Autologous Biomaterials Research Articles

Computer-guided Surgery in Anterior Esthetic Area with Autologous Deciduous Tooth-Derived Material: Case Report

Background The literature has described several biomaterials for guided bone regeneration. Some authors have proposed using a material derived from dentin/ enamel among autologous biomaterials. This study aims to test the effectiveness of autologous material derived from deciduous teeth in guided bone regeneration. Case Presentation A 24-year-old female shows up with missing tooth #1.1 for a domestic accident. This requires implant-prosthetic rehabilitation. It is decided to be performed before implant therapy, a bone regeneration guided using biomaterial resulting from the patient’s deciduous teeth stored in a plastic box. GBR (Guided Bone Rehabilitation) is performed, and after 6 months, the implant is inserted by computer-guided surgery, and then a provisional prosthesis is placed. Discussion The material deriving from deciduous teeth, not preserved with precautions, has had excellent integration results. This allowed the implant to be placed in the best position for the final prosthetic rehabilitation. Conclusion This clinical case shows that using biomaterial derived from deciduous teeth has allowed an excellent result with negligible biological cost.

Platelet concentrates – A panacea for periodontal regeneration.

Periodontitis is an inflammatory condition of the periodontium leading to loss of supporting structures of the tooth. The regeneration of periodontium refers to the restoration of the lost tissues to their original form and function by reiterating the fundamental wound healing processes involved in their development. Research has led to the development of “Autologous biomaterials” provide signals for healing, repair, and regeneration. These autologous substances also fosters neo-angiogenesis and new bone formation and therefore have yielded encouraging results in the field of regenerative dentistry. Platelet concentrates have higher concentration of growth factors which enhance periodontal regeneration. Blood derivatives have several advantages such as being autogenous, cost effective, less time consuming, simple to perform and prolonged release of growth factors. Since inception, many approaches have evolved also in-depth research has been done regarding its biological and clinical applications. Several modifications have been advocated in the conventional protocol like the advanced PRF, injectable PRF, PRF lysate and Titanium-prepared PRF. This review paper addresses the evolution, applications of platelet concentrates for tissue engineering, recent advances, and novel protocols. Furthermore, several future perspectives of platelet concentrates, such as platelet concentrates as drug delivery agents, platelet dust and liposomes encapsulating platelet concentrates are also discussed.

Platelet concentrates in periodontal tissue engineering: An updated review

Periodontitis is one of the common dental diseases that cause loss of teeth and adversely affects mastication and consequently the quality of life. Therefore, arresting the progression of periodontal diseases and the reconstruction of damaged tissues is the main concern. There are several strategies and (bio) materials already have been tried to achieve this goal, but the main obstacle was to find a unique biomaterial that can fulfill the tissue engineering criteria to ensure successful and reliable regenerative outcomes. Platelet-derived biomaterials (platelet concentrates) are widely used natural autologous biomaterials and show promising implementation due to their desired results in wound healing and tissue regeneration.

The use of platelet-rich plasma (PRP) in urology

Platelet-rich plasma (PRP) is one of the most common and practicable plasma-therapy techniques. The wide therapeutic range for the use of this technique in various medical fields is due to its high content of growth factors, cytokines, and chemokines. The property of PRP to induce tissue regeneration is particularly highlighted, which is used actively for the treatment of a broad range of urological diseases. The review aimed to highlight the accumulated material on the topic of the use of autologous biomaterials based on blood in urology. This article highlights the urgent need for further study of the prospects for the use of autoplasma technologies in wide multicenter studies.

The Use of Alb-PRF as a Drug Delivery System for Malignant Lesion Treatment

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.

Stabilizing A Vascularized Autologous Matrix with Flexible Magnesium Scaffolds to Reconstruct Dysfunctional Left Ventricular Myocardium in a Large-Animal Feasibility Study

The surgical reconstruction of dysfunctional myocardium is necessary for patients with severe heart failure. Autologous biomaterials, such as vascularized patch materials, have a regenerative potential due to in vivo remodeling. However, additional temporary mechanical stabilization of the biomaterials is required to prevent aneurysms or rupture. Degradable magnesium scaffolds could prevent these life-threatening risks. A left ventricular transmural defect was reconstructed in minipigs with a piece of the autologous stomach. Geometrically adaptable and degradable scaffolds made of magnesium alloy LA63 were affixed on the epicardium to stabilize the stomach tissue. The degradation of the magnesium structures, their biocompatibility, physiological remodeling of the stomach, and the heart's function were examined six months after the procedure via MRI (Magnetic Resonance Imaging), angiography, µ-CT, and light microscopy. All animals survived the surgery. Stable physiological integration of the stomach patch could be detected. No ruptures of the grafts occurred. The magnesium scaffolds showed good biocompatibility. Regenerative surgical approaches for treating severe heart failure are a promising therapeutic alternative to the currently available, far from optimal options. The temporary mechanical stabilization of viable, vascularized grafts facilitates their applicability in clinical scenarios.

