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Pavani MP, Reddy KRKM, Reddy BH, Biraggari SK, Babu CHC, Chavan V. Evaluation of platelet-rich fibrin and tricalcium phosphate bone graft in bone fill of intrabony defects using cone-beam computed tomography: A randomized clinical trial. J Indian Soc Periodontol 2021; 25:138-143. [PMID: 33888946 PMCID: PMC8041083 DOI: 10.4103/jisp.jisp_621_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 05/29/2020] [Accepted: 07/16/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Platelet-rich fibrin (PRF) is the second-generation platelet concentrate first described by Choukron et al. It incorporates leukocytes, platelets, and growth factors within dense fibrin matrix, can be used in periodontal regeneration alone or in combination with bone grafts. AIM This study assesses bone fill in intrabony defects, following the use of β tricalcium phosphate (TCP) bone graft with and without PRF. MATERIALS AND METHODS Thirty sites with intrabony defects in periodontitis patients were selected, randomly allotted into three groups: Group A open flap debridement (OFD), Group B OFD with β TCP with PRF, and Group C β TCP. Clinical parameters such as plaque index, gingival index, sulcus bleeding index, and PPD recorded at baseline and 6 months. Radiographic parameters include cementoenamel junction (CEJ) to base of defect, CEJ to alveolar crest, depth of defect, and bone fill assessed using the cone-beam computed tomography (CBCT). The comparison between the test group and control group in terms of clinical and radiographical parameters was assessed using the independent sample t-test. RESULTS Significant reduction in probing depth measurements, defect fill observed in both β TCP with PRF and β TCP alone groups compared to OFD. However, intergroup comparison assessed using the independent sample t-test found to be statistically nonsignificant (P < 0.05 is considered significant). CONCLUSION All three treatment strategies resulted in significant reduction in probing depth and bone fill at 6 months. Bone fill achieved in β TCP with PRF was more compared to β TCP alone and OFD at 6 months follow-up. CBCT can be accurately used to assess the morphology of intrabony defect and also in evaluating bone fill.
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Affiliation(s)
| | | | | | - Sunil Kumar Biraggari
- Department of Periodontics, Pulla Reddy Dental College, Kurnool, Andhra Pradesh, India
| | | | - Vinay Chavan
- Department of Periodontics, Meghna Dental College, Nizamabad, Telangana, India
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Benetti F, Bueno CRE, Reis-Prado AHD, Souza MT, Goto J, Camargo JMPD, Duarte MAH, Dezan-Júnior E, Zanotto ED, Cintra LTA. Biocompatibility, Biomineralization, and Maturation of Collagen by RTR®, Bioglass and DM Bone® Materials. Braz Dent J 2020; 31:477-484. [PMID: 33146330 DOI: 10.1590/0103-6440202003660] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/25/2020] [Indexed: 11/21/2022] Open
Abstract
This study evaluated the biocompatibility, biomineralization, and collagen fiber maturation induced by Resorbable Tissue Replacement (RTR®; β-tricalcium phosphate [TCP]), Bioglass (BIOG; bioactive glass), and DM Bone® (DMB; hydroxyapatite and β-TCP) in vivo. Sixty-four polyethylene tubes with or without (control group; CG) materials (n=8/group/period) were randomly implanted in the subcutaneous tissue of 16 male Wistar rats (four per rat), weighting 250 to 280 g. The rats were killed after 7 and 30 days (n=8), and the specimens were removed for analysis of inflammation using hematoxylin-eosin; biomineralization assay using von Kossa (VK) staining and polarized light (PL); and collagen fiber maturation using picrosirius red (PSR). Nonparametric data were statistically analyzed by Kruskal-Wallis and Dunn tests, and parametric data by one-way ANOVA test (p<0.05). At 7 days, all groups induced moderate inflammation (p>0.05). At 30 days, there was mild inflammation in the BIOG and CG, and moderate inflammation in the RTR and DMB groups, with a significant difference between the CG and RTR (p<0.05). The fibrous capsule was thick at 7 days and predominantly thin at 30 days in all groups. All materials exhibited structures that stained positively for VK and PL. Immature collagen fibers were predominant at 7 and 30 days in all groups (p>0.05), although DMB exhibited more mature fibers than BIOG at 30 days (p<0.05). RTR, BIOG, and DMB were biocompatible, inducing inflammation that reduced over time and biomineralization in the subcutaneous tissue of rats. DMB exhibited more mature collagen fibers than BIOG over a longer period.
