1
|
Ntontoulos V, Dabarakis N. The Effect of Denatured Albumin with Concentrated Growth Factors in Minimally Invasive Sinus Piezosurgery: Preliminary Pilot Study Results. Eur J Dent 2024; 18:680-686. [PMID: 37729926 PMCID: PMC11132767 DOI: 10.1055/s-0043-1772250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
A new protocol with albumin-concentrated growth factor (CGF) is investigated through Piezosurgery as a minimally invasive alternative to sinus-floor-augmentation that is associated with high morbidity and high incidence of sinusitis. The clinical sample consists of five patients (three men and two women) with an average age of 53.75 ± 3.59 years and a mean height of 3.7 ± 1.22 mm of residual bone. The Piezo-Alb-CGF protocol consists of a minimally invasive transcrestal approach with or without flap, piezosurgery preparation, applying the Schneiderian membrane's hydrodynamic detachment-elevation, injecting albumin-CGF into the sinus, optional bone grafting and implantation, and evaluation for 2 to 6 months postoperatively. Eight implants were placed without complications. After 4 to 6 months, cone-beam computed tomography and panoramic radiographs showed total osseointegration and the formation of new bone. In addition, a year of clinical follow-up was performed. There was a positive correlation between implant stability quotient values at all protocol stages. The significance level was 5%. Albumin-CGF regenerative protocol promotes new bone formation, reduces postoperative morbidity, and shortens healing time. It also offers a uniform and safe hydraulic membrane lift and bicortical implant fixation, even in cases with a residual bone height below 6 mm.
Collapse
Affiliation(s)
- Vasileios Ntontoulos
- Department of Dentoalveolar Surgery, Surgical Implantology & Roentgenology, Aristotle University of Thessaloniki, Greece
| | - Nikolaos Dabarakis
- Department of Dentoalveolar Surgery, Surgical Implantology & Roentgenology, Aristotle University of Thessaloniki, Greece
| |
Collapse
|
2
|
Miron RJ, Pikos MA, Estrin NE, Kobayashi-Fujioka M, Espinoza AR, Basma H, Zhang Y. Extended platelet-rich fibrin. Periodontol 2000 2024; 94:114-130. [PMID: 37986559 DOI: 10.1111/prd.12537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/30/2023] [Accepted: 10/02/2023] [Indexed: 11/22/2023]
Abstract
Platelet-rich fibrin (PRF) has been characterized as a regenerative biomaterial that is fully resorbed within a typical 2-3 week period. Very recently, however, a novel heating process was shown to extend the working properties of PRP/PRF from a standard 2-3 week period toward a duration of 4-6 months. Numerous clinicians have now utilized this extended-PRF (e-PRF) membrane as a substitute for collagen barrier membranes in various clinical applications, such as guided tissue/bone regeneration. This review article summarizes the scientific work to date on this novel technology, including its current and future applications in periodontology, implant dentistry, orthopedics and facial aesthetics. A systematic review was conducted investigating key terms including "Bio-Heat," "albumin gel," "albumin-PRF," "Alb-PRF," "extended-PRF," "e-PRF," "activated plasma albumin gel," and "APAG" by searching databases such as MEDLINE, EMBASE and PubMed. Findings from preclinical studies demonstrate that following a simple 10-min heating process, the transformation of the liquid plasma albumin layer into a gel-like injectable albumin gel extends the resorption properties to at least 4 months according to ISO standard 10 993 (subcutaneous animal model). Several clinical studies have now demonstrated the use of e-PRF membranes as a replacement for collagen membranes in GTR/GBR procedures, closing lateral windows in sinus grafting procedures, for extraction site management, and as a stable biological membrane during recession coverage procedures. Furthermore, Alb-PRF may also be injected as a regenerative biological filler that lasts extended periods with advantages in joint injections, osteoarthritis and in the field of facial aesthetics. This article highlights the marked improvement in the stability and degradation properties of the novel Alb-PRF/e-PRF technology with its widespread future potential use as a potential replacement for collagen membranes with indications including extraction site management, GBR procedures, lateral sinus window closure, recession coverage among others, and further highlights its use as a biological regenerative filler for joint injections and facial aesthetics. It is hoped that this review will pioneer future opportunities and research development in the field, leading to further progression toward more natural and less costly biomaterials for use in medicine and dentistry.
Collapse
Affiliation(s)
- Richard J Miron
- Advanced PRF Education, Jupiter, Florida, USA
- Department of Periodontology, University of Bern, Bern, Switzerland
| | | | | | - Masako Kobayashi-Fujioka
- Department of Oral and Maxillofacial Surgery, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | | | | | - Yufeng Zhang
- Department of Oral Implantology, University of Wuhan, Wuhan, China
| |
Collapse
|
3
|
de Lima Barbosa R, Rodrigues Santiago Rocha N, Stellet Lourenço E, de Souza Lima VH, Mavropoulos E, Mello-Machado RC, Spiegel C, Mourão CF, Alves GG. The Association of Nanostructured Carbonated Hydroxyapatite with Denatured Albumin and Platelet-Rich Fibrin: Impacts on Growth Factors Release and Osteoblast Behavior. J Funct Biomater 2024; 15:18. [PMID: 38248685 PMCID: PMC10817063 DOI: 10.3390/jfb15010018] [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: 11/17/2023] [Revised: 12/24/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024] Open
Abstract
Platelet-rich Fibrin (PRF), a second-generation blood concentrate, offers a versatile structure for bone regeneration due to its composition of fibrin, growth factors, and cytokines, with adaptations like denatured albumin-enriched with liquid PRF (Alb-PRF), showing potential for enhanced stability and growth factor dynamics. Researchers have also explored the combination of PRF with other biomaterials, aiming to create a three-dimensional framework for enhanced cell recruitment, proliferation, and differentiation in bone repair studies. This study aimed to evaluate a combination of Alb-PRF with nanostructured carbonated hydroxyapatite microspheres (Alb-ncHA-PRF), and how this association affects the release capacity of growth factors and immunomodulatory molecules, and its impact on the behavior of MG63 human osteoblast-like cells. Alb-PRF membranes were prepared and associated with nanocarboapatite (ncHA) microspheres during polymerization. MG63 cells were exposed to eluates of both membranes to assess cell viability, proliferation, mineralization, and alkaline phosphatase (ALP) activity. The ultrastructural analysis has shown that the spheres were shattered, and fragments were incorporated into both the fibrin mesh and the albumin gel of Alb-PRF. Alb-ncHA-PRF presented a reduced release of growth factors and cytokines when compared to Alb-PRF (p < 0.05). Alb-ncHA-PRF was able to stimulate osteoblast proliferation and ALP activity at lower levels than those observed by Alb-PRF and was unable to positively affect in vitro mineralization by MG63 cells. These findings indicate that the addition of ncHA spheres reduces the biological activity of Alb-PRF, impairing its initial effects on osteoblast behavior.