Use of platelet-rich fibrin a backbone in facial plastic surgery and wound healing: A review of literature

Platelet aggregates has been used in surgery for many years. The primary goal of these ‘Autologous Preparation’ was to aggregate platelets and their growth factors and to convey it to a surgical site, to improve healing only. The latest research work shows that the PRF also can be used for Protection of Graft, neo-angiogenesis, vascularization locally and release of various growth factors apart from healing. Platelet rich fibrin (PRF) is considered as the new generation of platelet concentrate. “Choukroun’s PRF” or Leucocyte PRF (L-PRF) is the new development, which was first developed by Choukroun’s et al. in 2001 as an ‘Autologous biomaterial.’ A systematic literature search was performed to identify relevant articles that describes the use of PRF, through PubMed and Scopus databases. The focus of this article is to explore the role of PRF in esthetic facial surgery.

Efficacy of fibrin-rich platelets and leukocytes (L-PRF) in tissue repair in surgical oral procedures in patients using zoledronic acid-case-control study.

IntroductionMedication-related osteonecrosis of the jaws (MRONJ) is a complication that develops in patients who use or have used antiresorptive or antiangiogenic medications for the treatment of bone metabolic disease and bone metastases. Clinically, MRONJ is characterized by the appearance of an inflammation in soft tissues and exposure of necrotic bone tissue in mandible or maxilla, for a period of 8 weeks, in patients with no history of head and neck radiotherapy that were being or are being treated with antiresorptive and/or antiangiogenic agents. The fibrin-rich platelets and leukocytes (L-PRF) membrane has been used as an alternative for MRONJ prevention. The aim of this study was to evaluate the use of L-PRF in prevention and treatment of bone necrosis.Material and MethodsThe patients included had MRONJ diagnosis confirmed after clinical and radiographic examination and patients whose only therapeutic option was dental extraction.ResultsTwenty patients were included in the study and were divided in three groups. Two patients were removed from the study due to previous history of pentoxifylline and tocopherol use. The result of surgical treatment was successful in 57% in group 1 (control/MRONJ prevention), 100% in group 2 (MRONJ prevention), and 80% in group 3 (MRONJ treatment).ConclusionL-PRF is an autologous biomaterial that allows the release of growth factors for a prolonged time, resulting in a better healing, reducing the risk contamination, edema, and postoperative pain, being a great ally in the prevention and treatment of MRONJ because it returns to these patients, mainly quality of life, reducing pain, and recurrent infections commonly seen in the processes of bone necrosis of the jaws.

Application of Biosheets as Right Ventricular Outflow Tract Repair Materials in a Rat Model

PurposesWe report the experimental use of completely autologous biomaterials (Biosheets) made by “in-body tissue architecture” that could resolve problems in artificial materials and autologous pericardium. Here, Biosheets were implanted into full-thickness right ventricular outflow tract defects in a rat model. Their feasibility as a reparative material for cardiac defects was evaluated.MethodsAs the evaluation of mechanical properties of the biosheets, the elastic moduli of the biosheets and RVOT-free walls of rats were examined using a tensile tester. Biosheets and expanded polytetrafluoroethylene sheet were used to repair transmural defects surgically created in the right ventricular outflow tracts of adult rat hearts (n = 9, each patch group). At 4 and 12 weeks after the operation, the hearts were resected and histologically examined.ResultsThe strength and elastic moduli of the biosheets were 421.3 ± 140.7 g and 2919 ± 728.9 kPa, respectively, which were significantly higher than those of the native RVOT-free walls (93.5 ± 26.2 g and 778.6 ± 137.7 kPa, respectively; P < 0.005 and P < 0.001, respectively). All patches were successfully implanted into the right ventricular outflow tract-free wall of rats. Dense fibrous adhesions to the sternum on the epicardial surface were also observed in 7 of 9 rats with ePTFE grafts, whereas 2 of 9 rats with biosheets. Histologically, the vascular-constructing cells were infiltrated into Biosheets. The luminal surfaces were completely endothelialized in all groups at each time point. There was also no accumulation of inflammatory cells.ConclusionsBiosheets can be formed easily and have sufficient strength and good biocompatibility as a patch for right ventricular outflow tract repair in rats. Therefore, Biosheet may be a suitable material for reconstructive surgery of the right ventricular outflow tract.

