Advanced Platelet-rich Fibrin Group Research Articles

Effect of Advanced Platelet-Rich Fibrin and Concentrated Growth Factor on Tissues Around Implants in the Maxillary Anterior Region

ABSTRACT Background and Aim: Tissue repair surrounding implants is essential for the cosmetic maxillary anterior zone to respond favorably to implant therapy. Grafting platelets from an individual’s blood was developed to overcome the esthetic requirements and speed up healing. Advanced platelet-rich fibrin (APRF) and concentrated growth factor (CGF) are used for good healing. Our aim was to evaluate the impact of APRF and CGF on healing of tissues around dental implants in the anterior region of the maxilla. Materials and Methods: A total of 60 patients who underwent dental implant placement procedures were included in this study. They were divided into two categories: category 1 consisted of patients who underwent dental implant placement procedures without APRF and CGF (n = 30) and category 2 consisted of patients who underwent dental implant placement procedures with APRF and CGF (n = 30). Assessment of alveolar bone height and bone density was conducted using CBCT at baseline and second, fourth, and sixth month postoperatively. Results: The alveolar height and alveolar bone density in APRF group and CGF group patients was greater compared to control group patients at all follow-ups. Conclusion: APRF and CGF have a positive effect on the tissues around dental implants, promoting faster and better tissue healing around dental implants.

Biological and Cellular Properties of Advanced Platelet-Rich Fibrin (A-PRF) Compared to Other Platelet Concentrates: Systematic Review and Meta-Analysis.

Platelet concentrates are used for cell induction and stimulation in tissue repair processes. The aim of the present systematic review and meta-analysis was to compare the biological and cellular properties of advanced platelet-rich fibrin (A-PRF) to those of other platelet concentrates. Searches were conducted on the PubMed/Medline, Scopus, Web of Science, Embase and LILACS databases using a search strategy oriented by the guiding question. A total of 589 records were retrieved. Seven articles of in vitro experimental studies were selected for qualitative data analysis and four were selected for meta-analysis. The release of growth factors, distribution of cells in the fibrin membrane, and cell viability, the fibrin network, and fibroblast migration were investigated. In the final analysis, statistically significant differences were found for the A-PRF group with regard to platelet-derived growth factor, transforming growth factor, epidermal growth factor and vascular endothelial growth factor at all assessment times. A difference was found with regard to bone morphogenetic protein only in the later assessment, and no differences among groups were found with regard to platelet-derived growth factor or insulin-like growth factor. The results of this systematic review and meta-analysis suggest that A-PRF has superior cellular properties and better release of growth factors compared to other platelet concentrates.

Advanced platelet-rich fibrin promotes healing of induced corneal ulcer in donkeys (Equus asinus)

Ulcerative keratitis is a common disease in horses which may cause blindness. To prevent secondary bacterial and fungal infections and promote quick re-growth of the epithelial layer, different treatment approaches have been employed. This study aimed to examine the effects of advanced platelet-rich fibrin (A-PRF) gel on the healing process of experimentally induced corneal ulcers in donkeys. Nine healthy adult donkeys were used for the study. The donkeys were divided into two groups: the control group, where no medication was applied to the corneal ulcer, and the A-PRF gel group, where A-PRF gel was applied once a day on specific days after ulcer induction. The healing process was evaluated through various examinations and analyses. The results demonstrated that the A-PRF gel group showed significant improvement in the corneal ulcer area, with epithelial and stromal regeneration. At day 35, about 60% of the A-PRF group showed negative fluorescein uptake. Additionally, fewer complications were observed during the healing process compared to the control group. In conclusion, A-PRF gel is an important and safe therapeutic option for controlling ocular surface infection and promoting corneal healing. We recommend using A-PRF gel as an alternative approach, avoiding eyelid suturing, and minimizing corneal irritation.

