fmre.2021.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/17/2021] [Accepted: 08/08/2021] [Indexed: 01/12/2023] Open
Abstract
Alveolar bone defects caused by tooth loss often lead to challenges in implant dentistry, with a need for development of optimal bone biomaterials to predictably rebuild these tissues. To address this problem, we fabricated a novel bone block using platelet-rich fibrin (PRF) and Deproteinized Bovine Bone Mineral (DBBM), and characterized their mechanical and biological properties. The bone block was prepared by mixing DBBM, Liquid-PRF, and Solid-PRF fragments in various combinations as follows: (1) BLOCK-1 made with Solid-PRF fragments + DBBM, (2) BLOCK-2 made with Liquid-PRF + DBBM, (3) BLOCK-3 made with Solid-PRF fragments + Liquid-PRF + DBBM. The time for solidification and the degradation properties were subsequently recorded. Scanning electron microscopy (SEM) and tensile tests were carried out to investigate the microstructure and mechanical properties of each block. The bioactivity of the three groups towards osteoblast differentiation was also evaluated by culturing cells with the conditioned medium from each of the three groups including cell proliferation assay, cell migration assay, alkaline phosphatase (ALP) staining, and alizarin red staining (ARS), as well as by real-time PCR for genes encoding runt-related transcription factor 2 (RUNX2), ALP, collagen type I alpha1(COL1A1) and osteocalcin (OCN). BLOCK-3 made with Solid-PRF fragments + Liquid-PRF + DBBM had by far the fastest solidification period (over a 10-fold increase) as well as the most resistance to degradation. SEM and tensile tests also revealed that the mechanical properties of BLOCK-3 were superior in strength when compared to all other groups and further induced the highest osteoblast migration and osteogenic differentiation confirmed by ALP, ARS and real-time PCR. PRF bone blocks made through the combination of Solid-PRF fragments + Liquid-PRF + DBBM had the greatest mechanical and biological properties when compared to either used alone. Future clinical studies are warranted to further support the clinical application of PRF bone blocks in bone regeneration procedures.
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Affiliation(s)
- Mengge Feng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430071, China
| | - Yulan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430071, China
| | - Yan Wei
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430071, China
| | - Xiaoxin Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430071, China
| | - Leyi Xiao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430071, China
| | - Zijian Gong
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430071, China
| | - Masako Fujioka-Kobayashi
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Scott Froum
- Clinical Assistant Professor State University of New York, Stony Brook Department of Periodontology, Private Practice New York, New York, USA
| | - Yufeng Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430071, China
- Medical Research Institute, School of Medicine, Wuhan University, Wuhan 430071, China
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27
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Zhang TS, Mudalal M, Ren SC, Zhou YM. Implant site development using titanium plate and platelet-rich fibrin for congenitally missed maxillary lateral incisors: A case report. World J Clin Cases 2022; 10:2015-2022. [PMID: 35317160 PMCID: PMC8891761 DOI: 10.12998/wjcc.v10.i6.2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/29/2021] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Bone deficiency and soft tissue atrophy in the absence of maxillary lateral incisors are among the most challenging problems for implant clinicians. Autologous bone grafting is the gold standard for bone augmentation, but not without limitations. Platelet-rich fibrin (PRF), a biodegradable autologous biomaterial, has been widely used for bone and soft tissue management. Moreover, titanium plate is an advantageous barrier due to its good space-maintaining ability. However, there is a lack of literature on implant site development using titanium plate and PRF for congenitally missing maxillary lateral incisors.
CASE SUMMARY The patient was a 19-year-old girl with a congenitally missing tooth (#12). She underwent implant placement and simultaneous autologous bone grafting with titanium plate and PRF. At the follow-up visit 15 d post-procedure, the vascularization of soft tissue was visible. There was no swelling or pain after the surgery. Six months postoperatively, bone regeneration was evident. Subsequently, the definitive restoration was placed, and the patient was satisfied with the esthetic outcomes.
CONCLUSION Implant site development using titanium plate and PRF for congenitally missing maxillary lateral incisors is a feasible procedure. In this case, the labial bone plate was displaced but remained connected to the base bone, ensuring blood supply. The titanium plate fixed the labial bone plate and maintained the osteogenic space, while the PRF provided growth factors and leukocytes for bone and soft tissue regeneration. Furthermore, the procedure reduced the surgical complexity and adverse reactions, displaying outstanding esthetic outcomes.
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Affiliation(s)
- Tian-Shou Zhang
- Department of Prosthodontics, School and Hospital of Stomatology, Jilin University, Changchun 130021, Jilin Province, China
| | - Mahmoud Mudalal
- Department of Dental Implantology, School and Hospital of Stomatology, Jilin University, Changchun 130021, Jilin Province, China
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry, The Arab American University, Jenin 240, Palestine
| | - Si-Cong Ren
- Department of Dental Implantology, School and Hospital of Stomatology, Jilin University, Changchun 130021, Jilin Province, China
| | - Yan-Min Zhou
- Department of Dental Implantology, School and Hospital of Stomatology, Jilin University, Changchun 130021, Jilin Province, China
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28
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Al-Maawi S, Becker K, Schwarz F, Sader R, Ghanaati S. Efficacy of platelet-rich fibrin in promoting the healing of extraction sockets: a systematic review. Int J Implant Dent 2021; 7:117. [PMID: 34923613 PMCID: PMC8684569 DOI: 10.1186/s40729-021-00393-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/04/2021] [Indexed: 01/03/2023] Open
Abstract
PURPOSE To address the focused question: in patients with freshly extracted teeth, what is the efficacy of platelet-rich fibrin (PRF) in the prevention of pain and the regeneration of soft tissue and bone compared to the respective control without PRF treatment? METHODS After an electronic data search in PubMed database, the Web of Knowledge of Thomson Reuters and hand search in the relevant journals, a total of 20 randomized and/or controlled studies were included. RESULTS 66.6% of the studies showed that PRF significantly reduced the postoperative pain, especially in the first 1-3 days after tooth extraction. Soft tissue healing was significantly improved in the group of PRF compared to the spontaneous wound healing after 1 week (75% of the evaluated studies). Dimensional bone loss was significantly lower in the PRF group compared to the spontaneous wound healing after 8-15 weeks but not after 6 months. Socket fill was in 85% of the studies significantly higher in the PRF group compared to the spontaneous wound healing. CONCLUSIONS Based on the analyzed studies, PRF is most effective in the early healing period of 2-3 months after tooth extraction. A longer healing period may not provide any benefits. The currently available data do not allow any statement regarding the long-term implant success in sockets treated with PRF or its combination with biomaterials. Due to the heterogeneity of the evaluated data no meta-analysis was performed.
