Combination Of Platelet-rich Fibrin Research Articles

Periodontal regeneration using platelet-rich fibrin. Furcation defects: A systematic review with meta-analysis.

The objective of the study was to compare the treatment outcomes of periodontal furcation defects by using platelet-rich fibrin (PRF) with other commonly utilized modalities. The eligibility criteria comprised randomized controlled trials (RCTs) comparing the clinical outcomes of PRF with those of other modalities for the treatment of furcation defects. Studies were classified into 11 categories in 3 different groups as follows: Group I (addition of PRF): (1) open flap debridement (OFD) alone versus OFD/PRF, (2) OFD/bone graft (OFD/BG) versus OFD/BG/PRF; Group II (comparative studies to PRF): (3) OFD/BG versus OFD/PRF, (4) OFD/collagen membrane versus OFD/PRF, (5) OFD/PRP versus OFD/PRF, (6) OFD/rhBMP2 versus OFD/PRF; and Group III (addition of biomaterial/biomolecule to PRF): OFD/PRF versus … (7) OFD/PRF/BG, (8) OFD/PRF/amniotic membrane (AM), (9) OFD/PRF/metformin, (10) OFD/PRF/bisphosphonates, (11) OFD/PRF/statins. Weighted means and forest plots were calculated for the reduction of probing pocket depth (PPD), gain of vertical and horizontal clinical attachment levels (VCAL and HCAL), gain in vertical and horizontal bone levels (VBL, HBL), and radiographic bone fill (RBF). From 45 articles identified, 21 RCTs reporting on class II furcations were included. The use of OFD/PRF and OFD/BG/PRF statistically significantly reduced PPD and improved VCAL and HCAL when compared to OFD or OFD/BG, respectively. The comparison between OFD/PRF alone versus OFD/BG, OFD/CM, OFD/PRP, or OFD/rhBMP2 led to similar outcomes for all investigated parameters, including a reduction in PPD, VCAL/HCAL gain, and RBF. The additional incorporation of a BG to OFD/PRF only mildly improved outcomes, whereas the addition of AM improved clinical outcomes. The addition of small biomolecules such as metformin, bisphosphonates, or statins all led to significant improvements in PPD, VCAL, and HCAL when compared to OFD/PRF alone. Noteworthy, a very high heterogeneity was found in the investigated studies. The use of PRF significantly improved clinical outcomes in class II furcation defects when compared to OFD alone, with similar levels being observed between OFD/PRF and/or OFD/BG, OFD/CM, OFD/PRP, or OFD/rhBMP2. Future research geared toward better understanding potential ways to enhance the regenerative properties of PRF with various small biomolecules may prove valuable for future clinical applications. Future histological research investigating PRF in human furcation defects is largely needed. The use of PRF in conjunction with OFD statistically significantly improved PPD, VCAL, and HCAL values, yielding comparable outcomes to commonly used biomaterials. The combination of PRF to bone grafts or the addition of small biomolecules may offer additional clinical benefits, thus warranting future investigation.

Potential Crown Discoloration Induced by the Combination of Various Intracanal Medicaments and Scaffolds Applied in Regenerative Endodontic Therapy.

Regenerative endodontics involves the use of various root canal medicaments and scaffolds, which may cause crown discoloration. This study aimed to investigate the combined crown discoloration of scaffolds [platelet-rich fibrin (PRF) and blood clot] applied after administration of different medicaments [modified triple antibiotic paste including doxycycline (mTAPd), modified double antibiotic paste (mDAP), calcium hydroxide (CH), and propolis]. In total, 100 human mandibular premolar teeth were selected and prepared. The teeth were apically resected to simulate immature teeth. The positive and negative control groups (n = 10) consisted solely of blood-only and serum-only samples. The remaining 80 teeth were used for the experimental groups with four different medicaments. Three weeks later, either blood or PRF was applied as a scaffold after removing the medicaments (n = 10). Color changes were assessed before medication placement and at the end of the first, second, and third weeks, as well as on days 0, 1, 30, 60, and 90 after scaffold application. Analysis was carried out using repeated measures of variance, Friedman, one-way ANOVA, Kruskal-Wallis, the dependent paired t-test, and Wilcoxon test. Statistical significance was determined at P = 0.05. All groups including blood and the group including propolis and PRF combination, resulted in a significant increase in discoloration (P < 0.05) and discoloration exceeding clinically acceptable thresholds. CH and the modified versions of TAP (mTAPd) and DAP (mDAP) demonstrated an acceptable level of discoloration when used with a combination of PRF at day 90.

