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Samiraninezhad N, Rezazadeh H, Rezazadeh H, Mardaninezhad R, Tabesh A, Rezazadeh F. Platelet-rich fibrin in the management of oral mucosal lesions: a scoping review. BMC Oral Health 2024; 24:1189. [PMID: 39369241 PMCID: PMC11456237 DOI: 10.1186/s12903-024-04981-5] [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: 07/01/2024] [Accepted: 09/30/2024] [Indexed: 10/07/2024] Open
Abstract
OBJECTIVES Oral mucosal lesions are prevalent and often cause pain, thus impacting patients' quality of life. Platelet-rich fibrin (PRF) has emerged as a promising autologous biomaterial for wound healing, yet comprehensive evidence regarding its efficacy in treating oral mucosal lesions is limited. This study aims to update the current evidence on the effectiveness of PRF in treating various types of oral mucosal lesions. MATERIALS AND METHODS We conducted a literature search in PubMed, Scopus, Embase, and Web of Science databases until April 2024. The search included studies that investigated the use of PRF in treating oral mucosal lesions. Twelve studies met the inclusion criteria, comprising three case reports, three randomized controlled trials, two animal studies, three split-mouth trials, and one retrospective study. We performed data extraction according to a predefined form. RESULTS PRF was applied in two forms-membranes and injectable gels-to treat a range of oral mucosal lesions, including ulcerative, red and white, pigmented, and potentially malignant or malignant lesions. Compared to control groups or conventional treatments, PRF generally demonstrated superior outcomes regarding faster healing, lesion size reduction, symptom relief, and lower recurrence rates. Histological and molecular analyses from some studies also indicated PRF's regenerative and anti-inflammatory effects. CONCLUSION PRF shows promise as an effective and safe alternative to current treatments for oral mucosal lesions due to its autologous nature, ease of preparation, and wound-healing capabilities. However, further research is needed to standardize PRF preparation protocols and confirm its long-term efficacy across different lesion types.
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Affiliation(s)
- Nazafarin Samiraninezhad
- School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
- Biotechnology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hojat Rezazadeh
- Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | - Hasan Rezazadeh
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Amir Tabesh
- School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fahimeh Rezazadeh
- Department of Oral and Maxillofacial Medicine, Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Alzoubi FM, AlRumaih HS, Alhumaidan AA, Al-Sulimmani W. Implant Stability After Graftless Motor-Driven Crestal Sinus Elevation: A Cohort Study. J ORAL IMPLANTOL 2024; 50:461-467. [PMID: 38961753 DOI: 10.1563/aaid-joi-d-24-00015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
Graftless motor-driven crestal sinus elevation may be a preferable alternative to conventional methods due to the reduction of postsurgical complications and lower cost. This prospective cohort study evaluated the stability of implants installed using this technique. Twenty-nine Straumann BLT (bone level tapered) implants in 29 patients were included in the sample. Average implant stability quotients (ISQ) were measured immediately after surgery (mean: 73.5 ± 9.2) and after a period of healing (mean: 77.1 ± 4.5) using resonance frequency analysis (RFA). There was a significant increase in implant stability after healing (P = .035). The healing duration did not significantly influence how implant stability increased (P =.373). The mean ISQ after healing was significantly higher than the clinically acceptable stability value of 65 ISQ (P < .001). Implant length and width were not significantly correlated with ISQ increase (P = .764 and P = .085, respectively). In addition, there were no significant differences in average ISQ values measured immediately postsurgery (at baseline) or after healing between implants with and without registered perforations during surgery (P = .118 and P = .366, respectively). The posthealing stability of 4 implants that did not achieve primary stability was not significantly less stable after the healing period than those that had achieved primary stability (P = .086). Moreover, the level of insertion torque significantly impacted implant stability immediately postsurgery (P < .001), but the ISQ values measured after healing were not significantly different based on the initial insertion torque values (P = .131). This study suggests that implants installed using graftless motor-driven crestal sinus elevation may achieve clinically acceptable stability as measured by RFA.
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Affiliation(s)
- Fawaz M Alzoubi
- Department of General Dental Practice, College of Dentistry, Kuwait University, Kuwait
| | - Hamad S AlRumaih
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdulkareem A Alhumaidan
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Saudi Arabia
| | - Woroud Al-Sulimmani
- Oral and Maxillofacial Surgery Department, Al-Jahra Hospital, Al-Jahra Medical Area, Ministry of Health, Kuwait
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Francisco L, Francisco M, Costa R, Vasques MN, Relvas M, Rajão A, Monteiro L, Rompante P, Guerra F, Infante da Câmara M. Sinus Floor Augmentation with Synthetic Hydroxyapatite (NanoBone ®) in Combination with Platelet-Rich Fibrin: A Case Series. Biomedicines 2024; 12:1661. [PMID: 39200126 PMCID: PMC11351586 DOI: 10.3390/biomedicines12081661] [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: 06/21/2024] [Revised: 07/16/2024] [Accepted: 07/23/2024] [Indexed: 09/01/2024] Open
Abstract
Several techniques have been described for maxillary sinus graft augmentation, including the lateral window technique and crestal approach with osteotomes or osseodensification. Platelet-rich fibrin has been used in maxillary sinus lift procedures due to its ability to accelerate soft and hard tissue healing. The aim of this study was to evaluate the potential of PRF in combination with the synthetic hydroxyapatite NanoBone® to enhance bone regeneration in sinus floor elevation with the lateral window technique. Out of the 50 individuals screened in a preoperative assessment visit from the CESPU-Famalicão clinical unit and intervened upon between January 2023 and December 2023, only 6 patients who met the study's inclusion criteria consented to participate. In a split-mouth study, twelve sinus graft surgeries were carried out. Our observations reveal that for the test group (NanoBone®/PRF), there is a 27.5 ± 4.9% increase new vital bone, 23.0 ± 3.7% increase in inert bone particles, and 49.4 ± 2.8% increase in connective tissue. Meanwhile, for the control group (NanoBone®), there is a 19.5 ± 3.0% increase in new vital bone, 23.4 ± 5.7% increase in inert bone particles, and 57.0 ± 3.5% increase in connective tissue. The results strongly indicate that mixing liquid PRF with NanoBone® does not have a negative influence on the amount of viable bone formation, and it seems to slightly increase the amount of new bone formation and revascularization in sinus bone graft procedures with the lateral window technique compared to the single use of NanoBone®.
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Affiliation(s)
- Luís Francisco
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal; (L.F.); (R.C.); (M.N.V.); (M.R.); (L.M.); (P.R.)
| | - Manuel Francisco
- Clinical Assistant Professor Postgraduate Implant Program, Famalicão Unit, University Institute of Health Sciences (IUCS-CESPU), Av. Marechal Humberto Delgado, 14, 4760-012 Vila Nova de Famalicão, Portugal;
| | - Rosana Costa
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal; (L.F.); (R.C.); (M.N.V.); (M.R.); (L.M.); (P.R.)
- Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
| | - Miguel Nunes Vasques
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal; (L.F.); (R.C.); (M.N.V.); (M.R.); (L.M.); (P.R.)
- Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
| | - Marta Relvas
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal; (L.F.); (R.C.); (M.N.V.); (M.R.); (L.M.); (P.R.)
- Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
| | - António Rajão
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal;
- Applied Molecular Biosciences Unit (UCIBIO), Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), 4585-116 Gandra, Portugal
| | - Luís Monteiro
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal; (L.F.); (R.C.); (M.N.V.); (M.R.); (L.M.); (P.R.)
- Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
| | - Paulo Rompante
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal; (L.F.); (R.C.); (M.N.V.); (M.R.); (L.M.); (P.R.)
| | - Fernando Guerra
- Institute of Oral Implantology and Prosthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal;
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
- Laboratory of Hard Tissues, Dentistry Department, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Marco Infante da Câmara
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal; (L.F.); (R.C.); (M.N.V.); (M.R.); (L.M.); (P.R.)
- Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
- Coordinator of the Postgraduate Implant Program, Famalicão Unit, University Institute of Health Sciences (IUCS-CESPU), Av. Marechal Humberto Delgado, 14, 4760-012 Vila Nova de Famalicão, Portugal
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A.K. S, Sahoo N, Kumar D, Malhi R. Efficacy of platelet-rich fibrin in maxillary sinus augmentation and simultaneous implant placement in deficient maxillary ridges: A pilot comparative study. Med J Armed Forces India 2024; 80:420-427. [PMID: 39071757 PMCID: PMC11279723 DOI: 10.1016/j.mjafi.2022.08.007] [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: 06/13/2022] [Accepted: 08/18/2022] [Indexed: 07/30/2024] Open
Abstract
Background Rehabilitation with dental implants has become the most widely accepted treatment protocol for rehabilitation of lost natural teeth. Direct sinus lift is one of the most predictable procedures for augmenting the deficient posterior maxillary ridges. Methods The study was designed in patients with insufficient bone for implants in the maxillary posterior ridges. The test group received platelet-rich fibrin alone as filler, and the control group received a bone allograft. The residual bone height (RBH), implant mobility, and soft tissue characteristics between and within the groups were compared and analyzed. Results Both the groups had considerable gain in RBH, and the intragroup analysis revealed clinical gain in bone height in both the groups, with the test group exhibiting statistically significant gain which kept on improving from 6 months with z= -3.477 and a p value of 0.001 to 9 months with z=-3.531 and a p value of 0.027. Conclusion The results suggest that the use of platelet-rich fibrin alone improves the bone regeneration, thereby achieving predictable and stable augmentation of the sinus floor required for the success of implant therapy.
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Affiliation(s)
- Shreehari A.K.
- Senior Specialist (Periodontology), ADC (R&R), New Delhi, India
| | - N.K. Sahoo
- Former DGDS, O/o DGDS, IHQ of MoD, Delhi, India
| | - Dinesh Kumar
- Associate Professor, ADC (R&R), New Delhi, India
| | - R.S. Malhi
- Professor, Department of Transfusion Medicine, Armed Forces Medical College, Pune, India
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Ozkal Eminoglu D, Arabaci T, Oztas Sahiner GA. The effect of titanium-platelet rich fibrin on periodontal intrabony defects: A randomized controlled split-mouth clinical study. PLoS One 2024; 19:e0304970. [PMID: 38843242 PMCID: PMC11156295 DOI: 10.1371/journal.pone.0304970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/20/2024] [Indexed: 06/09/2024] Open
Abstract
This study aimed to determine the contribution of titanium prepared platelet-rich fibrin (T-PRF) with open flap debridement (OFD) on clinical, biochemical and radiographic measurements of periodontal regeneration. Twenty periodontitis patients with bilateral intrabony defects and stage III grade A periodontitis were included in the study. A total of 40 defects were randomly selected for OFD alone (control group, n = 20) or combined OFD+ T-PRF (test group, n = 20). Clinical and radiographic parameters (at baseline and nine months after surgery), and growth factor levels in gingival crevicular fluid (at baseline and at two, four, six, and twelve weeks after surgical treatment) were also evaluated. Considering the clinical parameters, alterations in probing pocket depth, gingival marginal level and clinical endpoint in the test regions treated with T-PRF significantly improved (P<0.05). Fibroblast growth factor-2 and platelet-derived growth factor-BB levels between the two groups in the second and fourth weeks were also significantly different (P<0.05). Furthermore, the receptor activator of nuclear factor κB ligand/osteoprotegerin ratio between the groups was significantly different in the second, fourth, sixth, and twelfth weeks (P<0.05). The bone-filling rate was also significantly greater in the test group than in the control group (P <0.001). Compared with OFD alone, combining T-PRF with the procedure was more successful with regards to clinical, radiographic, and biochemical measurements of periodontal regeneration.
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Affiliation(s)
- Didem Ozkal Eminoglu
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Taner Arabaci
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
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Guillou E, Lerhe B, Gemmi T, Khenissa N, Latrèche S, Loridon G. Simultaneous sinus elevation and immediate implant placement without biomaterial: A technical note. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101677. [PMID: 37926189 DOI: 10.1016/j.jormas.2023.101677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 10/21/2023] [Accepted: 11/02/2023] [Indexed: 11/07/2023]
Abstract
Sinus floor elevation is widely considered as one of the most reliable and predictable procedures for augmenting posterior maxillary bone volume before implant placement. The lateral window technique is often described as the gold standard, especially when dealing with limited residual bone height. Traditionally, severe vertical defects in the posterior maxilla required a two-stage approach: first elevating the sinus membrane with biomaterial, followed by a second surgery for implant placement. This article introduces an innovative approach to the lateral sinus lift procedure, enabling simultaneous implant placement in sites with less than 5 mm of remaining bone height. This original one-stage surgical approach is interesting because it does not involve grafting of any biomaterial into the sinus. Its main objectives are to enhance safety and predictability while reducing the risk of post-operative infections. However, it's essential to emphasize that achieving an ideal implant position with adequate primary stability is crucial for its viability.