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Affiliation(s)
- Sarah Al-Maawi
- FORM, Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Goethe University, Theodor-Stern-Kai 7, 60596, Frankfurt/ Main, Germany
| | - Kathrin Becker
- Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany
| | - Frank Schwarz
- Department of Orthodontics, University of Düsseldorf, 40225, Düsseldorf, Germany
| | - Robert Sader
- FORM, Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Goethe University, Theodor-Stern-Kai 7, 60596, Frankfurt/ Main, Germany
| | - Shahram Ghanaati
- FORM, Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Goethe University, Theodor-Stern-Kai 7, 60596, Frankfurt/ Main, Germany.
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Comparison of the Postoperative Effects of Local Antibiotic versus Systemic Antibiotic with the Use of Platelet-Rich Fibrin on Impacted Mandibular Third Molar Surgery: A Randomized Split-Mouth Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:3040661. [PMID: 34901267 PMCID: PMC8660197 DOI: 10.1155/2021/3040661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/01/2021] [Accepted: 11/14/2021] [Indexed: 11/18/2022]
Abstract
The surgery of the impacted mandibular third molar is the most frequent procedure in dentistry. The prescription of systemic antibiotics after the third molar extraction is widespread among dentists, but this is still argumentative. This study is aimed at evaluating the postoperative effects of local antibiotic mixed with platelet-rich fibrin (PRF) and a postoperative systemic antibiotic prescribed for mandibular third molar surgery. The study included 75 patients divided into a control and 4 test groups (n = 15). In the control group, only PRF was placed into the extracted socket, and no antibiotic was prescribed. In the first and third groups, PRF was applied to the socket; penicillin and clindamycin were prescribed as oral medications, respectively. In the second and fourth groups, only PRF combined with penicillin and clindamycin was applied into the socket, respectively. The outcome variables were pain, swelling, analgesic intake, and trismus. These variables were also assessed based on the first, second, third, and seventh days following the operation. Unpaired Student's t-test and Mann–Whitney U test were used for analysis. There were significant differences in the total VAS pain scores between the control and group 3 (p < 0.05), groups 1 and 2 (p < 0.01), and group 4 (p < 0.001) in ascending order. For analgesic intake, there was no significant difference for group 1 (p > 0.05). However, there were statistical differences between the control group and groups 2 and 3 (p < 0.01) and group 4 (p < 0.001). Trismus and swelling did not differ among the groups (p > 0.05). This study showed that the effects of local and systemic antibiotics with the use of PRF reduced postoperative outcomes. Moreover, local antibiotics with PRF may be a viable method to avoid the possible side effects of systemic antibiotics.
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Qi L, Ge W, Cao N, Wang S, Qian Y, Wang X, Zhang L. Effects of autologous concentrated growth factor on gingival thickness in periodontal accelerated osteogenic orthodontics: a 6-month randomized controlled trial. BMC Oral Health 2021; 21:604. [PMID: 34814921 PMCID: PMC8609726 DOI: 10.1186/s12903-021-01967-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 11/10/2021] [Indexed: 12/22/2022] Open
Abstract
Background Earlier studies have not given clear results of concentrated growth factor (CGF) on gingival thickness (GT) in periodontal accelerated osteogenic orthodontics (PAOO). This randomized controlled trial aimed to evaluate the effects of CGF on GT in patients with thin gingival phenotype undergoing PAOO. Methods Forty four patients presenting 264 anterior mandibular teeth were recruited and randomly allocated to one of the groups: test—positioning of autologous CGF after PAOO or control—positioning of a collagen membrane after PAOO. GT, gingival height (GH), buccal alveolar bone thickness (BT), and buccal alveolar bone height (BH) were evaluated depending on cross-sectional CBCT images at t0 (before surgery) and t1(6 months after surgery). Results GT were increased in both groups at t1 compared to t0. Yet, higher values were observed in the test group (from 0.94 ± 0.23 to 1.31 ± 0.33 mm) compared to the control group (from 0.94 ± 0.19 to 1.02 ± 0.16 mm) (p < 0.05). Moreover, in the intergroup comparison, GT at t1 in the test group was significantly higher compared to the control group (p < 0.01). Furthermore, the GT of central incisors, lateral incisors and canine teeth all showed significantly changes compared with baseline and the test group showed higher increase (p < 0.01). No statistically significant difference were found in GH, BT, BH and all clinical parameters between two groups at t1 (p > 0.05). Conclusions Within the limitation of this study, gingival thickness could be increased by using CGF in PAOO for the patients with thin gingival phenotype. Trial registration The study was registered in Chinese Clinical Trial Registry (http://www.chictr.org.cn/index.aspx) under the number ChiCTRINR17013346, Registered 11 November 2017. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01967-5.
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Affiliation(s)
- Lei Qi
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, 200011, China.,National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Weiwen Ge
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, 200011, China.,National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Ningning Cao
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, 200011, China.,National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Shoupeng Wang
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, 200011, China.,National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Yifeng Qian
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, 200011, China.,National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Xudong Wang
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, 200011, China.,National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Lei Zhang
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China. .,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, 200011, China. .,National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China.
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Qu C, Luo F, Hong G, Wan Q. Effects of platelet concentrates on implant stability and marginal bone loss: a systematic review and meta-analysis. BMC Oral Health 2021; 21:579. [PMID: 34772376 PMCID: PMC8588658 DOI: 10.1186/s12903-021-01929-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 10/21/2021] [Indexed: 01/08/2023] Open
Abstract
Background Osseointegration is essential for the success and stability of implants. Platelet concentrates were reported to enhance osseointegration and improve implant stability. The purpose of this review is to systematically analyze the effects of platelet concentrates on implant stability and marginal bone loss. Methods Two researchers independently performed searches in the following databases (last searched on 21 July 2021): MEDLINE (PubMed), Cochrane Library, EMBASE, and Web of Science. In addition, a manual search was carried out on references of relevant reviews and initially included studies. All randomized controlled trials (RCTs) and controlled clinical trials (CCTs) on the application of platelet concentrates in the implant surgery procedure were included. The risk of bias of RCTs and CCTs were assessed with a revised Cochrane risk of bias tool for randomized trials (RoB 2.0) and the risk of bias in non-randomized studies—of interventions (ROBINS-I) tool, respectively. Meta-analyses on implant stability and marginal bone loss were conducted. Researchers used mean difference or standardized mean difference as the effect size and calculated the 95% confidence interval. In addition, subgroup analysis was performed based on the following factors: type of platelet concentrates, method of application, and study design. Results Fourteen studies with 284 participants and 588 implants were included in the final analysis. 11 studies reported implant stability and 5 studies reported marginal bone level or marginal bone loss. 3 studies had high risk of bias. The meta-analysis results showed that platelet concentrates can significantly increase implant stability at 1 week (6 studies, 302 implants, MD 4.26, 95% CI 2.03–6.49, P < 0.001) and 4 weeks (8 studies, 373 implants, MD 0.67, 95% CI 0.46–0.88, P < 0.001) after insertion, significantly reduced marginal bone loss at 3 months after insertion (4 studies, 95 implants, mesial: MD − 0.33, 95% CI − 0.46 to − 0.20, P < 0.001; distal: MD − 0.38, 95% CI − 0.54 to − 0.22, P < 0.001). However, the improvement of implant stability at 12 weeks after insertion was limited (P = 0.10). Subgroup analysis showed that PRP did not significantly improve implant stability at 1 week and 4 weeks after insertion (P = 0.38, P = 0.17). Platelet concentrates only placed in the implant sites did not significantly improve implant stability at 1 week after insertion (P = 0.20). Conclusions Platelet concentrates can significantly improve implant stability and reduce marginal bone loss in the short term. Large-scale studies with long follow‐up periods are required to explore their long-term effects and compare effects of different types. Trial registration This study was registered on PROSPERO, with the Registration Number being CRD42021270214. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01929-x.