Autologous Biomaterials and Their Application in Post-Extraction Dental Implants in Areas of High Aesthetic Compromise. A Case Report.

Autologous Biomaterials and Their Application in Post-Extraction Dental Implants in Areas of High Aesthetic Compromise. A Case Report.

Successful management of a large mucosal fenestration at 18-months follow-up.

Mucosal fenestrations are infrequent and often challenging to treat depending on the extent of soft and hard tissue destruction. This article presents the successful management of a relatively larger mucosal fenestration associated with complete absence of buccal bone plate in a mandibular incisor secondary to trauma-induced periapical pathosis. After non-surgical endodontic therapy, surgery was performed for debridement of the osseous defect, root resection/shaping, connective tissue graft (CTG) placement on the affected root surface and platelet rich fibrin (PRF) in periapical osseous defect rather than use of bone graft and/or barrier membrane. Healing was uneventful, however, a small mucosal defect remained at 2 weeks follow-up. After 3months of primary surgery, a corrective surgery was performed utilizing an "incision-free" approach i.e. tunnel technique with CTG in contrast to the contemporary flap approach. At 18 months follow-up, complete closure of the mucosal defect with a thick gingival biotype, normal sulcus depth, and good esthetic outcome were achieved. No recurrence and any clinical signs of infection or inflammation were observed. Based on the outcomes of present case, an early intervention utilizing the minimally invasive surgical therapy and autologous biomaterials may be considered a viable approach to treat such complex lesions. Endodontic therapy in combination with PRF and CTG appears to provide successful outcomes in treatment of a large mucosal fenestration with periapical osseous defect.

Outcome of using plat eletrich plasma in postextractional wound treatment

Background. Platelet-enriched plasma (PRP) is a revolutionary autologous biomaterial that stimulates bone regeneration, enhances regenerative processes and postoperative wound healing, thus simplifying future implant-prosthetic rehabilitation. Objective of the study. Evaluation of PRP regeneration properties in postextractional wound regeneration. Material and Methods. The clinical examination was used as research methods: inspection, palpation, paraclinical examination: panoramic radiography / CBCT and VAS test were performed. The diagnosis and treatment plan were established, as follows: extraction associated with PRP injection. Results. At the postoperative evaluation of the patient after 7 days of treatment, the intensity of pain according to the modified VAS method showed decreased values- from 4 to 1, the postextractional wound was completely healed, the level of regeneration was attested by the absence of dehiscence, presence of the pale pink epithelium, absence of the postoperative facial edema according to the craniometric points, the Celsius signs also were absent. Conclusion. The use of PRP biomaterial in wisdom tooth extraction is a minimally invasive method of tissue regeneration that reduces the rehabilitation period and prevents the occurrence of post-extraction complications.

Using platelet-rich fibrin scaffolds with diced cartilage graft in the treatment of empty nose syndrome.

Empty nose syndrome (ENS) is a rare entity in patients who undergo sinonasal surgery due to over-resection of the turbinate. This syndrome leads to debilitating symptoms that include dry nose, painful nasal breathing, paradoxical nasal obstruction, crusting, and sleep disorder. The goal of surgical treatment is to reestablish the volume of the turbinates to rehabilitate the nasal resistance. Endonasal microplasty with cartilage implants on the lateral wall of the nasal cavity is useful for creating the neoturbinate. Here, we present 2 cases that describe the management of empty nose syndrome by endonasal microplasty using platelet-rich fibrin (PRF) scaffolds embedded with a diced cartilage graft. The integration of the PRF scaffolds with diced cartilage efficiently facilitated the reestablishment of the neoturbinate. This autologous biomaterial is suitable for the treatment of ENS.