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Affiliation(s)
- Estelle Guillou
- Department of Oral Surgery, Oral and Dental Medicine Institute, 28 Boulevard de Riquier, Nice 06300, France.
| | - Barbara Lerhe
- Department of Oral and Maxillo-Facial Surgery, Head and Neck Institute, Nice 06100, France
| | - Thomas Gemmi
- Department of Oral Surgery, Oral and Dental Medicine Institute, 28 Boulevard de Riquier, Nice 06300, France; Private Practice, Saint-Raphaël 83700, France
| | - Nouha Khenissa
- Department of Oral Surgery, Oral and Dental Medicine Institute, 28 Boulevard de Riquier, Nice 06300, France
| | - Sarah Latrèche
- Department of Oral Surgery, Oral and Dental Medicine Institute, 28 Boulevard de Riquier, Nice 06300, France
| | - Guillaume Loridon
- Department of Oral Surgery, Oral and Dental Medicine Institute, 28 Boulevard de Riquier, Nice 06300, France
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Babich O, Lugassy E, Babich M, Abayov P, Haimov E, Juodzbalys G. The Use of Platelet-Rich Fibrin in Sinus Floor Augmentation Surgery: a Systematic Review. J Oral Maxillofac Res 2024; 15:e1. [PMID: 39139359 PMCID: PMC11318657 DOI: 10.5037/jomr.2024.15201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Accepted: 06/30/2024] [Indexed: 08/15/2024]
Abstract
Objectives This systematic review aims to critically assess the impact of platelet-rich fibrin on maxillary sinus floor augmentation and outline the specific aspects of new bone formation, bone height, implant stability quotient, and Schneiderian membrane thickness. Material and Methods A systematic review and meta-analysis were conducted, analysing studies from MEDLINE (PubMed), the Cochrane Library, and ScienceDirect databases, published from January 29, 2018 until January 29, 2024 that compared maxillary sinus floor augmentation (MSFA) using bone graft material with and without platelet-rich fibrin (PRF). This review focused on patients 18 years and older who undergone MSFA before the dental implant placement. It systematically examined five studies, encompassing randomized controlled trials, and reported on 112 MSFA procedures conducted in 84 patients. Results The meta-analysis reveals a marginal significance in new bone formation with PRF, suggesting a trend towards beneficial outcomes that were not statistically significant. No significant impact on bone height was observed. However, a notable improvement in implant stability quotient (ISQ) was recorded, indicating enhanced implant stability with PRF. The Schneiderian membrane thickness did not show significant changes post-treatment with PRF. Conclusions While platelet-rich fibrin shows promise in enhancing implant stability, its effects on new bone formation and Schneiderian membrane thickness are inconclusive, highlighting the need for further research. Platelet-rich fibrin did not significantly affect bone height. The findings support platelet-rich fibrin's potential as a beneficial adjunct in maxillary sinus floor augmentation, particularly for implant stability.
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Affiliation(s)
- Oren Babich
- Department of Maxillofacial Surgery, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, KaunasLithuania.
| | - Erel Lugassy
- Department of Maxillofacial Surgery, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, KaunasLithuania.
| | - Michael Babich
- Department of Maxillofacial Surgery, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, KaunasLithuania.
| | - Pinny Abayov
- Department of Maxillofacial Surgery, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, KaunasLithuania.
| | - Eliezer Haimov
- Department of Maxillofacial Surgery, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, KaunasLithuania.
| | - Gintaras Juodzbalys
- Department of Maxillofacial Surgery, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, KaunasLithuania.
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Valentini P, Calciolari E, Monlezun S, Akcalı A, Donos N, Quirynen M. APCs in sinus floor augmentation. Periodontol 2000 2024. [PMID: 38363055 DOI: 10.1111/prd.12554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/18/2023] [Accepted: 01/21/2024] [Indexed: 02/17/2024]
Abstract
After tooth loss in the posterior area of the maxilla, sinus floor elevation is often required to compensate the vertical bone loss due to sinus pneumatization. This narrative review reports on the potential benefits of autologous platelet concentrates (APCs) during this procedure. As for transcrestal approach, APCs have been used as "sole" substitute/graft. However, because of the low number of clinical trials available with PRGF, and even none for PRP, no definitive conclusions can be made regarding their efficacy. The number of studies on the use of L-PRF were outnumbered indicating good feasibility for vertical bone gain, with a high implant survival rate and a low degree of complications. PRP and PRGF have not been studied as a "single/sole" substitute for a one-stage lateral window approach, probably because of the weak physical characteristics of the membranes. L-PRF alone appears to be a predictable grafting material for lateral maxillary sinus grafting and a reduced RBH should not be considered as a risk factor. Compared to a "standard" bone substitute L-PRF shows slightly less vertical bone gain (consider enough membrane application and use of bony window as new sinus floor roof over the implant apices), enhanced early resorption (first 6 months after application), but a similar stable bone gain afterward. For a two-stage lateral window approach, APCs "alone" cannot be recommended, due to their weak withstand to the sinus pneumatization forces. APCs combined with bone substitutes seem to accelerate bone formation, without any additional benefits on the long-term new bone gain. The use of L-PRF membranes for the treatment of perforations appears to be an effective treatment option, but further clinical studies are needed to confirm this. Even though the abovementioned statements are based on large numbers of studies, additional RCTs comparing APCs with different types of grafting procedures for sinus elevation are needed.
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Affiliation(s)
- Pascal Valentini
- Department of Implant Surgery Tattone Hospital, University of Corsica Pasquale Paoli, Institute of Health, Corte, France
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, London, UK
- Dental school, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Sebastien Monlezun
- Department of Implant Surgery Tattone Hospital, University of Corsica Pasquale Paoli, Institute of Health, Corte, France
| | - Aliye Akcalı
- Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, London, UK
- Department of Periodontology, Dental Faculty, University of Dokuz Eylul, Izmir, Turkey
| | - Nikos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, London, UK
| | - Marc Quirynen
- Department of Oral Health Sciences, Katholieke Universiteit Leuven & University Hospitals Leuven, (section Periodontology), Leuven, Belgium
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Miron RJ. Optimized bone grafting. Periodontol 2000 2024; 94:143-160. [PMID: 37610202 DOI: 10.1111/prd.12517] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023]
Abstract
Bone grafting is routinely performed in periodontology and oral surgery to fill bone voids. While autogenous bone is considered the gold standard because of its regenerative properties, allografts and xenografts have more commonly been utilized owing to their availability as well as their differential regenerative/biomechanical properties. In particular, xenografts are sintered at high temperatures, which allows for their slower degradation and resorption rates and/or nonresorbable features. As a result, clinicians have combined xenografts with other classes of bone grafts (most notably allografts and autografts in various ratios) for procedures requiring better long-term stability, such as contour grafting, sinus elevation procedures, and vertical bone augmentations. This review addresses the regenerative properties of each class of bone grafts and then highlights the importance of understanding each of their biomechanical and regenerative properties for clinical applications, including extraction site management, contour augmentation, sinus grafting, and horizontal and vertical augmentation procedures. Thereafter, an introduction toward the novel production of nonresorbable bone allografts (NRBAs) via high-temperature sintering is presented. These NRBAs not only pose the advantage of being more biocompatible than xenografts owing to their origin (human vs. animal bone) but also display nonresorbable properties similar to those of xenografts. Thus, while packaging allografts with xenografts in premixtures specific to various clinical indications has never been permitted owing to cross-species contamination and FDA/CE requirements, the discovery and production of NRBAs allows premixing with standard allografts in various ratios without regulatory restrictions. Therefore, premixtures of allografts with NRBAs can be produced in various ratios for specific indications (e.g., a 1:1 ratio similar to an allograft/xenograft mixture for sinus grafting) without the need for purchasing separate classes of bone grafts. This optimized form of bone grafting could theoretically provide clinicians more precise ratios without the need to purchase separate bone grafts. This review highlights the future potential for simplified and optimized bone grafting in periodontology and implant dentistry.
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Affiliation(s)
- Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
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Desai KN, Thakkar RR, Patel J, Gupta E, Trivedi N, Sampat D. Comparative Evaluation of DFDBA versus PRF with DFDBA in Treatment of Grade-II Furcation Defects - A Clinical Trial. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S794-S796. [PMID: 38595476 PMCID: PMC11001046 DOI: 10.4103/jpbs.jpbs_1016_23] [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: 10/09/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 04/11/2024] Open
Abstract
Background In order to determine whether a method is more successful for treating a grade-II furcation deficiency, this randomized trial will compare demineralized freeze-dried bone allograft (DFDBA) to platelet-rich fibrin with DFDBA. Materials and Methods Twenty systematically healthy patients between the ages of 30 and 60 with a grade-II furcation were evaluated pre and postoperatively for changes in the modified plaque index, probing depth, relative vertical and horizontal clinical attachment level, gingival marginal level, and radiographic bone defect. Results The test group significantly outperformed the control group on all clinical and radiological measures. Conclusion The experimental group improved at both clinical attachment levels and had a higher decrease in probing depth than the control group did.
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Affiliation(s)
- Kinjal N. Desai
- Department of Periodontology and Implantology, Siddhpur Dental College and Hospital, Siddhpur, Gujarat, India
| | - Rohit R. Thakkar
- Department of Periodontology and Implantology, Siddhpur Dental College and Hospital, Siddhpur, Gujarat, India
| | - Jalpa Patel
- Department of Periodontology and Implantology, Narsinhbhai Patel Dental College and Hospital, Sankalchand Patel University, Visnagar, Gujarat, India
| | - Ekta Gupta
- Department of Orthodontics and Dentofacial Orthopedics, Siddhpur Dental College and Hospital, Patan, Gujarat, India
| | - Namrata Trivedi
- Senior Lecturer, Department of Periodontology and Implantology, College of Dental Science and Hospital, Amargadh, Gujarat, India
| | - Dipali Sampat
- Clinical Practitioner, Department of Periodontology and Implantology, Bhavtarini Charitable Trust Gondal, Gujarat, India
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Erdem NF, Abdioğlu G, Ekinci SA, Şişman AÇ. Radiological Evaluation and Biomechanical Stability of Implants Simultaneously Placed at the Sites with Sole Advanced Platelet-Rich Fibrin (A-PRF) Grafted Sinus Floor. J Maxillofac Oral Surg 2023; 22:1083-1090. [PMID: 38105860 PMCID: PMC10719193 DOI: 10.1007/s12663-022-01785-4] [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: 06/30/2021] [Accepted: 09/05/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction In this retrospective study stabilities of 24 implants simultaneously placed at posterior maxillae with sinuses grafted by advanced platelet rich fibrin (A-PRF) and newly formed bone around them were evaluated. Patient and Methods Fourteen augmented maxillary sinuses of 11 patients with a mean residual alveolar bone height of 4.55 mm were involved in this study. Maxillary sinus lifting via lateral window approach and implant site osteotomy were performed, and prepared A-PRF clots were used as sole graft material. Each of the implants was immediately placed with a good primary stability. Postoperative sixth month tomography images were compared with preoperative ones in order to calculate the gained bone height and implant stability quotient (ISQ) values were recorded. Results The new vertical mean bone height of 24 implant sites was 12.21 mm with an implant survival rate of 100%. ISQ values of the implants were ranging from 62 to 75 with a mean value of 68. Statistically the diameter of implant did not have any effect on new bone formation and the ISQ values, however the length of them did. Conclusion A-PRF as a graft material for sinus lifting with simultaneous implant placement is a reliable technique with its low cost and lack of immunogenic reaction risk.
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Affiliation(s)
- Necip Fazıl Erdem
- Department of Oral and Maxillofacial Surgery, Marmara University, School of Dentistry, No: 9/3, 34854 Başıbüyük, Maltepe, Istanbul Turkey
| | - Gürkan Abdioğlu
- Department of Oral and Maxillofacial Surgery, Marmara University, School of Dentistry, No: 9/3, 34854 Başıbüyük, Maltepe, Istanbul Turkey
| | - Senem Aşkın Ekinci
- Department of Oral and Maxillofacial Surgery, Marmara University, School of Dentistry, No: 9/3, 34854 Başıbüyük, Maltepe, Istanbul Turkey
| | - Alanur Çiftçi Şişman
- Department of Oral and Maxillofacial Surgery, Sağlık Bilimleri University, School of Dentistry, Selimiye Mah. Tıbbiye Cad. No: 38, 34668 Üsküdar, Istanbul Turkey
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Quirynen M, Siawasch S, Temmerman A, Cortellini S, Dhondt R, Teughels W, Castro AB. Do autologous platelet concentrates (APCs) have a role in intra-oral bone regeneration? A critical review of clinical guidelines on decision-making process. Periodontol 2000 2023; 93:254-269. [PMID: 37845802 DOI: 10.1111/prd.12526] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 07/05/2023] [Accepted: 08/15/2023] [Indexed: 10/18/2023]
Abstract
In the past decades, personalized regenerative medicine has gained increased attention. Autologous platelet concentrates (APCs) such as PRP, PRGF, and L-PRF, all serving as a source of a large variety of cells and growth factors that participate in hard and soft tissue healing and regeneration, could play a significant role in regenerative periodontal procedures. This narrative review evaluated the relative impact of APCs in alveolar ridge preservation, sinus floor augmentation, and the regeneration of bony craters around teeth, both as a single substitute or in combination with a xenograft. L-PRF has a significant beneficial effect on alveolar ridge preservation ( bone quality). The data for PRGF are less convincing, and PRP is controversial. L-PRF can successfully be used as a single substitute during transcrestal (≥3.5 mm bone gain) as well as 1-stage lateral window sinus floor elevation (>5 mm bone gain). For PRGF and especially PRP the data are very scarce. In the treatment of bony craters around teeth, during open flap debridement, L-PRF as a single substitute showed significant adjunctive benefits (e.g., >PPD reduction, >CAL gain, >crater depth reduction). The data for PRP and PRGF were non-conclusive. Adding PRP or L-PRF to a xenograft during OFD resulted in additional improvements (>PPD reduction, >CAL gain, >bone fill), for PRGF no data were found. Autologous platelet concentrates demonstrated to enhance bone and soft tissue healing in periodontal regenerative procedures. The data for L-PRF were most convincing. L-PRF also has the advantage of a greater simplicity of production, and its 100% autologous character.