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Affiliation(s)
- Changxing Qu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Feng Luo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, 610041, China.
| | - Guang Hong
- Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan.,Department of Prosthetic Dentistry, Faculty of Dental Medicine, Airlangga University, Surabaya, Indonesia
| | - Qianbing Wan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, 610041, China
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Platelet-Rich Fibrin Decreases the Inflammatory Response of Mesenchymal Cells. Int J Mol Sci 2021; 22:ijms222111333. [PMID: 34768764 PMCID: PMC8583104 DOI: 10.3390/ijms222111333] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 12/11/2022] Open
Abstract
Chronic inflammation is a pathological process where cells of the mesenchymal lineage become a major source of inflammatory mediators. Platelet-rich fibrin (PRF) has been shown to possess potent anti-inflammatory activity in macrophages, but its impact on mesenchymal cells has not been investigated. The aim of this study was, therefore, to expose mesenchymal cells to inflammatory cytokines together with lysates generated from liquid platelet-poor plasma (PPP), the cell-rich buffy coat layer (BC; concentrated-PRF or C-PRF), and the remaining red clot layer (RC), following centrifugation of blood. Heating PPP generates an albumin gel (Alb-gel) that when mixed back with C-PRF produces Alb-PRF. Membranes prepared from solid PRF were also subjected to lysis. We report here that lysates of PPP, BC, and PRF decreased the cytokine-induced expression of interleukin 6 (IL6) and nitric oxide synthase (iNOS) in the bone marrow-derived ST2 cells. Consistently, PPP, BC, and PRF greatly decreased the phosphorylation and nuclear translocation of p65 in ST2 cells. The inflammatory response caused by Pam3CSK4 was reduced accordingly. Moreover, PPP, BC, and PRF reduced the enhanced expression of inflammatory mediators IL6 and iNOS in 3T3-L1 pre-adipocyte mesenchymal cells, and iNOS and CCL5 in murine calvarial cells. Surprisingly, PRF lysates were not effective in reducing the inflammatory response of human gingival fibroblasts and HSC2 epithelial cells. The data from the present study suggest that both liquid PRF and solid PRF exert potent anti-inflammatory activity in murine mesenchymal cells.
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Shah SA, Singh BP, Rao J, Kumar L, Singh M, Singh PK. Biological and esthetic outcome of immediate dental implant with the adjunct pretreatment of immediate implants with platelet-rich plasma or photofunctionalization: A randomized controlled trial. J Indian Prosthodont Soc 2021; 21:348-355. [PMID: 34810362 PMCID: PMC8617446 DOI: 10.4103/jips.jips_217_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/02/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022] Open
Abstract
Aim The purpose of the study was to assess biological and esthetic outcomes of immediate dental implant in esthetic zone with the adjunct pretreatment of immediate implants with photofunctionalization or platelet-rich plasma in comparison to standard tapered root form implant without pretreatment. Settings and Design Patients visiting department of Prosthodontics of a tertiary care health Institution. Design of the study was randomized controlled trial. Materials and Methods Ninety subjects who required replacement of maxillary anterior teeth immediately after extraction were selected and randomly divided into three groups: control group and two case groups. Two case groups were treated with immediate implants with pretreatment with Photofunctionalization (PF group) or platelet-rich plasma (PRP group). Delayed loading protocol was followed with prosthesis given after 6 months. Follow-up was performed at 2nd and 4th weeks and 2, 4, 6, and 12 months (P < 0.05). Biological outcomes (mean marginal bone loss, implant stability), esthetic outcome (pink esthetic score and white esthetic score), and success and survival rate were evaluated. Statistical Analysis Used Outcomes were compared using one-way ANOVA, while intragroup changes with baseline and follow up were assesed using repeated-measures ANOVA. Statistical analyses were performed using Statistical Package for Social Sciences version 25.0 (SPSS Inc., Chicago, IL, USA). The level of significance was set at <.05. Results Mean marginal bone loss was not significantly different in PF group and PRP group than the control group. PF group and PRP group showed significantly greater implant stability as compared to the control group. Pink and white esthetic scores were not significantly different among groups. Conclusion Pretreatment of commercial dental implants with PF or PRP exhibited a statistically significant difference in implant stability but not with other outcomes.
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Affiliation(s)
- Shahid Ahmed Shah
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Balendra Pratap Singh
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Jitendra Rao
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Lakshya Kumar
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Mayank Singh
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Punit Kumar Singh
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
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Deesricharoenkiat N, Jansisyanont P, Chuenchompoonut V, Mattheos N, Thunyakitpisal P. The effect of acemannan in implant placement with simultaneous guided bone regeneration in the aesthetic zone: a randomized controlled trial. Int J Oral Maxillofac Surg 2021; 51:535-544. [PMID: 34429224 DOI: 10.1016/j.ijom.2021.07.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/15/2021] [Accepted: 07/26/2021] [Indexed: 01/16/2023]
Abstract
Acemannan, a linear polysaccharide produced by Aloe vera, has been shown to have important biological effects promoting wound healing and tissue regeneration. The aim of this randomized clinical trial was to investigate the impact of acemannan in guided bone regeneration (GBR) with simultaneous implant placement. Twenty patients were randomly allocated to a test group (deproteinized bovine bone with particulate acemannan (mean size 32.45 μm)) and a control group (deproteinized bovine bone only). Twenty implants were placed with simultaneous GBR. Radiographic measurements were conducted on cone beam computed tomography (CBCT) scans immediately post-surgery and at 3 and 6 months. Vertical and horizontal dimensions of the buccal bone were measured at the implant platform (0) and at points 2, 4, 6, and 8 mm apically. The dimensional reduction of vertical and horizontal buccal bone was significantly smaller in the test group at 3 months postoperative (P < 0.05) at every position measured (0, 2, 4, 6, 8 mm), but the difference was not statistically significant at 6 months. Acemannan was found to be a safe and predictable biomaterial for GBR, which resulted in enhanced dimensional stability of the regenerated tissue at 3 months. However, these results were not replicated at 6 months. Further studies are required to document the long-term efficacy and potential of acemannan use as a supplement in bone regeneration.
