Advanced Platelet-rich Fibrin Research Articles

Surgical Management of Radicular Cyst With the Use of Advanced Platelet-Rich Fibrin and Bone Graft: A Case Report

Surgical Management of Radicular Cyst With the Use of Advanced Platelet-Rich Fibrin and Bone Graft: A Case Report

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.

Horizontal ridge augmentation using guided bone regeneration with an association of particulate allografts mixed with platelet-rich fibrin, collagen membrane and tent-screws: a prospective study.

BackgroundGuided Bone Regeneration (GBR) is a versatile technique employed not only to correct pre-implant alveolar bone defects but also to facilitate bone defect correction during simultaneous implant placement. The effectiveness of GBR varies significantly among different protocols, as reported in the literature. This study specifically aimed to radiologically evaluate the horizontal bone gain obtained using a GBR procedure combining a particulate allograft, platelet-rich fibrin, resorbable collagen membrane, and screw tents. Materials and methodsA total of 42 patients with an insufficient alveolar bone width for dental implant placement were treated with a GBR technique using a mixture of particulate allograft (demineralised freeze-dried bone allograft 300–500 and 500–1000 µm), advanced platelet-rich fibrin (A-PRF), resorbable collagen membranes and screws tents (1.2 mm in diameter). Over the course of the study, a total of 63 GBR procedures were performed on these patients. Bone gains were measured by cone-beam computed tomography at 9.1 ± 2.0 months post-operative. ResultsA significant mean increase (P < 0.001) of 3.2 ± 0.9 mm at the sites of the greatest bone defect was observed. This improvement was consistent across various locations, including both maxillary and mandibular regions, and in cases of terminal and embedded edentulism, without any post-operative complications during the entire post-operative follow-up. All patients benefited from implant placement following the bone augmentation protocol. ConclusionGBR combining particulate allografts, A-PRF, collagen membranes, and screw tents achieves reliable, predictable, and reproducible clinical gains that allow for future implant placement.

Clinical evaluation of advanced platelet rich fibrin combined with nano-crystalline hydroxyapatite bone substitute for management of mandibular molar grade II furcation defects: a randomized controlled clinical trial.

Clinical evaluation of advanced platelet rich fibrin combined with nano-crystalline hydroxyapatite bone substitute for management of mandibular molar grade II furcation defects: a randomized controlled clinical trial.

The in vitro efficacy of advanced platelet-rich fibrin plus versus injectable platelet-rich fibrin on the proliferation, migration, and differentiation of stem cells from apical papilla

Background/purposePlatelet-rich fibrin (PRF) is a promising host-derived scaffold for regenerative endodontic treatment. This study investigated the effects of advanced PRF plus (A-PRF+) and injectable PRF (i-PRF) on the proliferation, migration, and differentiation of stem cells from apical papilla (SCAPs). Materials and methodsA-PRF+ and i-PRF were prepared using a DUO Quattro centrifuge following a standard protocol. A-PRF+ and i-PRF extract were diluted in Dulbecco's modified Eagle's medium and Ham's F-12 medium (DMEM/F12) to produce the experimental culture medium. DMEM/F12 and DMEM/F12 supplemented with 10% foetal bovine serum (FBS) were used as the negative control (NC) and positive control (PC) media, respectively. The proliferative ability of SCAPs was assessed using a counting method (haemocytometer). The migration ability was examined using a scratch-wound assay. Alkaline phosphatase, bone sialoprotein, dentin matrix protein 1, and dentin sialophosphoprotein expression were measured to determine the differentiation ability. ResultsThe proliferation, migration, and differentiation of SCAPs in the A-PRF+ group were similar to those of the PC group. In the i-PRF group, the cell number was significantly (p < 0.01) lower than that of the A-PRF+ group on days 8 and 10; the percentage of the scratched area on days 1 and 2 was significantly higher than in the A-PRF+ group (p < 0.05). The mRNA expression levels of biomarkers in the i-PRF group were similar to those in the A-PRF+ group. ConclusionBoth A-PRF+ and i-PRF induce SCAPs proliferation, migration, and differentiation. However, A-PRF+ was superior in supporting the proliferation and migration of SCAPs.