Collapse
Affiliation(s)
- Renata de Lima Barbosa
- Graduate Program in Science and Biotechnology, Fluminense Federal University, Niteroi 24210-201, Brazil
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24033-900, Brazil
| | | | - Emanuelle Stellet Lourenço
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24033-900, Brazil
| | - Victor Hugo de Souza Lima
- Graduate Program in Science and Biotechnology, Fluminense Federal University, Niteroi 24210-201, Brazil
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24033-900, Brazil
| | - Elena Mavropoulos
- Brazilian Center for Physics Research, Rio de Janeiro 22290-180, Brazil
| | | | - Carolina Spiegel
- Department of Cellular and Molecular Biology, Fluminense Federal University, Niteroi 24033-900, Brazil
| | - Carlos Fernando Mourão
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | - Gutemberg Gomes Alves
- Graduate Program in Science and Biotechnology, Fluminense Federal University, Niteroi 24210-201, Brazil
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24033-900, Brazil
| |
Collapse
|
4
|
Mourão CF. RE: Technical considerations in obtaining platelet-rich fibrin for clinical and periodontal research. J Oral Biol Craniofac Res 2024; 14:61-62. [PMID: 38234334 PMCID: PMC10792449 DOI: 10.1016/j.jobcr.2023.12.005] [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: 11/10/2023] [Accepted: 12/15/2023] [Indexed: 01/19/2024] Open
Abstract
Image 1.
Collapse
Affiliation(s)
- Carlos Fernando Mourão
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA
| |
Collapse
|
5
|
Wu Q, Yu S, Wang Y, Zhang X. Effect of thermal manipulation on the biological and mechanical characteristics of horizontal platelet rich fibrin membranes. BMC Oral Health 2023; 23:956. [PMID: 38041031 PMCID: PMC10693106 DOI: 10.1186/s12903-023-03412-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 09/12/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUD Regardless of application scenarios, proper mechanical characteristics and degradation properties are prerequisites for horizontal platelet rich fibrin (H-PRF) to manifest its ability. Among the methods used to modify PRF, thermal manipulation is promising as it is easy to handle without adding extra additives. Yet there is no consensus on optimal temperature treatment. This study aimed to investigate the effects of heating on the biological and mechanical characteristics of H-PRF and explore the optimum heating temperature for H-PRF thermal treatment. METHODS We employed a series of temperature gradients, room temperature, 50℃, 75℃, 90℃, 105℃. The microstructure and the mechanical properties were recorded by Scanning Electron Microscope (SEM) and tensile strength tests respectively. The degradation rate of H-PRF membranes was examined by digestion assay with plasmin and trypsin. The viability of cells within H-PRF membranes and the proliferation of osteoblasts cultured with extracts from different H-PRF groups was evaluated using CCK-8 assays. RESULTS Compared with the nonheated group, overheated manipulation beyond 90℃ can significantly prolong the degradation properties for up to 3 to 4 weeks and enhance the mass stress of H-PRF membranes. A high-temperature treatment of 105℃ accompanied by the cell activity beneath H-PRF reduced more than half, and thus, the biological effect on human osteoblasts (hFOBs) also reduced dramatically. CONCLUSIONS High thermal manipulation can prolong the degradation properties and enhance the mechanical properties of PRF membranes accompanied by the loss of biological effect.
Collapse
Affiliation(s)
- Qian Wu
- Department of Stomatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430079, China
| | - Shimin Yu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Yulan Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Xiaoxin Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China.
| |
Collapse
|
6
|
Nakamura M, Masuki H, Kawabata H, Watanabe T, Watanabe T, Tsujino T, Isobe K, Kitamura Y, Mourão CF, Kawase T. Plasma Gel Made of Platelet-Poor Plasma: In Vitro Verification as a Carrier of Polyphosphate. Biomedicines 2023; 11:2871. [PMID: 38001872 PMCID: PMC10669793 DOI: 10.3390/biomedicines11112871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/11/2023] [Accepted: 10/22/2023] [Indexed: 11/26/2023] Open
Abstract
Plasma gel (PG) is a blood-derived biomaterial that can be prepared by heating or chemical cross-linking without the aid of intrinsic coagulation activity and has gradually been applied in the field of esthetic surgery. To explore the applicability of PG in regenerative therapy or tissue engineering, in this study, we focused on the advantages of the heating method and verified the retention capacity of the resulting PG for polyphosphate (polyP), a polyanion that contributes to hemostasis and bone regeneration. Pooled platelet-poor plasma (PPP) was prepared from four healthy male adult donors, mixed with synthetic polyP, and heated at 75 °C for 10 or 30 min to prepare PG in microtubes. The PG was incubated in PBS at 37 °C, and polyP levels in the extra-matrix PBS were determined by the fluorometric method every 24 h. The microstructure of PG was examined using scanning electron microscopy. In the small PG matrices, almost all of the added polyP (~100%) was released within the initial 24 h. In contrast, in the large PG matrices, approximately 50% of the polyP was released within the initial 24 h and thereafter gradually released over time. Owing to its simple chemical structure, linear polyP cannot be theoretically retained in the gel matrices used in this study. However, these findings suggest that thermally prepared PG matrices can be applied as carriers of polyP in tissue engineering and regenerative medicine.