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Affiliation(s)
- Marc Quirynen
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Sam Siawasch
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Andy Temmerman
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Simone Cortellini
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Rutger Dhondt
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Anna B Castro
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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13
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Mao L, Wang X, Sun Y, Yang M, Chen X, Cui L, Bai W. Platelet-rich fibrin improves repair and regeneration of damaged endometrium in rats. Front Endocrinol (Lausanne) 2023; 14:1154958. [PMID: 37614713 PMCID: PMC10443704 DOI: 10.3389/fendo.2023.1154958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/12/2023] [Indexed: 08/25/2023] Open
Abstract
Purpose Intrauterine adhesion (IUA) is the most common cause of uterine infertility. This study aims to evaluate whether platelet-rich fibrin (PRF) treatment can stimulate damaged endometrium regeneration in rats. Methods First, hematoxylin and eosin (HE) staining, scanning and transmission electron microscopy, and ELISAs were used to evaluate the microstructure of PRF. Then, mechanical damage was used to establish an IUA rat model. A total of 40 SD female rats were randomized to three groups: PRF transplantation group, IUA group, and sham group. Rats were sacrificed at 3, 7, and 14 days and uteruses were obtained for further analysis. Finally, functional and histological recovery of the damaged endometrium was analyzed by pregnancy test, HE staining, Masson's staining, and immunohistochemistry. Results PRF has two distinct zones, platelets and fibrin zone. Long and narrow fibrin fibers interconnected with each other and formed a three-dimensional, flexible, and elastic structure; platelet aggregates were trapped in fibrin fibers, and each platelet is associated with several fibrin fibers. PRF exudates promoted endometrial stromal cell proliferation and migration in vitro. PRF transplantation was beneficial for maintaining uterine structure, promoting endometrial luminal epithelium and endometrial gland regeneration, and decreasing fibrotic areas in vivo. Conclusion Intrauterine administration of PRF was demonstrated to be effective in preventing IUA and stimulating damaged endometrium regeneration in rats. This study not only provided a promising method for its potential in endometrial regeneration in women who suffer from uterine infertility but also may prevent IUA after intrauterine surgery in clinical cases.
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Affiliation(s)
- Lele Mao
- Department of Obstetrics and Gynecology, Ninth Clinical Medical College, Peking University, Beijing Shijitan Hospital, Beijing, China
| | - XiaoXue Wang
- Department of Obstetrics and Gynecology, Ninth Clinical Medical College, Peking University, Beijing Shijitan Hospital, Beijing, China
| | - Yu Sun
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Mukun Yang
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Xing Chen
- Department of Obstetrics and Gynecology, Ninth Clinical Medical College, Peking University, Beijing Shijitan Hospital, Beijing, China
| | - Lei Cui
- Department of Obstetrics and Gynecology, Ninth Clinical Medical College, Peking University, Beijing Shijitan Hospital, Beijing, China
- Department of Plastic Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Wenpei Bai
- Department of Obstetrics and Gynecology, Ninth Clinical Medical College, Peking University, Beijing Shijitan Hospital, Beijing, China
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
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14
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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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15
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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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Molina Barahona M, Moreno Terreros L, Calle Jara F, Vásquez Palacios C. [Use of platelet concentrate in bone regeneration through exodontics. Narrative review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 11:e145. [PMID: 38303739 PMCID: PMC10832392 DOI: 10.21142/2523-2754-1101-2023-145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/28/2023] [Indexed: 02/03/2024] Open
Abstract
Introduction The post-exodontic alveolar atrophy requires quality bone regeneration techniques, and therefore, it is necessary to apply platelet concentrates, which are bioactive agents in the process of preserving the alveolar bone. The use of platelet concentrates proved to be an excellent osteoinducer since it leads to three important effects for maintaining bone structure. Objective To analyze the use of platelet concentrates in post-exodontic bone regeneration. Materials and methods A descriptive, explanatory study. A narrative review in which data was collected from 26 scientific articles published in scientific databases such as PubMed, Redalyc, ScienceDirect, and Ovid between 2012 and 2022. Conclusions Platelet concentrates are physiological materials that speed up the healing time of post-extraction wounds. They are autologous since they are taken from the patient him/herself, reducing the risk of postoperative reactions, and the transmission of diseases by parenteral route. They relieve both inflammation and edema as well as post-surgery symptoms that appear after a dental extraction. They also help to preserve the alveolar ridge, avoiding long-term atrophy.
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Affiliation(s)
- Magdalena Molina Barahona
- Carrera de Odontología, Universidad Católica de Cuenca, Odontología, Cuenca-Ecuador. , , , Universidad Católica de Cuenca Carrera de Odontología Universidad Católica de Cuenca, Odontología Cuenca Ecuador
| | - Lía Moreno Terreros
- Carrera de Odontología, Universidad Católica de Cuenca, Odontología, Cuenca-Ecuador. , , , Universidad Católica de Cuenca Carrera de Odontología Universidad Católica de Cuenca, Odontología Cuenca Ecuador
| | - Felipe Calle Jara
- Carrera de Odontología, Universidad Católica de Cuenca, Odontología, Cuenca-Ecuador. , , , Universidad Católica de Cuenca Carrera de Odontología Universidad Católica de Cuenca, Odontología Cuenca Ecuador
| | - Cristina Vásquez Palacios
- Carrera de Odontología, Universidad Católica de Cuenca, Odontología, Cuenca-Ecuador. , , , Universidad Católica de Cuenca Carrera de Odontología Universidad Católica de Cuenca, Odontología Cuenca Ecuador
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Al-Saadi TS, Al-Quisi AF. The Influence of the Hyaluronic Acid Gel on the Postoperative Sequelae following Surgical Removal of the Impacted Mandibular Third Molar in Comparison with the A-PRF: A Randomized Controlled Trial. Int J Biomater 2023; 2023:1883460. [PMID: 37159615 PMCID: PMC10163971 DOI: 10.1155/2023/1883460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/11/2023] Open
Abstract
One of the most common procedures in oral surgery is the removal of impacted mandibular third molars, often followed by pain, swelling, alveolitis, and trismus. Purpose. To compare the outcomes of the intrasocket application of 1% hyaluronic acid oral gel (HA) and advanced platelet-rich fibrin (A-PRF) on the expected postoperative complications, pain, swelling, and trismus follow the surgical extraction of the impacted mandibular third molar. Material and Methods. A randomized controlled trial was conducted at the Oral and Maxillofacial Surgery Unit, Dental Teaching Hospital. Healthy patients who required surgical removal of the impacted mandibular third molar were divided randomly into three groups. The extraction site of the group (A) patients remained without the addition of any material, just suturing of the wound with simple interrupted sutures, while in group (B) patients, the extraction site was filled with 1 cc of 1% hyaluronic acid gel (periokin®), and in group C patients, the extraction site was filled with A-PRF. Results. Sixty-six eligible patients participated in this study; both hyaluronic acid gel 1% (periokin®) and advanced platelet-rich fibrin showed a significant reduction in pain, swelling, and trismus on the 1st, third, and seventh postoperative days when compared to the control group, while the comparison between HA and A-PRF showed no significant differences except for the pain on the third postoperative day. There was a significant pain decrease in the A-PRF group than HA group. Conclusion. Intrasocket application of 1% hyaluronic acid gel (periokin®) or advanced platelet-rich fibrin can be an effective primary way to significantly reduce postoperative pain, trismus, and edema compared to the control group following mandibular third molar surgery.
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Affiliation(s)
| | - Ahmed Fadhel Al-Quisi
- Oral and Maxillofacial Surgery Department, College of Dentistry, University of Baghdad, Baghdad, Iraq
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18
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Naqvi A, Mishra G, Shahi S, Shakarwal P, Singh A, Singh R. Comparison between Platelet-rich Fibrin and Saline Filling after Sinus Elevation without Adjunctive Bone Graft in Dental Implants Insertion Using CBCT. J Contemp Dent Pract 2023; 24:9-15. [PMID: 37189006 DOI: 10.5005/jp-journals-10024-3474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
AIM The goal of this research was to compare radiographically the outcomes of hydraulic transcrestal sinus lifting with platelet-rich fibrin (PRF) or normal saline filling on implant survival rates, negative outcomes, and variations in the height of residual alveolar ridge (HARB). MATERIALS AND METHODS There were 80 study participants included and 90 dental implants were placed. The study participants were divided into two categories: Category A and Category B. Each category consists of 40 study participants. Category A: Normal saline was placed in the maxillary sinus. Category B: PRF was placed in the maxillary sinus. Implant survival, complications, and HARB alterations were the outcome metrics. Radiographic images through Cone-beam computed tomography (CBCT) were retrieved and compared prior to surgery (T0), immediately following surgery (T1), three months later (T2), 6 months later (T3), and 12 months later (T4). RESULTS There are 90 implants having an average length of 10.5 ± 0.7 mm were inserted into the posterior portion of the maxilla of 80 patients with an average HARB of 6.9 ± 1.2 mm. At T1, elevation in HARB peaked, and the sinus membrane continued to droop but steadied while observed at T3. The steady increment of areas of radiopacities was noticed below the elevated membrane of the maxillary antrum. A radiographic intrasinus bone increase of 2.9 ± 1.4 mm was caused by the PRF filling, compared to 1.8 ± 1.1 mm by the saline filling at T4 (p < 0.05). Over the course of the one-year follow-up period, all of the implants were operating normally with no major issues. CONCLUSION Platelet-rich fibrin when used as a filling medium alone without bone graft can cause significant ascend in height of the residual alveolar bone (HRAB). CLINICAL SIGNIFICANCE The degradation of the alveolar bone under the maxillary sinus following tooth loss frequently restricts the placement of the implant in the edentulous region of posterior maxilla. Numerous sinus-lifting surgery procedures and tools have been developed to address these problems. It has been a topic of debate regarding the benefits of bone grafts placed at the apical region of the implant. The sharp protrusions of the granules of bone graft may also provide a danger of membrane puncture. Recently, it was shown that regular bone gain might occur inside the maxillary antrum without the use of any bone transplant material. Additionally, if there were substances that filled the gap between the floor of the sinus and the raised sinus membrane, then the membrane of the maxillary sinus could be raised greater and for a longer period of time during the phase of formation of new bone formation.
