Platelet-Rich Fibrin in Single and Multiple Coronally Advanced Flap for Type 1 Recession: An Updated Systematic Review and Meta-Analysis

Multiple Recessions Coverage Using the Modified Tunnel Technique and Connective Tissue Graft with or Without Cross-Linked Hyaluronic Acid: 2-Year Outcomes of RCT

There is continuing interest in using biologics in root coverage procedures. The aim of the present study was to explore the 2-year outcomes following multiple gingival recessions (GRs) coverage using the application of cross-linked hyaluronic acid (HA) in combination with modified coronally advanced tunnel (MCAT) together with subepithelial connective tissue graft (SCTG). Adopting a split-mouth design, 266 GRs were randomly allocated to either a test (MCAT + SCTG + HA) or control group (MCAT + SCTG). The main outcome variable was the stability of the obtained mean root coverage from 6 months to 24 months. Twenty-four patients were evaluated at the 2-year follow-up. Comparisons between test and control sides at the same time points were evaluated using the t-test for independent variables. The changes in time were compared by one-way analysis of variance with the Tukey post hoc test separately for the test and control groups. The study protocol was registered at ClinicalTrials.gov (NCT05045586). At 2 years, around ninety percent of recessions showed complete root coverage (87.02% of the test group and 91.90% of the control group). Mean root coverage did not differ between the two sides, with 81.37 ± 37.17% (test) and 84.63 ± 35.33% (control), respectively. Significant improvements in the reduction of gingival recession height, clinical attachment level gain, gingival thickness increase, and the root esthetic score were found in both groups after 2 years, but no statistically significant difference was observed between the groups. The adjunctive application of HA significantly improved soft tissue texture (STT, 0.94 ± 0.23 for the test group vs. 0.71 ± 0.46 for the control group). Treatment of multiple gingival recessions with MCAT + SCTG with or without HA yielded marked and comparable 2-year clinical outcomes, which could be maintained over a period of 24 months. The clinical relevance of the demonstrated significant difference in STT between groups may be minimal.

Autologous platelet concentrates in root coverage procedures

Gingival recessions are vastly prevalent among the general population. With regards to their treatment, recent advancements in periodontal and microsurgical procedures, focusing on minimal invasiveness and patient-centered therapies, have propelled a shift in their contemporary treatment, highlighting the field of biologics and bioactive mediators. Among different classes and types of biologics, autologous platelet concentrates (APCs), also referred to as autologous blood-derived products, are commonly used and preferred among many clinicians. These are essentially obtained via venipuncture (intravenous access) followed by centrifugation, for which numerous protocols and preparation methods have been used, leading to varieties of blood-derived products. In this review, via a systematic search, we explored the efficacy of the different utilized preparation methods and centrifugation protocols of APCs (e.g., platelet-rich plasma (PRP), platelet-rich fibrin (PRF), leucocyte-PRF, advanced-PRF, concentrated growth factor (CGF), etc.) for the treatment of type 1 gingival recessions (RT1, without interproximal attachment loss or noticeable tooth displacement), as well as their effectiveness relative to a common control (treatment with flap advancement alone without any additional material). Based on the available literature from randomized trials found in our systematic search, we observed that utilization of PRF can significantly enhance treatment outcomes when performing a coronally advanced flap, in terms of the amount of root coverage. The improvement in root coverage was further enhanced in the presence of baseline keratinized tissue width, and with an increasing relative magnitude (the more the baseline keratinized tissue width, the better the root coverage outcomes when using PRF). The efficacy of these products needs to be further explored with different graft substitutes and matrices, as well as relative to other commonly applied biologics, through well-conducted and adequately-powered randomized clinical trials.