Effects of advanced platelet-rich fibrin on deep partial-thickness burn wounds in nude mice

Effects of advanced platelet-rich fibrin on deep partial-thickness burn wounds in nude mice

Extraction and Socket Preservation before Implant Placement Using Freeze-Dried Allograft (FDBA) and Platelet-Rich Fibrin in Smokers: Radiographic and Histological Evaluation

Background: Dental extraction can initiate a sequence of biological events that may lead to an insufficient bone volume, which can compromise implant placement. To minimize bone loss, alveolar ridge preservation procedures were developed. However, smoking has been shown to adversely affect the outcomes of the procedures. Hence, this clinical study aimed to assess the ability of platelet-rich fibrin to maintain ridge volume and its ability to generate vital bone in smokers. Methods: Eighteen current heavy smokers with a total of forty upper molars indicated for extraction and implant placement were randomly allocated to four different groups: an advanced platelet-rich fibrin group (A-PRF) (n = 10), a factor-enriched bone graft matrix covered by A-PRF group (A/S-PRF) (n = 10); a freeze-dried bone allograft covered by a crosslinked collagen membrane group (FDBA/CM) (n = 10), which served as a positive control; and a negative-control resorbable collagen plug group (RCP) (n = 10). Two consecutive high-resolution CBCT images were taken for each augmented socket to evaluate the bone volume, one at baseline and the other after six months, and four different measurements (vertical height, horizontal 1 mm H1, horizontal 3 mm, and horizontal 5 mm) were taken for each image. To evaluate the bone vitality, three bone samples were harvested for each group and were analyzed histologically using H and E staining. The results were analyzed using SPSS version 26.0 through the Wilcoxon sign rank test and Kruskal–Wallis test. Results: In terms of preserving bone volume, A/S-PRF showed no significant reduction in bone after six months, while A-PRF showed a significant loss according to two measurements (vertical and horizontal 5 mm), and the last two groups showed a significant loss in all four measurements. For vital bone formation, three groups (A-PRF, A/S-PRF, and RCP) showed the generation of only vital bone, while the fourth group (FDBA/CM) showed the generation of a mixture of vital and non-vital bone. Conclusions: Based on the outcomes of this study, PRF was able to minimize bone loss following dental extraction and generate vital bone in smokers.

Comparative Evaluation of the Effect of Two Platelet Concentrates (a-PRF and L-PRF) on the Cellular Activity of Pre-osteoblastic MG-63 Cell Line: An in vitro Study.

Currently, the reconstruction of bone defects with new platelet concentrates is considered a significant challenge in periodontics. This study aimed to evaluate advanced- platelet rich fibrin (A-PRF) and leukocyte- and platelet rich fibrin's (L-PRF) effects on the proliferation and differentiation of MG-63 cells. In this in vitro study, blood samples of five healthy non-smoking volunteers were collected and immediately centrifuged according to the two protocols of Choukroun and Ghanaati, without adding any anticoagulants, to prepare L-PRF and A-PRF. After freezing the clots for one hour, they were crushed and centrifuged once more. After culturing MG-63 cells, the effects of 20%, 10%, 1%, and 0.5% concentrations of A-PRF and L-PRF extracts on cell proliferation and mineralization were evaluated by methyl thiazolyl tetrazolium (MTT) assay and Alizarin Red staining, respectively. Generally, survival and proliferation in the L-PRF group at both time intervals were higher than the A-PRF group and increased with increasing the extract concentration. However, in the A-PRF group, there were no significant differences between the different concentrations, and only the number of cells increased over time. After three days, in the study on mineralization, nodule formation was observed only in the positive control group (osteogenic). In seven days, mineralized nodules were formed in all groups with different concentrations of A-PRF, but not in any of the L-PRF groups. According to the results, L-PRF increased proliferation, and A-PRF exerted a positive effect on the differentiation of MG-63 cells.

The Influence of the Hyaluronic Acid Gel on the Postoperative Sequelae following Surgical Removal of the Impacted Mandibular Third Molar in Comparison with the A-PRF: A Randomized Controlled Trial.

