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Sinha A, Jain AK, Rao RD, Sivasailam S, Jain R. Effect of platelet-rich fibrin on periapical healing and resolution of clinical symptoms in patients following periapical surgery: A systematic review and meta-analysis. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2023; 26:366-376. [PMID: 37705554 PMCID: PMC10497090 DOI: 10.4103/jcd.jcd_195_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 09/15/2023]
Abstract
Context Adjuvant use of platelet-rich fibrin (PRF) in many areas of dentistry is well documented. However, its role in periapical surgery remains contested which requires further clarification by a higher level of evidence. Aim The objective of this systematic review was to evaluate the effect of PRF on periapical surgery using meta-analysis. Materials and Methods A comprehensive literature search was conducted in PUBMED, Cochrane Central Register of Controlled Trials, SCIENCE DIRECT, and GOOGLE SCHOLAR for randomized controlled trials (RCT) published until May 2021. Meta-analysis was performed for comparisons of baseline (pretreatment) versus posttreatment values for different measurement parameters (postoperative pain, peri apical healing both qualitatively and quantitatively). The risk of bias in all the included trials was assessed after the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. Results Among the 356 eligible articles found in the initial search, 10 RCTs from 2011 through 2021 were included. Qualitative analysis of all the included studies showed that PRF may play a positive role in bone healing, reduction in periapical lesions, and enhancing quality of life using different imaging modalities. The results of the meta-analysis indicated a significant reduction in postoperative pain when PRF was used (standard mean difference [SMD] = 0.515; 95% confidence interval [CI] = 0.061- 0.969;P = 0.026; I 2 = 0%). However, there was no statistically significant association observed while evaluating peri apical bone healing both qualitatively (odds ratio [OR] = 1.427; 95% CI = 0.309-6.584; P = 0.648) and quantitatively measured by Cone beam computed tomography (SMD = -0.264; 95% CI = -0.974-0.447;P = 0.454) between PRF and control group. Conclusions Considering the notable benefits demonstrated by use of PRF, it may be considered as a valuable adjunct in periapical surgery. However, more high-quality trials are necessary to assess the exact role of PRF.
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Affiliation(s)
- Anandita Sinha
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Ashish K Jain
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Rahul D Rao
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Shreya Sivasailam
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Rishab Jain
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Premixed Calcium Silicate-Based Root Canal Sealer Reinforced with Bioactive Glass Nanoparticles to Improve Biological Properties. Pharmaceutics 2022; 14:pharmaceutics14091903. [PMID: 36145651 PMCID: PMC9506183 DOI: 10.3390/pharmaceutics14091903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/27/2022] [Accepted: 09/04/2022] [Indexed: 11/17/2022] Open
Abstract
Recently, bioactive glass nanoparticles (BGns) have been acknowledged for their ability to promote interactions with the periapical tissue and enhance tissue regeneration by releasing therapeutic ions. However, there have been no studies on calcium silicate sealers with bioactive glass nanoparticle (BGn) additives. In the present study, a premixed calcium silicate root canal sealer reinforced with BGn (pre-mixed-RCS@BGn) was developed and its physicochemical features and biological effects were analyzed. Three specimens were in the trial: 0%, 0.5%, and 1% bioactive glass nanoparticles (BGns) were gradually added to the premixed type of calcium silicate-based sealer (pre-mixed-RCS). To elucidate the surface properties, scanning electron microscopy, X-ray diffraction, and energy-dispersive spectroscopy were used and flowability, setting time, solubility, and radiopacity were analyzed to evaluate the physical properties. Chemical properties were investigated by water contact angle, pH change, and ion release measurements. The antibacterial effects of the bioactive set sealers were tested with Enterococcus faecalis and the viability of human bone marrow-derived mesenchymal stem cells (hMSCs) with this biomaterial was examined. In addition, osteogenic differentiation was highly stimulated, which was confirmed by ALP (Alkaline phosphatase) activity and the ARS (Alizarin red S) staining of hMSCs. The pre-mixed-RCS@BGn satisfied the ISO standards for root canal sealers and maintained antimicrobial activity. Moreover, pre-mixed-RCS@BGn with more BGns turned out to have less cytotoxicity than pre-mixed-RCS without BGns while promoting osteogenic differentiation, mainly due to calcium and silicon ion release. Our results suggest that BGns enhance the biological properties of this calcium silicate-based sealer and that the newly introduced pre-mixed-RCS@BGn has the capability to be applied in dental procedures as a root canal sealer. Further studies focusing more on the biocompatibility of pre-mixed-RCS@BGn should be performed to investigate in vivo systems, including pulp tissue.