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Affiliation(s)
- N Deesricharoenkiat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - P Jansisyanont
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
| | - V Chuenchompoonut
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - N Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - P Thunyakitpisal
- Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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González-Serrano J, Vallina C, González-Serrano C, Sánchez-Monescillo A, Torres J, Hernández G, López-Pintor RM. Effect of Platelet Concentrates on Marginal Bone Loss of Immediate Implant Procedures: A Systematic Review and Meta-Analysis. MATERIALS (BASEL, SWITZERLAND) 2021; 14:4582. [PMID: 34443105 PMCID: PMC8401659 DOI: 10.3390/ma14164582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND To evaluate marginal bone loss (MBL) in immediate implant procedures (IIP) placed in conjunction with platelet concentrates (PCs) compared to IIP without PCs. METHODS A search was performed in four databases. Clinical trials evaluating MBL of IIP placed with and without PCs were included. The random effects model was conducted for meta-analysis. RESULTS Eight clinical trials that evaluated MBL in millimeters were included. A total of 148 patients and 232 immediate implants were evaluated. The meta-analysis showed a statistically significant reduction on MBL of IIP placed with PCs when compared to the non-PCs group at 6 months (p < 0.00001) and 12 months (p < 0.00001) follow-ups. No statistically significant differences were observed on MBL of IIP when compared PCs + bone graft group vs. only bone grafting at 6 months (p = 0.51), and a significant higher MBL of IIP placed with PCs + bone graft when compared to only bone grafting at 12 months was found (p = 0.03). CONCLUSIONS MBL of IIP at 6 and 12 months follow-ups is lower when PCs are applied in comparison to not placing PCs, which may lead to more predictable implant treatments in the medium term. However, MBL seems not to diminish when PCs + bone graft are applied when compared to only bone grafting.
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Affiliation(s)
- José González-Serrano
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (C.V.); (J.T.); (G.H.); (R.M.L.-P.)
| | - Carmen Vallina
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (C.V.); (J.T.); (G.H.); (R.M.L.-P.)
| | - Carlos González-Serrano
- IDIBO Research Group, Stomatology Department, School of Health Sciences, Rey Juan Carlos University, Av. de Atenas, S/N, Alcorcón, 28922 Madrid, Spain;
| | - Andrés Sánchez-Monescillo
- Division of Restorative Sciences, Norris Dental Science Center, Herman Ostrow School of Dentistry, University of Southern California, 925 W 34th Street, DEN 311, Los Angeles, CA 90089-0641, USA;
| | - Jesús Torres
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (C.V.); (J.T.); (G.H.); (R.M.L.-P.)
| | - Gonzalo Hernández
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (C.V.); (J.T.); (G.H.); (R.M.L.-P.)
| | - Rosa María López-Pintor
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (C.V.); (J.T.); (G.H.); (R.M.L.-P.)
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Biomaterials for Periodontal and Peri-Implant Regeneration. MATERIALS 2021; 14:ma14123319. [PMID: 34203989 PMCID: PMC8232756 DOI: 10.3390/ma14123319] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/03/2021] [Accepted: 06/09/2021] [Indexed: 12/23/2022]
Abstract
Periodontal and peri-implant regeneration is the technique that aims to restore the damaged tissue around teeth and implants. They are surrounded by a different apparatus, and according to it, the regenerative procedure can differ for both sites. During the last century, several biomaterials and biological mediators were proposed to achieve a complete restoration of the damaged tissues with less invasiveness and a tailored approach. Based on relevant systematic reviews and articles searched on PubMed, Scopus, and Cochrane databases, data regarding different biomaterials were extracted and summarized. Bone grafts of different origin, membranes for guided tissue regeneration, growth factors, and stem cells are currently the foundation of the routinary clinical practice. Moreover, a tailored approach, according to the patient and specific to the involved tooth or implant, is mandatory to achieve a better result and a reduction in patient morbidity and discomfort. The aim of this review is to summarize clinical findings and future developments regarding grafts, membranes, molecules, and emerging therapies. In conclusion, tissue engineering is constantly evolving; moreover, a tailor-made approach for each patient is essential to obtain a reliable result and the combination of several biomaterials is the elective choice in several conditions.
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Castro AB, Van Dessel J, Temmerman A, Jacobs R, Quirynen M. Effect of different platelet-rich fibrin matrices for ridge preservation in multiple tooth extractions: A split-mouth randomized controlled clinical trial. J Clin Periodontol 2021; 48:984-995. [PMID: 33847018 DOI: 10.1111/jcpe.13463] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/03/2021] [Accepted: 03/19/2021] [Indexed: 12/19/2022]
Abstract
AIM To evaluate dimensional changes in the alveolar ridge and bone structure after tooth extraction when L-PRF or A-PRF+ was used in comparison to unassisted socket healing. MATERIALS AND METHODS Twenty patients in need of at least three tooth extractions in the aesthetic zone were included. L-PRF, A-PRF+ or control was randomly assigned, leaving one empty socket/edentulous site between conditions. CBCT scans were obtained immediately after tooth extraction and after 3 months of healing. Horizontal and vertical dimensional changes of the ridge and socket fill were calculated. Histological and micro-CT analysis of bone biopsies were used to evaluate post-surgical bone structural healing. RESULTS Mean horizontal and vertical changes at 1-mm below the crest (buccal and palatal side) were similar for the three sites (p > 0.05). For the socket fill, L-PRF (85.2%) and A-PRF+ (83.8%) showed superior values than the control (67.9%). The histological and radiological analysis reported more newly formed bone for the PRF groups, without any significant differences between both. CONCLUSIONS PRF matrices failed to reduce the dimensional changes after multiple tooth extractions in the premaxilla. After 3-month healing, both PRF matrices showed radiographically a significant superiority for the socket fill. Histologically, they seemed to accelerate new bone formation.
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Affiliation(s)
- Ana B Castro
- Department of Oral Health Sciences, Section of Periodontology and Oral Microbiology, KU Leuven, University Hospitals Leuven Dentistry, Leuven, Belgium
| | - Jeroen Van Dessel
- Department of Imaging and Pathology, OmfsImpath Research Group, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Andy Temmerman
- Department of Oral Health Sciences, Section of Periodontology and Oral Microbiology, KU Leuven, University Hospitals Leuven Dentistry, Leuven, Belgium
| | - Reinhilde Jacobs
- Department of Imaging and Pathology, OmfsImpath Research Group, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marc Quirynen
- Department of Oral Health Sciences, Section of Periodontology and Oral Microbiology, KU Leuven, University Hospitals Leuven Dentistry, Leuven, Belgium
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Mercado F, Vaquette C, Hamlet S, Ivanovski S. Enamel matrix derivative promotes new bone formation in xenograft assisted maxillary anterior ridge preservation-A randomized controlled clinical trial. Clin Oral Implants Res 2021; 32:732-744. [PMID: 33715279 DOI: 10.1111/clr.13742] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To compare the effectiveness of deproteinized bovine bone mineral with 10% collagen alone (DBBMC) or with enamel matrix derivative (DBBMC-EMD) in ridge preservation. METHODS 42 maxillary anterior teeth were extracted and received either a DBBMC (control) or DBBMC-EMD (test) treatment protocol. CBCT taken before and 4 months after the extraction procedure was used to measure changes in alveolar ridge width (RW), buccal bone height (BH) and palatal bone height (PH). Bone cores were harvested during implant osteotomy preparation, and the samples processed histomorphometrically to assess the fraction of new bone (%NB), residual graft (%RG) and soft tissue matrix (%STM). RESULTS Overall, both treatment groups showed significant reductions in mean RW from baseline to 4 months after extraction, but no significant change in either mean BH or PH over this time. When CBCT measurements were analysed according to the initial thickness of the buccal wall (BT < 1 mm vs. BT ≥ 1 mm), significant reductions in all ridge dimensions (RW, BH and PH) were noted in the <1 mm BT group. Histomorphometrically, the DBBMC-EMD test group showed significantly increased new bone formation (%NB): (control = 16.5 ± 6.9% cf.; test = 45.1 ± 8.8%) with less residual graft (%RG): (control = 36.8 ± 8.8% cf.; test = 20.3 ± 7.2%) compared to the DBBMC control group. CONCLUSIONS Both DBBMC alone and DBBMC-EMD treated sites 4 months after extraction lost RW but showed no significant change in BH or PH. Irrespective of treatment, maxillary anterior teeth with thick initial buccal walls (≥1 mm) exhibited less alveolar ridge reduction 4 months after treatment. The addition of EMD to DBBMC resulted in more new bone formation in the test group.