Collapse
Affiliation(s)
- Masayuki Nakamura
- Tokyo Plastic Dental Society, Tokyo 114-0002, Japan; (M.N.); (H.M.); (H.K.); (T.W.); (T.W.); (T.T.); (K.I.); (Y.K.)
| | - Hideo Masuki
- Tokyo Plastic Dental Society, Tokyo 114-0002, Japan; (M.N.); (H.M.); (H.K.); (T.W.); (T.W.); (T.T.); (K.I.); (Y.K.)
| | - Hideo Kawabata
- Tokyo Plastic Dental Society, Tokyo 114-0002, Japan; (M.N.); (H.M.); (H.K.); (T.W.); (T.W.); (T.T.); (K.I.); (Y.K.)
| | - Taisuke Watanabe
- Tokyo Plastic Dental Society, Tokyo 114-0002, Japan; (M.N.); (H.M.); (H.K.); (T.W.); (T.W.); (T.T.); (K.I.); (Y.K.)
| | - Takao Watanabe
- Tokyo Plastic Dental Society, Tokyo 114-0002, Japan; (M.N.); (H.M.); (H.K.); (T.W.); (T.W.); (T.T.); (K.I.); (Y.K.)
| | - Tetsuhiro Tsujino
- Tokyo Plastic Dental Society, Tokyo 114-0002, Japan; (M.N.); (H.M.); (H.K.); (T.W.); (T.W.); (T.T.); (K.I.); (Y.K.)
| | - Kazushige Isobe
- Tokyo Plastic Dental Society, Tokyo 114-0002, Japan; (M.N.); (H.M.); (H.K.); (T.W.); (T.W.); (T.T.); (K.I.); (Y.K.)
| | - Yutaka Kitamura
- Tokyo Plastic Dental Society, Tokyo 114-0002, Japan; (M.N.); (H.M.); (H.K.); (T.W.); (T.W.); (T.T.); (K.I.); (Y.K.)
| | - Carlos Fernando Mourão
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA 02111, USA;
| | - Tomoyuki Kawase
- Division of Oral Bioengineering, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan
| |
Collapse
|
7
|
Javid K, Mourão CF, Mello-Machado RC, Sartoretto SC, Torres M, Stellet Lourenço E, Leite PEC, Granjeiro JM, Alves GG, Calasans-Maia MD. Clinical and Biochemical Evaluation of the Use of Alb-PRF versus L-PRF in Mandibular Third Molar Extractions: A Split-Mouth Randomized Clinical Trial. J Funct Biomater 2023; 14:505. [PMID: 37888172 PMCID: PMC10607814 DOI: 10.3390/jfb14100505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 09/29/2023] [Accepted: 10/08/2023] [Indexed: 10/28/2023] Open
Abstract
Bone tissue engineering seeks biomaterials that enable cell migration, angiogenesis, matrix deposition, and tissue regeneration. Blood concentrates like platelet-rich fibrin (L-PRF) offer a cost-effective source of cells and growth factors to enhance healing. The present study aimed to evaluate heated serum albumin with liquid PRF (Alb-PRF) and L-PRF clinically and biochemically after placement in dental sockets following mandibular third molar extraction. In a controlled, split-mouth study involving 10 volunteers, 20 extracted molars were treated with either Alb-PRF or L-PRF. Post-extraction, pain, trismus, infection presence, and swelling were measured. The concentrations of different analytes in the surgical sites were also examined. The data were statistically analyzed, with significance defined at p < 0.05 (t-test). No significant difference was noted between the groups for pain and trismus, but Alb-PRF showed a significant reduction in swelling on day seven. The Alb-PRF group showed lower levels of pro-inflammatory cytokines (GM-CSF, IL-1b, IL-6, IFNy, IL-8, IL-15, RANTES, and MIP-1a) after seven days, with only higher expressions of MIP-1b, IL-1b, and MCP-1 found in the L-PRF group. Differences were observed in the release of analytes between L-PRF and Alb-PRF, with Alb-PRF significantly reducing edema after seven days. Alb-PRF reduced edema, while L-PRF increased inflammatory cytokines. When compared to L-PRF, Alb-PRF reduced edema and the release of inflammatory cytokines, suggesting promising effects in socket healing while underscoring the role of growth factors and cytokines in potential applications of blood concentrates.
Collapse
Affiliation(s)
- Kayvon Javid
- Graduate Program in Dentistry, Fluminense Federal University, Niterói 24020-140, Brazil
| | - Carlos Fernando Mourão
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | | | | | - Madelaine Torres
- Graduate Program in Dentistry, Fluminense Federal University, Niterói 24020-140, Brazil
| | | | - Paulo Emilio Correa Leite
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niterói 24033-900, Brazil
| | - José Mauro Granjeiro
- Department of Oral Surgery, Fluminense Federal University, Niterói 24020-140, Brazil
| | - Gutemberg Gomes Alves
- Department of Biotechnology, Fluminense Federal University, Niterói 24033-900, Brazil
| | | |
Collapse
|
8
|
Mourão CF, Lowenstein A, Mello-Machado RC, Ghanaati S, Pinto N, Kawase T, Alves GG, Messora MR. Standardization of Animal Models and Techniques for Platelet-Rich Fibrin Production: A Narrative Review and Guideline. Bioengineering (Basel) 2023; 10:482. [PMID: 37106669 PMCID: PMC10135737 DOI: 10.3390/bioengineering10040482] [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: 03/01/2023] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Experimental research is critical for advancing medical knowledge and enhancing patient outcomes, including in vitro and in vivo preclinical assessments. Platelet-rich fibrin (PRF) is a blood by-product that has garnered attention in the medical and dental fields due to its potential for tissue regeneration and wound healing. Animal models, such as rabbits and rats, have been used to produce PRF and examine its properties and applications. PRF has demonstrated potential in the dental and medical fields for reducing inflammation, promoting tissue repair, and accelerating wound healing. This narrative review aims to compare existing evidence and provide guidelines for PRF animal research, emphasizing the importance of standardizing animal models, following ethical considerations, and maintaining transparency and accountability. The authors highlight the necessity to use the correct relative centrifugal force (RCF), standardize centrifugal calibration, and report detailed information about blood collection and centrifuge parameters for reproducible results. Standardizing animal models and techniques is crucial for narrowing the gap between laboratory research and clinical applications, ultimately enhancing the translation of findings from bench to bedside.