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Latifi M, Sani M, Salmannejad M, Kabir-Salmani M, Babakhanzadeh Bavanati H, Talaei-Khozani T. Synergistic impact of platelet rich plasma-heparin sulfate with hydroxyapatite/zirconia on the osteoblast differentiation potential of adipose-derived mesenchymal stem cells. Cell Tissue Bank 2021; 23:669-683. [PMID: 34665403 DOI: 10.1007/s10561-021-09966-0] [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: 06/29/2020] [Accepted: 09/13/2021] [Indexed: 11/24/2022]
Abstract
3D porous hydroxyapatite (HA) has been reinforced by zirconia (ZrO2) coating and impregnation with a combination of platelet rich plasma (PRP) as a source of growth factors (GFs) and Heparin sulfate (HS) to sustain the release of GFs. Adipose mesenchymal stem cells (ADMSCs) were characterized by flow cytometry for CD (cluster of differentiation) 44, CD105, CD106, CD34 and CD144, along with checking the multipotency by differentiation into the adipocytes and osteoblasts. Then, they were cultured on the scaffold treated with and without osteogenic media on days 7, 14 and 21. Electron micrograph and PKH staining show that the ADMSCs have a fusiform phenotype in the absence of osteogenic induction. Cell viability assay shows a higher number of the viable cells on the PRP-containing scaffolds than PRP-free scaffolds on day 7. Colorimetric evaluation, quantitative RT-PCR and immunocytochemistry demonstrate that PRP and HS significantly elevate the alkaline phosphatase enzyme activity and also accelerate the production of both early and mid-osteogenic markers, including collagen I and osteopontin expression with and without osteogenic conditions. The PRP-HS also accelerates the expression of the late osteogenic marker, osteocalcin, in both mRNA and protein level expression with a peak on day 21. In conclusion, supplementation of HA/ZrO2 with PRP/HS has a synergistic impact on the ADMSCs, even in the absence of chemical induction. It seems that HA/ZrO2/PRP/HS scaffold provides a higher osteoconductive microenvironment for stem cell differentiation to osteoblasts.
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Affiliation(s)
- Mona Latifi
- Tissue Engineering Lab, Anatomy Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahsa Sani
- Department of Tissue Engineering, School of Advanced Medical Science and Technologies, Shiraz University of Medical Science, Shiraz, Iran
| | - Mahin Salmannejad
- Tissue Engineering Lab, Anatomy Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Kabir-Salmani
- Department of Stem Cell and Regenerative Medicine, Medical Biotechnology Faculty, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | | | - Tahereh Talaei-Khozani
- Tissue Engineering Lab, Anatomy Department, Shiraz University of Medical Sciences, Shiraz, Iran.
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Gaviño-Orduña JF, Fernández-Guallart I, Caviedes-Bucheli J, Espadas-García M, López-López J. Regenerative endodontic procedure combined with apical surgery of a necrotic permanent incisor with extensive periapical lesion using plasma rich in growth factors (PRGF): A Case report with 6 years post-op evaluation using CBCT. J Clin Exp Dent 2021; 13:e620-e625. [PMID: 34188770 PMCID: PMC8223161 DOI: 10.4317/jced.58113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/23/2021] [Indexed: 01/09/2023] Open
Abstract
Background The aim of this case report is to describe the step-by step and outcomes of a treatment approach which simultaneously combines a Regenerative Endodontic Procedure (REP) and apical surgery using PRGF as treatment of a post-traumatic necrotic permanent central incisor with extensive periapical lesion and undeveloped apex in a 16 years-old patient.