Horizontal platelet-rich fibrin versus advanced platelet-rich fibrin plus in gingival recession management

BACKGROUND

Newer generation platelet concentrates, such as advanced platelet-rich fibrin plus (A-PRF+) obtained following low-speed centrifugation concept and horizontal platelet-rich fibrin (H-PRF) obtained from swing out and bucket system, showed increased platelet entrapment and growth factor release in the in-vitro studies. This prospective study aimed to evaluate and compare the clinical outcomes of A-PRF+ and H-PRF membranes in the treatment of gingival recession defects. The objectives of this study were to compare the changes in the recession height (RH) and the mean root coverage percentage (MRC%) between and within the research groups.

METHODS

Forty-four systemically healthy patients diagnosed with 84 Cairo's RT 1 and RT 2 gingival recession defects in the maxillary anterior and premolars were randomly treated with a combination of the coronally advanced flap (CAF) and A-PRF+ membrane (n = 22 subjects) or H-PRF membrane (n = 22 subjects). Patients were reviewed at 3 and 6 months postoperatively. Parameters including RH, MRC%, complete root coverage (CRC), gingival thickness, keratinized tissue height, and root coverage esthetic scores were documented.

RESULTS

Both treatments resulted in a significant reduction in RH (p < 0.001). The CAF + A-PRF+ group demonstrated a reduction in RH from 2.47 ± 1.00 mm to 0.59 ± 0.52 mm and the MRC% was 76.33 ± 22.54%, at 6 months. In the CAF+H-PRF group, the mean RH decreased from 2.43 ± 1.01 mm to 0.38 ± 0.59 mm and the MRC% was 85.51 ± 19.87%. Three- and six-month intergroup analysis revealed statistically insignificant differences in the observed clinical parameters between the groups (p > 0.05).

CONCLUSIONS

The study found that both CAF + H-PRF and CAF + A-PRF+ protocols resulted in similar clinical outcomes while treating maxillary gingival recession defects.

PLAIN LANGUAGE SUMMARY

Numerous modifications have been proposed to improve the growth factor content in the platelet concentrates and thereby therapeutic potential. This study compared platelet-derived membranes obtained by two different spin protocols in the treatment of gum recession. Forty-four patients were treated with either platelet-derived membrane obtained by horizontal spin protocol (test group) or low-speed spin concept (control group). Both treatment methods resulted in satisfactory healing. At the end of 6 months, no differences were noted with regard to the changes in clinical measurements and root coverage percentage indicating similar clinical efficacy of both preparatory techniques.

Efficacy of autologous platelet concentrates for root coverage of Miller's Class I and II gingival recession defects: A systematic review and meta-analysis

Background

This systematic review and meta-analysis aimed to assess the efficacy of autologous platelet concentrate (APCs) in comparison with coronally-advanced flap alone or in combination with connective tissue graft or other biomaterials or bioactive agents for root coverage (RC) of Miller's Class I and II gingival recession defects by measuring the keratinized mucosa width (KMW).

Materials and Methods

This systematic review and meta-analysis was conducted in accordance with the preferred reporting items for systematic reviews and meta-analysis guidelines. An electronic search of the literature was conducted in PubMed, EMBASE, Scopus, Cochrane, Web of Science, Magiran, Scientific Information Database, and Irandoc for randomized clinical trials (RCTs) that used APCs for RC in their intervention group. Eligible articles were retrieved by assessment of titles and abstracts and then the full texts. The risk of bias was assessed by the Cochrane Library Risk of Bias Assessment Tool. Meta-analysis was carried out by RevMan 5.3 software. In the case of homogeneity, variables were reported as weighted mean difference (WMD) with 95% confidence interval (CI) for each group.

Results

The search yielded 689 articles; out of which, 32 were eligible for study inclusion. Meta-analysis did not show any additional effect for RC and KMW with APCs. Clinical parameters were as follows: RC: WMD = -1.57 mm (95% CI: -2.49, -0.659; P = 0.001) and KMW: -0.106 mm (95% CI: -0.3222, 0.110; P = 0.337).

Conclusion

The application of APCs for RC of Miller's Class I and II gingival recession defects does not seem to improve the clinical parameters.