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Affiliation(s)
- Faustino Mercado
- School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia.,School of Dentistry, University of Queensland, Brisbane, QLD, Australia
| | - Cedryck Vaquette
- School of Dentistry, University of Queensland, Brisbane, QLD, Australia
| | - Stephen Hamlet
- School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia.,Menzies Health Institute, Griffith University, Gold Coast, QLD, Australia
| | - Sašo Ivanovski
- School of Dentistry, University of Queensland, Brisbane, QLD, Australia
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Castro AB, Andrade C, Li X, Pinto N, Teughels W, Quirynen M. Impact of g force and timing on the characteristics of platelet-rich fibrin matrices. Sci Rep 2021; 11:6038. [PMID: 33727689 PMCID: PMC7971031 DOI: 10.1038/s41598-021-85736-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/04/2021] [Indexed: 02/08/2023] Open
Abstract
Recently, new centrifugation protocols for the preparation of platelet-rich fibrin (PRF) have been introduced in an attempt to further improve the beneficial impact of these 2nd generation platelet concentrate membranes. This in-vitro study aimed to compare the biological and physical characteristics of three types of PRF membranes using two different centrifuges with adapted relative centrifugal forces (RCF): leucocyte- and platelet-rich fibrin, advanced platelet-rich fibrin, and advanced platelet-rich fibrin+. Release of growth factors, macroscopic dimensions, cellular content and mechanical properties of the respective membranes, prepared from blood of the same individual were explored. Furthermore, the impact of timing (blood draw-centrifugation and centrifugation-membrane preparation) was assessed morphologically as well as by electron microscopy scanning. No statistically significant differences amongst the three PRF modifications could be observed, neither in their release of growth factors or the cellular content, nor in clot/membrane dimensions. The difference between both centrifuges were negligible when the same g-force was used. A lower g-force, however, reduced membrane tensile strength. Timing in the preparation process had a significant impact. Adaptation of RCF only had a minimal impact on the final characteristics of PRF membranes.
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Affiliation(s)
- Ana B Castro
- Department of Oral Health Sciences, Periodontology, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, blok a - bus 07001, 3000, Leuven, Belgium.
| | - C Andrade
- Department of Periodontology and Oral Implantology, Faculty of Dentistry, School of Dentistry, University of Los Andes, Santiago, Chile
| | - X Li
- Department of Oral Health Sciences, KU Leuven, BIOMAT and University Hospitals Leuven Dentistry, Leuven, Belgium
| | - N Pinto
- Department of Periodontology and Oral Implantology, Faculty of Dentistry, School of Dentistry, University of Los Andes, Santiago, Chile
| | - W Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, blok a - bus 07001, 3000, Leuven, Belgium
| | - M Quirynen
- Department of Oral Health Sciences, Periodontology, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, blok a - bus 07001, 3000, Leuven, Belgium
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Hartlev J, Schou S, Isidor F, Nørholt SE. A clinical and radiographic study of implants placed in autogenous bone grafts covered by either a platelet-rich fibrin membrane or deproteinised bovine bone mineral and a collagen membrane: a pilot randomised controlled clinical trial with a 2-year follow-up. Int J Implant Dent 2021; 7:8. [PMID: 33554323 PMCID: PMC7868310 DOI: 10.1186/s40729-021-00289-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/08/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose To compare the survival and clinical performance of implants placed in sites previously augmented with autogenous bone grafts covered by either a platelet-rich fibrin (PRF) membrane (PRF group) or a standard procedure (gold standard) involving coverage of the autogenous bone graft with deproteinised bovine bone mineral and a resorbable collagen membrane (control group). Methods A total of 27 partially edentulous patients (test n = 14, control n = 13) with indication for staged lateral bone block augmentation and dental implant placement were included. Twenty-four months after crown placement (range: 14–32 months), patients were recalled for a final clinical and radiographic follow-up. Outcome measures were implant survival, implant crown survival, clinical parameters of the implant, peri-implant marginal bone level, marginal bone level of adjacent tooth surfaces, biological and technical complications and patient-related outcome measures. Results Two implants were lost in the control group (85% survival rate); none were lost in the PRF group (100% survival rate). None of the 26 initially placed implant crowns were lost, but one implant and therefore one implant crown were lost after 20 months. Consequently, the definitive implant crown survival was 92% (95% confidence interval (CI): 73–110%) in the control group and 100% in the PRF group. No statistical difference in implant survival rate (p = 0.13) or implant crown survival was seen between the groups (p = 0.28). The mean marginal bone level at the follow-up was 0.26 mm (95% CI: 0.01–0.50 mm) in the PRF group and 0.68 mm (95% CI: 0.41–0.96 mm) in the control group. The difference between the groups was − 0.43 mm (95% CI: − 0.80 to − 0.05 mm, p = 0.03), which was statistically significant (p = 0.03). Both groups demonstrated similar healthy peri-implant soft tissue values at the final follow-up. Conclusion Although the current study is based on a small sample of participants, the findings suggest that the methodology of the PRF and the control group approach can both be used for bone augmentation with a similar outcome. A significant, but clinically irrelevant, higher peri-implant marginal bone level was registered in the PRF group than in the control group. Patients in both groups were highly satisfied with the treatment. Trial registration ClinicalTrials.gov Identifier: NCT04350749. Registered 17 April 2020. Retrospectively registered.