Case description A 16 years-old patient with an extensive periapical lesion in the maxillary central incisor was treated with a combination of REP and periapical surgery in the same visit. A Bi- antibiotic paste (BAP) was used to priorly disinfect the canal, which was posteriorly sealed with MTA placed over a PRGF clot at the same time that the periapical lesion was surgically debrided, removed and grafted, The radiographic and CBCT follow-up results showed a complete healing of the radiolucent lesion, which was replaced with bone-like tissue in two years and well preserved until six years later.
Practical implications A combined approach of a Regenerative Endodontic Procedure and apical surgery using PRGF may be a good treatment modality in cases of extensive periapical lesions in necrotic teeth with open apexes. PRGF has shown to act as an ideal autologous matrix because it is stable, provides growth factors and bioactive molecules, and stimulates collagen production, angiogenesis, and cell differentiation. Key words:Regenerative endodontic procedure, open apex necrotic tooth, periodontal apical lesion, growth factors, apical surgery.
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Affiliation(s)
| | - Inés Fernández-Guallart
- DDs, MsC Dentist. Department of Odonto-Stomatology, School of Dentistry, University of Barcelona
| | - Javier Caviedes-Bucheli
- DDs, MsC Centro de Investigaciones Odontologicas (CIO) Pontificia Universidad Javeriana Bogota Colombia
| | - Manuel Espadas-García
- MD, DDS, Dentist. Department of Odonto-Stomatology, School of Dentistry, University of Barcelona
| | - José López-López
- PhD, MD, DDS, Dentist. University of Barcelona. Spain. Professor of Oral Patholoy. School of Dentistry, Barcelona University / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona 08907, Spain
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Liu TJ, Zhou JN, Guo LH. Impact of different regenerative techniques and materials on the healing outcome of endodontic surgery: a systematic review and meta-analysis. Int Endod J 2020; 54:536-555. [PMID: 33159322 DOI: 10.1111/iej.13440] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/02/2020] [Accepted: 11/04/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Regenerative techniques are increasingly applied in endodontic surgery, but different materials used in regenerative techniques may have varying impacts on wound healing. OBJECTIVES This study evaluated the effects of different regenerative techniques and materials on the outcome of endodontic surgery. PARTICIPANTS patients with persistent periapical lesions, treated with root-end surgery. CONTROL endodontic surgery without the use of regenerative techniques/materials. INTERVENTION endodontic surgery with the use of regenerative techniques/materials. OUTCOME combined clinical and radiographic results. METHODS PubMed, Web of Science, Embase, SinoMed and the CENTRAL Cochrane were searched up to 10th July 2020, followed by a manual search. Detailed eligibility criteria were applied. Cochrane's risk-of-bias tool 2.0 was used to assess the risk of bias of the eligible studies. Meta-analysis was conducted using RevMan software. Subgroup analyses were performed based on the regenerative materials used in endodontic surgery. RESULTS Eleven eligible randomized controlled trials (RCTs) were included in the meta-analysis: two had a low risk of overall bias, and nine had some concerns of overall bias. Generally, the use of regenerative techniques significantly improved the outcome of endodontic surgery (risk ratio [RR]: 0.42; 95% confidence interval [CI], 0.26-0.68; P < 0.001). On subgroup analysis, the use of expanded polytetrafluoroethylene (e-PTFE) membranes alone had no added benefits (RR: 2.00; 95% CI, 0.22-18.33; P = 0.54). The application of collagen membranes or autologous platelet concentrates (APCs) alone was associated with a trend for better outcomes (RR: 0.51; 95% CI, 0.20-1.25; P = 0.14) (RR: 0.55; 95% CI, 0.18-1.71; P = 0.30). The combined use of collagen membranes and bovine-derived hydroxyapatite significantly improved the outcome (RR: 0.35; 95% CI, 0.17-0.75; P = 0.007). DISCUSSION This systematic review evaluated the effects of collagen membranes, e-PTFE membranes, APCs and bone grafting materials, providing detailed information about the risks and benefits of using each regenerative technique/material or its combination in endodontic surgery. CONCLUSIONS Regenerative techniques improve periapical lesion healing after endodontic surgery. The combined use of collagen membranes and bovine-derived hydroxyapatite may be beneficial as an adjunct to endodontic surgery. In contrast, the positive efficacy of e-PTFE membranes or APCs alone remains doubtful.