Collapse
Affiliation(s)
- Carlos Fernando Mourão
- Department of Periodontology, Division of Dental Research Administration, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | - Adam Lowenstein
- Department of Periodontology, Division of Dental Research Administration, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | | | - Shahram Ghanaati
- Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, 60596 Frankfurt Am Main, Germany
| | - Nelson Pinto
- Department of Periodontics and Implant Dentistry, University of the Andes, Santiago 12455, Chile
| | - Tomoyuki Kawase
- Division of Oral Bioengineering, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8514, Japan
| | - Gutemberg Gomes Alves
- Clinical Research Unit, Antonio Pedro Hospital, Fluminense Federal University, Niterói 24033-900, Brazil
| | - Michel Reis Messora
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14040-904, Brazil
| |
Collapse
|
9
|
Mourão CF, Lowenstein A, Pinto N, Alves GG, Kawase T, Messora MR. RE: Platelet-Rich Fibrin Progressive Protocol: Third Generation of Blood Concentrates. J Oral Maxillofac Surg 2023; 81:262. [PMID: 36868681 DOI: 10.1016/j.joms.2022.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 10/10/2022] [Indexed: 03/05/2023]
|
10
|
Mourão CF, Lowenstein A. The Use of Alb-PRF as a Drug Delivery System for Malignant Lesion Treatment. REVISTA BRASILEIRA DE CANCEROLOGIA 2023. [DOI: 10.32635/2176-9745.rbc.2023v69n2.3762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Bioengineering is an area of biotechnology that offers tools for different therapeutic strategies, including tissue therapies. For this, cells are associated with growth factors and scaffolds composed of biocompatible biomaterials capable of promoting the regeneration of tissues, such as bones. Autologous biomaterials produced from human peripheral blood have a proven ability to produce/release activating factors for tissue repair, with potential application as a vehicle for carrying substances for local release. The present idea proposes the use of a new blood-derived concentrate, Alb-PRF, an activated plasma albumin gel with the platelet-rich fibrin in the liquid phase (Liquid PRF). Alb-PRF can be able to stabilize the fibrin matrix of the scaffold, acting as a drug delivery system vehicle in malignant lesions.
Collapse
|
11
|
Palaiologou A, Keeling F. Autologous blood products: Usage and preparation protocols. Clin Adv Periodontics 2022; 12:287-293. [PMID: 35906935 DOI: 10.1002/cap.10221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/26/2022] [Indexed: 11/08/2022]
Abstract
FOCUSED CLINICAL QUESTION What are the appropriate preparation protocols for autologous blood products to support their clinical utilization? SUMMARY Autologous blood products provide a unique clinical benefit. Their popularity among the professions is growing. However, as this is a rapidly evolving field, multiple modalities are presented within the literature. Frequently there is no demonstrated superiority to previous iterations. This brief review attempts to offer a concise chronology on their evolution, preparation, and where possible, evidence to support their clinical utilization. CONCLUSIONS The field of autologous blood products is expanding rapidly. These products appear to yield variable clinical benefits in specific indications. However, evidence supporting their universal application is scant, and the superiority of one formulation versus another is yet to be demonstrated.
Collapse
Affiliation(s)
- Archontia Palaiologou
- Department of Periodontics, University of Texas Health San Antonio School of Dentistry, San Antonio, Texas, USA
| | - Francis Keeling
- Department of Periodontics, University of Texas Health San Antonio School of Dentistry, San Antonio, Texas, USA
| |
Collapse
|
12
|
Huang L, Dong Y, Li C, Han S, Cheng B, Yang CS, Cheng B. Effect of platelet concentrate prepared by different methods on the healing of full-thickness skin defects. J Cosmet Dermatol 2022; 21:5910-5921. [PMID: 35778915 DOI: 10.1111/jocd.15204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/10/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Platelet-rich plasma and concentrated growth factors have been widely utilized in tissue regeneration. However, very few studies have focused on comparing the merits of these two materials in skin repair. AIMS We aim to compare the wound healing effects of four platelet concentrates. METHODS Auto-platelet-rich plasma, artificial platelet-rich plasma, concentrated growth factors in a liquid phase, and a gel phase were prepared, and a full-thickness skin defect model of mice was made. The skin defects were treated with normal saline as a control and also the four kinds of platelet concentrates mentioned above, respectively. Wound size was measured and calculated on days 3, 5, 7, and 10, with histological analysis performed. RESULTS All four platelet concentrates accelerated wound healing in mice. Interleukin-1β (IL-1β) and tumor necrosis factor (TNF-α) in concentrated growth factors in a liquid phase, a gel phase, and artificial platelet-rich plasma groups were significantly lower than those in the control group; and vascular endothelial growth factor (VEGF) and CD34 were significantly higher than those in the control group and auto-platelet-rich plasma group. CONCLUSIONS All four platelet concentrates appear to promote wound healing. Compared with auto-platelet-rich plasma, concentrated growth factors in a liquid phase and in a gel phase, and artificial platelet-rich plasma seem to have more substantial effects in promoting angiogenesis, epithelialization, and reducing inflammation, thus promoting a stronger effect on wound healing.