Evaluation optimum ratio of synthetic bone graft material and platelet rich fibrin mixture in a metal 3D printed implant to enhance bone regeneration

BackgroundThis study aims to evaluate the optimal ratio of synthetic bone graft (SBG) material and platelet rich fibrin (PRF) mixed in a metal 3D-printed implant to enhance bone regeneration.MethodsSpecialized titanium hollow implants (5 mm in diameter and 6 mm in height for rabbit; 6 mm in diameter and 5 mm in height for pig) were designed and manufactured using 3D printing technology. The implants were divided into three groups and filled with different bone graft combinations, namely (1) SBG alone; (2) PRF to SBG in 1:1 ratio; (3) PRF to SBG in 2:1 ratio. These three groups were replicated tightly into each bone defect in distal femurs of rabbits (nine implants, n = 3) and femoral shafts of pigs (fifteen implants, n = 5). Animal tissue sections were obtained after euthanasia at the 8th postoperative week. The rabbit specimens were stained with analine blue, while the pig specimens were stained with Masson–Goldner’s trichrome stain to perform histologically examination. All titanium hollow implants were well anchored, except in fracture specimens (three in the rabbit and one fracture in the pig).ResultRabbit specimens under analine blue staining showed that collagen tissue increased by about 20% and 40% in the 1:1 ratio group and the 2:1 ratio group, respectively. Masson–Goldner's trichrome stain results showed that new bone growth increased by 32% in the 1:1 ratio PRF to SBG, while − 8% in the 2:1 ratio group.ConclusionThis study demonstrated that placing a 1:1 ratio combination of PRF and SBG in a stabilized titanium 3D printed implant resulted in an optimal increase in bone growth.

The Association of Nanostructured Carbonated Hydroxyapatite with Denatured Albumin and Platelet-Rich Fibrin: Impacts on Growth Factors Release and Osteoblast Behavior.

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.

Combination of Platelet-rich Fibrin (PRF) in Advanced Periodontitis Stage Treatment

Introduction: The treatment of advanced periodontitis has been a challenge for clinicians. Platelet-rich fibrin (PRF) is a second-generation platelet concentrate that contains various growth factorss and cytokines that promote tissue regeneration. The use of PRF in combination with other regenerative materials and techniques has been shown to be effective in the treatment of intrabony defects. This case series aims to evaluate the efficacy of PRF combinations in the regenerative treatment of patients with advanced periodontitis. Case report: Two patients diagnosed with advanced periodontitis (stage III/IV grade C) were selected for this study. After the completion of periodontal initial therapy, there were still pockets with a probing depth ≥ 5 mm (5–10 mm). Therefore, surgical interventions were planned. The first case used the combination of PRF with bone graft and guided tissue regeneration (GTR), while open flap debridement (OFD) with the addition of PRF and bone graft to create sticky bone was done in the second case. Three to five months of follow-up showed favorable outcomes, as evidenced by reductions in probing depth (PD), gains in clinical attachment level, and filling of bone defects, as well as improvements in patient comfort and rapid wound healing. Conclusion: The combination of PRF with grafting material and/or GTR has been shown to be a beneficial therapeutic approach for periodontal regenerative therapy. Platelet-rich fibrin in periodontal surgery may accelerate the tissue healing process.