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Affiliation(s)
- T J Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - J N Zhou
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - L H Guo
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
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Gupta S, Verma P, Tikku AP, Chandra A, Yadav RK, Bharti R, Bains R. “Effect of local application of simvastatin in bone regeneration of peri-apical defects-a clinico-radiographic study. J Oral Biol Craniofac Res 2020; 10:583-591. [DOI: 10.1016/j.jobcr.2020.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 11/27/2022] Open
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Impact of Platelet-rich Plasma in the Healing of Through-and-through Periapical Lesions Using 2-dimensional and 3-dimensional Evaluation: A Randomized Controlled Trial. J Endod 2020; 46:1167-1184. [DOI: 10.1016/j.joen.2020.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/28/2020] [Accepted: 06/07/2020] [Indexed: 12/11/2022]
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Sureshbabu NM, Ranganath A, Jacob B. Concentrated Growth Factor - Surgical Management of Large Periapical Lesion Using a Novel Platelet Concentrate in Combination with Bone Graft. Ann Maxillofac Surg 2020; 10:246-250. [PMID: 32855951 PMCID: PMC7433950 DOI: 10.4103/ams.ams_80_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 01/03/2020] [Accepted: 01/10/2020] [Indexed: 11/04/2022] Open
Abstract
Although endodontic therapy is typically successful, in approximately 10%-15% of the cases, symptoms can persist or reoccur. Periapical surgery is the preferred treatment of choice in failed root canal therapy, chronic periapical lesion, persistent apical periodontitis, etc., i.e., when conventional treatment modalities fail. Over the past few decades, although the list of indications for endodontic surgery has diminished, there exist definite cases in which the tooth cannot be retained without surgery. This case report, however, sheds light on the incorporation of a novel autologous platelet concentrate-concentrated growth factor (CGF) coupled with an osseograft in surgical endodontic procedure to ensure a swift and successful recovery of the periapical region subjected to extensive lesions. The use of an osseograft combined with CGF has numerous advantages as well due to the formation of sticky bone. There are no articles published in the literature with respect to the potent application of CGF and bone graft (sticky bone) in large periapical lesions to aid in the reparative process. In this case report, the 1-year follow-up radiographs and cone-beam computed tomography showed complete healing of the hard and soft-tissue lesions that conform to achieving repair and regeneration at a rapid rate in extensive periapical lesions.
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Affiliation(s)
- Nivedhitha Malli Sureshbabu
- Department of Conservative Dentistry and Endodontics, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Aishwarya Ranganath
- Department of Conservative Dentistry and Endodontics, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Benoy Jacob
- Department of Conservative Dentistry and Endodontics, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
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PRP and BMAC for Musculoskeletal Conditions via Biomaterial Carriers. Int J Mol Sci 2019; 20:ijms20215328. [PMID: 31717698 PMCID: PMC6862231 DOI: 10.3390/ijms20215328] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/21/2019] [Accepted: 10/21/2019] [Indexed: 02/06/2023] Open
Abstract
Platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) are orthobiologic therapies considered as an alternative to the current therapies for muscle, bone and cartilage. Different formulations of biomaterials have been used as carriers for PRP and BMAC in order to increase regenerative processes. The most common biomaterials utilized in conjunction with PRP and BMAC clinical trials are organic scaffolds and natural or synthetic polymers. This review will cover the combinatorial strategies of biomaterial carriers with PRP and BMAC for musculoskeletal conditions (MsCs) repair and regeneration in clinical trials. The main objective is to review the therapeutic use of PRP and BMAC as a treatment option for muscle, bone and cartilage injuries.