Collapse
Affiliation(s)
- Liwen Huang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yunqing Dong
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Changhui Li
- Guangzhou Nature Beauty Clinic, Guangzhou, China
| | - Sheng Han
- Beijing Showily BeauCare Clinic, Beijing, China
| | - Biao Cheng
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Ching-Sheng Yang
- Department of Dermatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - Biao Cheng
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Burn and Plastic Surgery, General Hospital of Southern Theater Command, PLA, Guangzhou, China
| |
Collapse
|
13
|
Exploration of proper heating protocol for injectable horizontal platelet-rich fibrin gel. Int J Implant Dent 2022; 8:36. [PMID: 36098849 PMCID: PMC9470793 DOI: 10.1186/s40729-022-00436-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/15/2022] [Indexed: 12/05/2022] Open
Abstract
Purpose Platelet-rich fibrin (PRF) has been proposed as promising biomaterials with the advantages of host accumulation of platelets and leukocytes with entrapment of growth factors and fibrin scaffold. However, limitations including fast resorption rate (~ 2 weeks) restricts its clinical application. Recent studies have demonstrated heating treatment can prolong PRF degradation. Current published articles used the method of 75 °C for 10 min to obtain longer degradation, while few studies investigated the most suitable temperature for heating horizontal PRF. Our present study was to discover and confirm the optimum temperature for heat treatment before obtaining H-PRF gels by investigating their structure, mechanical properties, and bioactivity of the H-PRF gels after heating treatment. Methods In the present study, 2-mL upper layer of horizontal PRF was collected and heated at 45 °C, 60 °C, 75 °C, and 90 °C to heat 2-mL upper layer of horizontal PRF for 10 min before mixing with the 2-mL lower layer horizontal PRF. The weight, solidification time and the degradation properties were subsequently recorded. Scanning electron microscopy (SEM) and rheologic tests were carried out to investigate the microstructure and rheologic properties of each H-PRF gel. The biological activity of each H-PRF gel was also evaluated using live/dead staining. Results H-PRF gel prepared at 75 °C for 10 min had the fast solidification period (over a tenfold increase than control) as well as the best resistance to degradation. The number of living cells in H-PRF gel is greater than 90%. SEM showed that H-PRF gel becomes denser as the heating temperature increases, and rheologic tests also revealed that the heat treatment improved the mechanical properties of H-PRF gels when compared to non-heated control group. Future clinical studies are needed to further support the clinical application of H-PRF gels in tissue regeneration procedures. Conclusions Our results demonstrated that the H-PRF gel obtained at 75 °C for 10 min could produce a uniform, moldable gel with a short time for solidification time, great rheologic behavior and, high percent of live cells in PRF gel. A promising use of the commonly utilized PRF gel was achieved facilitating tissue regeneration and preventing degradation.
Collapse
|
14
|
Varghese J, Rajagopal A, Shanmugasundaram S. Role of Biomaterials Used for Periodontal Tissue Regeneration—A Concise Evidence-Based Review. Polymers (Basel) 2022; 14:polym14153038. [PMID: 35956553 PMCID: PMC9370319 DOI: 10.3390/polym14153038] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/04/2022] [Accepted: 07/06/2022] [Indexed: 12/14/2022] Open
Abstract
Periodontal infections are noncommunicable chronic inflammatory diseases of multifactorial origin that can induce destruction of both soft and hard tissues of the periodontium. The standard remedial modalities for periodontal regeneration include nonsurgical followed by surgical therapy with the adjunctive use of various biomaterials to achieve restoration of the lost tissues. Lately, there has been substantial development in the field of biomaterial, which includes the sole or combined use of osseous grafts, barrier membranes, growth factors and autogenic substitutes to achieve tissue and bone regeneration. Of these, bone replacement grafts have been widely explored for their osteogenic potential with varied outcomes. Osseous grafts are derived from either human, bovine or synthetic sources. Though the biologic response from autogenic biomaterials may be better, the use of bone replacement synthetic substitutes could be practical for clinical practice. This comprehensive review focuses initially on bone graft replacement substitutes, namely ceramic-based (calcium phosphate derivatives, bioactive glass) and autologous platelet concentrates, which assist in alveolar bone regeneration. Further literature compilations emphasize the innovations of biomaterials used as bone substitutes, barrier membranes and complex scaffold fabrication techniques that can mimic the histologically vital tissues required for the regeneration of periodontal apparatus.
Collapse
|
15
|
Advances in Modification Methods Based on Biodegradable Membranes in Guided Bone/Tissue Regeneration: A Review. Polymers (Basel) 2022; 14:polym14050871. [PMID: 35267700 PMCID: PMC8912280 DOI: 10.3390/polym14050871] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 02/04/2023] Open
Abstract
Guided tissue/bone regeneration (GTR/GBR) is commonly applied in dentistry to aid in the regeneration of bone/tissue at a defective location, where the assistive material eventually degrades to be substituted with newly produced tissue. Membranes separate the rapidly propagating soft tissue from the slow-growing bone tissue for optimal tissue regeneration results. A broad membrane exposure area, biocompatibility, hardness, ductility, cell occlusion, membrane void ratio, tissue integration, and clinical manageability are essential functional properties of a GTR/GBR membrane, although no single modern membrane conforms to all of the necessary characteristics. This review considers ongoing bone/tissue regeneration engineering research and the GTR/GBR materials described in this review fulfill all of the basic ISO requirements for human use, as determined through risk analysis and rigorous testing. Novel modified materials are in the early stages of development and could be classified as synthetic polymer membranes, biological extraction synthetic polymer membranes, or metal membranes. Cell attachment, proliferation, and subsequent tissue development are influenced by the physical features of GTR/GBR membrane materials, including pore size, porosity, and mechanical strength. According to the latest advances, key attributes of nanofillers introduced into a polymer matrix include suitable surface area, better mechanical capacity, and stability, which enhances cell adhesion, proliferation, and differentiation. Therefore, it is essential to construct a bionic membrane that satisfies the requirements for the mechanical barrier, the degradation rate, osteogenesis, and clinical operability.