One of the most common procedures in oral surgery is the removal of impacted mandibular third molars, often followed by pain, swelling, alveolitis, and trismus. Purpose. To compare the outcomes of the intrasocket application of 1% hyaluronic acid oral gel (HA) and advanced platelet-rich fibrin (A-PRF) on the expected postoperative complications, pain, swelling, and trismus follow the surgical extraction of the impacted mandibular third molar. Material and Methods. A randomized controlled trial was conducted at the Oral and Maxillofacial Surgery Unit, Dental Teaching Hospital. Healthy patients who required surgical removal of the impacted mandibular third molar were divided randomly into three groups. The extraction site of the group (A) patients remained without the addition of any material, just suturing of the wound with simple interrupted sutures, while in group (B) patients, the extraction site was filled with 1 cc of 1% hyaluronic acid gel (periokin®), and in group C patients, the extraction site was filled with A-PRF. Results. Sixty-six eligible patients participated in this study; both hyaluronic acid gel 1% (periokin®) and advanced platelet-rich fibrin showed a significant reduction in pain, swelling, and trismus on the 1st, third, and seventh postoperative days when compared to the control group, while the comparison between HA and A-PRF showed no significant differences except for the pain on the third postoperative day. There was a significant pain decrease in the A-PRF group than HA group. Conclusion. Intrasocket application of 1% hyaluronic acid gel (periokin®) or advanced platelet-rich fibrin can be an effective primary way to significantly reduce postoperative pain, trismus, and edema compared to the control group following mandibular third molar surgery.

Comparing efficacy of the platelet rich plasma and advanced platelet rich fibrin on tibial bone defect regeneration in dogs

This study aimed to evaluate the efficacy of platelet rich plasma (PRP) and advanced platelet rich fibrin(A-PRF) on regeneration of induced tibial bone defects in dogs. A 7mm circular and 10mm deep tibial defect was made at upper end of the right and left tibiae of 12 adult clinically-proven healthy male mongrel dogs. The animals were randomly divided into three groups: a control group, PRP group and A-PRF group. Regeneration of the tibial defect was evaluated by radiography, computed tomography (CT), and histopathological examination at 6 and 12 weeks postoperatively (PO). At 6 weeks PO, the tibial defect, in the control group, was partially filled with fibrous tissue and appeared radiolucent under radiography. While in PRP group, the defect was shown to be partially filled with newly formed bone and appeared more radiopaque than it did with the control group. As for A-PRF tibial defect, it was completely closed with newly formed bone and appeared more radiopaque than the PRP group did. At 12 weeks PO, the tibial defect was partially filled with newly formed bone and looked more radiopaque in control group and completely closed with newly formed bone and seemed radiopaque in PRP group. Interestingly, the tibial defect of the A-PRF group was completely closed with newly formed bone and couldn’t have been differentiated from the neighboring normal bone tissue. In conclusion, using of PRP and A-PRF improved bone healing. However, using A-PRF is more likely to heal tibial defect in the early weeks of injury than PRP would.

Comparison of physical, mechanical and biological effects of leucocyte-PRF and advanced-PRF on polyacrylamide nanofiber wound dressings: In vitro and in vivo evaluations.

Platelet-rich fibrin (PRF) is extracted from the blood without biochemical interference and, also, with the ability of a long-term release of growth factors that can stimulate tissue repair and regerenation. Here, leucocyte- and platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF) were extracted and utilized for the creation of nanofibers containing polyacrylamide (PAAm), PAAm / L-PRF and PAAm / A-PRP through electrospinning processing technique. The effect of the type of PRF on the physical, mechanical and biological properties of the resultant nanofiberous wound dressings are thoroughly evaluated. The results presented in the current study reveals that the fiber diameter is grealtly reduced through the utilization of L-PRF. In addition, mechanical property is also positively affected by L-PRF and the degradation rate is found to be higher compared to A-PRF group. The L929 cells proliferation and adhesion, angiogenesis potential and wound healing ability was significantly higher in PAAm/A-PRF nanofibers compared to pure PAAm and PAAm/L-PRF nanofibers owed to the release of vascular endothelial growth factor (VEGF) and platelet derived growth factor (PDGF). Overall, the utilization of L-PRF or A-PRF can improve the physical, mechanical and biological behavior of nanofiber making them an ideal candidate for wound dressings, with the emphasis on the skin tissue repair and regeneration applications.

Changes in Migratory Speed Rate of Human Dental Pulp Stromal Cells Cultured in Advanced Platelet-Rich Fibrin.

