The Combined Effect of Bioactive Glass and Platelet-Rich Fibrin in Treating Human Periodontal Intrabony Defects - A Clinicoradiographic Study

The efficacy of Platelet and Leukocyte Rich Fibrin (L-PRF) in the healing process and bone repair in oral and maxillofacial surgeries: a systematic review

INTRODUCTION

The search to optimize the healing and bone repair processes in oral and maxillofacial surgeries reflects the constant evolution in clinical practice, driven by the demand for increasingly satisfactory results and the need to minimize postoperative complications.

OBJECTIVE

To evaluate the efficacy of Platelet and Leukocyte Rich Fibrin (L-PRF) in the healing and bone repair process in oral and maxillofacial surgeries.

MATERIALS AND METHODS

The systematic review protocol for this study included the definition of the research question, the domain of the study, the databases searched, the search strategy, the inclusion and exclusion criteria, the types of studies to be included, the measures of effect, the methods for screening, data extraction and analysis, and the approach to data synthesis. Systematic literature searches were carried out on Cochrane databases, Web of Science, PubMed, ScienceDirect, Embase and Google Scholar.

RESULTS

The strategic search in the databases identified 1,159 studies. After removing the duplicates with the Rayyan© software, 946 articles remained. Of these, 30 met the inclusion criteria. After careful evaluation based on the inclusion and exclusion criteria, 8 studies were considered highly relevant and included in the systematic review.

CONCLUSION

Platelet and Leukocyte Rich Fibrin (L-PRF) has a positive effect on the healing process and bone repair in oral and maxillofacial surgeries.

Fabrication and Characterization of an Innovative Silver- and Gadolinium-Doped Bioglass for Bone Regeneration

Background Periodontal regeneration aims for the three-dimensional reconstruction of bone defects, and over the years, bone grafts with or without barrier membranes have provided us with promising results. Particulate bone grafts can be classified according to the source of procurement as autografts, allografts, xenografts, and alloplasts. Bioglass, an innovative alloplast that uses silica particles as a matrix incorporated with calcium and phosphorus, has been extensively used as a propitious material for bone regeneration owing to its inherent osteogenic ability and biocompatibility but presents with various disadvantages such as slow degradation rate, low mechanical strength, and fracture resistance. A novel silver (Ag)-gadolinium (Gd)-doped bioglass was fabricated to improve the mechanical properties, biocompatibility, and osteogenic ability when compared with bioglass (control). Materials and methods The Ag- and Gd-doped bioglass network was prepared and assessed for the morphological and structural properties by scanning electron microscopy (SEM) analysis, X-ray diffraction (XRD), and attenuated total reflectance (ATR)-infrared (IR). The cytotoxicity of Gd and Ag-doped bioglass was assessed using the MG63 cell line through the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyl tetrazolium bromide) assay at various concentrations and the absorbance of the solution was measured at 570 nm using a microplate reader. The osteogenic ability of the material was assessed by alkaline phosphatase activity and collagen estimation. Results ATR-IR spectroscopy, SEM, and XRD were used to examine the bioglass network doped with Gd and Ag. ATR-IR exhibited classic silicate bands, whereas SEM indicated particles bigger than 5 μm. XRD analysis revealed the production of Na2Ca2Si3O9, Na2Ca4(PO4)2SiO4, and wollastonite. The excellent crystallinity of Na2Ca2Si3O9 provided the bioglass network with good mechanical characteristics. The Gd-Ag-bioglass did not exhibit any toxicity towards the living cells at increasing concentrations from 12.5 µg to 100 µg. The alkaline phosphatase activity was increased by 10% and the collagen estimation remained consistent with bioglass (control). Conclusion In conclusion, the fabrication of the novel Gd-Ag-doped bioglass shows good cytocompatibility and osteogenic ability and shows great potential to enhance bone regeneration.

Biodegradability of Amniotic Membrane as Potential Scaffold for Periodontal Regeneration

Background In the periodontal regenerative procedure, the membrane used should possess good mechanical stability with suitable resorption time to allow restoration of the lost periodontium. Amniotic membrane (AM) has regenerative potential as a scaffold or barrier membrane due to its various beneficial properties. However, its degradation rate is not clearly reported. Methodology This study aimed to evaluate the resorption capacity of AM and its surface architecture after being subjected to hydrolytic degradation analysis in phosphate buffer solution (PBS). AM was cut into sizes of 10 × 10 mm2 for three replicates. The membranes were weighed before and at different time intervals (days 7, 14, 21, and 28) after immersion in PBS. The degradation rate was determined by the percentage of mean weight loss from the initial weight at different time intervals. The AM surface profile was observed under scanning electron microscopy (SEM) before and after 28 days of immersion. Results The result shows a 92% loss of weight over 28 days with the highest attained in the first seven days (67%), followed by 7%, 17%, and 1% after days 14, 21, and 28, respectively. SEM of the AM surface before the degradation test showed a polygonal shape forming a well-arranged mosaic pattern covered with microvilli. At day 28, the remaining AM appears as porous surface architecture, irregularly arranged fibers, and no microvilli seen. Conclusions This study demonstrated that over four weeks of degradation analysis, AM was not entirely degraded but had lost some of the microstructure. The biodegradability of AM should be further evaluated to elucidate its stability within adequate time parallel with the tissue healing process in periodontal tissue regeneration.

Bioactive Glasses in Periodontal Regeneration: Existing Strategies and Future Prospects-A Literature Review

The present review deals with bioactive glasses (BGs), a class of biomaterials renowned for their osteoinductive and osteoconductive capabilities, and thus widely used in tissue engineering, i.e., for the repair and replacement of damaged or missing bone. In particular, the paper deals with applications in periodontal regeneration, with a special focus on in vitro, in vivo and clinical studies. The study reviewed eligible publications, identified on the basis of inclusion/exclusion criteria, over a ranged time of fifteen years (from 1 January 2006 to 31 March 2021). While there are many papers dealing with in vitro tests, only a few have reported in vivo (in animal) research, or even clinical trials. Regardless, BGs seem to be an adequate choice as grafts in periodontal regeneration.

Non-Incised Papilla Surgical Approach and Leukocyte Platelet-Rich Fibrin in Periodontal Reconstruction of Deep Intrabony Defects: A Case Series

We present the preliminary results of the treatment of teeth with a deep, non-contained periodontal residual defect, vestibular bone dehiscence, and soft tissue recession, by combining an apical non-incised papilla surgical approach (NIPSA) to the defect and leukocyte platelet-rich fibrin (L-PRF) in the vestibular aspect. Four patients (upper left first premolar, upper left central incisor, upper right central incisor and upper right lateral incisor) have been treated. At one year of follow up, all cases showed a considerable reduction in the periodontal pocket depth, a gain in clinical attachment and no bleeding on probing, as well as an improvement in the marginal soft tissue minimizing soft tissue contraction (recession and/or loss of papilla) and improving soft tissue architecture. NIPSA plus L-PRF seem to improve clinical outcomes in deep non-contained intrabony defects associated with soft tissue recession.