Collapse
|
16
|
Gheno E, Alves GG, Ghiretti R, Mello-Machado RC, Signore A, Lourenço ES, Leite PEC, Mourão CFDAB, Sohn DS, Calasans-Maia MD. "Sticky Bone" Preparation Device: A Pilot Study on the Release of Cytokines and Growth Factors. MATERIALS 2022; 15:ma15041474. [PMID: 35208017 PMCID: PMC8879971 DOI: 10.3390/ma15041474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/24/2022] [Accepted: 02/09/2022] [Indexed: 11/25/2022]
Abstract
Sticky bone, a growth factor-enriched bone graft matrix, is a promising autologous material for bone tissue regeneration. However, its production is strongly dependent on manual handling steps. In this sense, a new device was developed to simplify the confection of the sticky bone, named Sticky Bone Preparation Device (SBPD®). The purpose of this pilot study was to investigate the suitability of the SBPD® to prepare biomaterials for bone regeneration with autologous platelet concentrates. The SBPD® allows the blending of particulate samples from synthetic, xenograft, or autogenous bone with autologous platelet concentrates, making it easy to use and avoiding the need of further manipulations for the combination of the materials. The protocol for the preparation of sticky bone samples using the SBPD® is described, and the resulting product is compared with hand-mixed SB preparations regarding in vitro parameters such as cell content and the ability to release growth factors and cytokines relevant to tissue regeneration. The entrapped cell content was estimated, and the ability to release biological mediators was assessed after 7 days of incubation in culture medium. Both preparations increased the leukocyte and platelet concentrations compared to whole-blood samples (p < 0.05), without significant differences between SB and SBPD®. SBPD® samples released several growth factors, including VEGF, FGFb, and PDGF, at concentrations physiologically equivalent to those released by SB preparations. Therefore, the use of SBPD® results in a similar product to the standard protocol, but with more straightforward and shorter preparation times and less manipulation. These preliminary results suggest this device as a suitable alternative for combining bone substitute materials with platelet concentrates for bone tissue regeneration.
Collapse
Affiliation(s)
- Ezio Gheno
- Post-Graduation Program in Dentistry, Fluminense Federal University, Niteroi 24220-140, RJ, Brazil; (E.G.); (R.C.M.-M.); (E.S.L.)
- Surgical Sciences and Integrated Diagnostics Department, University of Genoa, 16132 Genoa, Italy;
| | - Gutemberg Gomes Alves
- Cell and Molecular Biology Department, Institute of Biology, Fluminense Federal University, Niteroi 24220-000, RJ, Brazil;
- Clinical Research Unit of the Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24220-000, RJ, Brazil;
| | - Roberto Ghiretti
- Maxillofacial Surgeon, Private Practitioner, 46047 Porto, Italy;
| | - Rafael Coutinho Mello-Machado
- Post-Graduation Program in Dentistry, Fluminense Federal University, Niteroi 24220-140, RJ, Brazil; (E.G.); (R.C.M.-M.); (E.S.L.)
- Implant Dentistry Department, Universidade Iguaçu, Nova Iguaçu 26260-045, RJ, Brazil
| | - Antonio Signore
- Surgical Sciences and Integrated Diagnostics Department, University of Genoa, 16132 Genoa, Italy;
- Therapeutic Dentistry Department, Institute of Dentistry, I.M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia
| | - Emanuelle Stellet Lourenço
- Post-Graduation Program in Dentistry, Fluminense Federal University, Niteroi 24220-140, RJ, Brazil; (E.G.); (R.C.M.-M.); (E.S.L.)
- Clinical Research Unit of the Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24220-000, RJ, Brazil;
| | - Paulo Emílio Correa Leite
- Post-Graduation Program in Sciences and Biotechnology, Fluminense Federal University, Niteroi 24220-000, RJ, Brazil;
| | | | - Dong-Seok Sohn
- Department of Dentistry and Oral and Maxillofacial Surgery, Catholic University Medical Center of Daegu, Daegu 705-718, Korea;
| | - Mônica Diuana Calasans-Maia
- Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niteroi 24020-140, RJ, Brazil
- Correspondence:
| |
Collapse
|
17
|
Inchingolo F, Hazballa D, Inchingolo AD, Malcangi G, Marinelli G, Mancini A, Maggiore ME, Bordea IR, Scarano A, Farronato M, Tartaglia GM, Lorusso F, Inchingolo AM, Dipalma G. Innovative Concepts and Recent Breakthrough for Engineered Graft and Constructs for Bone Regeneration: A Literature Systematic Review. MATERIALS 2022; 15:ma15031120. [PMID: 35161065 PMCID: PMC8839672 DOI: 10.3390/ma15031120] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 02/06/2023]
Abstract
Background: For decades, regenerative medicine and dentistry have been improved with new therapies and innovative clinical protocols. The aim of the present investigation was to evaluate through a critical review the recent innovations in the field of bone regeneration with a focus on the healing potentials and clinical protocols of bone substitutes combined with engineered constructs, growth factors and photobiomodulation applications. Methods: A Boolean systematic search was conducted by PubMed/Medline, PubMed/Central, Web of Science and Google scholar databases according to the PRISMA guidelines. Results: After the initial screening, a total of 304 papers were considered eligible for the qualitative synthesis. The articles included were categorized according to the main topics: alloplastic bone substitutes, autologous teeth derived substitutes, xenografts, platelet-derived concentrates, laser therapy, microbiota and bone metabolism and mesenchymal cells construct. Conclusions: The effectiveness of the present investigation showed that the use of biocompatible and bio-resorbable bone substitutes are related to the high-predictability of the bone regeneration protocols, while the oral microbiota and systemic health of the patient produce a clinical advantage for the long-term success of the regeneration procedures and implant-supported restorations. The use of growth factors is able to reduce the co-morbidity of the regenerative procedure ameliorating the post-operative healing phase. The LLLT is an adjuvant protocol to improve the soft and hard tissues response for bone regeneration treatment protocols.