Migratory speed rate evaluation of human dental pulp stromal cells (hDP-SCs) is one of the important steps in dental pulp regeneration. Therefore, the aim of the study is to analyze various concentrations of advanced platelet-rich fibrin (A-PRF) culture media toward hDP-SCs' migratory speed rate evaluations. The hDP-SCs were divided into four groups: control: hDP-SCs in Dulbecco's modified Eagle medium + 10% fetal bovine serum group; hDP-SCs in 1% A-PRF group; hDP-SCs in 5% A-PRF group; and hDP-SCs in 10% A-PRF group, which were planted in 24-well (5 × 104 cell/well). The migratory speed rate of all groups was measured by using cell migration assay (scratch wound assay) after 24 hours. Cell characteristics were evaluated under microscope (Inverted microscope, Zeiss, Observer Z1, UK) that can be read through image-J interpretation. This image J represented the measurement of migratory speed rate (nm/h) data. Statistical analysis was conducted using one-way analysis of variance and post hoc Tamhane's test (p < 0.05) (IBM SPSS Statistics Software, version 22.0). There was a statistically significant difference in the migratory speed rates of hDP-SCs among various concentration groups of A-PRF (1, 5, and 10%) compared with the control group. The increase in the migratory speed rate of hDP-SCs was highest in 10% A-PRF group.

Comparative Evaluation of Clinical Efficacy of Leukocyte-Rich Platelet-Rich Fibrin with Advanced Platelet-Rich Fibrin in Management of Gingival Recession Defects: A Randomized Controlled Trial

Background: The aim of this research was to determine and compare the clinical efficacy of leukocyte platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF) in combination with coronally advanced flap (CAF) in the treatment of gingival recession defects. Methods: Systemically healthy subjects presenting with 30 Miller’s class I or II gingival recession defects in maxillary anteriors and premolars, were treated with either CAF + L-PRF or CAF + A-PRF. Clinical parameters such as recession height (RH), width, probing pocket depth, clinical attachment level (CAL), keratinized tissue height (KTH), and width of attached gingiva (WAG) were measured at baseline, 3, and 6 months. Gingival biotype was evaluated at baseline and 6 months post-surgery. Mean root coverage percentage (MRC%) was evaluated at 3 and 6 months. Results: Statistically significant reduction in mean RH was observed from baseline (2.53 ± 0.74 mm, 2.63 ± 0.82 mm) to 6 months (0.87 ± 0.83 mm, 0.53 ± 0.91 mm) in CAF + L-PRF and CAF + A-PRF groups, respectively. The MRC% achieved at 6 months was 67.20 ± 32.81 in the CAF + L-PRF group and 81.66 ± 28.21 in the CAF + A-PRF group. Statistically significant gain in CAL, WAG, and KTH was observed in both therapeutic groups (p < 0.05). Intergroup analysis revealed no statistically significant differences among study parameters between groups at any time point (p > 0.05). Conclusion: Based on the findings of this study, both L-PRF and A-PRF may be suggested as viable treatment options for the management of gingival recession in maxilla.

Effect of advanced platelet-rich fibrin and concentrated growth factor on tissues around implants in maxillary anterior region.

To assess the effect of advanced platelet-rich fibrin (APRF) and concentrated growth factor (CGF) on tissues around implants in the maxillary anterior region. This was a prospective clinical study. Thirty subjects were divided into three groups with 10 dental implants in each group, i.e., Group 1: Control group, Group 2: Endosseous implant placement with APRF, and Group 3: Endosseous implant placement with CGF. The subjects were assessed at baseline (at the time of prosthesis placement), 2 weeks, 2 months, 6 months, and 1 year for modified sulcular bleeding index, periimplant probing depth, mucosal suppuration, bleeding on probing, crestal bone level as well as implant stability. Oneway Analysis of variance and Post hoc Bonferroni were the statistical tests used. The difference in implant stability at 2 months was significantly (P < 0.05) more among the control and CGF groups compared to APRF group. However; the crestal bone levels, periimplant probing depth, modified sulcular bleeding index, mucosal suppuration, and bleeding on probing were statistically non-significant (P > 0.05). CGF and APRF accelerated osseointegration. Furthermore, they had a positive effect on stabilization values. However, CGF showed better results and with further clinical trials may show a positive effect on implant healing period.