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Guided Tissue Regeneration in Surgical Endodontic Treatment: Case Report and Literature Review. BALKAN JOURNAL OF DENTAL MEDICINE 2019. [DOI: 10.2478/bjdm-2019-0019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Summary
Background/Aim: Guided tissue regeneration is widely used in endodontic surgery. The aim is to aid in the healing process and bone regeneration and provide more successful and predictable outcomes.
Case report: This case report describes the successful treatment of an endodontic-periodontal lesion (with primary endodontic involvement), including root canal retreatment and endodontic surgery with the use of GTR (collagen absorbable membrane-xenogeneic bone graft). CBCT examination was used to aid in diagnosis and in the follow-up examination after two years to provide additional confirmation of the healing process. An extensive literature review was undertaken focusing on clinical studies that assessing the added benefit of GTR in surgical endodontics. The clinical and radiographic examinations showed uneventful healing and the reconstruction of the buccal plate and periapical area. The patient remained asymptomatic throughout the entire two years period after surgical intervention. A literature review concluded that lesion type, lesion size and the selection of the biomaterial are important factors that influence the outcome of GTR in comparison control groups. A favorable outcome was found in cases of large periapical lesions (>10mm), through-through lesions and with the use of an absorbable membrane, with or without a bone graft.
Conclusions: GTR is thought to provide an added benefit in bone regeneration and the healing process in specific cases. The outcomes in the case report are consistent with the conclusions of literature review.
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Sumida R, Maeda T, Kawahara I, Yusa J, Kato Y. Platelet-rich fibrin increases the osteoprotegerin/receptor activator of nuclear factor-κB ligand ratio in osteoblasts. Exp Ther Med 2019; 18:358-365. [PMID: 31258673 PMCID: PMC6566034 DOI: 10.3892/etm.2019.7560] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/25/2019] [Indexed: 12/13/2022] Open
Abstract
Platelet-rich fibrin (PRF) is a platelet concentrate derived from complete autologous blood rich in growth factors in the fibrin matrix. Although PRF has been used during oral surgery to optimize wound healing in soft and hard tissue, the precise role of PRF in bone healing remains unclear. The present study assessed the role of PRF in bone remodeling. PRF was prepared from whole blood by low speed centrifugation without any anti-coagulants. Culture of MC3T3-E1 cells with PRF induced the expression of osteoprotegerin (OPG), but had no effect on the expression of receptor activator of nuclear factor-κB ligand (RANKL), increasing the OPG/RANKL ratio. Expression of other osteoblastic differentiation makers, including BMP-2 and −4 and RUNX2, was not affected. PRF filling of a hole defect in the mental foramen bone of rats increased OPG positivity and decreased tartrate-resistant acid phosphatase positivity compared with unfilled control. In conclusion, PRF increased the OPG/RANKL ratio by inducing OPG expression, suggesting that PRF enhances early stage osteogenesis by optimizing osteoblastic differentiation. The present study provides a scientific basis for clinical findings showing that PRF can enhance bone regeneration such as sinus lift.