Collapse
Affiliation(s)
- Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
- Correspondence: (F.I.); (F.L.); (G.D.); Tel.: +39-3312111104 (F.I.); +39-3282132586 (F.L.); +39-3396989939 (G.D.)
| | - Denisa Hazballa
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
- Kongresi Elbasanit, Rruga: Aqif Pasha, 3001 Elbasan, Albania
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Maria Elena Maggiore
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Marco Farronato
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
- Correspondence: (F.I.); (F.L.); (G.D.); Tel.: +39-3312111104 (F.I.); +39-3282132586 (F.L.); +39-3396989939 (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
- Correspondence: (F.I.); (F.L.); (G.D.); Tel.: +39-3312111104 (F.I.); +39-3282132586 (F.L.); +39-3396989939 (G.D.)
| |
Collapse
|
18
|
Shah R, Gowda TM, Thomas R, Kumar T. Second generation liquid platelet concentrates: A literature review. Curr Pharm Biotechnol 2021; 23:1315-1326. [PMID: 34425742 DOI: 10.2174/1389201022666210823102618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/03/2021] [Accepted: 06/14/2021] [Indexed: 11/22/2022]
Abstract
Liquid or injectable platelet rich fibrin (PRF) is a second-generation platelet concentrate which is completely autologous and free of external additives like bovine thrombin and calcium chloride. Additionally, it is the only one to be obtained in a liquid form among the second generation platelet concentrates. This allows for wide applications such as to maximize injections or mixing with biomaterials such as bone grafts or antibiotics. Since it was first introduced in 2015, several modifications of the original protocol have been proposed which aim at maximizing its biological and mechanical properties. This includes changes in centrifugation speed, time, and so on. The aim of this review is to summarize the various modifications of the injectable/liquid formation of PRF as well as to discuss the potential applications and future research direction.
Collapse
Affiliation(s)
- Rucha Shah
- Department of Periodontology, Bapuji Dental College and Hospital, Davangere. India
| | - Triveni M Gowda
- Department of Periodontology, Bapuji Dental College and Hospital, Davangere. India
| | - Raison Thomas
- Department of Periodontology, Bapuji Dental College and Hospital, Davangere. India
| | - Tarun Kumar
- Department of Periodontology, Bapuji Dental College and Hospital, Davangere. India
| |
Collapse
|
19
|
Pascoal MDANC, Dos Santos NBM, Completo AMG, Fernandes GVDO. Tensile strength assay comparing the resistance between two different autologous platelet concentrates (leucocyte-platelet rich fibrin versus advanced-platelet rich fibrin): a pilot study. Int J Implant Dent 2021; 7:1. [PMID: 33447875 PMCID: PMC7809075 DOI: 10.1186/s40729-020-00284-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/17/2020] [Indexed: 01/31/2023] Open
Abstract
Background Since the leucocyte-platelet rich fibrin (L-PRF) was published in 2001, many studies have been developed, analyzing its properties, and also verifying new possibilities to improve it. Thereby, it emerges the advanced-platelet rich fibrin (A-PRF) with a protocol that optimizes the properties obtained by the L-PRF. Nonetheless, there is a gap in the literature to landmark the evolutive process concerning the mechanical properties in specific the resistance to tensile strength which consequently may influence the time for membrane degradation. Thus, this study had the goal to compare the resistance to the traction of membranes produced with the original L-PRF and A-PRF protocols, being the first to this direct comparison. Findings The harvest of blood from a healthy single person, with no history of anticoagulant usage. We performed the protocols described in the literature, within a total of 13 membranes produced for each protocol (n = 26). Afterward, the membranes were prepared and submitted to a traction test assessing the maximal and the average traction achieved for each membrane. The data were analyzed statistically using the unpaired t test. Regarding average traction, A-PRF obtained a value of 0.0288 N mm−2 and L-PRF 0.0192 N mm−2 (p < 0.05 using unpaired t test). For maximal traction, A-PRF obtained 0.0752 N mm−2 and L-PRF 0.0425 N mm−2 (p < 0.05 using unpaired t test). Conclusion With this study, it was possible to conclude that indeed A-PRF has a significative higher maximal traction score and higher average traction compared to L-PRF, indicating that it had a higher resistance when two opposing forces are applied.
Collapse
Affiliation(s)
| | - Nuno Bernardo Malta Dos Santos
- Periodontics Department, Center for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
| | | | - Gustavo Vicentis de Oliveira Fernandes
- Periodontics Department, Center for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal. .,Implantology and Biomaterials Department, Faculty of Dental Medicine, Universidade Católica Portuguesa, Quinta da Alagoa Ave., 225 - 1 DT, 3500-606, Viseu, Portugal.
| |
Collapse
|
20
|
The Platelet Concentrates Therapy: From the Biased Past to the Anticipated Future. Bioengineering (Basel) 2020; 7:bioengineering7030082. [PMID: 32751638 PMCID: PMC7552713 DOI: 10.3390/bioengineering7030082] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/25/2020] [Accepted: 07/28/2020] [Indexed: 12/23/2022] Open
Abstract
The ultimate goal of research on platelet concentrates (PCs) is to develop a more predictable PC therapy. Because platelet-rich plasma (PRP), a representative PC, was identified as a possible therapeutic agent for bone augmentation in the field of oral surgery, PRP and its derivative, platelet-rich fibrin (PRF), have been increasingly applied in a regenerative medicine. However, a rise in the rate of recurrence (e.g., in tendon and ligament injuries) and adverse (or nonsignificant) clinical outcomes associated with PC therapy have raised fundamental questions regarding the validity of the therapy. Thus, rigorous evidence obtained from large, high-quality randomized controlled trials must be presented to the concerned regulatory authorities of individual countries or regions. For the approval of the regulatory authorities, clinicians and research investigators should understand the real nature of PCs and PC therapy (i.e., adjuvant therapy), standardize protocols of preparation (e.g., choice of centrifuges and tubes) and clinical application (e.g., evaluation of recipient conditions), design bias-minimized randomized clinical trials, and recognize superfluous brand competitions that delay sound progress. In this review, we retrospect the recent past of PC research, reconfirm our ultimate goals, and discuss what will need to be done in future.