Assessing the effectiveness of advanced platelet rich fibrin in treating gingival recession: a systematic review and meta-analysis

OBJECTIVES

The literature lacks comprehensive evidence on the efficacy of advanced platelet rich fibrin(A-PRF) in treating gingival recession. Therefore, this systematic review and meta-analysis aimed to evaluate the effectiveness of A-PRF in the treatment of gingival recession.

MATERIALS AND METHODS

We adhered to the guidelines of PRISMA in searching the following databases: PubMed/MEDLINE, Embase, Cochrane Library, Web of Science, and Scopus to include all the eligible studies according to the prespecified inclusion and exclusion criteria. We conducted our search up to February 28, 2024. We conducted a meta-analysis of the primary and secondary clinical outcomes to measure the changes from baseline to 6 months after surgery.

RESULTS

Our review included 10 randomized clinical trials in which 146 participants with 457 recession defects were included. We found that combination of A-PRF with various surgical techniques, such as coronally advanced flap (CAF) connective tissue graft (CTG), VISTA, tunneling, and pinhole surgical technique, demonstrated promising outcomes but varied by comparison group. We observed that CTG with CAF showed a higher reduction in recession depth in comparison to A-PRF with CAF. This review indicated no statistical or clinical differences in recession width, width of keratinized gingiva, probing depth, and clinical attachment level between the study and control groups.

CONCLUSIONS

Due to the less invasive nature of A-PRF, it provides a better clinical option to improve the outcomes of treating gingival recession. However, more well-designed RCTs with standardized approaches are needed to confirm these results.

From Healing to Regeneration: A Comprehensive Review of the Efficacy of Platelet-Rich Fibrin in Periodontal Plastic Surgery Procedures

This review examines platelet-rich fibrin (PRF) efficacy in periodontal plastic surgery, highlighting its crucial role in promoting periodontal regeneration and healing. Various forms of PRF are discussed, like leukocyte- and platelet-rich fibrin, advanced PRF, and injectable PRF, in addition to their application in different periodontal procedures such as root coverage and increasing the width of keratinized tissue surrounding the teeth. This review emphasizes the biological benefits of PRF, such as faster wound healing, reduced postsurgical pain, and better management of bleeding. The presence of growth factors, cytokines, and leukocytes in PRF significantly aids in promoting tissue regeneration, thereby improving the clinical outcomes of periodontal therapy. This review also provides recommendations for further research using standardized PRF protocols to optimize the benefits of PRF in clinical practice.

Horizontal Platelet-Rich Fibrin in Vestibuloplasty: A Case Report

Vestibuloplasty (VP) is a surgical technique that allows the deepening of the vestibule of the mouth. The gold standard, especially if an increase in keratinized tissue (KT) is required, is represented by the free gingival graft (FGG). The need for a donor site, however, is a source of discomfort and possible complications. To overcome these aspects, numerous techniques and materials have been used. Horizontal platelet-rich fibrin (H-PRF) has been very successful in recent years in various oral surgery procedures due to its ability to promote tissue healing and regeneration. The reported case presents a new technique of VP using H-PRF, which allows avoiding the second surgical site. A 25-year-old patient with post-surgical reduction of vestibule depth and poor KT was treated with VP. The patient refused an FGG procedure. Therefore, VP was performed using an H-PRF membrane as a graft material to lengthen the vestibule and promote KT regeneration. After nine weeks, an increase in vestibule depth and KT width was evident. The use of H-PRF in VP has allowed predictable surgery without significant complications. It therefore represents an alternative to the traditional FGG to be seriously taken into consideration.

Treatment of multiple adjacent gingival recessions using leucocyte- and platelet-rich fibrin with coronally advanced flap: a 12-month split-mouth controlled randomized clinical trial

OBJECTIVE

This split-mouth randomized study aimed to assess efficacy of leucocyte-platelet-rich fibrin (L-PRF) versus connective tissue graft (CTG) in achieving root coverage (RC) for multiple adjacent gingival recessions (MAGRs) throughout 12-month period.