Advanced platelet-rich fibrin (A-PRF) has an impact on the initial healing of gingival regeneration after tooth extraction

ObjectivesPlatelet-rich fibrin (PRF) is widely used in wound healing because it contains several growth factors, including vascular endothelial growth factor (VEGF). In this study, we investigated the effects of advanced PRF (A-PRF) in early-stage gingival regeneration after tooth extraction. MethodsBlood sample was collected from females beagle dogs (age: 12 months) before tooth extraction for A-PRF preparation. All animals were sacrificed by perfusion-fixation on postoperative days 1, 3, and 7. The upper jaws were prepared for hematoxylin and eosin staining and immunostaining (for CD34 and VEGF). The lower jaw samples were prepared for scanning electron microscope observations. Blood flow in the gingiva before and after surgery was measured using laser Doppler flowmetry. ResultsIn the A-PRF group, a large number of microvessels were observed in the gingival tissue on postoperative day 1. The microvessels in the control group were fewer and sparse. Regarding the vascular resin cast, a large number of new blood vessels were observed on postoperative day 1 in the A-PRF group. A stronger CD34-positive signal was obtained around the blood vessels in the A-PRF group than in the control group. Further, a strong VEGF-positive signal was observed in the perivascular tissue in the A-PRF group. Gingival blood flow was significantly higher in the A-PRF group after surgery. ConclusionA-PRF had a positive impact on angiogenesis in the gingiva through the induction of VEGF expression. Thus, A-PRF may be beneficial for gingival tissue regeneration.

Hyaluronic Acid Accelerates VEGF and PDGF Release from Advance Platelet Rich Fibrin in Diabetic Foot Ulcer

BACKGROUND: Hyaluronic acid (HA) is an essential component of extracellular matrix and mediates signaling in wound healing. HA could induce growth factor release from Advanced Platelet Rich Fibrin (A-PRF), including Vascular Endothelial Growth Factor (VEGF) and Platelet-derived Growth Factor (PDGF). However, concentrations of the released-VEGF and PDGF have not been clearly disclosed. Therefore, current study was conducted to measure the release of these growth factors in HA + A-PRF gel of diabetic foot ulcer (DFU) subjects.METHODS: Twenty DFU subjects were included in the study and treated with A-PRF or HA+A-PRF. A-PRF was derived from autologous peripheral blood and processed with low-speed centrifugation. HA was added with a ratio of 1:0.6. A-PRF or HA + A-PRF was applied topically on DFU. Upper tips of A-PRF or HA + A-PRF gels were collected on day 0, 3 and 7 for measurements of VEGF and PDGF concentrations with Enzyme-linked Immune-sorbent Assay (ELISA) methods.RESULTS: On day-3, both VEGF and PDGF concentrations of HA + A-PRF group were significantly higher than the VEGF (p=0.000) and PDGF (p=0.019) concentrations of A-PRF group. The VEGF and PDGF concentrations were continuously and significantly increased on day-7 of HA + A-PRF group, compared to the VEGF (p=0.000) and PDGF (p=0.004) concentrations of A-PRF group.CONCLUSION: Combination HA+A-PRF induces VEGF and PDGF release from A-PRF. A mixture of A-PRF and HA could be more effective than A-PRF alone for treatment of DFU.KEYWORDS: hyaluronic acid, advanced platelet rich fibrin, PRF, growth factor, VEGF, PDGF, diabetic foot ulcer

Randomized Clinical Trial: Comparing In-Vitro Release of Growth Factors from Combination of Hyaluronic Acid and Advanced Platelet Rich Fibrin (A-PRF) Gel