Radiographic Outcomes of Mineral Trioxide Aggregate (MTA) with and Without Platelet-Rich Fibrin (PRF) In Direct Pulp Capping: A Clinical Pilot Study

Aim: The purpose of the current investigation was to determine by radiographic means if a calcific dentinal bridge had formed following direct pulp capping (DPC) with calcium hydroxide (CH), mineral trioxide aggregate (MTA), or a combination of platelet-rich fibrin (PRF) and MTA. Materials and Methods: In the beginning, 45 systemically healthy patients who needed DPC and had pulpal exposure were enrolled in the trial. They were then randomly assigned to one of three groups: CH (control, n = 15), MTA ( n = 15), or PRF + MTA ( n = 15). To determine the radiographic density of the dentin immediately underneath the location of pulpal exposure, pre-operative intraoral digital radiographs of the afflicted teeth were acquired. Through sequential imaging, the radiographic evaluation of dentinal bridge formation was performed. All images were studied carefully, keeping the reference point constant. Results: Out of the 45 patients, finally 10 per group were analysed. According to an analysis of variance, difference in mean density values among the various groups was found to be significant [( p = .001). On bi-group comparison (using post-Tukey HSD), difference between CH and PRF + MTA was significant ( p = .001), between MTA and PRF + MTA was significant ( p = .022), and between CH and MTA not significant ( p = .347)]. The PRF + MTA group showed the highest increase in mean density values. Conclusion: The results of the present study suggest that PRF and MTA when used in combination have better radiographic outcomes compared to MTA alone when used as DPC agents.

Regenerative potential of a combination of PRF and bioactive glass for the treatment of horizontal bone defects in stage II and stage III periodontitis: a split-mouth randomized controlled trial

Objective: The aim of the study was to evaluate the efficacy of calcium phosphosilicate bioactive glass in combination with Platelet Rich Fibrin (PRF) in the treatment of horizontal bone defects in stages II and III periodontitis. Materials and Methods: The randomized controlled trial included 51 sites of horizontal bone defects from 4 patients with stages II and III periodontitis. The three treatment groups were: Group A - open flap debridement (OFD) + bone graft + PRF gel; Group B - OFD + bone graft + PRF gel covered by PRF membrane; Group C - OFD alone. The clinical and radiographic parameters were recorded at baseline and 9 months post-surgery. Results: All three groups showed statistically significant improvement in clinical and radiographic parameters, except for defect width at 9 months post-surgery. Conclusion: The findings of the present study allow us to conclude that the use of PRF in combination with bone graft can serve as a promising therapeutic approach for the treatment of horizontal bone defects, resulting in improvement of both clinical and radiographic parameters.

Osteogenic potential of apical papilla stem cells mediated by platelet-rich fibrin and low-level laser

To evaluate the osteogenic potential of platelet-rich fibrin (PRF) and low-level laser therapy (LLLT) on human stem cells from the apical papilla (SCAP) we isolated, characterized, and then cultured in an osteogenic medium cells with PRF and/or LLLT (660 nm, 6 J/m2-irradiation). Osteogenic differentiation was assessed by bone nodule formation and expression of bone morphogenetic proteins (BMP-2 and BMP-4), whereas the molecular mechanisms were achieved by qRT-PCR and RNA-seq analysis. Statistical analysis was performed by ANOVA and Tukey’s post hoc tests (p < 0.05* and p < 0.01**). Although PRF and LLLT increased bone nodule formation after 7 days and peaked at 21 days, the combination of PRF + LLLT led to the uppermost nodule formation. This was supported by increased levels of BMP-2 and -4 osteogenic proteins (p < 0.005). Furthermore, the PRF + LLLT relative expression of specific genes involved in osteogenesis, such as osteocalcin, was 2.4- (p = 0.03) and 28.3- (p = 0.001) fold higher compared to the PRF and LLLT groups, and osteopontin was 22.9- and 1.23-fold higher, respectively (p < 0.05), after 7 days of interaction. The transcriptomic profile revealed that the combination of PRF + LLLT induces MSX1, TGFB1, and SMAD1 expression, after 21 days of osteogenic differentiation conditions exposition. More studies are required to understand the complete cellular and molecular mechanisms of PRF plus LLLT on stem cells. Overall, we demonstrated for the first time that the combination of PRF and LLLT would be an excellent therapeutic tool that can be employed for dental, oral, and craniofacial repair and other tissue engineering applications.