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Affiliation(s)
- Ryuta Sumida
- Department of Oral and Maxillofacial Surgery, Ohu University School of Dentistry, Koriyama, Fukushima 963-8611, Japan
| | - Toyonobu Maeda
- Department of Oral Function and Molecular Biology, Ohu University School of Dentistry, Koriyama, Fukushima 963-8611, Japan
| | - Ichiro Kawahara
- Department of Oral and Maxillofacial Surgery, Ohu University School of Dentistry, Koriyama, Fukushima 963-8611, Japan
| | - Junko Yusa
- Department of Oral Medical Sciences, Ohu University School of Dentistry, Koriyama, Fukushima 963-8611, Japan
| | - Yasumasa Kato
- Department of Oral Function and Molecular Biology, Ohu University School of Dentistry, Koriyama, Fukushima 963-8611, Japan
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Shahsavari-Pour S, Aliabadi E, Latifi M, Zareifard N, Namavar MR, Talaei-Khozani T. Evaluation of the Possible Synergic Regenerative Effects of Platelet-Rich Plasma and Hydroxyapatite/Zirconia in the Rabbit Mandible Defect Model. IRANIAN JOURNAL OF MEDICAL SCIENCES 2018; 43:633-644. [PMID: 30510340 PMCID: PMC6230930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Platelet-rich plasma (PRP) and bioceramics such as hydroxyapatite (HA) and zirconium oxide (ZrO2) are used to reconstruct mandibular defects. We sought to determine the synergistic effects of HA/ZrO2 and PRP and compare their osteogenic activity. METHODS ZrO2 scaffolds were constructed by the slurry method and were then coated with HA and impregnated by PRP/heparan sulfate (HS). Bilateral mandibular defects were created in 26 male rabbits. In 20 rabbits, the left defects were treated with HA/ZrO2/PRP (Group 1) and the corresponding right defects were filled with HA/ZrO2 (Group 2). The 6 remaining models were treated with PRP gels at both sides (Group 3). The osteoconductivity of HA/ZrO2/PRP was compared with that of HA/ZrO2 or PRP by radiological and histological methods after the follow-up period, at weeks 2, 6 and 8. The statistical analyses were performed by ANOVA and LSD using SPSS, version 16.0, for Windows (P<0.05). RESULTS After 2 weeks, the percentage of the surface occupied by bone was significantly higher in the HA/ZrO2/PRP-treated defects than in the PRP-treated defects (P=0.007). Osteoblast and osteocyte counts were higher significantly in the PRP-treated group (P=0.032); however, the cells had not started matrix formation on a large scale and just small islands of osteoid with trapped osteocytes were observed. In the long term, the regenerative potential of all the scaffolds was the same. CONCLUSION HA/ZrO2 showed a superior osteoconductive capacity over PRP in the short term; however, they showed no long-term synergic effects.
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Affiliation(s)
- Sheila Shahsavari-Pour
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz Iran
| | - Ehsan Aliabadi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz Iran
| | - Mona Latifi
- Department of Tissue Engineering, National Institute of Genetic Engineering and Biotechnology, Iran
| | - Nehle Zareifard
- Stem Cell Lab, Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Namavar
- Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Talaei-Khozani
- Tissue Engineering Lab, Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Latifi M, Talaei-Khozani T, Mehraban-Jahromi H, Sani M, Sadeghi-Atabadi M, Fazel-Anvari A, Kabir-Salmani M. Fabrication of platelet-rich plasma heparin sulfate/hydroxyapatite/zirconia scaffold. BIOINSPIRED BIOMIMETIC AND NANOBIOMATERIALS 2018. [DOI: 10.1680/jbibn.17.00038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Mona Latifi
- Department of Stem Cell and Regenerative Medicine, Medical Biotechnology Faculty, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran; Tissue Engineering Lab, Anatomy Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Talaei-Khozani
- Tissue Engineering Lab, Anatomy Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Mehraban-Jahromi
- Department of Metallurgy and Material Sciences, School of Engineering, Shiraz University, Shiraz, Iran
| | - Mahsa Sani
- Tissue Engineering Lab, Anatomy Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmood Sadeghi-Atabadi
- Department of Reproductive Biology, School of Advanced Medical Science and Technologies, Shiraz University of Medical Science, Shiraz, Iran
| | - Abbas Fazel-Anvari
- Department of Biomedical Engineering, Materials and Biomaterials Research Center, Tehran, Iran
| | - Maryam Kabir-Salmani
- Department of Stem Cell and Regenerative Medicine, Medical Biotechnology Faculty, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
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Rodella LF, Bonazza V. Platelet preparations in dentistry: How? Why? Where? When? World J Stomatol 2015; 4:39-55. [DOI: 10.5321/wjs.v4.i2.39] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 04/08/2015] [Accepted: 04/30/2015] [Indexed: 02/06/2023] Open
Abstract
The aim of this article is to review the outcomes of platelet preparations in dentistry. A structured electronic search discovered 348 articles, which described the use of autologous platelet concentrates with a relevance to clinical dentistry. Among these articles, 220 articles investigated platelet rich plasma, 99 investigated platelet rich fibrin, 22 investigated plasma rich in growth factors and 7 investigated the use of concentrated growth factors. Several studies reported beneficial treament outcomes in terms of enhanced bone and soft tissue regeneration.