Effect of Advanced Platelet-Rich Fibrin (A-PRF) on Postoperative Level of Pain and Swelling Following Third Molar Surgery

BackgroundPostoperative pain and swelling following third molar (M3) removal can be debilitating, and there is interest in using advanced platelet-rich fibrin (A-PRF) to reduce their severity. PurposeThis study compared postoperative pain and swelling between A-PRF and gelatin dressing in extraction sockets following mandibular M3 removal. Study design, setting, sampleThis split-mouth, single-blinded, randomized controlled trial was completed at the Oral Surgery clinic of University of Otago between November 2020 and July 2021. Patients aged between 16–40 years, with bilateral impacted mandibular M3 of similar Pederson index difficulty and deemed to be American Society of Anesthesiologists (ASA) I or II comprised the study sample. Predictor/exposure/independent variableThe exposure variable was M3 socket management. One socket received A-PRF and 1 gelatin dressing, while the other received 2 gelatin dressings. Main outcome variable(s)The outcome variables were postoperative pain and swelling over 7 days. Pain was measured using the visual analog scale, and swelling using stereophotogrammetry. CovariatesDemographic characteristics (gender, ethnicity, and age), dental anxiety, smoking status, Pederson index, and intraoperative surgical time were the covariates. AnalysesThe two sides were compared using cross-tabulations and the McNemar test for categorical and paired t-tests for continuous variables. Statistical analysis used IBM SPSS Statistics for Windows (Version 28). Alpha level was at 0.05. Results76 (87.3%) of 87 patients who met the eligibility criteria participated in the study, and 70 (65.7% female; age range 16-30 years) were included in the analysis. Mean VAS scores showed no statistically significant difference between the A-PRF and control sides, being 29.6 (95% CI 23.9, 35.3) and 29.5 (95% CI 23.5, 35.5) on day 2, and falling to 12.6 (95% CI 8.7, 16.5) and 14.2 (95% CI 10.0, 18.4) by day 7. Likewise, mean peak facial swelling on day 2 was recorded as 6.3cm3 (95% CI 4.9, 7.7) and 6.6cm3 (95% CI 5.5, 7.7), and by day 7 they were 1.1cm3 (95% CI 0.5, 1.7) and 1.0cm3 (95% CI 0.3, 0.7) on the A-PRF and control sides, respectively. Conclusions and RelevanceA-PRF placement in M3 sockets did not reduce postoperative pain and swelling over gelatin dressing alone.

Effectiveness of Advanced Platelet-Rich Fibrin on Postoperative Sequelae for Impacted Mandibular Third Molar Surgery: A Prospective Study.

Introduction Impacted third molar extraction is frequently removed surgically by maxillofacial surgeons, which is mostly associated with postoperative sequelae like pain and swelling. It is essential to minimize the complications and enhance wound healing in the extracted socket of the third molar. Hence, this study aimed to assess the efficiency of advanced platelet-rich fibrin (A-PRF) in wound healing and reducing pain after surgical extraction of the impacted mandibular third molar (IMTM). Materials and methods Thirtyhealthy patients who have been diagnosed with Pell and Gregory class II IMTM were included in this study. In the study group, which comprises 15 patients, extraction sockets were filled with A-PRF extract. In the control group, no material was placed in the extraction sockets. The pain was assessed preoperative and on the third and seventh postoperative days using a visual analog scale (VAS). Wound healing was assessed on the third and seventh postoperative days using a modified laundry scale. SPSS for Windows was used for data analysis. Categorical data was compared between the groups using the Chi-square test. P-value less than 0.05 was considered as statistically significant. Results The study population's mean age was 25.67 ± 2.4 years. Nineteen patients were male, and 11 patients were female. Differences in mean pain scores between the groups were not statistically significant both on the third postoperative day (p=0.59)and the seventh postoperative day (p=0.33). During the seventh day postoperative day, the study group exhibited better wound healing compared to the control group and the results were statistically significant (p=0.01). Conclusion A-PRF is a simple and effective method of reducing postoperative sequela by promoting wound healing after surgical extraction of IMTM. Ithas the advantage of less chance of allergic and anaphylactic reactions, unlike their predecessor platelet concentrates.