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Affiliation(s)
- Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, UFMG - Universidade Federal de Minas Gerais, , Belo Horizonte, MG, Brazil.,Department of Endodontics, School of Dentistry, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | | | | | - Marina Trevelin Souza
- Department of Materials Engineering, Vitreous Materials Laboratory (LaMaV) UFSCar - Universidade Federal de São Carlos, SP, Brazil
| | - Juliana Goto
- Department of Endodontics, School of Dentistry, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | | | - Marco Antônio Húngaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, School of Dentistry, USP - Universidade de São Paulo, Bauru, SP, Brazil
| | - Elói Dezan-Júnior
- Department of Endodontics, School of Dentistry, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Edgar Dutra Zanotto
- Department of Materials Engineering, Vitreous Materials Laboratory (LaMaV) UFSCar - Universidade Federal de São Carlos, SP, Brazil
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Qiao J, Duan J, Zhang Y, Chu Y, Sun C. The effect of concentrated growth factors in the treatment of periodontal intrabony defects. Future Sci OA 2016; 2:FS136. [PMID: 28642822 PMCID: PMC5476933 DOI: 10.4155/fsoa-2016-0019] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 05/13/2016] [Indexed: 11/19/2022] Open
Abstract
AIM To investigate the effect of concentrated growth factors (CGFs) in human intrabony defect treatment. METHODS Thirty-one intrabony defects were randomly treated with CGFs + bovine porous bone mineral (BPBM) or BPBM alone. Probing depth, clinical attachment level and hard tissue fill were evaluated at baseline and 1 year post surgery. RESULTS No differences in any of the investigated parameters were observed at baseline. At 1 year post therapy, both groups showed significant improvement in clinical parameters (p < 0.001). CGFs + BPBM was more effective than BPBM alone at decreasing probing depth (4.2 ± 1.3 mm vs 3.0 ± 1.6 mm) and clinical attachment level gain (3.7 ± 1.3 mm vs 2.4 ± 1.1 mm; p ≤ 0.05). A favorable increase of hard tissue fill was noted in CGFs + BPBM group compared with BPBM group (p > 0.05). The contents of growth factors in CGFs were statistically higher than those in platelet poor plasma (p < 0.001). CONCLUSION Addition of CGFs significantly improved clinical effectiveness of BPBM for intrabony defect treatment.
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Affiliation(s)
- Jing Qiao
- Department of Periodontology, Outpatient Center, Peking University School & Hospital of Stomatology, Beijing, China
| | - Jinyu Duan
- Department of Periodontology, Outpatient Center, Peking University School & Hospital of Stomatology, Beijing, China
| | - Yong Zhang
- Department of Periodontology, Outpatient Center, Peking University School & Hospital of Stomatology, Beijing, China
| | - Yi Chu
- Department of Periodontology, Outpatient Center, Peking University School & Hospital of Stomatology, Beijing, China
| | - Changzhou Sun
- Department of Periodontology, Outpatient Center, Peking University School & Hospital of Stomatology, Beijing, China
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Das S, Jhingran R, Bains VK, Madan R, Srivastava R, Rizvi I. Socket preservation by beta-tri-calcium phosphate with collagen compared to platelet-rich fibrin: A clinico-radiographic study. Eur J Dent 2016; 10:264-276. [PMID: 27095909 PMCID: PMC4813448 DOI: 10.4103/1305-7456.178298] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: This study was primarily designed to determine the clinico-radiographic efficacy of platelet-rich fibrin (PRF) and beta-tri-calcium phosphate with collagen (β-TCP-Cl) in preserving extraction sockets. Materials and Methods: For Group I (PRF), residual sockets (n = 15) were filled with autologous PRF obtained from patients' blood; and for Group II (β-TCP-Cl), residual sockets (n = 15) were filled with β-TCP-Cl. For the sockets randomly selected for Group II (β-TCP-Cl), the reshaped Resorbable Tissue Replacement cone was inserted into the socket. Results: Clinically, there was a significantly greater decrease in relative socket depth, but apposition in midcrestal height in Group II (β-TCP-Cl) as compared to Group I (PRF), whereas more decrease in buccolingual width of Group I (PRF) than Group II (β-TCP-Cl) after 6 months. Radiographically, the mean difference in socket height, residual ridge, and width (coronal, middle, and apical third of socket) after 6 months was higher in Group I (PRF) as compared to Group II (β-TCP-Cl). The mean density (in Hounsfield Units) at coronal, middle, and apical third of socket was higher in Group I (PRF) as compared to Group II (β-TCP-Cl). There were statistically significant apposition and resorption for Group I (PRF) whereas nonsignificant resorption and significant apposition for Group II (β-TCP-Cl) in buccal and lingual/palatal cortical plate, respectively, at 6 months on computerized tomography scan. Conclusion: The use of either autologous PRF or β-TCP-Cl was effective in socket preservation. Results obtained from PRF were almost similar to β-TCP-Cl; therefore being autologous, nonimmune, cost-effective, easily procurable regenerative biomaterial, PRF proves to be an insight into the future biofuel for regeneration.