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Budamakuntla L, Suryanarayan S, Sarvajnamurthy SS, Hurkudli SD. Autologous platelet rich plasma in pyoderma gangrenosum - two case reports. Indian J Dermatol 2015; 60:204-5. [PMID: 25814720 PMCID: PMC4372924 DOI: 10.4103/0019-5154.152539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Leelavathy Budamakuntla
- Department of Dermatology, Sexually Transmitted Disease and Leprosy, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India. E-mail:
| | - Shwetha Suryanarayan
- Department of Dermatology, Sexually Transmitted Disease and Leprosy, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India. E-mail:
| | - Sacchidanand S Sarvajnamurthy
- Department of Dermatology, Sexually Transmitted Disease and Leprosy, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India. E-mail:
| | - Suresh Deepak Hurkudli
- Department of Dermatology, Sexually Transmitted Disease and Leprosy, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India. E-mail:
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Outcome of nonsurgical retreatment and endodontic microsurgery: a meta-analysis. Clin Oral Investig 2015; 19:569-82. [DOI: 10.1007/s00784-015-1398-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 01/02/2015] [Indexed: 01/23/2023]
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E. D, Kumar A, Tewari RK, Mishra SK, Iftekhar H. Management of large preiapical lesion with the combination of second generation platelet extract and hydroxyapatite bone graft: a report of three cases. J Clin Diagn Res 2015; 9:ZD24-7. [PMID: 25738094 PMCID: PMC4347185 DOI: 10.7860/jcdr/2015/10885.5482] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 11/05/2014] [Indexed: 12/30/2022]
Abstract
The pulp tissue necrosis and extensive periodontal diseases leads to the development of the inflammatory periapical lesion which causes a local response of bone around the apex of the tooth. Depends upon the nature of wound and available biological growth factors the outcome will be either regeneration or repair. Being a rich source of growth factors, platelet rich fibrin (PRF) posses many advantages in bone regeneration. The purpose of this case report is to present an attempt to evaluate the healing potential of the combination of PRF and Hydroxyapatite bone graft as opposed to using these materials alone. A periapical endodontic surgery was performed on three patients with a large periapical inflammatory lesion and a large bony defect. The defect was then filled with a combination of PRF and Hydroxyapatite bone graft crystals. Clinical examination exhibited uneventful wound healing. The HA crystals have been replaced by new bone radiographically at the end of two years in Case 1 and Case 2, Case 3 were followed upto one year. On the basis of our cases outcome, we conclude the use of PRF in combination with HA crystals might have accelerate the bone regeneration.
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Affiliation(s)
- Deenadayalan E.