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Affiliation(s)
- Jens Hartlev
- Section for Oral Surgery and Oral Pathology, Department of Dentistry and Oral Health, Health, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark.
| | - Søren Schou
- Department of Periodontology, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Noerre Alle 20, DK-2200, Copenhagen N, Denmark
| | - Flemming Isidor
- Section for Prosthetics, Department of Dentistry and Oral Health, Health, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark
| | - Sven Erik Nørholt
- Section for Oral Surgery and Oral Pathology, Department of Dentistry and Oral Health, Health, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark.,Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200, Aarhus N, Denmark
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Lima VCDS, Miguel MMV, Ferraz LFF, Filho ABDM, Jardini MAN, Santamaria MP. Use of Platelet-Rich Fibrin Membranes With Single Implant Placement for Peri-Implant Mucosal Thickness Augmentation: A Case Series Study. Clin Adv Periodontics 2020; 12:17-20. [PMID: 33340395 DOI: 10.1002/cap.10143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/10/2020] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The use of platelet-rich fibrin (PRF) membranes has been evaluated for different purposes. However, few studies aimed to assess the effect of PRF membranes on peri-implant mucosal thickness augmentation. Thus, the aim was to evaluate whether the use of PRF membranes placed using the same surgical procedure of single implant installation in the anterior area of the maxilla can result in peri-implant mucosal thickness increase. CASE SERIES Eight patients received single maxillary implants (anterior area), covered by three PRF membranes (2,500 rpm/12 minutes, RCFmax = 719.71 g). Clinical parameters (baseline and 3 months postoperative) and patient-centered parameters were evaluated. The buccal peri-implant mucosal thickness (BMT) and ridge defect (RD) parameters showed a statistically significant difference, with a gain of 0.7 ± 0.3 mm in BMT and reduction of 0.8 ± 0.3 mm in RD. Supracrestal tissue height (STH) was >3 mm after 3 months. Postoperative pain and number of analgesics showed low values (0.95 ± 1.06 and 1.92 ± 2.75), respectively, using a visual analog scale (VAS). CONCLUSION The use of three PRF membranes along with single implant placement in the anterior maxilla led to an increase in the BMT.
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Affiliation(s)
- Victória Clara da Silva Lima
- Division of Periodontics, São Paulo State University (Unesp), São José dos Campos, Institute of Science and Technology, São Paulo, Brazil
| | - Manuela Maria Viana Miguel
- Division of Periodontics, São Paulo State University (Unesp), São José dos Campos, Institute of Science and Technology, São Paulo, Brazil
| | - Laís Fernanda Ferreira Ferraz
- Division of Periodontics, São Paulo State University (Unesp), São José dos Campos, Institute of Science and Technology, São Paulo, Brazil
| | - Antonio Braulino de Melo Filho
- Division of Integrated Clinic, São Paulo State University (Unesp), São José dos Campos, Institute of Science and Technology, São Paulo, Brazil
| | - Maria Aparecida Neves Jardini
- Division of Periodontics, São Paulo State University (Unesp), São José dos Campos, Institute of Science and Technology, São Paulo, Brazil
| | - Mauro Pedrine Santamaria
- Division of Periodontics, São Paulo State University (Unesp), São José dos Campos, Institute of Science and Technology, São Paulo, Brazil
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Antibacterial effects of platelet-rich fibrin produced by horizontal centrifugation. Int J Oral Sci 2020; 12:32. [PMID: 33243983 PMCID: PMC7693325 DOI: 10.1038/s41368-020-00099-w] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/06/2020] [Accepted: 10/18/2020] [Indexed: 12/13/2022] Open
Abstract
Platelet-rich fibrin (PRF) has been widely used owing to its ability to stimulate tissue regeneration. To date, few studies have described the antibacterial properties of PRF. Previously, PRF prepared by horizontal centrifugation (H-PRF) was shown to contain more immune cells than leukocyte- and platelet-rich fibrin (L-PRF). This study aimed to compare the antimicrobial effects of PRFs against Staphylococcus aureus and Escherichia coli in vitro and to determine whether the antibacterial effects correlated with the number of immune cells. Blood samples were obtained from eight healthy donors to prepare L-PRF and H-PRF. The sizes and weights of L-PRF and H-PRF were first evaluated, and their antibacterial effects against S. aureus and E. coli were then tested in vitro using the inhibition ring and plate-counting test methods. Flow-cytometric analysis of the cell components of L-PRF and H-PRF was also performed. No significant differences in size or weight were observed between the L-PRF and H-PRF groups. The H-PRF group contained more leukocytes than the L-PRF group. While both PRFs had notable antimicrobial activity against S. aureus and E. coli, H-PRF demonstrated a significantly better antibacterial effect than L-PRF. Furthermore, the antimicrobial ability of the PRF solid was less efficient than that of wet PRF. In conclusion, H-PRF exhibited better antibacterial activity than L-PRF, which might have been attributed to having more immune cells.
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Aravena PC, Sandoval SP, Pizarro FE, Simpson MI, Castro-Adams N, Serandour G, Rosas C. Leukocyte and Platelet-Rich Fibrin Have Same Effect as Blood Clot in the 3-Dimensional Alveolar Ridge Preservation. A Split-Mouth Randomized Clinical Trial. J Oral Maxillofac Surg 2020; 79:575-584. [PMID: 33171113 DOI: 10.1016/j.joms.2020.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 01/16/2023]
Abstract
PURPOSE Leukocyte- and platelet-rich fibrin (L-PRF) has been used for alveolar ridge preservation (ARP) in postextraction tooth sockets. However, current reports have measured its effectiveness in linear measurements of 3-dimensional ridge preservation. The purpose of this study was to determine the effectiveness of the use of L-PRF filling versus natural clot blood healing in ARP according to the clinical, radiographic, and volumetric measurements of postextraction tooth sockets. MATERIALS AND METHODS A split-mouth randomized clinical trial was designed. Healthy patients who needed bilateral extraction of upper third molars were selected. After the tooth extraction, the socket was filled and distributed randomly with L-PRF and the contralateral socket only with the blood clot. The dimensional change of soft tissue healing around the sockets, and the length, depth, and difference of bone formation were examined using standardized periapical radiographs. Volumetric measurement variation of the sockets was evaluated by 3-dimensional scanning of dental casts. Changes of all measures were analyzed at 7 days (initial) and 3 months (final) after the tooth extraction and compared between both groups (t test; P < .05). RESULTS Sixteen patients (aged 24.75 ± 3.53 years; 56.25% women) participated. Measurements of wound healing and the length, depth, and difference of bone formation were similar for both study groups at initial and final times. The calculation of initial-final volumetric socket variation was 15.45 ± 13.12 μL using L-PRF and 14.12 ± 11.23 μL using blood clot (P = .78). CONCLUSIONS L-PRF filling showed the same dimensional and volumetric behavior as normal blood clot healing in the ARP of postextraction tooth sockets. Future investigations will have to analyze the use of surgical models and digital instruments in ARP techniques.