English

The periodontal ligament is a unique specialised connective tissue between the cementum covering the tooth root and the alveolar bone. It is believed that periodontal ligament cells are responsible for not only osteogenesis and osteoclasia of the alveolar bone but also for fibrogenesis and fibroplasia of the ligament itself, as well as cementogenesis and the presence of cementoblasts on the root surface. Injury to the periodontal ligament (PDL) and its compromised healing (external inflammatory resorption and replacement resorption) has been cited as one of the major reasons for the failure of transplantation and replantation procedures. The necessity of having a healthy PDL so that the tooth can re-attach and be retained in the socket determines the prognosis of replanted teeth. Thus, the importance of maintaining the periodontal viability has led to an increased interest in the development of platelet concentrates, which have been considered as autologous biomaterials having the ability to potentiate healing, repair, and regenerate. PRF (platelet rich fibrin) is a living biomaterial derived from human blood containing fibrin, platelets, growth factors, leukocytes and stem cells entrapped in a fibrin-based scaffold / matrix, which has been documented to promote bone and soft tissue healing and regeneration. PRF technology has grabbed the attention of clinicians because it is readily available, is easy to prepare, can be produced immediately at the chairside, is easy to use, and widely applicable in dentistry, while being financially realistic for the patient and the clinician. Thus, the purpose of this review is to enumerate the biologic, chemical and physical properties of PRF and highlight the essential role it plays in periodontal regeneration and repair, which can be highly beneficial in improving the treatment success rate of transplantation and replantation procedures. KEY WORDS Platelet Rich Fibrin, Replantation, Transplantation, Periodontal Ligament, Periodontal Regeneration

Cocktail Protocol for Preparation of Platelet-Rich Fibrin Glue for Autologous Use.

BackgroundBiomaterials containing platelets have been used to promote healing of ulcers and burns, as well as in implantology and maxillofacial and plastic surgery to achieve wound healing and tissue repair. Commercial devices to prepare autologous biomaterials involve diverse preparation methods that can have high production costs and low yields. Hence, we designed a protocol for preparation of large amounts of autologous platelet-rich fibrin (PRF) glue using conventional processing techniques for blood components.MethodsAutologous whole blood collected 72 h before surgery was processed to prepare platelet concentrates and cryoprecipitate. In a closed system, calcium was added to the cryoprecipitate to release autologous thrombin and generate a firm fibrin clot. The fibrin clot, platelets and calcium were then placed in a conical flask in which a PRF glue formed. The protocol was validated through determination of pre- and post-platelet counts and fibrinogen amounts in the product.ResultsPlatelets were recovered with 68% efficiency during the preparation. Essentially no platelets or fibrinogen were found in the supernatant of the PRF glue, suggesting that nearly all had been incorporated in a PRF glue having a relatively large (8 cm × 10 cm) size.ConclusionThe protocol described here is a cost-effective, simple and closed system that can be used to produce large-size PRF glue to promote repair of major surgical defects.

Current Insights into the Potential Misuse of Platelet-based Applications for Doping in Sports.

Platelet-based applications are currently used for the delivery of growth factors and other biomolecules as autologous biomaterials in regenerative medicine and cosmetic therapies. Many studies have revealed that platelet-based applications such as platelet-rich plasma and platelet releasate exhibit beneficial biological effects after a sports injury or trauma when administered locally by intramuscular injections. At present, treatment of the public, patients and athletes with platelet-based applications is permitted and regulated by the Food and Drug Administration and the World Anti-Doping Agency. Since 2011 the use of autologous platelet-rich plasma is permitted in competitive sports by the World Anti-Doping Agency, due to the lack of evidence in performance enhancement and anabolic effects. However, accumulating research has recently shed light on the role of platelet-derived growth factors in wound healing, skeletal myogenesis, muscle stem cell function and tissue regeneration. Although any ergogenic potential of platelet-rich plasma and platelet releasate on intact skeletal muscle and human sports performance remain to be established, novel evidence suggests that platelet-derived growth factors can modulate muscle, tendon, ligament, protein synthesis/degradation, vascularization, energy utilization and regenerative capacity in various experimental settings. Since platelet-based applications are currently not prohibited, they constitute a tool for potential abuse and doping in sports. The aim of this review is to critically discuss and assimilate current insights and biological evidence that set the ground for exploitation and misuse in competitive sports, and develop strategies to combat these activities.

Fluid Cartilage as New Autologous Biomaterial in the Treatment of Minor Nose Defects: Clinical and Microscopic Difference Amongst Diced, Crushed, and Fluid Cartilage.