Comparison Between the Use of Advanced Platelet-Rich Fibrin (A-PRF) and Connective Tissue Graft in the Treatment of Cairo Type 1 Gingival Recession Associated with the Coronally Advanced Flap

Comparison Between the Use of Advanced Platelet-Rich Fibrin (A-PRF) and Connective Tissue Graft in the Treatment of Cairo Type 1 Gingival Recession Associated with the Coronally Advanced Flap

Regeneración de una lesión ósea de gran tamaño con fibrina rica en plaquetas: Reporte de Caso

Introduction: This case report analyzes the regeneration potential of advanced-platelet rich fibrin (A-PRF) in large bony lesions. Advanced-platelet rich fibrin provides various growth factors which aids in faster healing. Materials and Methods: Patient presented with peri-apical radiolucency. CBCT showed bony radiolucency in teeth 31, 32, 41, 42. A full mouth mucoperiosteal flap was raised and a cyst lining was enucleated. Apicoectomy was done with respect to 31, 32, 41, 42 along with and retrograde with a preparation of APRF clots were placed in the bony cavity. Results: Post-op CBCT at 6 months showed a significant difference in size and bone density of the lesion. Conclusions: Advanced-platelet rich fibrin has shown promising results in reducing the size of bony defect and periapical lesion in this case. Keywords: Cysts; Apicoectomy; Endodoncia Regenerativa; Platelet-Rich Fibrin; Regeneration; Cone-Beam Computed Tomography.

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.

Comparative Evaluation of Vestibular Incision Subperiosteal Tunnel Access (VISTA) Technique With and Without Advanced Platelet Rich Fibrin for Treatment of Maxillary Anterior Gingival Recessions.

Gingival recession is an apical shift of the gingival margin with exposure of the root surface to the oral cavity which creates an aesthetic problem. The present study was attempted to compare Vestibular incision subperiosteal tunnel access (VISTA) with and without Advanced platelet rich fibrin(A-PRF) in the treatment of Miller's class I gingival recessions. 24 patients were assigned randomly either to test (VISTA with A-PRF) or control (VISTA alone) group. Clinical parameters like recession depth (RD), recession width (RW), clinical attachment loss (CAL), width of keratinized gingiva (WKG), gingival thickness (GT) and probing depth (PD) were recorded at baseline,3 and 6 months post operatively. Inter group comparison of mean RC in mm, %RC, ΔWKG and CAG revealed no statistically significant difference (p>0.05). Change in GT showed statistically significant improvement in test group. Within the limitations of this study, both treatment options (VISTA with A-PRF and VISTA alone) have resulted in predictable and comparable root coverage with increased gingival thickness in the test group.

Do blood concentrates influence inflammatory signs and symptoms after mandibular third molar surgery? A systematic review and network meta-analysis of randomized clinical trials.

To investigate, through a network meta-analysis, the effectiveness of blood concentrates in reducing pain perception, trismus, and edema after mandibular third molar extraction. An electronic search was performed in nine databases to locate randomized clinical trials comparing blood concentrate use after mandibular third molar extraction. Two authors selected and extracted the data independently. The individual risk of bias in the studies was assessed with the RoB v2.0 tool. A network meta-analysis compared postoperative pain and trismus scores after applying different blood concentrates, using the mean difference (MD) as an effect estimate. The GRADE approach assessed the certainty of evidence. Thirty-one randomized clinical trials were included in the review and 18 in the meta-analysis. Leukocyte- and platelet-rich fibrin (L-PRF) was the most used blood concentrate, followed by platelet-rich plasma (PRP). The network meta-analysis, depending on the analyzed period, evaluated up to 1240 surgeries. Among the analyzed blood concentrates, advanced platelet-rich fibrin (A-PRF) performed better among the analyzed blood concentrates, decreasing postoperative pain in 1, 2, 3, and 7 days and reducing trismus up to the inflammatory peak compared to blood clots. Only two studies had a low risk of bias. Based on very low certainty of evidence, using concentrates seemed efficient compared to blood clots in reducing pain and trismus after mandibular third molar surgeries. A-PRF decreased postoperative pain throughout the evaluated time and trismus during the acute inflammatory peak. A-PRF after mandibular third molar extractions performed better among the analyzed blood concentrates and seemed efficient in improving postoperative quality by decreasing inflammatory signs and symptoms.