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Affiliation(s)
- Pedro Christian Aravena
- Associate Professor, Head Department of Odontostomatology, School of Dentistry, Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile.
| | - Stephania Pilar Sandoval
- Clinical Instructor, Department of Odontostomatology, School of Dentistry, Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile
| | - Felipe Eduardo Pizarro
- Clinical Instructor, Department of Odontostomatology, School of Dentistry, Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile
| | - María Isabel Simpson
- Adjunct Professor, School of Dentistry, Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile
| | - Nicolás Castro-Adams
- Mechanical Engineer, Laboratory Assistant, LeufüLab Laboratory, Faculty of Science of Engineering. Universidad Austral de Chile, Valdivia, Chile
| | - Guillaume Serandour
- Professor, Mechanical Engineer, Head LeufüLab Laboratory, Faculty of Science of Engineering, Universidad Austral de Chile, Valdivia, Chile
| | - Cristian Rosas
- Adjunct Professor, School of Dentistry, Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile
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Opris H, Bran S, Dinu C, Baciut M, Prodan DA, Mester A, Baciut G. Clinical applications of avian eggshell-derived hydroxyapatite. Bosn J Basic Med Sci 2020; 20:430-437. [PMID: 32651970 PMCID: PMC7664787 DOI: 10.17305/bjbms.2020.4888] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 07/04/2020] [Indexed: 12/13/2022] Open
Abstract
The search for bone reconstruction materials and methods is an ongoing challenge. The aim of this review is to systemically search the available literature concerning the clinical performance of eggshell as a substitute material in guided bone regeneration in oral surgery. Five databases (PubMed, Cochrane, Web of Science, Scopus, and Embase) were searched up to February 2020. Clinical trials that used eggshell as a bone substitute material were included in the review. Animal and in vivo studies were excluded from the review. ROBINS-I was used to evaluate the risk of bias. A total of 840 studies were retrieved, out of which 55 full-text articles were screened. Five studies were finally included: one study showed critical and four serious risk of bias. A total of 74 patients and 88 intervention sites were included in the five studies. Clinical and radiological evaluation showed complete healing during the follow-ups. Statistically significant radiological and clinical evidence of new bone formation was achieved for socket preservation, grafting after third molar extraction, and cystic/apicectomy grafting. One patient with complications was reported. Histological analysis and micro computed tomography confirmed that it promotes bone regeneration. A comparison with synthetic hydroxyapatite showed similar healing characteristics. Within the limitations of the included studies, the eggshell can be safely and efficiently used in guided bone regeneration procedures, but more research is needed to completely evaluate the full potential of this material.
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Affiliation(s)
- Horia Opris
- Department of Maxillofacial Surgery and Implantology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simion Bran
- Department of Maxillofacial Surgery and Implantology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Maxillofacial Surgery and Implantology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Baciut
- Department of Maxillofacial Surgery and Implantology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Daiana Antoaneta Prodan
- Department of Maxillofacial Surgery and Implantology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandru Mester
- Department of Oral Health, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grigore Baciut
- Department of Maxillofacial Surgery and Implantology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Picciolo G, Peditto M, Irrera N, Pallio G, Altavilla D, Vaccaro M, Picciolo G, Scarfone A, Squadrito F, Oteri G. Preclinical and Clinical Applications of Biomaterials in the Enhancement of Wound Healing in Oral Surgery: An Overview of the Available Reviews. Pharmaceutics 2020; 12:E1018. [PMID: 33114407 PMCID: PMC7692581 DOI: 10.3390/pharmaceutics12111018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 02/07/2023] Open
Abstract
Oral surgery has undergone dramatic developments in recent years due to the use of biomaterials. The aim of the present review is to provide a general overview of the current biomaterials used in oral surgery and to comprehensively outline their impact on post-operative wound healing. A search in Medline was performed, including hand searching. Combinations of searching terms and several criteria were applied for study identification, selection, and inclusion. The literature was searched for reviews published up to July 2020. Reviews evaluating the clinical and histological effects of biomaterials on post-operative wound healing in oral surgical procedures were included. Review selection was performed by two independent reviewers. Disagreements were resolved by a third reviewer, and 41 reviews were included in the final selection. The selected papers covered a wide range of biomaterials such as stem cells, bone grafts, and growth factors. Bioengineering and biomaterials development represent one of the most promising perspectives for the future of oral surgery. In particular, stem cells and growth factors are polarizing the focus of this ever-evolving field, continuously improving standard surgical techniques, and granting access to new approaches.
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Affiliation(s)
- Giacomo Picciolo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.P.); (D.A.); (G.O.)
| | - Matteo Peditto
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.P.); (D.A.); (G.O.)
| | - Natasha Irrera
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy;
| | - Giovanni Pallio
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
| | - Domenica Altavilla
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.P.); (D.A.); (G.O.)
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy;
| | - Mario Vaccaro
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
| | - Giuseppe Picciolo
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy;
| | - Alessandro Scarfone
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
| | - Francesco Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy;
| | - Giacomo Oteri
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.P.); (D.A.); (G.O.)
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Kargarpour Z, Nasirzade J, Panahipour L, Miron RJ, Gruber R. Relative Centrifugal Force (RCF; G-Force) Affects the Distribution of TGF-β in PRF Membranes Produced Using Horizontal Centrifugation. Int J Mol Sci 2020; 21:E7629. [PMID: 33076376 PMCID: PMC7589083 DOI: 10.3390/ijms21207629] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/06/2020] [Accepted: 10/12/2020] [Indexed: 01/03/2023] Open
Abstract
Solid platelet-rich fibrin (PRF) is produced with centrifugation tubes designed to accelerate clotting. Thus, activated platelets may accumulate within the fibrin-rich extracellular matrix even before centrifugation is initiated. It can thus be assumed that platelets and their growth factors such as transforming growth factor-β (TGF-β) are trapped within PRF independent of their relative centrifugal force (RCF), the gravitation or g-force. To test this assumption, we prepared PRF membranes with tubes where clotting is activated by a silicone-coated interior. Tubes underwent 210 g, 650 g and 1500 g for 12 min in a horizontal centrifuge. The respective PRF membranes, either in total or separated into a platelet-poor plasma and buffy coat fraction, were subjected to repeated freeze-thawing to prepare lysates. Gingival fibroblasts were exposed to the PRF lysates to provoke the expression of TGF-β target genes. We show here that the expression of interleukin 11 (IL11) and NADPH oxidase 4 (NOX4), and Smad2/3 signaling were similarly activated by all lysates when normalized to the size of the PRF membranes. Notably, platelet-poor plasma had significantly less TGF-β activity than the buffy coat fraction at both high-speed protocols. In contrast to our original assumption, the TGF-β activity in PRF lysates produced using horizontal centrifugation follows a gradient with increasing concentration from the platelet-poor plasma towards the buffy coat layer.
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Affiliation(s)
- Zahra Kargarpour
- Department of Oral Biology, Medical University of Vienna, 1090 Vienna, Austria; (Z.K.); (J.N.); (L.P.)
| | - Jila Nasirzade
- Department of Oral Biology, Medical University of Vienna, 1090 Vienna, Austria; (Z.K.); (J.N.); (L.P.)
| | - Layla Panahipour
- Department of Oral Biology, Medical University of Vienna, 1090 Vienna, Austria; (Z.K.); (J.N.); (L.P.)
| | - Richard J. Miron
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland;
| | - Reinhard Gruber
- Department of Oral Biology, Medical University of Vienna, 1090 Vienna, Austria; (Z.K.); (J.N.); (L.P.)