Developing cartilage constructs with injectability, appropriate matrix composition, and persistent cartilaginous phenotype remains an enduring challenge in cartilage repair. Fourteen patients with minor contour deformity were treated with fluid cartilage filler gently injected as autologous fluid graft in deep planes of defect of the nose that were close to the bone or the cartilage. A computerized tomographic scan control was performed after 12 months. Pearson’s Chi-square test was used to investigate differences in cartilage density between native and newly formed cartilages. The endpoints were the possibility of using fluid cartilage as filler with aesthetic and functional improvement and versatility. Patients were followed up for two years. The constructs of fluid cartilage graft that were injected in the deep plane resulted in a persistent cartilage tissue with appropriate morphology, adequate central nutritional perfusion without central necrosis or ossification, and further augmented nasal dorsum without obvious contraction and deformation. This report demonstrated that fluid cartilage grafts are useful for cartilage regeneration in patients with outcomes of rhinoplasty, internal nasal valve collapse, and minor congenital nose aesthetics deformity.

Gene activated adipose tissue fragments as advanced autologous biomaterials for bone regeneration: osteogenic differentiation within the tissue and implications for clinical translation

Cost-effective, expedited approaches for bone regeneration are urgently needed in an ageing population. Bone Morphogenetic Proteins (BMPs) stimulate osteogenesis but their efficacy is impeded by their short half-life. Delivery by genetically modified cells can overcome this problem. However, cell isolation and propagation represent significant obstacles for the translation into the clinic. Instead, complete gene activated fragments of adipose tissue hold great potential for bone repair. Here, using an in-vitro culture system, we investigated whether adenoviral transduction with human BMP-2 can promote osteogenic differentiation within adipose tissue fragments. Osteoinduction in adipose tissue fragments was evaluated by quantitative reverse transcriptase polymerase chain reaction, immunohistology and histomorphometry. BMP-2 transduced adipose tissue synthesized BMP-2 protein over 30 days peaking by day six, which significantly promoted osteogenic differentiation as indicated by increased calcium depositions, up-regulation of bone marker genes, and bone-related protein expression. Our results demonstrate that cells within adipose tissue fragments can differentiate osteogenically after BMP-2 transduction of cells on the surface of the adipose tissue. BMP-2 gene activated adipose tissue represents an advanced osteo-regenerative biomaterial that can actively contribute to osteogenesis and potentially enable the development of a novel, cost-effective, one-step surgical approach to bone repair without the need for cell isolation.

The Effect of Platelet-Rich Fibrin and Titanium Prepared Platelet-Rich Fibrin on Early Soft Tissue Healing of Extraction Sites

Objective: Physiological changes start after tooth extraction. Some post-operative symptoms may accompany this healing period, and affect patient's life quality. Many techniques have been developed to promote healing soft and hard tissue and improve patient's life quality. So, the aim of this study was to compare the early soft tissue healing of extraction sites treated with leucocyte-platelet rich fibrin (L-PRF), titanium prepared platelet rich fibrin (T-PRF) and non-treated control sites. Material&amp;amp;Methods:A total of 42 single root teeth were enrolled to study. Extraction site was treated by L-PRF or T-PRF. Spontanous healing sockets were considered as control sites. Landy Wound Healing Index (LWH) scores and H2O2 bubbling test results for complete wound epithelization (CWE) were recorded at 1st and 2nd week. Also, the patient was requested to record the VAS scale and the number of analgesics that taken during two days after extraction. Results: The LWH were statistically significantly improved for all groups at 2nd week according to 1st week (p&amp;lt;0.05). However there was no difference among three groups in each week. According to H2O2 bubbling test results, the CWE ratio at 1st week was 7.1%, 53,3% and 69.2% of control, L-PRF and T-PRF groups, respectively. The control group rate of CWE was statistically significantly lower than both of the test groups (p&amp;lt;0.05). Both of the test groups at 2nd week showed 100% CWE, however this rate was only 35.7% of control group. The VAS score, at 1st day, was statistically significantly higher at control group than both of the test groups at first day (p&amp;lt;0.05). There was non-significant difference among groups at 2nd day. There wass also non-significant difference among groups with regard to number of analgesics. Conclusion: Both T-PRF and L-PRF, which are completely autologous biomaterials, enhance wound epithelzation and reduced post-op discomfort at extraction sockets.

Ocular surface regeneration with autologous biomaterials

Ocular surface regeneration with autologous biomaterials