The Effects of Injectable Platelet-Rich Fibrin and Advanced-Platelet Rich Fibrin on Gingival Fibroblast Cell Vitality, Proliferation, Differentiation.

Injectable Platelet Rich Fibrin (I-PRF) and Advanced-Platelet Rich Fibrin (A-PRF) are autologous materials derived from patients' blood and employed in periodontal regenerative surgery. Although I-PRF and A-PRF have different characteristics, their biological effects on gingival tissue fibroblasts remain unclear. This research aims to compare the in vitro capacity in inducing gene expression and proliferation of human gingival fibroblasts between A-PRF and I-PRF. Human donors undergoing dental implant surgery were sampled for normal human gingival fibroblasts (NHGFCs), followed by preparing A-PRF and I-PRF membranes. Enzyme-linked immunosorbent assay (ELISA) kit was used to assess the release of platelet-derived growth factor-AA (PDGF-AA), transforming growth factor-beta1 (TGF- β1), and insulin growth factor-1 (IGF-1) at different periods. Cell viability and proliferation of A-PRF and I-PRF were compared using CCK-8 assay. The impacts of platelet concentration on human gingival fibroblast cells (HGFCs) were evaluated by quantifying the level or amount of phosphorylated extracellular signal-regulated protein kinase (p-ERK), and Matrix metalloproteinases (MMPs), MMP-1 and MMP-3. The effects of PRF on aged human gingival fibroblast cells were examined retrospectively. Overall, A-PRF demonstrated a higher release of TGF-B1 and PDGF-AA, while I-PRF reflected higher levels of IGF-1. A significantly higher level of cell proliferation was induced by higher cell proliferation by A-PRF and I-PRF. Additionally, in comparison to I-PRF, the expression of ERK phosphorylation and MMP-1 &MMP-3 in HGFCs was demonstrated by I-PRF and A-PRF. The increase in A-PRF was time-dependent (p < 0.05). Both I-PRF and A-PRF induced a stimulatory biological impact on the proliferation of human gingiva fibroblasts, with the latter demonstrating better capacity in facilitating the release of different growth factors. A-PRF also induced higher gene expression of p-ERK, MMP-1 &MMP-3, and the proliferation of fibroblasts.

The management of gingival fenestration: A series of three cases.

The aim of this article is to introduce three treatments for patients with gingival fenestration as a result of chronic apical periodontitis. Gingival fenestration is a relatively uncommon soft tissue lesion in which the root apex is exposed in the oral environment after the destruction of the overlying buccal bone plate and mucosa. At present, no clear etiology or treatment guidelines exist for gingival fenestration. This article reports three successfully treated cases of gingival fenestration associated with chronic periapical infection. This report can help contribute to treatment guidelines for gingival fenestration. All cases were treated with apicoectomy in conjunction with a connective tissue graft (CTG). According to the different conditions of the patients, we used some slightly different treatment methods during the operation. In case 1, we treated gingival fenestration in the mandibular left first premolar by endodontic therapy with root-end resection and retrograde filling and regenerative surgical therapy using a xenograft and CTG. In case 2, we treated gingival fenestration in the maxillary left lateral incisor by endodontic therapy with root-end resection and retrograde filling in vitro and regenerative surgical therapy using advanced platelet-rich fibrin (A-PRF) and CTG. In case 3, we treated gingival fenestration in the mandibular left second premolar by endodontic therapy with root-end resection and retrograde filling and regenerative surgical therapy using CTG. Endodontic treatment was combined with periodontal surgery to achieve predictable treatment results. After 13 to 25 months of follow-up, all cases showed that the gingival fenestration had healed well, and the patients had no discomfort. These three cases show the possibility of using apical excision combined with a CTG and/or bone graft/PRF in the treatment of gingival fenestration. Reporting these three cases may help advance the field of treatments for gingival fenestration.