MATERIALS AND METHODS

The study enrolled 59 teeth from 12 patients with Miller Class I MAGRs ≥ 2 mm on bilateral or contralateral sides. Patients were randomly assigned to receive coronally advanced flap (CAF) with either CTG (control) or L-PRF (test) treatment. Various parameters, including plaque and gingival index, clinical attachment level, recession depth, probing depth, recession width (RW), papilla width (PW), keratinized tissue width (KTW), gingival thickness (GT), percentage of RC, complete root coverage (CRC), and location of the relative gingival margin concerning the cemento-enamel junctions (GMCEJ) after CAF, were recorded at baseline, 3-, 6-, and 12-months post-surgery. On June 29, 2021 the study was registred to ClinicalTrials.gov (NCT04942821).

RESULTS

Except KTW and GT gain, all clinical parameters, RC, and CRC were similar between the groups at all follow-up periods (p > 0.05). The higher GT and KTW gains were detected in the control group compared to test group at 12 months (p < 0.05). Both RC and CRC were positively associated with initial PW and GMCEJ, but negatively with initial RW (p < 0.05).

CONCLUSIONS

The current study concludes that L-PRF were equally effective as CTG in treating MAGRs in terms of RC and CRC. Additionally, RC and CRC outcomes appeared to be influenced by GMCEJ, PW, and RW.

CLINICAL RELEVANCE

L-PRF could represent a feasible substitute for CTG in treating MAGRs.

Treatment of Multiple RT1 Gingival Recessions Using a Coronally Advanced Flap Associated with L-PRF or Subgingival Connective Tissue Graft from Maxillary Tuberosity: A Randomized, Controlled Clinical Trial

The goal of plastic periodontal surgery is to obtain complete root coverage, increasing gingival thickness (GT), a positive prognostic factor for gingival margin stability over time. The aim of this study was to compare the effectiveness of the Coronally Advanced Flap (CAF) in RT1 (GR; gingival recession with no loss of interproximal attachment) when associated with a connective tissue graft from the maxillary tuberosity (tCTG) or with leukocyte and platelet-rich fibrin (L-PRF) membranes in obtaining root coverage and increasing the thickness and width of the keratinized tissue, along with aesthetic improvement, taking into account a number of patient-related outcomes. Thirty patients with two adjacent RT1 GRs (GRs with no loss of interproximal attachment) were each treated using CAF associated with tCTG (15 patients) or L-PRF. The main outcome was a GT increase; secondary outcomes were keratinized tissue width (KT), gingival recession (GR), probing depth (PD), clinical attachment level (CAL), root coverage percentage (RC%), complete root coverage (CRC), and root coverage esthetic score (RES). Patient-reported outcomes were discomfort (D), dentine hypersensitivity (DH), patient-related esthetic score (PRES), and overall treatment satisfaction (OTS). After 12 months, clinical and patient-reported parameters did not show significant differences between groups, with the only exception being a GT gain, which was significantly greater in the CAF + tCTG group. Our results showed that both techniques were effective in treating RT1 GRs, with comparable patient-related outcomes. However, the use of tCTG produces significantly thicker tissue, covering the exposed root surface.

Parodontgel® on Wound Healing and Patient-Reported Outcome Measures (PROMs) after Tunneled Coronally Advanced Flap (TCAF)