Collapse
|
21
|
Gheno E, Mourão CFDAB, Mello-Machado RCD, Stellet Lourenço E, Miron RJ, Catarino KFF, Alves AT, Alves GG, Calasans-Maia MD. In vivo evaluation of the biocompatibility and biodegradation of a new denatured plasma membrane combined with liquid PRF (Alb-PRF). Platelets 2020; 32:542-554. [PMID: 32531175 DOI: 10.1080/09537104.2020.1775188] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Guided bone regeneration (GBR) is a process that involves the regeneration of bone defects through the application of occlusive membranes that mechanically exclude the population of non-osteogenic cells from the surrounding soft tissue. Interestingly, platelet-rich fibrin (PRF) has previously been proposed as an autologous GBR membrane despite its short-term resorption period of 2-3 weeks. Recent clinical observations have demonstrated that, by heating a liquid platelet-poor plasma (PPP) layer and mixing the cell-rich buffy coat zone, the resorption properties of heated albumin gel with liquid-PRF (Alb-PRF) can be significantly improved. The aim of this study was to evaluate the inflammatory reaction, biocompatibility, and extended degradation properties of a new autologous Alb-PRF membrane in comparison to commonly utilized standard PRF after nude mice implantation, according to ISO 10993-6/2016. Two standard preparations of PRF (L-PRF and H-PRF) were compared to novel Alb-PRF following subcutaneous implantation at 7, 14, and 21 days. All groups demonstrated excellent biocompatibility owing to their autologous sources. However, it is worth noting that, while both L-PRF and H-PRF membranes demonstrated significant or complete resorption by 21 days, the Alb-PRF membrane remained volume-stable throughout the duration of the study. This study demonstrates-for the first time, to the best of our knowledge-a marked improvement in the membrane stability of Alb-PRF. This indicates its future potential for use as a biological barrier membrane for GBR procedures with a long-lasting half-life, or as a biological filler material in esthetic medicine applications. Thus, further studies are warranted to explore future clinical applications in various fields of medicine.
Collapse
Affiliation(s)
- Ezio Gheno
- Post-Graduation Program in Dentistry, Fluminense Federal University, Niterói, Brazil.,Di.S.C Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Italy
| | | | | | | | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | | | - Adriana Terezinha Alves
- Department of Oral Pathology, Dentistry School, Fluminense Federal University, Niterói, Brazil
| | - Gutemberg Gomes Alves
- Department of Molecular and Cell Biology, Institute of Biology, Fluminense Federal University, Niterói, Brazil
| | - Mônica D Calasans-Maia
- Oral Surgery Department, Dentistry School, Fluminense Federal University, Niterói, Brazil
| |
Collapse
|
22
|
Fujioka-Kobayashi M, Schaller B, Mourão CFDAB, Zhang Y, Sculean A, Miron RJ. Biological characterization of an injectable platelet-rich fibrin mixture consisting of autologous albumin gel and liquid platelet-rich fibrin (Alb-PRF). Platelets 2020; 32:74-81. [PMID: 31959025 DOI: 10.1080/09537104.2020.1717455] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Platelet-rich fibrin (PRF) has been proposed as an autologous membrane with the advantages of host accumulation of platelets and leukocytes with entrapment of growth factors. However, limitations include its faster resorption properties (~2 weeks). Interestingly, recent studies have demonstrated that by heating a liquid platelet-poor plasma (PPP) layer, the resorption properties of heated albumin (albumin gel) can be extended from 2 weeks to greater than 4 months (e-PRF). The aim of the present study was to characterize the biological properties of this novel regenerative modality. Whole blood collected from peripheral blood in 9-mL plastic tubes was centrifuged at 700 g for 8 minutes. Thereafter, the platelet-poor plasma layer was heated at 75°C for 10 minutes to create denatured albumin (albumin gel). The remaining cells and growth factor found within the buffy coat layer (liquid PRF) were thereafter mixed back together with the cooled albumin gel to form Alb-PRF. Histological analysis, including the distribution of cells within Alb-PRF, was then performed. Seven different growth factor release kinetics from Alb-PRF were characterized up to 10 days, including PDGF-AA, PDGF-AB, PDGF-BB, TGF-β1, VEGF, IGF and EGF. Thereafter, gingival fibroblast cell responses to Alb-PRF were investigated by means of a live/dead assay at 24 hours; migration assay at 24 hours; proliferation assay at 1, 3 and 5 days; real-time PCR for the expression of TGF-β and collagen 1a2 at 3 and 7 days; and collagen 1 immunostaining at 14 days. It was first observed histologically that viable cells were evenly distributed throughout the Alb-PRF formulation. Growth factor release demonstrated a slow and gradual release, particularly for TGF-β1 and PDGF-AA/AB, during the entire 10-day period. Alb-PRF also exhibited statistically significantly higher cell biocompatibility at 24 hours and statistically significantly induced greater fibroblast proliferation at 5 days when compared to those of control TCP. Alb-PRF further induced statistically significantly greater mRNA levels of TGF-β at 3 and 7 days, as well as collagen 1 at 7 days. The present results indicate that Alb-PRF possesses regenerative properties induced by the slow and gradual release of growth factors found in liquid PRF via albumin gel degradation. Future studies are thus warranted to fully characterize the degradation properties of Alb-PRF in vivo and explore future clinical applications in various fields of medicine.
Collapse
Affiliation(s)
- Masako Fujioka-Kobayashi
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern , Bern, Switzerland
| | - Benoit Schaller
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern , Bern, Switzerland
| | | | - Yufeng Zhang
- Department of Oral Implantology, University of Wuhan , Wuhan, China
| | - Anton Sculean
- Department of Periodontology, University of Bern , Bern, Switzerland
| | - Richard J Miron
- Department of Periodontology, University of Bern , Bern, Switzerland
| |
Collapse
|
23
|
Mourão CFDAB, Alves GG. Answer controversies about hemostatic properties of platelet-rich fibrin. Oral Maxillofac Surg 2019; 23:121. [PMID: 30610622 DOI: 10.1007/s10006-018-0739-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 12/13/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Carlos Fernando de Almeida Barros Mourão
- Department of Molecular and Cell Biology, Institute of Biology, Fluminense Federal University, Niterói, RJ, Brazil.
- Department of Oral Surgery, Dentistry School, Fluminense Federal University, Rua Miguel de Frias, 9 - Icaraí, Niterói, RJ, 24220-900, Brazil.
| | - Gutemberg Gomes Alves
- Department of Molecular and Cell Biology, Institute of Biology, Fluminense Federal University, Niterói, RJ, Brazil
| |
Collapse
|