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland;
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Biomimetic Aspects of Oral and Dentofacial Regeneration. Biomimetics (Basel) 2020; 5:biomimetics5040051. [PMID: 33053903 PMCID: PMC7709662 DOI: 10.3390/biomimetics5040051] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/09/2020] [Accepted: 10/10/2020] [Indexed: 12/12/2022] Open
Abstract
Biomimetic materials for hard and soft tissues have advanced in the fields of tissue engineering and regenerative medicine in dentistry. To examine these recent advances, we searched Medline (OVID) with the key terms “biomimetics”, “biomaterials”, and “biomimicry” combined with MeSH terms for “dentistry” and limited the date of publication between 2010–2020. Over 500 articles were obtained under clinical trials, randomized clinical trials, metanalysis, and systematic reviews developed in the past 10 years in three major areas of dentistry: restorative, orofacial surgery, and periodontics. Clinical studies and systematic reviews along with hand-searched preclinical studies as potential therapies have been included. They support the proof-of-concept that novel treatments are in the pipeline towards ground-breaking clinical therapies for orofacial bone regeneration, tooth regeneration, repair of the oral mucosa, periodontal tissue engineering, and dental implants. Biomimicry enhances the clinical outcomes and calls for an interdisciplinary approach integrating medicine, bioengineering, biotechnology, and computational sciences to advance the current research to clinics. We conclude that dentistry has come a long way apropos of regenerative medicine; still, there are vast avenues to endeavour, seeking inspiration from other facets in biomedical research.
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Liquid Platelet-Rich Fibrin and Heat-Coagulated Albumin Gel: Bioassays for TGF-β Activity. MATERIALS 2020; 13:ma13163466. [PMID: 32781631 PMCID: PMC7475845 DOI: 10.3390/ma13163466] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/31/2020] [Accepted: 08/03/2020] [Indexed: 02/07/2023]
Abstract
Liquid platelet-rich fibrin (PRF) can be prepared by high centrifugation forces separating the blood into a platelet-poor plasma (PPP) layer and a cell-rich buffy coat layer, termed concentrated PRF (C-PRF). Heating the liquid PPP was recently introduced to prepare an albumin gel (Alb-gel) that is later mixed back with the concentrated liquid C-PRF to generate Alb-PRF. PRF is a rich source of TGF-β activity; however, the overall TGF-β activity in the PPP and the impact of heating the upper plasma layer remains unknown. Here, we investigated for the first time the in vitro TGF-β activity of all fractions of Alb-PRF. We report that exposure of oral fibroblasts with lysates of PPP and the buffy coat layer, but not with heated PPP, provoked a robust increase in the TGF-β target genes interleukin 11 and NADPH oxidase 4 by RT-PCR, and for IL11 by immunoassay. Consistent with the activation of TGF-β signaling, expression changes were blocked in the presence of the TGF-β receptor type I kinase inhibitor SB431542. Immunofluorescence and Western blot further confirmed that lysates of PPP and the buffy coat layer, but not heated PPP, induced the nuclear translocation of Smad2/3 and increased phosphorylation of Smad3. The immunoassay further revealed that PPP and particularly BC are rich in active TGF-β compared to heated PPP. These results strengthen the evidence that not only the cell-rich C-PRF but also PPP comprise a TGF-β activity that is, however, heat sensitive. It thus seems relevant to mix the heated PPP with the buffy coat C-PRF layer to regain TGF-β activity, as proposed during the preparation of Alb-PRF.
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Platelet-Rich Fibrin Can Neutralize Hydrogen Peroxide-Induced Cell Death in Gingival Fibroblasts. Antioxidants (Basel) 2020; 9:antiox9060560. [PMID: 32604944 PMCID: PMC7346145 DOI: 10.3390/antiox9060560] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 12/15/2022] Open
Abstract
Hydrogen peroxide is a damage signal at sites of chronic inflammation. The question arises whether platelet-rich fibrin (PRF), platelet-poor plasma (PPP), and the buffy coat can neutralize hydrogen peroxide toxicity and thereby counteract local oxidative stress. In the present study, gingival fibroblasts cells were exposed to hydrogen peroxide with and without lysates obtained from PRF membranes, PPP, heated PPP (75 °C for 10 min), and the buffy coat. Cell viability was examined by trypan blue staining, live-dead staining, and formazan crystal formation. Cell apoptosis was assessed by cleaved caspase-3 Western blot analysis. Reverse transcription-quantitative polymerase chain reaction (RT-PCR) was utilized to determine the impact of PRF lysates on the expression of catalase in fibroblasts. It was reported that lysates from PRF, PPP, and the buffy coat—but not heated PPP—abolished the hydrogen peroxide-induced toxicity in gingival fibroblasts. Necrosis was confirmed by a loss of membrane integrity and apoptosis was ruled out by the lack of cleavage of caspase-3. Aminotriazole, an inhibitor of catalase, reduced the cytoprotective activity of PRF lysates yet blocking of glutathione peroxidase by mercaptosuccinate did not show the same effect. PRF lysates had no impact on the expression of catalase in gingival fibroblasts. These findings suggest that PRF, PPP, and the buffy coat can neutralize hydrogen peroxide through the release of heat-sensitive catalase.
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TGFβ activity released from platelet-rich fibrin adsorbs to titanium surface and collagen membranes. Sci Rep 2020; 10:10203. [PMID: 32576959 PMCID: PMC7311486 DOI: 10.1038/s41598-020-67167-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 05/26/2020] [Indexed: 02/07/2023] Open
Abstract
Platelet-rich fibrin (PRF) contains a broad spectrum of bioactive molecules that can trigger several cellular responses. However, these molecules along with their upstream responses remain mostly uninvestigated. By means of proteomics we revealed that PRF lysates contain more than 650 proteins, being TGF-β one of the few growth factors found. To uncover the major target genes regulated by PRF lysates, gingival fibroblasts were exposed to lysates obtained from PRF membranes followed by a whole genome array. We identified 51 genes strongly regulated by PRF including IL11, NOX4 and PRG4 which are characteristic TGF-β target genes. RT-PCR and immunoassay analysis confirmed the TGF-β receptor I kinase-dependent increased expression of IL11, NOX4 and PRG4. The PRF-derived TGF-β activity was verified by the translocation of Smad2/3 into the nucleus along with the increased phosphorylation of Smad3. Considering that PRF is clinically used in combination with dental implants and collagen membranes, we showed here that PRF-derived TGF-β activity adsorbs to titanium implants and collagen membranes indicated by the changes in gene expression and immunoassay analysis. Our study points towards TGF-β as major target of PRF and suggest that TGF-β activity released by PRF adsorbs to titanium surface and collagen membranes
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