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Affiliation(s)
- Akbar Naqvi
- Department of Dentistry, HIMSR and HAHC Hospital, New Delhi, India
| | - Gaurav Mishra
- Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India, Phone: +91 9651771144, e-mail:
| | - Siddharth Shahi
- Department of Conservative Dentistry and Endodontics, Sarjug Dental College and Hospital, Laheriasarai, Darbhanga, Bihar, India
| | - Parul Shakarwal
- Department of Conservative Dentistry and Endodontics, Sardar Patel Post Graduate Institute of Dental and Medical sciences, Lucknow, Uttar Pradesh, India
| | - Abhishek Singh
- Department of Conservative Dentistry and Endodontics, Sardar Patel Post Graduate Institute of Dental and Medical sciences, Lucknow, Uttar Pradesh, India
| | - Rohit Singh
- Department of Pedodontics and Preventive Dentistry, Vananchal Dental College and Hospital, Garhwa, Jharkhand, India
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Powell CA, Casarez-Quintana A, Zellner J, Al-Bayati O, Font K. The application of leukocyte- and platelet-rich fibrin (L-PRF) in maxillary sinus augmentation. Clin Adv Periodontics 2022; 12:277-286. [PMID: 35761474 DOI: 10.1002/cap.10216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 06/21/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Since the introduction of sinus augmentation in the 1970s the procedure has been performed with or without biomaterials. Autologous blood products (ABPs) for use in sinus augmentation was first introduced in the 2000s, to aid potentially in bone and soft tissue healing. METHODS Three different applications of leukocyte- and platelet-rich fibrin (L-PRF) in maxillary sinus augmentation are presented in this case series. In case 1, L-PRF is used in bilateral sinus augmentation to support placement of implants to support a maxillary hybrid denture. Case 2 highlights the use of L-PRF in a complication associate with Schneiderian membrane elevation. Case 3 provides histology taken at the time of implant placement 6 months following L-PRF/xenograft sinus augmentation. RESULTS All cases resulted in the successful placement of dental implants. In case 2, an osseodensification procedure was performed with freeze-dried bone allograft, which provided an approximate 4 mm of additional vertical height for implant placement. Histology from case 3 at 6 months post sinus augmentation demonstrated the presence of new vital bone in contact with the xenograft. CONCLUSION To date, there is only a limited amount of evidence reporting on platelet-rich fibrin (PRF) or L-PRF use in maxillary sinus augmentation. Bone gain from either product has ranged from 3.2 to 11.8 mm, with the percentage of newly formed bone reported in case series as 33% ± 5%. Despite the lack of strong evidence, L-PRF appears to have beneficial effects on bone regeneration when used in sinus augmentation.
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Affiliation(s)
- Charles A Powell
- Department of Periodontics, UT Health San Antonio, San Antonio, Texas
| | | | - Jacob Zellner
- Department of Periodontics, UT Health San Antonio, San Antonio, Texas
| | | | - Kerri Font
- Division of Periodontics, Department of Surgical Dentistry, University of Colorado School of Dental Medicine, Aurora, Colorado
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Palaiologou A, Keeling F. Autologous blood products: Usage and preparation protocols. Clin Adv Periodontics 2022; 12:287-293. [PMID: 35906935 DOI: 10.1002/cap.10221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/26/2022] [Indexed: 11/08/2022]
Abstract
FOCUSED CLINICAL QUESTION What are the appropriate preparation protocols for autologous blood products to support their clinical utilization? SUMMARY Autologous blood products provide a unique clinical benefit. Their popularity among the professions is growing. However, as this is a rapidly evolving field, multiple modalities are presented within the literature. Frequently there is no demonstrated superiority to previous iterations. This brief review attempts to offer a concise chronology on their evolution, preparation, and where possible, evidence to support their clinical utilization. CONCLUSIONS The field of autologous blood products is expanding rapidly. These products appear to yield variable clinical benefits in specific indications. However, evidence supporting their universal application is scant, and the superiority of one formulation versus another is yet to be demonstrated.
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Affiliation(s)
- Archontia Palaiologou
- Department of Periodontics, University of Texas Health San Antonio School of Dentistry, San Antonio, Texas, USA
| | - Francis Keeling
- Department of Periodontics, University of Texas Health San Antonio School of Dentistry, San Antonio, Texas, USA
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Liu X, Yin M, Li Y, Wang J, Da J, Liu Z, Zhang K, Liu L, Zhang W, Wang P, Jin H, Zhang B. Genipin modified lyophilized platelet-rich fibrin scaffold for sustained release of growth factors to promote bone regeneration. Front Physiol 2022; 13:1007692. [PMID: 36246111 PMCID: PMC9561255 DOI: 10.3389/fphys.2022.1007692] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022] Open
Abstract
Lyophilized platelet-rich fibrin (L-PRF) was shown to further activate resident platelets in platelet-rich fibrin causing a higher amount of growth factors release. However, it still required further experimental studies to resolve the uncontrolled degradation and burst release problem. In this study, the nature crosslinker genipin is introduced to improve the performance of L-PRF scaffold. We used a series of gradient concentration genipin solutions to react with L-PRF. The crosslinking degree, micro morphology, mean pore size, water absorption and mechanical properties of the crosslinked scaffold were evaluated. In order to study the effect of genipin modification on the release kinetics of growth factors from L-PRF, we detected the release of platelet-derived growth factor, vascular endothelial growth factor and transforming growth factor in vitro by ELISA. To investigate the biodegradability of the crosslinked L-PRF in vivo, the scaffolds were transplanted subcutaneously into backs of rats, and the materials were recovered at 1, 2 and 4 weeks after implantation. The biodegradation, inflammatory reaction and biocompatibility of the scaffolds were examined by histological staining. Finally, the genipin crosslinked/uncrosslinked L- Platelet-rich fibrin scaffolds were implanted with freshly prepared SHED cell sheets into rat critical size calvarial defects and the skull samples were recovered to examine the treatment efficacy of genipin crosslinked L-PRF by histologic and radiographic approaches. Results of this study indicated that genipin can be used to modify L-PRF at room temperature at a very low concentration. Genipin-modified L-PRF shows better biomechanical performance, slower biodegradation, good bioavailable and sustained release of growth factors. The 0.01% w/v and 0.1% w/v genipin crosslinked L-PRF have good porous structure and significantly promote cell proliferation and enhance the expression of key genes in osteogenesis in vitro, and work best in promoting bone regeneration in vivo.
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Affiliation(s)
- Xiaoyao Liu
- Heilongjiang Provincial Key Laboratory of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Department of Stomatology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Mingjing Yin
- Heilongjiang Provincial Key Laboratory of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Department of Stomatology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ying Li
- Heilongjiang Provincial Key Laboratory of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jianqun Wang
- Heilongjiang Provincial Key Laboratory of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Junlong Da
- Heilongjiang Provincial Key Laboratory of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhongshuang Liu
- Department of Stomatology, Shenzhen University General Hospital, Shenzhen University, Shenzhen, China
| | - Kai Zhang
- Heilongjiang Provincial Key Laboratory of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Lixue Liu
- Heilongjiang Provincial Key Laboratory of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wenxuan Zhang
- Heilongjiang Provincial Key Laboratory of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Peijun Wang
- Department of Stomatology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Han Jin
- Heilongjiang Provincial Key Laboratory of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- *Correspondence: Han Jin, ; Bin Zhang,
| | - Bin Zhang
- Heilongjiang Provincial Key Laboratory of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Heilongjiang Academy of Medical Sciences, Harbin, China
- *Correspondence: Han Jin, ; Bin Zhang,
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Karagah A, Tabrizi R, Mohammadhosseinzade P, Mirzadeh M, Tofangchiha M, Lajolo C, Patini R. Effect of Sinus Floor Augmentation with Platelet-Rich Fibrin Versus Allogeneic Bone Graft on Stability of One-Stage Dental Implants: A Split-Mouth Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159569. [PMID: 35954926 PMCID: PMC9367838 DOI: 10.3390/ijerph19159569] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/31/2022] [Accepted: 08/02/2022] [Indexed: 02/04/2023]
Abstract
Rehabilitation of an edentulous posterior maxilla with dental implants is challenging, and sinus floor augmentation could be considered as an important surgical procedure for bone augmentation in this region before implant placement. Platelet-rich fibrin (PRF) is a new-generation platelet concentrate with simplified processing: its application in sinus floor augmentation has been widely investigated in literature. However, the biological properties and actual efficacy of this product remain controversial. This study assessed the effect of sinus floor augmentation with PRF versus freeze-dried bone allograft (FDBA) on stability of one-stage dental implants. This split-mouth randomized clinical trial evaluated 10 patients who required bilateral sinus floor augmentation. PRF and L-PRF membrane were used in one quadrant while FDBA and collagen membrane were used in the other quadrant. Implant stability was assessed by resonance frequency analysis (RFA) immediately, and 2, 4, and 6 months after implant placement. The implant stability quotient (ISQ) was compared over time and between the two groups using repeated measures ANOVA and independent sample t-test. The mean ISQ significantly increased over time in both groups (p < 0.001). The increase was greater in the PRF group (p < 0.05). Within the limitations of this study, PRF yielded superior results compared with FDBA regarding the stability of one-stage dental implants.
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Affiliation(s)
- Aida Karagah
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Qazvin University of Medical Sciences, Qazvin 34199-15315, Iran
| | - Reza Tabrizi
- Department of Oral and Maxillofacial Surgery, Shahid Beheshti University of Medical Sciences, Tehran 11151-19857, Iran
| | | | - Monirsadat Mirzadeh
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 34199-15315, Iran
| | - Maryam Tofangchiha
- Department of Oral and Maxillofacial Radiology, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin 34199-15315, Iran
- Correspondence: (M.T.); (C.L.); Tel.: +98-9121825156 (M.T.); +39-0630154286 (C.L.); Fax: +98-2833353066 (M.T)
| | - Carlo Lajolo
- Department of Head, Neck and Sense Organs “Fondazione Policlinico Universitario A. Gemelli-IRCCS”, School of Dentistry, Catholic University of Sacred Heart, 00168 Rome, Italy
- Correspondence: (M.T.); (C.L.); Tel.: +98-9121825156 (M.T.); +39-0630154286 (C.L.); Fax: +98-2833353066 (M.T)
| | - Romeo Patini
- Department of Head, Neck and Sense Organs “Fondazione Policlinico Universitario A. Gemelli-IRCCS”, School of Dentistry, Catholic University of Sacred Heart, 00168 Rome, Italy
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da Silva LMP, Sávio DDSF, de Ávila FC, Vicente RM, Reis GGD, Denardi RJ, da Costa NMM, Silva PHF, Mourão CFDAB, Miron RJ, Messora MR. Comparison of the effects of platelet concentrates produced by high and low-speed centrifugation protocols on the healing of critical-size defects in rat calvaria: a microtomographic and histomorphometric study. Platelets 2022; 33:1175-1184. [PMID: 35591762 DOI: 10.1080/09537104.2022.2071851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The current study evaluated the healing of critical-size defects (CSD) created in rat calvaria treated with platelet concentrates produced by high-speed (Leukocyte- and Platelet-Rich Fibrin - L-PRF) and low-speed (Advanced Platelet-Rich Fibrin - A-PRF) protocols of centrifugation. Twenty-four rats were distributed into three groups: Control, L-PRF, and A-PRF. Five mm diameter CSD were created on the animals' calvaria. The defects of the L-PRF and A-PRF groups were filled with 0.01 ml of L-PRF and A-PRF, respectively. The control group defects were filled with a blood clot only. All animals were euthanized on the 35th postoperative day. Histomorphometric and microtomographic analyses were then performed. The L-PRF and A-PRF groups had significantly higher bone volume and neoformed bone area than those of the control group and lowered bone porosity values (p < .05). No significant differences were observed between A-PRF and L-PRF groups for the analyzed parameters. Therefore, it can be concluded that i) L-PRF and A-PRF potentiated the healing of CSD in rat calvaria; ii) high and low-speed centrifugation protocols did not produce PRF matrices with different biological impacts on the amount of bone neoformation.
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Affiliation(s)
- Lucia Moitrel Pequeno da Silva
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Débora de Souza Ferreira Sávio
- Department of Morphology, Physiology, and Basic Pathology - DMFPB, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP
| | - Felipe Correa de Ávila
- Department of Morphology, Physiology, and Basic Pathology - DMFPB, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP
| | - Raphael Martini Vicente
- Department of Orthopedics and Anesthesiology, Ribeirão Preto Medical School, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Gabriel Guerra David Reis
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ricardo Junior Denardi
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Natacha Malu Miranda da Costa
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Pedro Henrique Felix Silva
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Michel Reis Messora
- Department of Oral and Maxillofacial Surgery and Periodontology - DCTBMF, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Salgado-Peralvo AO, Mateos-Moreno MV, Uribarri A, Kewalramani N, Peña-Cardelles JF, Velasco-Ortega E. Treatment of oroantral communication with Platelet-Rich Fibrin: A systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e367-e375. [PMID: 35318134 DOI: 10.1016/j.jormas.2022.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/15/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Oroantral communication (OAC) is the opening between the maxillary sinus and the oral cavity, which constitutes a gate for the mucosal infection in the maxillary sinus. On the other hand, an OAF develops when the OAC does not close spontaneously, remains manifest and is epithelialized. Several methods have been proposed to solve these situations, however, they are associated with increased postoperative morbidity and/or higher associated costs and require some experience of the surgeon to perform them. To overcome these disadvantages, the use of Platelet-Rich Fibrin (PRF) is proposed. The present study aims to perform a systematic review of the literature, collecting cases in which PRF was used in the treatment of OACs/OAFs. MATERIALS AND METHODS An electronic search of the MEDLINE database (via PubMed) and Web of Science was performed using the following MeSH terms (Medical Subjects Headings): (oroantral communication OR oroantral fistula OR buccosinusal communication) AND (platelet-rich fibrin OR prf OR fibrin mesh). The criteria used were those described by the PRISMA® Statement. The search was not time-restricted and was updated to April 2021. RESULTS After searching, 11 articles were included that met the established criteria. In these, PRF was used alone or in combination with bi- or trilaminar techniques achieving complete resolution in 100% of cases (n = 116). CONCLUSIONS With the limitations of this study, it can be established that PRF can be used alone for the treatment of OACs/OAFs up to 5 mm and, in larger defects, it is advisable to combine it with bi- or trilaminar techniques. PRF is an effective therapeutic option, with minimal associated postoperative morbidity compared to other techniques and allows the position of the mucogingival junction to be preserved. Its combination with bone grafting improves the starting point before the replacement of the missing tooth with a dental implant.