Effects of T-PRF and A-PRF on the Osteogenic Biomarkers in Intrabony Defects of Periodontitis Patients

Background: Different derivatives of platelet-rich fibrin (PRF) have been developed but the efficacy of these derivatives in tissue healing and regeneration is still unclear. The aim of this study was to evaluate the effects of titanium-prepared PRF (T-PRF) and advanced PRF (A-PRF) on osteogenic biomarkers in gingival crevicular fluid (GCF) and clinical parameters. Methods: Seventeen systemically healthy participants with 30 bilateral infrabony defects were recruited. Following phase I periodontal therapy, intrabony defects were treated either with A-PRF+open flap debridement (OFD) or T-PRF+OFD. Plaque index (PI), gingival index (GI), pocket depth (PD), clinical attachment loss (CAL) was recorded at the baseline and 6th month after treatment. GCF samples were collected at the baseline and 3rd, 6th months after surgery. Nuclear factor receptor activator (RANK), receptor activator nuclear kappa-B ligand (RANKL), osteoprotegerin (OPG) and tumor necrosis factor alpha converting enzyme (TACE) in GCF samples were analyzed by human enzyme-linked immunosorbent assay (ELISA). Results: In both groups, statistically significant changes were observed in clinical parameters, however, there was no difference between the groups. In terms of osteogenic biomarkers in GCF, there were no statistically significant differences between and within the groups. Conclusion: Different derivatives of PRF can be used to enhance the clinical outcomes of intrabony defects in periodontitis.

Growth Factors Released from Advanced Platelet-Rich Fibrin in the Presence of Calcium-Based Silicate Materials and Their Impact on the Viability and Migration of Stem Cells of Apical Papilla.

Advanced platelet-rich fibrin (A-PRF) provides the scaffold and growth factors necessary for stem cells to proliferate and differentiate in successful regenerative endodontic procedures. This study investigates the release of transforming growth factor-β1 (TGF-β1), platelet-derived growth factor (PDGF), and vascular endothelial growth factor (VEGF) from A-PRF in cell culture media in the presence and absence of mineral trioxide aggregate (MTA) or Biodentine. Additionally, this research assesses the viability and migration of stem cells of the apical papilla (SCAP) in previously conditioned media. A-PRF obtained from 14 participants were incubated for 7 days in cell culture media alone or via layering with MTA or Biodentine discs and the release of selected growth factors in the media was evaluated using ELISA. The viability of SCAP grown in conditioned media was measured using the CCK8 assay, while SCAP migration was assessed via a transwell assay by counting migrated cells. The release of TGF-β1, PDGF, and VEGF was significantly higher in media with A-PRF alone than in the presence of either calcium-based silicate material (p < 0.05), which showed no difference from the no-A-PRF control (p < 0.05). None of the tested growth factors released in the A-PRF-conditioned media correlated with clot weight. A-PRF-conditioned media, both with and without calcium-based silicate materials, did not impact SCAP viability and migration (p > 0.05). This study shows that SCAP behavior is not impacted by the decrease in growth factor released in the presence of calcium-based silicate materials and that their role in REPs warrants further investigation.