Liquid fibrinogen (Advanced platelet-rich fibrin – A-PRF) is an injectable platelet concentrate rich in platelets, leukocytes, and fibrinogen obtained by blood centrifugation. Hyaluronic acid (HA) had been known to induce growth factor release from PRF. This study aimed to analyze and assess the in-vitro release of different growth factors from the combination of HA + A-PRF at different times. The concentration of platelet-derived growth factor-AB (PDGF-AB) and vascular endothelial growth factor (VEGF) released by liquid fibrinogen were examined with ELISA at three-time points (D-0, D-3, D-14). Twenty DFU subjects were involved in this study and randomized into HA + A-PRF group and A-PRF only group. A-PRF was obtained by peripheral blood centrifugation. HA+ A-PRF was prepared by homogenizing PRF and HA with a ratio of 1:0.6. PDGF-AB and VEGF were quantified in HA + A-PRF and the supernatant serum after freezing it in 80 o C while protein profiles were determined by SDS-PAGE. Fibrin gel VEGF level was found to be significantly higher in HA + A-PRF compared PRF alone (on D-3, p=0.010, and D-7, p= 0.043). The PDGF level was found to be significantly higher in fibrin gel on D-3 (p=0.049) and D-7 (p=0.023). Observation of the fibrin gel’s density revealed that the HA + A-PRF group showed a longer melting time compare with A-PRF group (p =0.002). The combination of HA + PRF results in better induction of growth factor release, denser fibrin gel, and better retention of growth factors compared to PRF alone. Funding: This study was funded by Medical Science Doctoral Programme, Universitas Indonesi Ethical Approval: The study has been approved by The Ethics Committee of the Faculty of Medicine Universitas Indonesia ID 0855/UN2.F1/ETIK/2018.

Minimally invasive treatment of gingival recession by vestibular incision subperiosteal tunnel access technique with collagen membrane and advanced platelet-rich fibrin: A 6-month comparative clinical study.

Aim:The study aimed to assess the minimally invasive Vestibular Incision Subperiosteal Tunnel Access (VISTA) technique for treatment of Millers Class I or Class II buccal gingival recession defects and to compare the effectiveness of a bioresorbable collagen membrane or advanced platelet rich fibrin (A-PRF).Methods and Material:20 sites with Millers Class I or II gingival recession were recruited and allocated into 2 groups with 10 sites each. Group 1: VISTA with A-PRF, Group 2: VISTA with with bioresorbable collagen membrane (Healiguide)®.Standardized Clinical Parameters:Plaque Index (PI), Gingival Index (GI), Clinical attachment level (CAL )Pocket Probing Depth (PPD) Recession Height (RH ) and width of keratinized gingiva (WKG) were measured at baseline 3 months and 6 months.Results:Both groups showed significant improvement in clinical parameters. However reduction in recession height and mean root coverage percentage was greater in A-PRF group after 6 months.Conclusions:VISTA with both A-PRF and Healiguide showed good clinical outcomes but better results were obtained when A-PRF was used.

Micro- and nanoscale characterization of different natural biomaterials for ocular surface regeneration

Objectives: This study aims to characterize the widely used biological derived membranes in clinics in terms of micro-nano scale mechanical and morphological properties. Within this scope, advanced platelet-rich fibrin (A-PRF), leucocyte-and platelet-rich fibrin (L-PRF) and human amniotic membrane were studied in this research study. Methods: Nano-indentation, optical coherence tomography (OCT), scanning electron microscopy (SEM), and in vitro degradation test were performed for material characterization. Results: The nano-indentation test revealed significantly higher modulus of elasticity and hardness values in A-PRF group, while OCT presented significantly higher thickness measurements when compared L-PRF. A loose 3D architecture formation due to the large pores formed by means of large fiber diameter were observed in A-PRF group. Besides, platelets were observed among the large fibers in A-PRF membranes on the contrary of L-PRF membranes. Low fiber diameter and high cellular separation were recorded in L-PRF group due to the high centrifugal force application. Therefore, it was observed that the platelets were located mostly on the surface of the membranes in L-PRF. The loose 3D architecture of A-PRF membranes is thought to release growth factors for a longer period of time, ensuring cellular integrity. On the other hand, degradation test results indicated that amniotic membranes degrade to about 85% in one week, while L-PRF and A-PRF were lost their initial weights approximately 31% and 40%, respectively. Conclusions: This comparative characterization study of three different natural biomaterials used in a wide range of clinical applications, from dentistry to ophthalmology, was thought to guide surgeons on the selection of site-specific material.

Effect of A-PRF Application on Palatal Wound Healing after Free Gingival Graft Harvesting: A Prospective Randomized Study.