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Affiliation(s)
| | - María-Victoria Mateos-Moreno
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid 28040, Spain
| | - Andrea Uribarri
- Department of Basic Health Sciences, Rey Juan Carlos University, Madrid 28922, Spain
| | - Naresh Kewalramani
- Department of Nursery and Stomatology, Rey Juan Carlos University, Madrid 28922, Spain
| | | | - Eugenio Velasco-Ortega
- Department of Stomatology, Faculty of Dentistry, University of Seville, Seville 41009, Spain
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Deshwal R, Salaria S, Dahiya R, Deshwal N. Socket-shield technique with minimally invasive osteotomy preparation as well as simultaneous sinus lift utilizing Densah Bur and platelet-rich fibrin membrane followed by immediate implant placement in a symptomatic posterior endodontically treated decayed root stumps site: A case report with 1-year follow-up. J Indian Soc Periodontol 2022; 26:507-511. [PMID: 36339379 PMCID: PMC9626781 DOI: 10.4103/jisp.jisp_699_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/07/2022] [Accepted: 06/26/2022] [Indexed: 11/21/2022] Open
Abstract
Soft-tissue defect and alveolar bundle bone resorption (horizontally and vertically) are inevitable events following tooth extraction predominately on the buccal aspect which will impact the implant surgical planning starting from implant size selection, position, emergence profile, etc. To overcome the same, complex soft and hard tissue regeneration procedures have been recommended in the literature but they are highly expensive and technique sensitive too. To prevent buccal bone resorption and gain good emergence profile socket-shield technique (SST) is widely recommended. Additionally, in order to improve implant biomechanical primary stability, bone mineral density, and bone to implant contact novel osseodensification approach is recommended for osteotomy preparation and sinus membrane lift whereas platelet rich fibrin (PRF) autograft is a suitable alternative for the protection of Schneiderian membrane during immediate implant placement in sinus sub cavity. The present case report describes the successful single-stage management of symptomatic endodontically maltreated posterior root stumps site utilizing SST in conjunction with Densah Bur and PRF autograft-assisted minimally invasive osteotomy preparation and sinus lift with immediate implant placement.
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26
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The Growth Factors in Advanced Platelet-Rich Fibrin (A-PRF) Reduce Postoperative Complications after Mandibular Third Molar Odontectomy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413343. [PMID: 34948953 PMCID: PMC8702191 DOI: 10.3390/ijerph182413343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/10/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022]
Abstract
Surgical removal of impacted mandibular third molars constitutes one of the most frequently performed procedures within oral surgery. This surgery procedure is associated with many post-operative complications. Advanced platelet-rich fibrin (A-PRF) belongs to the second generation of platelet concentrates and is rich in numerous growth factors. The aim of this study was to assess the influence of A-PRF on selected clinical features following the surgical removal of impacted mandibular third molars. The research was conducted on 100 generally healthy patients, who underwent a lower third molar odontectomy in Department of Oral Surgery, Medical University of Gdańsk, Poland, between 2018 and 2019. The research group consisted of 50 patients (immediate A-PRF socket filling) and control group (50 patients without A-PRF socket filling). During the study, the following clinical features were assessed: pain (visual analog scale), analgesics intake, the presence of trismus, edema, hematomas within the surrounding tissues (e.g., cheek), prevalence of pyrexia, dry socket, secondary bleeding, presence of hematomas, skin warmth in the post-operative area, and bleeding time observed by the patient were analyzed on the 3rd, 7th, and 14th day after the procedure. There was a significant association between A-PRF socket filling and pain intensity, the analgesics intake, trismus, and edema on the 3rd and the 7th day (p < 0.05). The presence of hematomas and skin warmth on the 3rd day after the surgery (p < 0.05) were also statistically associated with A-PRF use. The study showed that in reducing the incidence of postoperative complications, A-PRF was more important than the position of the tooth or the duration of the procedure. The growth factors in A-PRF reduce postoperative complications, such as pain, trismus, edema, analgesics intake, presence of hematomas, and skin warmth, after mandibular wisdom teeth odontectomy.
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Cecerska-Heryć E, Goszka M, Serwin N, Roszak M, Grygorcewicz B, Heryć R, Dołęgowska B. Applications of the regenerative capacity of platelets in modern medicine. Cytokine Growth Factor Rev 2021; 64:84-94. [PMID: 34924312 DOI: 10.1016/j.cytogfr.2021.11.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/20/2021] [Accepted: 11/30/2021] [Indexed: 02/06/2023]
Abstract
Platelets produce platelet growth factors such as PDGF, IGF-1, EGF-, HGF, TGFβ, bFGF, and VEGF, which are crucial in regulating all stages of the wound healing process. The source of these substances is platelet-rich plasma (PRP). Over the past five decades, the interest and use of the regenerative properties of platelets have increased significantly in many different fields of medicine around the world. PRP and PRF plate preparations are used in: 1. Dentistry (they reduce bleeding, facilitate and accelerate soft tissue healing and bone regeneration - FGF 2, IGF-1, IGF-2, TGF-β1, and PDGF); 2. Sports medicine - IGF-1, IGF-2, TGF-β, VEGF, PDGF and bFGF, EGF); 3. dermatology and cosmetology (treatment of alopecia, hair reconstruction - FGF-7, HGF, acne scars, skin rejuvenation and regeneration, treatment of chronic and poorly healing wounds, burns, and acquired vitiligo); 4. Gynecology and reproductive medicine (treatment of infertility, erectile dysfunction - PDGF-β, TGF-β, IGF-1, in sexual dysfunction - PDGF, in vaginal atrophy); 5 Ophthalmology (in the healing of corneal epithelial wounds, in the treatment of dormant corneal ulcers, dry eye syndrome and the reconstruction of the corneal surface; 6. Neurology (regeneration of neurons, pain alleviation, and clinical symptoms - TGF-β 1, IGF-1, PDGF, VEGF) and FGF). Platelet-rich plasma therapy is a very interesting alternative and complement to traditional methods of treatment. However, the potential for using platelets is still not fully understood. The composition of platelet-rich plasma depends on many factors that may affect its use's efficacy and clinical benefits. Further research is necessary to standardize PRP delivery's preparation procedures and methods for a specific disease entity or clinical case.
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Affiliation(s)
- Elżbieta Cecerska-Heryć
- Department of Laboratory Medicine, Pomeranian Medical University of Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland.
| | - Małgorzata Goszka
- Department of Laboratory Medicine, Pomeranian Medical University of Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Natalia Serwin
- Department of Laboratory Medicine, Pomeranian Medical University of Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Marta Roszak
- Department of Laboratory Medicine, Pomeranian Medical University of Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Bartłomiej Grygorcewicz
- Department of Laboratory Medicine, Pomeranian Medical University of Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Rafał Heryć
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University of Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Barbara Dołęgowska
- Department of Laboratory Medicine, Pomeranian Medical University of Szczecin, Powstancow Wielkopolskich 72, 70-111 Szczecin, Poland
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Puterman I, Weinstein B, Walton P, Fien M. The Modified Osseodensification Visco-Elastic (MOVE) Sinus Protocol: A Case Series to Illustrate the Combination of Osseodensification with Viscoelastic Bone Replacement Material. Clin Adv Periodontics 2021; 12:180-185. [PMID: 34762775 DOI: 10.1002/cap.10188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 10/25/2021] [Indexed: 11/10/2022]
Abstract
INTRODUCTION The Modified Osseodensification Visco-Elastic (MOVE) protocol combines two established techniques for sinus lifting: osseodensification drills to elevate the Schneiderian membrane, and the use of a viscoelastic putty to distribute forces on the membrane, a combination first described by Neiva et al. (2019). This case series elucidates the technique for combining these materials, and its possible benefits, which include reduced procedure time, less traumatic sinus elevation, and more versatility for unusual sinus anatomy, such as sloped sinus floors and immediate implant sites. CASE SERIES The three cases, illustrating a single implant, adjacent implants, and an immediate implant, demonstrate various indications for using the MOVE protocol, documented with two- and three-dimensional radiography. The MOVE protocol is explained in detail with supplemental photos of the steps. CONCLUSION Applying the MOVE protocol has the potential to allow for same-day implant placement in sites that previously required preoperative bone augmentation or lateral wall sinus access, thereby reducing the extent of surgical invasiveness associated with implant placement in the posterior maxilla.
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Affiliation(s)
| | - Bradley Weinstein
- Department of Periodontics, Private Practice, Seattle, WA and University of Washington, Seattle, Washington, USA
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29
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Chen MC, Chiu HC, Kuo PJ, Chiang CY, Fu MM, Fu E. Bone formation with functionalized 3D printed poly-ε-caprolactone scaffold with plasma-rich-fibrin implanted in critical-sized calvaria defect of rat. J Dent Sci 2021; 16:1214-1221. [PMID: 34484590 PMCID: PMC8403799 DOI: 10.1016/j.jds.2021.01.015] [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: 11/16/2020] [Revised: 01/29/2021] [Indexed: 11/26/2022] Open
Abstract
Background/purpose Space-making is one of the essential factors for bone regeneration in severe bony defect. To test the hypothesis that an appropriately designed scaffold may be beneficial for the bone formation in defect, the new bone formed in the critical-size calvarial defect of rat was examined after implanted with a 3D-printed poly-ɛ-caprolactone (PCL) scaffold, retaining with and without plasma rich fibrin (PRF). Materials and methods Thirty-two rats were divided into four groups (control, PCL, PRF, and PCL-plus-PRF). A custom-made 3D-printed PCL scaffold, 900 μm in pore size, retaining with and without PRF, was implanted into a critical-sized calvarial defect, 6 mm in diameter. Animals were sacrificed at week-4 or 8 after implantation for assessing the new bone formation by dental radiography, micro-computed tomography (μ-CT), and histology. Results By radiography and μ-CT, significantly greater mineralization areas/volumes were observed in defects with 3D-printed scaffold groups compared to that without the scaffold in both two-time points. However, no advantage was found by adding PRF. Histology showed that bone tissues grew into the central zone of the critical defect when 3D-printed PCL scaffold was present. In contrast, for the groups without the scaffolds, new bones were formed mostly along defect borders, and the central zones of the defects were collapsed and healed with thin connective tissue. Conclusion Our results suggest that the use of a 900 μm pore size 3D-printed PCL scaffold may have the potential in facilitating the new bone formation.
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Affiliation(s)
- Min-Chia Chen
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Hsien-Chung Chiu
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Po-Jan Kuo
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Cheng-Yang Chiang
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Martin M Fu
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Earl Fu
- Department of Dentistry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, ROC
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30
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Sachdeva SV, Saluja H, Mani A. Novel technique for esthetic root coverage with titanium prepared platelet-rich fibrin. Natl J Maxillofac Surg 2021; 12:418-421. [PMID: 35153442 PMCID: PMC8820295 DOI: 10.4103/njms.njms_276_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/11/2021] [Accepted: 05/28/2021] [Indexed: 11/23/2022] Open
Abstract
Leukocyte- and platelet-rich fibrin (L-PRF) can be defined as an autologous leukocyte and platelet-rich biomaterial. Unlike other platelet-rich products, this technique does not require an anticoagulant or bovine thrombin. However, it is simply centrifuged blood without any additives, which makes it possible to avoid all of the legal restrictions related to the reimplantation of blood-derived products. L-PRF is composed of a fibrin matrix polymerized in a tetramolecular structure and is involved in the joining of platelets, leukocytes, cytokines, and circulating stem cells. The use of silica- coated test tubes is arising a lot of queries about the safety of L-PRF prepared within these test tubes. So, to avoid the use of silicacoated test tubes, titanium prepared PRF has come in practice now, as titanium is biocompatible metal and has property of histoconduction. The present case report is about successful esthetic root coverage around mandibular anterior teeth with clinical attachment loss of 4–5 mm at baseline. The patient had reduced sensitivity, CAL was 1 mm, and attached gingiva covered denuded root surface after 15 days and after 3-month recall appointment.