Histopathological Study of the Effect of Xenogeneic Platelet-Rich Fibrin on Achilles Tendon Healing in Rabbit

Tendon is a mechanical bridge that transforms the force generated by muscle contraction into movement. This tissue is well known for its low cellularity and vascularity; therefore, any tendon damage is characterized by a slow and inefficient healing process resulting in mechanically, structurally, and functionally inferior tissue. The current study aimed to evaluate the effect of the regenerative capacity of xenogeneic platelet-rich fibrin on the acceleration of Achilles tendon healing in rabbits. 24 adult rabbits weighing (1.5-2) kg were used in this study. The animals were divided equally into three groups: A-PRF group, in which the tendon defect was treated with xenogeneic Advance-platelet rich fibrin; L-PRF group, which used xenogeneic for tendon defect treatment; and control groups treated with normal saline. Clinical investigation of the rabbits during the experiment period revealed improvement of lameness and disappearance of swelling and redness at the operation site in the A-PRF and L-PRF groups compared to the control group at the same period. Histopathological examination revealed a good tendon healing process in the A-PRF group characterized by a highly organized Achilles tendon and lightly stained collagen fibers arranged in parallel. At the same time, these are less evident in the L-PRF group. In conclusion, this study suggests that xenogeneic Advanced platelet-rich fibrin treatment can be useful as a biomaterial for accelerating Achilles tendon healing in rabbits and this biomaterial. Keywords: Xenogeneic platelet-rich fibrin; Rabbit Achilles tendon; tendon healing; Advanced platelet-rich fibrin; Iraq.

Effect of calcium carbonate nanoparticles, silver nanoparticles and advanced platelet-rich fibrin for enhancing bone healing in a rabbit model

This study aimed to evaluate the efficacy of calcium carbonate nanoparticles (CCNPs) to induce new bone formation in a critical size segmental bone defect in rabbit’s radius when used alone, combined with silver nanoparticles (AgNPs) as a paste, or as a composite containing CCNPs, AgNPs, and advanced platelet-rich fibrin (A-PRF). Thirty-six adult apparently healthy male New Zealand White rabbits aging from 5 to 6 months and weighting 3.5 ± 0.5 kg were used. The animals were divided into four groups; control group, CCNPs group, CCNPs/AgNPs paste group, and CCNPs/AgNPs/A-PRF composite group. The animals were investigated at 4, 8, and 12 weeks post-implantation in which the healing was evaluated using computed tomographic (CT) and histopathological evaluation. The results revealed that CCNPs/AgNPs paste and CCNPs/AgNPs/A-PRF composite has a superior effect regarding the amount and the quality of the newly formed bone compared to the control and the CCNPs alone. In conclusion, addition of AgNPs and/or A-PRF to CCNPs has reduced its resorption rate and improved its osteogenic and osteoinductive properties.

Comparative evaluation of the effectiveness of bioresorbable collagen membrane in combination with deproteinized bovine bone matrix xenograft (DBBM), and advanced platelet rich fibrin membrane in combination with deproteinized bovine bone matrix xenograft for periodontal regeneration

Introduction: Periodontitis is a chronic, multifactorial, inflammatory disease that leads to gradual loss of bone and periodontal attachment. Thus, periodontal surgery is required according to severity of diseases. The goal of periodontal reconstructive surgery is to regenerate soft and hard tissues destroyed during periodontal disease. Aim: To compare the effectiveness of bioresorbable collagen membrane in combination with Deproteinized Bovine Bone Matrix xenograft (group A); and Advanced Plasma rich fibrin(A-PRF) membrane in combination with Deproteinized Bovine Bone Matrix xenograft (group B) in the treatment of human infrabony defects. Methods: This randomised controlled trial will be carried out at the periodontics outpatient department. We will choose 24 patients with moderate to advanced chronic periodontitis who are otherwise systemically healthy. Infrabony defects will be treated by open flap debridement using bovine-derived xenograft and bioresorbable collagen membrane (group A) and open flap debridement using bovine-derived xenograft and A-PRF after the completion of first therapy (group B). At baseline and six months after undergoing periodontal surgery, probing pocket depth, clinical attachment level, radiographic bone fill, gingival recession, oral hygiene status, and gingival health will be measured. Expected results: It is suggested that Bioresorbable Collagen Membrane in combination with Deproteinized Bovine Bone Matrix xenograft will show better results as compared to Advanced Platelet Rich Fibrin Membrane with Deproteinized Bovine Bone Matrix Xenograft. Clinical trial registry of India (CTRI): REF/2023/05/066732. Protocol version: v1 (12/05/23)