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Affiliation(s)
- Swati Das
- Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Rajesh Jhingran
- Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Vivek Kumar Bains
- Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Rohit Madan
- Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Ruchi Srivastava
- Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Iram Rizvi
- Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
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Fernandes G, Wang C, Yuan X, Liu Z, Dziak R, Yang S. Combination of Controlled Release Platelet-Rich Plasma Alginate Beads and Bone Morphogenetic Protein-2 Genetically Modified Mesenchymal Stem Cells for Bone Regeneration. J Periodontol 2016; 87:470-80. [PMID: 26745613 DOI: 10.1902/jop.2016.150487] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Platelet-rich plasma (PRP) consists of platelet-derived growth factor and transforming growth factor-β that increase proliferation of mesenchymal stem cells (MSCs), whereas bone morphogenetic protein-2 (BMP2) promotes osteogenic differentiation of MSCs. However, the high degradation rate of fibrin leads to the dissociation of cytokines even before the process of bone regeneration begins. To the best of the authors' knowledge, this is the first study to examine the combined effect of sustained release of PRP from alginate beads on BMP2-modified MSC osteogenic differentiation in vitro and sustained release of PRP alone on a fracture defect model ex vivo as well as its effect on calvarial suture closure. METHODS After optimizing the alginate concentration for microspheres, the combined osteogenic and mineralization effect of PRP and BMP2 on MSCs was studied. Self-setting alginate hydrogel carrying PRP was tested on a femur defect model ex vivo. The effect of PRP at day 15 on the closure of the embryonic mouse calvaria sutures ex vivo was also studied. RESULTS Increase of PRP concentration promoted proliferation of MSCs, and 2.5% to 10% of PRP gradually increased alkaline phosphatase (ALP) activity in the cells in a dose-dependent manner. Sustained release of PRP and BMP2 demonstrated significantly higher ALP and mineralization activity (P <0.05). Radiographs of alginate hydrogel with PRP-treated bone demonstrated nearly complete healing of the fracture, and histologic sections of the embryonic calvaria revealed that PRP leads to suture fusion. CONCLUSION Sustained release of PRP along with BMP2-modified MSCs can significantly promote bone regeneration.
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Affiliation(s)
- Gabriela Fernandes
- Department of Oral Biology, University at Buffalo, The State University of New York, Buffalo, NY
| | - Changdong Wang
- Department of Oral Biology, University at Buffalo, The State University of New York, Buffalo, NY
| | - Xue Yuan
- Department of Oral Biology, University at Buffalo, The State University of New York, Buffalo, NY
| | - Zunpeng Liu
- Department of Oral Biology, University at Buffalo, The State University of New York, Buffalo, NY
| | - Rosemary Dziak
- Department of Oral Biology, University at Buffalo, The State University of New York, Buffalo, NY
| | - Shuying Yang
- Department of Oral Biology, University at Buffalo, The State University of New York, Buffalo, NY.,Developmental Genomics Group, New York State Center of Excellence in Bioinformatics and Life Sciences, University at Buffalo
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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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