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Affiliation(s)
- Shivani V Sachdeva
- Department of Periodontology, Pravara Institute of Medical Sciences, Rural Dental College, Loni, Maharashtra, India
| | - Harish Saluja
- Department of Oral and Maxillofacial Surgery, Pravara Institute of Medical Sciences, Rural Dental College, Loni, Maharashtra, India
| | - Amit Mani
- Department of Periodontology, Pravara Institute of Medical Sciences, Rural Dental College, Loni, Maharashtra, India
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Mangano C, Giuliani A, De Tullio I, Raspanti M, Piattelli A, Iezzi G. Case Report: Histological and Histomorphometrical Results of a 3-D Printed Biphasic Calcium Phosphate Ceramic 7 Years After Insertion in a Human Maxillary Alveolar Ridge. Front Bioeng Biotechnol 2021; 9:614325. [PMID: 33937211 PMCID: PMC8082101 DOI: 10.3389/fbioe.2021.614325] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 03/08/2021] [Indexed: 02/04/2023] Open
Abstract
Introduction: Dental implant placement can be challenging when insufficient bone volume is present and bone augmentation procedures are indicated. The purpose was to assess clinically and histologically a specimen of 30%HA-60%β-TCP BCP 3D-printed scaffold, after 7-years. Case Description: The patient underwent bone regeneration of maxillary buccal plate with 3D-printed biphasic-HA block in 2013. After 7-years, a specimen of the regenerated bone was harvested and processed to perform microCT and histomorphometrical analyses. Results: The microarchitecture study performed by microCT in the test-biopsy showed that biomaterial volume decreased more than 23% and that newly-formed bone volume represented more than 57% of the overall mineralized tissue. Comparing with unloaded controls or peri-dental bone, Test-sample appeared much more mineralized and bulky. Histological evaluation showed complete integration of the scaffold and signs of particles degradation. The percentage of bone, biomaterials and soft tissues was, respectively, 59.2, 25.6, and 15.2%. Under polarized light microscopy, the biomaterial was surrounded by lamellar bone. These results indicate that, while unloaded jaws mimicked the typical osteoporotic microarchitecture after 1-year without loading, the BCP helped to preserve a correct microarchitecture after 7-years. Conclusions: BCP 3D-printed scaffolds represent a suitable solution for bone regeneration: they can lead to straightforward and less time-consuming surgery, and to bone preservation.
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Affiliation(s)
| | - Alessandra Giuliani
- Department of Clinical Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Ilaria De Tullio
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Mario Raspanti
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy.,Chair of Biomaterials Engineering, Catholic University of San Antonio de Murcia (UCAM), Murcia, Spain.,Fondazione Villaserena per la Ricerca, Città Sant'Angelo, Italy
| | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
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Chenna D, Shastry S, Das S. Cocktail Protocol for Preparation of Platelet-Rich Fibrin Glue for Autologous Use. Malays J Med Sci 2021; 28:35-40. [PMID: 33679218 PMCID: PMC7909360 DOI: 10.21315/mjms2021.28.1.5] [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: 08/06/2020] [Accepted: 11/19/2020] [Indexed: 10/26/2022] Open
Abstract
Background Biomaterials containing platelets have been used to promote healing of ulcers and burns, as well as in implantology and maxillofacial and plastic surgery to achieve wound healing and tissue repair. Commercial devices to prepare autologous biomaterials involve diverse preparation methods that can have high production costs and low yields. Hence, we designed a protocol for preparation of large amounts of autologous platelet-rich fibrin (PRF) glue using conventional processing techniques for blood components. Methods Autologous whole blood collected 72 h before surgery was processed to prepare platelet concentrates and cryoprecipitate. In a closed system, calcium was added to the cryoprecipitate to release autologous thrombin and generate a firm fibrin clot. The fibrin clot, platelets and calcium were then placed in a conical flask in which a PRF glue formed. The protocol was validated through determination of pre- and post-platelet counts and fibrinogen amounts in the product. Results Platelets were recovered with 68% efficiency during the preparation. Essentially no platelets or fibrinogen were found in the supernatant of the PRF glue, suggesting that nearly all had been incorporated in a PRF glue having a relatively large (8 cm × 10 cm) size. Conclusion The protocol described here is a cost-effective, simple and closed system that can be used to produce large-size PRF glue to promote repair of major surgical defects.
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Affiliation(s)
- Deepika Chenna
- Department of Immunohematology and Blood Transfusion, Kasturba Medical College of Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shamee Shastry
- Department of Immunohematology and Blood Transfusion, Kasturba Medical College of Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Soumya Das
- Department of Immunohematology and Blood Transfusion, Kasturba Medical College of Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.,Department of Transfusion Medicine, All India Institute of Medical Sciences, Nagpur, India
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Aragoneses Lamas JM, Sánchez MG, González LC, Suárez García A, Aragoneses Sánchez J. Vertical Bone Gain after Sinus Lift Procedures with Beta-Tricalcium Phosphate and Simultaneous Implant Placement-A Cross-Sectional Study. ACTA ACUST UNITED AC 2020; 56:medicina56110609. [PMID: 33202885 PMCID: PMC7697819 DOI: 10.3390/medicina56110609] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/01/2020] [Accepted: 11/11/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The objective of this cross-sectional study was to evaluate the vertical bone gain achieved after the sinus lift procedure with beta-tricalcium phosphate (β-TCP) used as a bone substitute and simultaneous implant placement. METHODS One hundred and twenty-eight sinus lift procedures (utilizing a synthetic ceramic containing 99.9% tricalcium phosphate as a bone substitute) and simultaneous implant placements were performed on 119 patients. The lateral window approach surgical protocol for maxillary sinus lift was performed on the patients. The implants were evaluated using cone-beam computed tomography (CBCT) at 6 months following placement. The vertical bone gain was considered a primary variable, while implant length, diameter, and location were considered secondary variables. RESULTS The ANOVA results showed no statistical difference in vertical bone gain with implant parameters like implant length, width, and position. Pearsons correlation revealed a statistically significant positive correlation with vertical bone gain and implant length and diameter. A further multivariate linear regression analysis was performed and it observed statistically significant associations between the variables in the study after adjusting for confounding factors. CONCLUSIONS This study concluded that there was vertical bone gain with the usage of β-TCP in maxillary sinus lift surgical procedure with immediate implant placement and that implant variables like length and diameter had a significant influence on the average bone gain values. The implant position did not have a statistically significant influence but there was considerable variation in the bone gain between first, second premolar, and molar regions.
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Affiliation(s)
- Juan Manuel Aragoneses Lamas
- Department of Dental Research, Federico Henriquez y Carvajal University, Santo Domingo 10106, Dominican Republic; (J.M.A.L.); (J.A.S.)
| | | | - Leví Cuadrado González
- Department of Implantology and Regeneration, Universidad de Vic-Universidad Central de Cataluña, 08500 Barcelona, Spain;
| | - Ana Suárez García
- Department of Pre-clinical Dentistry, Universidad Europea de Madrid, 28670 Madrid, Spain;
| | - Javier Aragoneses Sánchez
- Department of Dental Research, Federico Henriquez y Carvajal University, Santo Domingo 10106, Dominican Republic; (J.M.A.L.); (J.A.S.)
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Abstract
Platelet rich fibrin (PRF) is an autologous biological product which becomes popular day by day and available in a wide variety of fields in medicine. Platelet concentrates which are introduced at the early 90s have evolved over the years. The use such autologous materials have become trendy in recent years to encounter demanding expectations of patients, improve treatment success and maximize patient comfort. Despite its increasing use in dentistry and oral surgery, the most indications and effects are still being discussed. PRF is easily accepted by patients because of its low cost, easy to receive, low donor morbidity, low postoperative complication and infection rate. This biomaterial may be a solution for patients who have strong negative beliefs about the use of allografts and xenografts or who are afraid of complications during the grafting procedure. The objectives of these technologies are to use their synergistic effect to improve the hard and soft tissue regeneration. PRF in oral surgery are used for alveolar bone reconstruction, dental implant surgery, sinus augmentation, socket preservation, osteonecrosis, oroantral fistula closure, struggling with oral ulcers, preventing swelling and edema constitution. This chapter aims to review the clinical applications of platelets in oral surgery and the role of molecular components in tissue healing.
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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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Silberman JJ, Moldauer BI, Torres J, Gallardo C, Sanabria-Liviac D. Palatal root surgery of a maxillary molar using a piezosurgery transantral approach with simultaneous sinus lift grafting: a case report. Int Endod J 2020; 54:464-475. [PMID: 33012051 DOI: 10.1111/iej.13423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 09/27/2020] [Accepted: 09/28/2020] [Indexed: 11/28/2022]
Abstract
AIM To report a case involving transantral palatal root piezoelectric surgery followed by a sinus floor augmentation procedure with the purpose of minimizing and managing complications associated with sinus lining perforations and optimizing bone regeneration at the site of the surgical defect. SUMMARY An asymptomatic 28-year-old male patient with the diagnosis of chronic apical periodontitis on a previously root filled right maxillary first molar (FDI tooth 16) and second premolar (No. 15) was managed by transantral apical surgery. Cone-beam computerized tomography (CBCT) revealed the position of the palatal root of the first molar within the maxillary sinus. The case highlights the management of the palatal root and the handling of a perforation of the Schneiderian membrane through a combination of piezosurgery and a sinus lift grafting procedure involving a second-generation of platelet concentrates. No postoperative complications were observed. Sinus bone augmentation after a 26-month recall period was confirmed by CBCT in the clinically asymptomatic teeth. KEY LEARNING POINTS The selective bone tissue cutting and enhanced visibility obtained by piezoelectric surgery in comparison with current rotary techniques make this technology the preferred tool for apical surgery when the mucosal lining of the maxillary sinus could be compromised. The wound healing and physical properties of the platelet-rich fibrin membranes in combination with an allograft material can be considered as sinus bone graft options when a transantral approach is performed on a palatal root of a maxillary molar. A preoperative tomographic examination is essential for apical surgery using a transantral approach with sinus bone augmentation, because of the information obtained from the axial and coronal views on the CBCT scan.
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Affiliation(s)
- J J Silberman
- Department of Endodontics, Nova Southeastern University College of Dental Medicine, Fort-Lauderdale, FL, USA
| | - B I Moldauer
- Department of Endodontics, Nova Southeastern University College of Dental Medicine, Fort-Lauderdale, FL, USA
| | - J Torres
- Department of Endodontics, Universidad Privada San Juan Bautista, Lima, Perú
| | - C Gallardo
- Department of Endodontics, Universidad Científica del Sur, Lima, Peru
| | - D Sanabria-Liviac
- Department of Endodontics, Universidad Inca Garcilaso de la Vega, Lima, Peru
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Alsherif AA, Eltokhey HM, Taiema DA. Platelet rich fibrin versus ozone gel for periodontal regeneration in induced rats' intrabony three-wall periodontal defects. J Oral Biol Craniofac Res 2020; 10:639-649. [PMID: 32983858 PMCID: PMC7493000 DOI: 10.1016/j.jobcr.2020.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/22/2020] [Accepted: 09/02/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The question of whether platelet rich fibrin and ozone can enhance regeneration of periodontal defect was addressed. MATERIALS AND METHODS three-wall periodontal defects were surgically created in 30 rats involving mesial aspect of right mandibular first molar. Rats were randomly assigned into three groups: 1) Group I (Positive control group). 2) Group II (Ozone treated group) and 3) Group III (PRF treated group). Two weeks after surgery, five rats from each group were euthanized and the remaining was euthanized 4 weeks post surgery. The degree of periodontal regeneration was evaluated using light microscope and scanning electron microscope. Histomorphometric measurements and anti-PCNA immunohistochemical counting were statistically analyzed. RESULTS group I showed intense inflammatory reaction with mild new bone formation. In group II, partial regeneration was seen with moderate new woven bone formation in 2 weeks period. After 4 weeks, almost complete restoration of periodontium was seen. In group III, after 2 weeks, moderate lamellar bone formation was observed. In 4 weeks period, the periodontal regeneration was almost completed. Histomorphometric analysis showed a significant difference between group I and group II. The difference between group I and group III was significant in 2 weeks and highly significant after 4 weeks. That between group II and group III was nonsignificant in 2 weeks and significant in 4 weeks. Anti-PCNA analysis was nonsignificant between groups. CONCLUSIONS both Platelet rich fibrin and ozone can improve histological parameters associated with healing of experimental intrabony periodontal defects in rats with the former being superior.