- Resident, Department of Conservative Dentistry and Endodontics, Aligarh Muslim University, Aligarh, India
| | - Ashok Kumar
- Professor, Department of Conservative Dentistry and Endodontics, Aligarh Muslim University, Aligarh, India
| | - Rajendra Kumar Tewari
- Professor and Principal, Department of Conservative Dentistry and Endodontics, Aligarh Muslim University, Aligarh, India
| | - Surendra Kumar Mishra
- Professor and Chairman, Department of Conservative Dentistry and Endodontics, Aligarh Muslim University, Aligarh, India
| | - Huma Iftekhar
- Assistant Professor, Department of Conservative Dentistry and Endodontics, Aligarh Muslim University, Aligarh, India
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18
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Affiliation(s)
- M S Makarov
- N.V. Sklifosovskiy Research Institute for Emergency Care, Moscow Department of Health Care, Moscow, Russia
| | - I N Ponomarev
- N.V. Sklifosovskiy Research Institute for Emergency Care, Moscow Department of Health Care, Moscow, Russia
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Roffi A, Filardo G, Kon E, Marcacci M. Does PRP enhance bone integration with grafts, graft substitutes, or implants? A systematic review. BMC Musculoskelet Disord 2013; 14:330. [PMID: 24261343 PMCID: PMC3870962 DOI: 10.1186/1471-2474-14-330] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 11/04/2013] [Indexed: 01/07/2023] Open
Abstract
Background Several bone implants are applied in clinical practice, but none meets the requirements of an ideal implant. Platelet-rich plasma (PRP) is an easy and inexpensive way to obtain growth factors in physiologic proportions that might favour the regenerative process. The aim of this review is to analyse clinical studies in order to investigate the role of PRP in favouring bone integration of graft, graft substitutes, or implants, and to identify the materials for which the additional use of PRP might be associated with superior osseo- and soft tissues integration. Methods A search on PubMed database was performed considering the literature from 2000 to 2012, using the following string: ("Bone Substitutes"[Mesh] OR "Bone Transplantation"[Mesh] OR "Bone Regeneration"[Mesh] OR "Osseointegration"[Mesh]) AND ("Blood Platelets"[Mesh] OR "Platelet-Rich Plasma"[Mesh]). After abstracts screening, the full-texts of selected papers were analyzed and the papers found from the reference lists were also considered. The search focused on clinical applications documented in studies in the English language: levels of evidence included in the literature analysis were I, II and III. Results Literature analysis showed 83 papers that fulfilled the inclusion criteria: 26 randomized controlled trials (RCT), 14 comparative studies, 29 case series, and 14 case reports. Several implant materials were identified: 24 papers on autologous bone, 6 on freeze-dried bone allograft (FDBA), 16 on bovine porous bone mineral (BPBM), 9 on β-tricalcium phosphate (β-TCP), 4 on hydroxyapatite (HA), 2 on titanium (Ti), 1 on natural coral, 1 on collagen sponge, 1 on medical-grade calcium sulphate hemihydrate (MGCSH), 1 on bioactive glass (BG) and 18 on a combination of biomaterials. Only 4 papers were related to the orthopaedic field, whereas the majority belonged to clinical applications in oral/maxillofacial surgery. Conclusions The systematic research showed a growing interest in this approach for bone implant integration, with an increasing number of studies published over time. However, knowledge on this topic is still preliminary, with the presence mainly of low quality studies. Many aspects still have to be understood, such as the biomaterials that can benefit most from PRP and the best protocol for PRP both for production and application.
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Affiliation(s)
| | | | - Elizaveta Kon
- Nano-Biotechnology Laboratory, Rizzoli Orthopaedic Institute, Via di Barbiano n 1/10, Bologna 40136, Italy.
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Dorozhkin SV. Calcium orthophosphates in dentistry. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2013; 24:1335-1363. [PMID: 23468163 DOI: 10.1007/s10856-013-4898-1] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 02/18/2013] [Indexed: 06/01/2023]
Abstract
Dental caries, also known as tooth decay or a cavity, remains a major public health problem in the most communities even though the prevalence of disease has decreased since the introduction of fluorides for dental care. Therefore, biomaterials to fill dental defects appear to be necessary to fulfill customers' needs regarding the properties and the processing of the products. Bioceramics and glass-ceramics are widely used for these purposes, as dental inlays, onlays, veneers, crowns or bridges. Calcium orthophosphates belong to bioceramics but they have some specific advantages over other types of bioceramics due to a chemical similarity to the inorganic part of both human and mammalian bones and teeth. Therefore, calcium orthophosphates (both alone and as components of various formulations) are used in dentistry as both dental fillers and implantable scaffolds. This review provides brief information on calcium orthophosphates and describes in details current state-of-the-art on their applications in dentistry and dentistry-related fields. Among the recognized dental specialties, calcium orthophosphates are most frequently used in periodontics; however, the majority of the publications on calcium orthophosphates in dentistry are devoted to unspecified "dental" fields.
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