The adjunctive use of healing gels following periodontal plastic surgery is not common in clinical practice, and no definitive benefits have yet been demonstrated. Case Presentation. A 33-year-old male patient with a central lower incisor class RT1 recession sought treatment due to sensitivity and dissatisfaction with the appearance of his smile. The patient had no history of periodontal disease; however, he was under orthodontic treatment contributing to the gingival recession and irregular gum contours. Treatment. The patient underwent two sequential surgical procedures. Initially, an apically repositioned flap (APF) was performed to correct the frenulum reducing flap tension and improving the gum line aesthetics. Subsequently, after 8 weeks, a tunneled coronally advanced flap (TCAF) was executed to further refine the gum contours and achieve root coverage. Postoperative Healing Protocol. To enhance the healing process and alleviate postoperative discomfort, a healing gel containing hyaluronic acid as the active molecule was applied to the surgical sites. The gel was expected to reduce pain perception and minimize the need for painkiller intake during the critical first week of recovery. The patient was asked to fill a pain chart for the initial 7 days, recording pain levels on a visual analogue scale (VAS 0-10) and the number of paracetamol tablets taken as painkillers. Results. After both the APF and TCAF surgeries, the patient reported pain levels with a mean VAS score of 4.33 and 4.25, respectively. The painkiller intake during the first week was noted to be 3 tablets for the APF and 2 tablets for the TCAF. Notably, the application of the healing gel with hyaluronic acid did not cause any adverse reactions, indicating its potential safety and efficacy in this context. Conclusion. The application of a healing gel containing hyaluronic acid after periodontal plastic surgery showed promising results in reducing postoperative pain and the need for painkillers during the initial week of recovery. However, further investigations through randomized clinical trials are required to establish the potential benefits and broader applicability of such healing gel applications in the context of periodontal plastic surgery.

Comparison of Sub-epithelial Connective Tissue Graft and Platelet Rich Fibrin in Peri-implant Soft Tissue Augmentation: A Randomized Clinical Split-mouth Study

Aims and Background:

Gingival phenotype has a crucial impact on the peri-implant marginal bone stability. The aim of this clinical trial is to assess and compare the efficacy of the sub-epithelial connective tissue graft (SCTG) and platelet-rich fibrin (PRF) in improving the peri-implant soft tissue phenotype and enhancing esthetic outcomes.

Materials and Methods:

The present study was a split-mouth randomized controlled clinical trial. A total of ten patients who had bilateral missing teeth in the maxillary esthetic zone with a thin gingival phenotype were included in this study. For each study participant, one randomly selected site was treated with SCTG, while the other was treated with PRF membrane during dental implant placement. Treatment outcomes included the assessment of the facial gingival thickness using cone-beam computed tomography (CBCT) at the baseline (T0) and 6 months postoperatively (T1), and the Pink esthetic score (PES) at T1 and 3 months later after prosthesis placement (T2).

Results and Discussion:

Both treatment options resulted in a significant increase in gingival tissue thickness at T1 compared with T0, and in PES at T2 compared with T1 (p ˂ 0.05).

Conclusion:

PRF is an effective alternative to SCTG in augmenting peri-implant soft tissue phenotype and improving esthetic outcomes. This would help overcome the complications associated with harvesting the SCTG and increasing patients’ satisfaction.

Clinical Trial Registration ID: ISRCTN11961919.

Effect of leukocyte and platelet-rich fibrin on free gingival graft healing: A clinical and histological study in rabbits

Background. Recently, the use of leukocyte- and platelet-rich fibrin (L-PRF) has been recommended due to the presence of various growth factors to increase the success of free gingival grafts (FGG). This study evaluated the effect of using L-PRF in the healing of FGG in rabbits. Methods. Twenty rabbits were randomly divided into two groups. In each group, FGG was performed in two separate sites with or without L-PRF. One of these groups was sacrificed on the 7th day and the other on the 28th day and analyzed in terms of clinical indices, including wound healing, gingi-val thickness (GT), and keratinized tissue width (KTW). Then histologic sections were obtained and stained for type and degree of inflammation and rate of vascular formation analysis. SPSS 22 was used for statistical analysis. Results. The extent of changes in GT, KTW, wound healing index, and vascular formation between the test and control groups was not statistically significant. The difference in the type of inflammation was significant only between the -7day and -28day control groups (P=0.003). The degree of inflammation between the -7day test group and the -28day control group, as well as the -7day and -28day control groups, were statistically significant (P=0.011 and P=0.002, respectively). Conclusion. Using L-PRF with FGG could improve FGG healing compared to using FGG alone, but the results were not statistically significant.