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Affiliation(s)
- Aya Anwar Alsherif
- Oral Biology Department, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | | | - Doaa Ameen Taiema
- Oral Biology Department, Faculty of Dentistry, Tanta University, Tanta, Egypt
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Cho YS, Hwang KG, Jun SH, Tallarico M, Kwon AM, Park CJ. Radiologic comparative analysis between saline and platelet-rich fibrin filling after hydraulic transcrestal sinus lifting without adjunctive bone graft: A randomized controlled trial. Clin Oral Implants Res 2020; 31:1087-1093. [PMID: 32871620 DOI: 10.1111/clr.13655] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 07/30/2020] [Accepted: 08/13/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate implant survival rate, any complications, and changes in residual alveolar bone height (RABH) using saline or platelet-rich fibrin (PRF) filling after hydraulic transcrestal sinus lifting. METHODS Dental implants were placed after hydraulic transcrestal sinus lifting and the filling of saline (20 patients) or PRF (20 patients). Outcome measurements were implant survival, any complications, and RABH changes. Cone-beam computed tomography (CBCT) scans were taken and compared preoperatively (T0), immediately postoperatively (T1), at 3 months (T2), 6 months (T3), and 12 months postoperatively (T4), respectively. RESULTS In a total of 40 patients, 45 implants with a mean length of 10.4 ± 0.8 mm were placed in posterior maxilla of a mean RABH of 6.8 ± 1.1 mm. The increase in RABH peaked at T1, and continuous drooping of the sinus membrane was observed but stabilized at T3. Meanwhile, the gradual increase in the radiopacities was found below the lifted sinus membrane. The PRF filling induced the radiographic intrasinus bone gain of 2.6 ± 1.1 mm, which was significantly more than 1.7 ± 1.0 mm of saline filling at T4 (p < .05). All the implants were in function with no significant complications over the one-year follow-up period. CONCLUSIONS In this randomized case-control study, the feasibility of hydraulic transcrestal sinus lifting without bone graft was confirmed and PRF might be a better filler to support the elevated sinus membrane. However, adjunctive bone grafting should still be indicated for cases requiring more than 2-3 mm of intrasinus bone gain.
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Affiliation(s)
- Yong-Seok Cho
- Private Practice, Oral and Maxillofacial Surgery, Apsun Dental Hospital, Seoul, Korea
| | - Kyung-Gyun Hwang
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul, Korea
| | - Sang Ho Jun
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Marco Tallarico
- Department of Periodontology and Implantology, University of Sassari, Sassari, Italy
| | - Amy M Kwon
- Biostatistics Core, Medicine-Engineering-Bio (MEB) Global Development Research Center, Industry-University Cooperation Foundation, Hanyang University, Seoul, Korea
| | - Chang-Joo Park
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul, Korea
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A new insight of Platelet-Rich Fibrin clots morphology and their elemental composition. Tissue Cell 2020; 65:101362. [PMID: 32746996 DOI: 10.1016/j.tice.2020.101362] [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: 02/27/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 12/24/2022]
Abstract
This study analyzed the architecture of Platelet-Rich Fibrin (PRF) clots and assessed their elemental composition in order to provide new insight into this biomaterial. Five surplus PRF clots (2,700 RPM, 12 min.) donated by patients (63.6 ± 12.3 years old) were prepared for use in dental clinical procedures. The internal three-dimensional morphology of the red zones and the thirds of the yellow zones of the clots were analyzed by Variable Pressure Scanning Electron Microscope (VPSEM) after sample preparation by two methods: 1. Fixation (2.5% gluataraldehyde); and 2. Fixation with subsequent partial removal of extracellular elements (8 N, HCl). Semi-quantitative elemental analysis was performed by energy-dispersive X-ray spectrometry (EDX). VPSEM analysis showed erythrocytes in both the red zone and the yellow zone, which consisted mainly of fibrin. Removal of extracellular elements enriched the morphology of both zones; the organization of the fibrin was observed to differ in the thirds of the yellow zone, with increasing density and organization to distal. The elements that compose organic substances (C-Carbon, N-Nitrogen, O-Oxygen, Na-Sodium and P-Phosphorus) and halogens (Cl-Chloride and S-Sulfur) were detected; the highest concentrations were of C, followed by O (p < 0.05), in the proximal region of the fibrin. The results of the present study suggest organization of fibrin in the PRF clot, and also reveal the distribution of the elements present in the different regions of the clot. Improved understanding of these characteristics may favor the use of this biomaterial by increasing its efficiency and functionality.
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Effects of Autologous Platelet-Rich Fibrin in Post-Extraction Alveolar Sockets: A Randomized, Controlled Split-Mouth Trial in Dogs with Spontaneous Periodontal Disease. Animals (Basel) 2020; 10:ani10081343. [PMID: 32759693 PMCID: PMC7459700 DOI: 10.3390/ani10081343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/29/2020] [Accepted: 07/31/2020] [Indexed: 12/17/2022] Open
Abstract
Simple Summary The effects of autologous platelet-rich fibrin were evaluated in dogs with spontaneous periodontal disease after tooth extraction. Both radiographic and histological findings attributed to the platelet-rich fibrin a potential ability to stimulate the natural process of tissue healing and regeneration of bone and soft tissues. Platelet-rich fibrin could, therefore, be considered as a simple and effective therapeutic aid in the management of post-extraction socket healing in dogs. Abstract Periodontal disease (PD) is a common inflammatory condition in dogs; in severe stages, dental extraction is frequently required. Platelet-rich fibrin (PRF) has been used in human oral surgical procedures and has been experimentally tested on post-extraction sockets in healthy dogs. This is the first split-mouth, randomized, controlled trial designed to compare post-extractive alveolar socket healing with and without topical application of PRF in canine spontaneous PD. Clinical evaluation, radiographic density, and histological scores for inflammation and regeneration were assessed at recruitment (T0) and after a three-week follow up (T1) on 12 dogs, for a total of 31 pairs of sockets. No complications or clinically evident differences between the treated sites and the control sites were observed. Comparing the radiographic densities of the extraction sites measured at T0 and T1, a significant enhancement was observed within the PRF group, but not within control group. The histological score decreased significantly from T0 to T1 within group PRF, but not within the control group; at T1, the PRF group showed a significantly lower histological score than the control group. These findings suggest that PRF could be able to stimulate the natural process of tissue healing and regeneration of post-extraction sites in dogs with spontaneous periodontal disease (PD).
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Tarallo F, Mancini L, Pitzurra L, Bizzarro S, Tepedino M, Marchetti E. Use of Platelet-Rich Fibrin in the Treatment of Grade 2 Furcation Defects: Systematic Review and Meta-Analysis. J Clin Med 2020; 9:jcm9072104. [PMID: 32635413 PMCID: PMC7408882 DOI: 10.3390/jcm9072104] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 02/07/2023] Open
Abstract
In periodontitis patients, furcation defects are crucial sites to regenerate due to their complex anatomy. Various modern surgical techniques and use of biomaterials have been suggested in the literature. Among all, platelet-rich fibrin (PRF) has potential in tissue regeneration thanks to its role in the release of growth factors. Therefore, the purpose of this study was to evaluate the beneficial effect of the addition of PRF to open flap debridement (OFD) or as an adjuvant to other biomaterials such as bone grafts in the treatment of grade 2 mandibular furcation defects. Systematic research was carried out on the databases Medline, Scopus, Embase, and Cochrane Library and registered on PROSPERO (CRD42020167662). According to the PICO guidelines by Cochrane, randomized trials and prospective non-randomized trials were evaluated, with a minimum follow-up period of 6 months. The inclusion criteria were the absence of systemic diseases, non-smoking patients, and a population aged from 18 to 65 years. Vertical pocket probing depth (PPD), vertical clinical attachment level (VCAL), and gingival recession (REC) were the primary outcomes. Vertical furcation depth (VFD), and the percentage of bone defect fill (%v-BDF) were considered as secondary outcomes. A meta-analysis of the primary and secondary outcomes was performed. Publication bias was assessed through a funnel plot. Eighty-four articles were initially extracted. Eight randomized clinical trials were analyzed according to the exclusion and inclusion criteria. The Quality assessment instrument (QAI) revealed four articles at low risk of bias, one at moderate, and three at high risk of bias. The metanalysis showed significant data regarding PPD, VCAL, VFD and %v-BDF in the comparison between PRF + OFD vs. OFD alone. The adjunct of PRF to a bone graft showed a significant difference for VCAL and a not statistically significant result for the other involved parameters. In conclusion, the adjunctive use of PRF to OFD seems to enhance the periodontal regeneration in the treatment of grade 2 furcation defects. The combination of PRF and bone graft did not show better clinical results, except for VCAL, although the amount of literature with low risk of bias is scarce. Further well-designed studies to evaluate the combination of these two materials are therefore needed.
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Affiliation(s)
- Francesco Tarallo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 L’Aquila, Coppito, Italy; (L.M.); (E.M.)
- Correspondence:
| | - Leonardo Mancini
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 L’Aquila, Coppito, Italy; (L.M.); (E.M.)
| | - Luciano Pitzurra
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (L.P.); (S.B.)
| | - Sergio Bizzarro
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (L.P.); (S.B.)
| | - Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 L’Aquila, Coppito, Italy;
| | - Enrico Marchetti
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 L’Aquila, Coppito, Italy; (L.M.); (E.M.)
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Marchetti E, Mancini L, Bernardi S, Bianchi S, Cristiano L, Torge D, Marzo G, Macchiarelli G. Evaluation of Different Autologous Platelet Concentrate Biomaterials: Morphological and Biological Comparisons and Considerations. MATERIALS 2020; 13:ma13102282. [PMID: 32429210 PMCID: PMC7288147 DOI: 10.3390/ma13102282] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/09/2020] [Accepted: 05/11/2020] [Indexed: 12/11/2022]
Abstract
The field of regeneration interventions in oral and maxillofacial surgeries still represents a challenge for researchers and clinicians. Understanding the biological and morphological behaviour of human cells towards the materials used for the regeneration surgeries is key to successfully choosing and applying the appropriate biomaterials for specific clinical situations. The aim of the study was the biological and morphological evaluation of autologous platelet concentrate materials obtained with different protocols, in culture with human periodontal ligament fibroblasts (HPLF). The study design included the evaluation of Leukocyte-Platelet-Rich-Fibrin (L-PRF), Concentrated Growth Factors (CGF) and autologous platelet gel (APG) in contact with the HPLF cell line after 24 h, 72 h and 7 days of in vitro culture. Cell proliferation and, therefore, viability were evaluated with XTT assays. The morphological response of the cells was evaluated by light microscopy, scanning electron microscopy and confocal microscopy. The XTT assay showed an interesting response in the growth curve. In particular, the material that gave the best results was the CGF. The morphological data supported the XTT assay, showing the best results for the CGF and L-PRF. In conclusion, all the platelet-derived materials stimulated the onset of the growth of the HPLF cell line, making them promising options for periodontal regeneration interventions.
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Affiliation(s)
- Enrico Marchetti
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (E.M.); (L.M.); (S.B.); (L.C.); (D.T.); (G.M.); (G.M.)
| | - Leonardo Mancini
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (E.M.); (L.M.); (S.B.); (L.C.); (D.T.); (G.M.); (G.M.)
| | - Sara Bernardi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (E.M.); (L.M.); (S.B.); (L.C.); (D.T.); (G.M.); (G.M.)
- Microscopy Center, University of L’Aquila, 67100 L’Aquila, Italy
- Correspondence:
| | - Serena Bianchi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (E.M.); (L.M.); (S.B.); (L.C.); (D.T.); (G.M.); (G.M.)
| | - Loredana Cristiano
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (E.M.); (L.M.); (S.B.); (L.C.); (D.T.); (G.M.); (G.M.)
| | - Diana Torge
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (E.M.); (L.M.); (S.B.); (L.C.); (D.T.); (G.M.); (G.M.)
| | - Giuseppe Marzo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (E.M.); (L.M.); (S.B.); (L.C.); (D.T.); (G.M.); (G.M.)
| | - Guido Macchiarelli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (E.M.); (L.M.); (S.B.); (L.C.); (D.T.); (G.M.); (G.M.)
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Kempraj J, Sundaram SS, Doss GPT, Nakeeran KP, Raja VBKK. Maxillary Sinus Augmentation Using Xenograft and Choukroun's Platelet-Rich Fibrin as Grafting Material: A Radiological Study. J Maxillofac Oral Surg 2020; 19:263-268. [PMID: 32346238 DOI: 10.1007/s12663-019-01197-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/02/2019] [Indexed: 01/09/2023] Open
Abstract
Aim The objective of the study was to assess the efficacy of xenograft (BIO-OSS) and platelet-rich fibrin in maxillary sinus augmentation using lateral window approach. Materials and Methods A total of 22 direct sinus lifts were done within a period of two years, and the results were analyzed using two parameters: (1) augmented bone height and (2) bone density in the maxillary sinus. Pre-operative and three-month CT scan was taken for all the 22 patients. Bone densities were calculated using CT scan, and the results were compared between xenograft (BIO-OSS) and platelet-rich fibrin (PRF). Results Statistical analysis of the two groups was performed using independent t test and paired t test, and results were tabulated.