Objective The aim of this study was to investigate the healing effect of advanced platelet-rich fibrin (A-PRF) clot membranes in palatal wounds, resulting from free gingival graft (FGG) harvesting, on the reepithelization rate and on the pain experience after surgery. Materials and Methods Twenty-five patients requiring FGG have participated in this prospective cohort study. After FGG harvesting, the test group ( n = 14) received A-PRF clot membranes at the palatal wound and the control group ( n = 11) received a gelatin sponge. Epithelialization rate of the palatal wound, wound healing area, correspondent percentage of reduction, and postsurgical pain experience were assessed at 2, 7, 14, 30, and 90 days. Results A-PRF group had higher palatal wound reduction than the control group, at 7, 14, and 30 days of follow-up. The highest difference between the groups was attained at 30 days (91.5% for A-PRF vs. 59.0% control group). At 14 days, a significant difference in the proportion of patients showing total epithelization was found: 64.3% for A-PRF versus 9.1% for the control group. At 90 days, both groups showed total recovery. The control group experienced higher pain level and discomfort until the 14th day, being notably higher on the second day. Conclusion The results suggest that A-PRF membranes haste the healing process, and promote greater reduction along the recovery period and less painful postoperative period.

Different Regenerative Responses of Two Platelet Concentrates in the Treatment of Human Periodontal Infrabony Defects: A Clinico-Radiographic Study.

Background:Platelet concentrates usage in the treatment of intrabony defects has been improved due to advancement of research. Many generation of platelet concentrates were used, but research regarding advanced platelet-rich fibrin (A-PRF) regarding periodontal treatment is scanty.Aim:The purpose of the study was to evaluate and compare PRF and A-PRF in the treatment of human periodontal infrabony defects (IBDs) both clinically and radiographically.Materials and Methods:Twenty-eight patients having IBDs were divided into Group A (PRF) and Group B (A-PRF). Clinical parameters such as plaque index, gingival index, probing pocket depth (PPD), and clinical attachment level (CAL) were recorded at baseline and 3 and 6 months and radiographic examination at baseline and 6 months were also recorded to evaluate defect fill, resolution, and change in the alveolar crest height. Then, all the data were tabulated in a Microsoft Excel sheet and subjected to statistical analysis. Mean and standard deviations of the clinical and radiographic parameters were calculated, and unpaired t-test was performed to assess intergroup comparison at different time intervals.Results:Intragroup comparison showed statistically significant improvement in PPD and CAL at 3 and 6 months while statistically significant improvement was observed in mean defect fill and resolution in Group B.Conclusion:Individually, both the materials have shown promising results. However, statistically, PRF group (Group A) showed better treatment outcome in terms of bone fill and A-PRF group (Group B) in terms of soft tissue healing.

Effects of leukocyte-platelet-rich fibrin and advanced platelet-rich fibrin on the viability and migration of human gingival fibroblasts.

Background:Platelet products play a fundamental role in the process of healing. The new generation of platelet-rich fibrin (PRF), namely advanced PRF (A-PRF), has different biological and mechanical properties compared to those of leukocyte-PRF (L-PRF). This study aimed to compare the effects of L-PRF and A-PRF on the viability and migration of human gingival fibroblasts (HGFs).Materials and Methods:In this in vitro study, the effects of A-PRF and L-PRF on the viability and migration of HGFs after 24 and 48 h were evaluated using the methyl thiazolyl tetrazolium assay. The viability of the negative control culture medium was considered to be 100%. The mean optical density of the test groups was divided by that of the negative control group and reported as percentage. One-way ANOVA was applied to assess the effects of time and type of PRF on the viability and migration of HGFs. Pairwise comparisons were made using the Tukey's test.Results:At 24 h, cell viability in the L-PRF group was significantly higher than that in the A-PRF group (P < 0.05). However, no significant difference was noted between the two groups at 48 h. At 24 h, L-PRF caused significantly higher cell migration compared to the negative control group, whereas at 48 h, both A-PRF and L-PRF significantly increased cell migration compared to the control group.Conclusion:Within the limitations of this study, L-PRF and A-PRF had significant effects on the viability and migration of HGFs. Further studies on these platelet concentrates are warranted.