A New Matrix for Soft Tissue Management

Gingival recession is a mucogingival defect defined as the apical shifting of the gingival margin in relation to the CEJ. The use of connective tissue autografts allows for the obtention of very satisfactory results but is associated with undoubted disadvantages. The aim of the present work is to carry out a systematic review of the literature using a meta-analysis to investigate the clinical efficacy of xenogeneic collagen matrix (XCM) in the treatment of gingival recessions. This revision was carried out strictly following the guidelines published in the Cochrane Handbook. Thus, a meta-analysis was performed to calculate relative risks and standardized mean differences for each of the variables considered. The results of the meta-analysis show that CAF + CTG was statistically better than CAF + XCM in almost all the variables analyzed: complete root coverage (RR 0.46), mean root coverage (SMD −0.89), recession reduction (SMD −0.98), clinical attachment level (SMD −0.63) and gingival thickness (SMD −1.68). Meanwhile, CAF + XCM was slightly better than CAF alone in regard to: mean root coverage (SMD 0.51), recession reduction (SMD 0.47) and gingival thickness (SMD 0.56). It is possible to conclude that CAF + CTG still remains the gold standard in radicular coverage.

Platelets' Role in Dentistry: From Oral Pathology to Regenerative Potential

Platelets are a cellular subgroup of elements circulating in the bloodstream, responsible for the innate immunity and repairing processes. The diseases affecting this cellular population, depending on the degree, can vary from mild to severe conditions, which have to be taken into consideration in cases of minor dental procedures. Their secretion of growth factors made them useful in the regenerative intervention. The aim of this review is to examine the platelets from biological, examining the biogenesis of the platelets and the biological role in the inflammatory and reparative processes and clinical point of view, through the platelets' pathology and their use as platelets concentrates in dental regenerative surgery.

Evaluation of the Use of Platelet-Rich Fibrin Xenologous Membranes Derived from Bubaline Blood in Canine Periodontal Defects

Periodontal disease is the most common oral disease in dogs. Platelet-rich fibrin (PRF) is widely utilized to facilitate soft and hard tissue healing and has been proposed in periodontal healing in small animal treatment. However, the quality and amount of autologous PRF is compromised in animals with systemic diseases. The present study aimed to evaluate the efficacy of xenologous bubaline blood-derived PRF (bPRF) on periodontal tissue healing in canine periodontal defects. Split-mouth design was employed in twenty dogs diagnosed with periodontal disease. The defects were divided randomly into two groups: the open-flap debridement (OFD)-treated group and the OFD with bPRF (OFD+bPRF) application group. Results demonstrated that gingival index and periodontal probing depth decreased significantly in the OFD+bPRF group compared with those treated with OFD alone. Application of bPRF in periodontal defects also promoted fibrous tissue formation, as confirmed by the marked increase in fibrosis score. bPRF application significantly increased COL1A1 and PDGFB mRNA levels at day 14 compared with the baseline. Taking this evidence together, bPRF provided a favorable therapeutic modality in canine periodontal defects. bPRF could be an alternative biomaterial for the treatment of periodontal defects in dogs.

Bio-Morphological Reaction of Human Periodontal Ligament Fibroblasts to Different Types of Dentinal Derivates: In Vitro Study