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Affiliation(s)
- Jaghandeep Kempraj
- 1Department of Oral and Maxillofacial Surgery, SRM Dental College, Ramapuram, Chennai, 6000089 India
- Chennai, India
| | - S Shanmuga Sundaram
- 1Department of Oral and Maxillofacial Surgery, SRM Dental College, Ramapuram, Chennai, 6000089 India
| | - Guru Prasad Thulasi Doss
- 1Department of Oral and Maxillofacial Surgery, SRM Dental College, Ramapuram, Chennai, 6000089 India
| | - Komagan Prabhu Nakeeran
- 1Department of Oral and Maxillofacial Surgery, SRM Dental College, Ramapuram, Chennai, 6000089 India
| | - V B Krishna Kumar Raja
- 1Department of Oral and Maxillofacial Surgery, SRM Dental College, Ramapuram, Chennai, 6000089 India
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Ondur E, Bolukbasi Balcioglu N, Soluk Tekkesin M, Guzel O, Ersanli S. Effects of Platelet-Rich Fibrin on Hard Tissue Healing: A Histomorphometric Crossover Trial in Sheep. MATERIALS 2020; 13:ma13071695. [PMID: 32260464 PMCID: PMC7178662 DOI: 10.3390/ma13071695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 11/16/2022]
Abstract
Bone defects lead to aesthetic and functional losses, causing dental rehabilitation to be more difficult. The objective of this work is to histologically assess the hard tissue healing of bone defects filled with platelet-rich fibrin (PRF) alone or as an adjuvant for mixing with and covering anorganic bovine bone (ABB), compared to ABB covered with a resorbable collagen membrane (CM). This study was designed as a crossover animal study. Four 5-mm tibia defects, 5 mm apart from each other, were surgically created on the tibias of 6 sheep. The defects were randomly filled with ABB + CM; PRF alone; ABB+PRF; or were left empty. The animals were euthanized on days 10, 20, and 40 post-operatively. No group showed any signs of bone necrosis. Inflammation was observed in 2 control and 3 test defects with no statistically significant difference between groups at each time point. The ABB + CM and ABB + PRF groups experienced the highest bone regeneration ratios. No differences between the empty-defect and PRF groups were observed in regard to bone regeneration. No statistical difference was observed between the ABB+PRF and ABB + CM groups in regard to bone regeneration and the amount of residual graft material at each time point. The use of PRF should be preferred due to its autogenous origin, low cost, and ease of use.
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Affiliation(s)
- Esra Ondur
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Istanbul 34093, Turkey; (E.O.); (S.E.)
| | - Nilufer Bolukbasi Balcioglu
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Istanbul 34093, Turkey; (E.O.); (S.E.)
- Correspondence: or
| | - Merva Soluk Tekkesin
- Department of Tumor Pathology, Institute of Oncology, Istanbul University, Istanbul 34093, Turkey;
| | - Ozlem Guzel
- Department of Surgery, Veterinary Faculty, Istanbul University Cerrahpasa, Istanbul 34320, Turkey;
| | - Selim Ersanli
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Istanbul 34093, Turkey; (E.O.); (S.E.)
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Deeb MA. Role of Platelet-Rich Fibrin (PRF) and Platelet-Rich Plasma (PRP) in Oro-Facial Tissue Regeneration: A Narrative Review. JOURNAL OF ADVANCED ORAL RESEARCH 2020. [DOI: 10.1177/2320206819895836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background and Aim:Regeneration potential of platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) in oral tissues regeneration has revolutionized the clinical dentistry in recent years. The in vivo and in vitro research on PRP and PRF has opened a new avenue in the dentistry and medicinal care. It is a minimally invasive and cost-effective technique that will raise the bar of clinical dentistry. The results presently documented are overwhelming; the potential to use PRF and PRP in the clinical dentistry have improved dental quality, satisfaction, and clinical outcome. The aim of the review was to recapitulate the regenerative and healing potential of platelet extracts in different disciplines of clinical dentistry.Materials and Methods:The attempt was to answer the following question: what are the various clinical oral health applications for PRF and PRP available in the published literature? The dual functions (tissue sealants and drug delivery systems to carry biomolecules and chemotactic growth factors) have helped the practitioners to treat the complicated oral conditions and tissues regeneration. The PRF and plasma has emerged as a powerful therapeutic tool for management of soft and hard tissue healing and regenerative procedures, including implant osseointegration. More research is mandatory to use these platelets concentrate to their full potential in various clinical applications.Conclusion:PRF is an emerging therapeutic tool in the management of oral soft and hard tissue healing and regenerative procedures.
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Affiliation(s)
- Modhi Al Deeb
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Saudi Arabia
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Application of Platelet-Rich Fibrin as Regeneration Assistant in Immediate Auototransplantation of Third Molar with Unformed Roots: Case Report and Review of Literature. Case Rep Dent 2020; 2020:8170646. [PMID: 32089902 PMCID: PMC6996676 DOI: 10.1155/2020/8170646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 12/22/2019] [Accepted: 01/06/2020] [Indexed: 01/24/2023] Open
Abstract
Background Autogenous Tooth Transplantation (ATT) is the surgical movement of a maturely or immaturely formed tooth from its original site to another extraction site or a surgically prepared socket in the same individual. The most important factor in the healing process after autotransplantation is the presence of intact and viable periodontal ligament cells, which have the ability to differentiate into osteoblasts and able to induce bone production. ATT can successfully replace removable dentures as a restoration option in a growing patient, while implants can be placed only after skeletal maturity is attained. Case Presentation. In this case, we presented an immediate ATT of the third molar with unformed roots to the extraction socket of the first molar with evidence of continued root formation after 2 years of follow-up. Conclusion Platelet-Rich Fibrin (PRF) can induce sustainable and accelerated healing, and it can also induce the regeneration process of the periodontal tissues and pulpal formation. This process plays a key role in future root development and success rate.
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Evaluation of New Bone Formation Using Autogenous Tooth Bone Graft Combined with Platelet-Rich Fibrin in Calvarial Defects. J Craniofac Surg 2020; 30:1662-1666. [PMID: 30939548 DOI: 10.1097/scs.0000000000005413] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of the present study was to evaluate the contributions of autogenous tooth bone graft (ATBG) combined with platelet-rich fibrin (PRF) on new bone formation and bone morphogenetic protein (BMP)-2 in rabbit calvarial defects. Twelve male New Zealand rabbits were used in this study. Three circular bone defects were prepared in each rabbit with a drill. These defects were divided into 3 groups: control, treated with ATBG, and treated with ATBG+PRF. The animals were sacrificed at 28 days. Samples were evaluated by histomorphometric analyses and total augmented area, new bone area and bone density were calculated. In addition, expression of BMP-2 was determined by immunohistochemical staining. The total augmented area, new bone area and bone density were significantly greater in the ATBG group than in the control group (P <0.05). Also, these values were significantly higher in the ATBG+PRF group than the ATBG group (P <0.05). Test groups demonstrated significantly increased BMP-2 levels compared with the control group (P <0.05). The present study suggested that ATBG combined with PRF significantly increased the new bone formation and enhanced bone healing in cranial defects.
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Fan Y, Perez K, Dym H. Clinical Uses of Platelet-Rich Fibrin in Oral and Maxillofacial Surgery. Dent Clin North Am 2020; 64:291-303. [PMID: 32111269 DOI: 10.1016/j.cden.2019.12.012] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Platelet-rich fibrin (PRF) is an autogenous material that is derived from a person's own platelets and is used to enhance wound healing and tissue regeneration. Platelet concentrates have been applied in dermatology, pain management, sports medicine, plastic surgery, cardiac surgery, urology, and also dentistry. PRF has garnered significant interest in the dental community because of its proposed regenerative properties and its ability to aid in wound healing. PRF is proposed to have a direct effect on enhancing a patient's wound healing by suprasaturating the wound with growth factors that promote tissue healing. Clinically, PRF is easily produced chairside from the patient's own blood. The autologous nature of PRF makes it preferred over a variety of allografts used in dentistry today. Therefore, PRF has significant potential in being applicable to all areas of dentistry, including oral and maxillofacial surgeries.
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Affiliation(s)
- Yijiao Fan
- Division of Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 DeKalb Avenue, Brooklyn, NY 11201, USA
| | - Karla Perez
- Division of Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 DeKalb Avenue, Brooklyn, NY 11201, USA
| | - Harry Dym
- Department of Dentistry and Oral & Maxillofacial Surgery, The Brooklyn Hospital Center, Outpatient Care Building-1st Floor, 121 DeKalb Avenue, Brooklyn, NY 11201, USA.
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Ortega-Mejia H, Estrugo-Devesa A, Saka-Herrán C, Ayuso-Montero R, López-López J, Velasco-Ortega E. Platelet-Rich Plasma in Maxillary Sinus Augmentation: Systematic Review. MATERIALS 2020; 13:ma13030622. [PMID: 32019255 PMCID: PMC7040697 DOI: 10.3390/ma13030622] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 01/23/2020] [Accepted: 01/28/2020] [Indexed: 12/14/2022]
Abstract
Background: Sinus augmentation can be performed with or without grafting biomaterials, and to date, there is no quality evidence regarding the augmentation of the sinus floor using only platelet concentrates, which can improve the healing period and enhance bone regeneration by stimulating angiogenesis and bone formation. The main objective of this paper was to assess the effect of the sole use of platelet concentrates in sinus augmentation in terms of newly formed bone, augmented bone height, and clinical outcomes and to assess the additional beneficial effects of platelet-rich fibrin (PRF) in combination with other grafting biomaterials. Methods: A systematic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Pooled analyses were performed with the Review Manager software. Results: For sinus elevation only using platelet concentrates, 11 studies met the inclusion criteria and were included for qualitative synthesis. Only one study was a clinical trial, which reported improved outcomes for the allograft group compared to the titanium-PRF (T-PRF) group. A total of 12 studies where PRF was used in addition to grafting biomaterials met eligibility criteria and were included in the review. Results from meta-analyses provided no additional beneficial effects of PRF in sinus augmentation in terms of bone height and percentage of soft tissue area. There was a statistically significant lower percentage of residual bone substitute material in the PRF (+) group compared to the PRF (−) group. The percentage of newly formed bone was slightly higher in the PRF (+) group, but this was not statistically significant. Conclusion: There is no robust evidence to make firm conclusions regarding the beneficial effects of the sole use of platelet concentrates in sinus augmentation. However, studies have shown favorable outcomes regarding implant survival, bone gain, and bone height. The use of PRF with other grafting biomaterials appears to provide no additional beneficial effects in sinus lift procedures, but they may improve the healing period and bone formation. Well-conducted randomized clinical trials (RCTs) are necessary to confirm the available results to provide recommendations for the clinical practice.
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Affiliation(s)
- Holmes Ortega-Mejia
- Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08970 Barcelona, Spain; (H.O.-M.); (C.S.-H.)
| | - Albert Estrugo-Devesa
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08970 Barcelona, Spain; (A.E.-D.); (R.A.-M.)
| | - Constanza Saka-Herrán
- Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08970 Barcelona, Spain; (H.O.-M.); (C.S.-H.)
| | - Raúl Ayuso-Montero
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08970 Barcelona, Spain; (A.E.-D.); (R.A.-M.)
| | - José López-López
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08970 Barcelona, Spain; (A.E.-D.); (R.A.-M.)
- Service of the Medical-Surgical Area of Dentistry Hospital, University of Barcelona, 08970 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-402-42-71; Fax: +34-93-402-42-48
| | - Eugenio Velasco-Ortega
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41013 Seville, Spain
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Arabaci T, Albayrak M. Titanium-prepared platelet-rich fibrin provides advantages on periodontal healing: A randomized split-mouth clinical study. J Periodontol 2019; 89:255-264. [PMID: 29543995 DOI: 10.1002/jper.17-0294] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 09/20/2017] [Accepted: 09/23/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND The aim of this study to evaluate the contributions of titanium-prepared platelet-rich fibrin (T-PRF) combined with open flap debridement (OFD) on biological markers in gingival crevicular fluid (GCF)and periodontal outcomes. METHODS Twenty-nine participants with chronic periodontitis were treated either with autologous T-PRF+OFD or OFD alone. GCF growth factor levels and relative receptor activator nuclear factor kappa-B/osteoprotegerin (RANKL/OPG) ratio at baseline and 2, 4, and 6 weeks postoperatively were analyzed, and clinical parameters such as probing depth (PD), relative attachment level (RAL) and gingival margin level (GML) at baseline and 9 months after surgery were compared. RESULTS The mean PD reduction, RAL gain, and GML change were significantly greater in the OFD+T-PRF sites than in the OFD sites (P = 0.033, P = 0.029, and P = 0.026, respectively). Both groups demonstrated increased growth factor levels at week 2 compared with baseline, followed by reductions at weeks 4 and 6. GCF growth factor levels in the test group were seen at higher concentrations with respect to control group until 6 weeks post-surgery. During this 6-week period, relative RANKL/OPG ratio was found significantly lower in the OFD+T-PRF group compared to the OFD group(P < 0.05). CONCLUSIONS Using T-PRF membrane combined with OFD provided significantly higher concentrations of growth factors and lower RANKL/OPG ratio in GCF for approximately 4 to 6 weeks, and improved periodontal healing compared to conventional flap sites.
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Affiliation(s)
- Taner Arabaci
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Mevlut Albayrak
- Medical Laboratory Department, Health Services Vocational Training School, Ataturk University, Erzurum, Turkey
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