Understanding the biological and morphological reactions of human cells towards different dentinal derivate grafting materials is fundamental for choosing the type of dentin for specific clinical situations. This study aimed to evaluate human periodontal ligament fibroblasts (hPLF) cells exposed to different dentinal derivates particles. The study design included the in vitro evaluation of mineralized dentine (SG), deproteinized and demineralized dentine (DDP), and demineralized dentine (TT) as test materials and of deproteinized bovine bone (BIOS) as the positive control material. The materials were kept with the hPLF cell line, and the evaluations were made after 24 h, 72 h, and 7 days of in vitro culture. The evaluated outcomes were proliferation by using XTT assays, the morphological characteristics by light microscopy (LM) and by the use of scanning electron microscopy (SEM), and adhesion by using confocal microscopy (CLSM). Overall, the experimental materials induced a positive response of the hPLFs in terms of proliferation and adhesion. The XTT assay showed the TT, and the SG induced significant growth compared to the negative control at 7 days follow-up. The morphological data supported the XTT assay: the LM observations showed the presence of densely packed cells with a modified shape; the SEM observations allowed the assessment of how fibroblasts exposed to DDP and TT presented cytoplasmatic extensions; and SG and BIOS also presented the thickening of the cellular membrane. The CLMS observations showed the expression of the proliferative marker, as well as and the expression of cytoskeletal elements involved in the adhesion process. In particular, the vinculin and integrin signals were stronger at 72 h, while the actin signal remained constantly expressed in all the follow-up of the sample exposed to SG material. The integrin signal was stronger at 72 h, and the vinculin and actin signals were stronger at 7 days follow-up in the sample exposed to DDP material. The vinculin and integrin signals were stronger at 72 h follow-up in the sample exposed to TT material; vinculin and integrin signals appear stronger at 24 h follow-up in the sample exposed to BIOS material. These data confirmed how dentinal derivates present satisfying biocompatibility and high conductivity and inductivity properties fundamental in the regenerative processes. Furthermore, the knowledge of the effects of the dentin’s degree of mineralization on cellular behavior will help clinicians choose the type of dentine derivates material according to the required clinical situation.

Platelet-Rich Fibrin: A Viable Therapy for Endodontic-Periodontal Lesions? A Preliminary Assessment

Background and Objectives: The endodontic system and the periodontium are closely interrelated and the infection of both leads to the appearance of endodontic-periodontal lesions. Along with the endodontic and periodontal classic treatment, in most cases, there is a need for regenerative periodontal therapy for the repair of the damaged tissue. One material that stimulates bone healing is represented by platelet-rich fibrin (PRF). The aim of this study was to determine if the inclusion of PRF in the treatment protocol of endodontic-periodontal lesions is effective. Materials and Methods: This review was conducted according to the PRISMA guidelines. Four databases, MEDLINE (through PubMed), Scopus, Web of Science, and Google Scholar, were used in order to find all significant articles on the topic. Relevant keywords were used in different combinations. Results: The inclusion criteria were met by six studies, published between 2014 and 2020 and they were selected for the review. The use of PRF for the regenerative therapy of endodontic-periodontal lesions showed favorable outcomes in all of the studies included, with significant reductions in the probing depths. Conclusion: While platelet-rich fibrin may be beneficial, further research is needed.

Biomaterials for Periodontal and Peri-Implant Regeneration

Periodontal and peri-implant regeneration is the technique that aims to restore the damaged tissue around teeth and implants. They are surrounded by a different apparatus, and according to it, the regenerative procedure can differ for both sites. During the last century, several biomaterials and biological mediators were proposed to achieve a complete restoration of the damaged tissues with less invasiveness and a tailored approach. Based on relevant systematic reviews and articles searched on PubMed, Scopus, and Cochrane databases, data regarding different biomaterials were extracted and summarized. Bone grafts of different origin, membranes for guided tissue regeneration, growth factors, and stem cells are currently the foundation of the routinary clinical practice. Moreover, a tailored approach, according to the patient and specific to the involved tooth or implant, is mandatory to achieve a better result and a reduction in patient morbidity and discomfort. The aim of this review is to summarize clinical findings and future developments regarding grafts, membranes, molecules, and emerging therapies. In conclusion, tissue engineering is constantly evolving; moreover, a tailor-made approach for each patient is essential to obtain a reliable result and the combination of several biomaterials is the elective choice in several conditions.