Enhancing Osteogenic Ability and Nutritional Status with Combined Platelet-Rich Fibrin and Ginkgo Biloba Extracts In Maxillary Sinus Floor Augmentation: A Clinical Study

This study investigated the effects of combined platelet-rich fibrin and Ginkgo biloba extracts on osteogenic ability following maxillary sinus floor augmentation. The study enrolled 77 patients at our institution. The control group (41 patients) received Bio-Oss TM bone powder, while the research group (36 patients) received platelet-rich fibrin. We compared periodontal conditions, complications, changes in maxillary bone mineral density, and growth factor levels pre-and post-surgery. The results indicated significant improvements in the research group compared to the control group, including lower bleeding index, probing depth, and attachment loss, alongside increased bone height and thickness (P &lt; 0.05). The research group exhibited a lower incidence of postoperative oral mucosal inflammation and swelling, higher bone mineral density, and elevated growth factor levels compared with the control group (P &lt; 0.05). Nutritional assessments indicated better lipid profiles and less mild malnutrition in the research group (P &lt; 0.05). Mouse osteoblast MC3T3 cells were treated with platelet-rich fibrin to assess cell proliferation and expression of RUNX2 and OCN. Results showed enhanced cell viability, increased RUNX2 and cyanate levels, and reduced apoptosis (P &lt; 0.05). In conclusion, combined platelet-rich fibrin and Ginkgo biloba extracts significantly enhanced osteogenic ability and nutritional status following maxillary sinus floor augmentation, suggesting substantial clinical value.

Clinical effect of platelet-rich fibrin in combination with narrow-band ultraviolet B treatment in patients with small area deep burn wounds

Purpose: To investigate the influence of the combined use of platelet-rich fibrin and narrow-band UV B (NB-UVB) treatment on small-area deep burn wounds in patients.Methods: A total of 86 patients with small area deep burn wounds were assigned to control and study groups (n = 43/group). The control patients received routine drugs in combination with NB-UVB, while the study group was administered a combination of platelet-rich fibrin and NB-UVB therapy. Clinical efficacy indices were.Results: In the study group, the pre and post-treatment serum levels of TNF-α were 222.75 ± 4.86 and 65.42 ± 5.33 ng/L, while those in control group were 221.45 ± 6.84 and 114.68 ± 2.53 ng/L, respectively. The study group serum concentrations of IL-8 at pre- and post-treatment were 120.75 ± 4.53 ng/L and 45.39 ± 8.26 ng/L, while the control group values were 122.38 ± 2.65 and 79.52 ± 2.34 ng/L, respectively. After treatment, the serum levels of TNF-α and IL-8 were significantly down-regulated in both groups, relative to pre-treatment values, with lower levels in the study group (p &lt; 0.001). Wound healing time and frequency of dressing change in the study group were 20.6 ± 3.6 days and 7.1 ± 2.5 times, respectively, which were significantly lower than the corresponding control group values of 40.3 ± 10.7 days and 20.5 ± 5.6 times (p &lt; 0.001). There was a significantly higher incidence of scars in the control group than in study group (p &lt; 0.05).Conclusion: Combined use of platelet-rich fibrin and NB-UVB in the treatment of small area deep burn wounds lowers the serum levels of inflammatory factors. However, the combined therapy should be subjected to further clinical trials prior to application in clinical practice.

The effects of fat graft and platelet-rich fibrin combination after epineurectomy in rats.

One of the most important factors that adversely affects the outcome of peripheral nerve surgery is the formation of epineural and extraneural scar tissue after surgery. Many surgical methods and pharmacological and chemical agents have been used to prevent the formation of epineural scar tissue, but satisfactory results have not been achieved in clinical applications. The purpose of this study was to investigate the combined effect of fat graft and platelet-rich fibrin on the formation of epineural scar tissue and on nerve healing in the mature rat model. A total of 24 female Sprague-Dawley rats were used. A circumferential segment of epineurium was excised from both bilateral sciatic nerves. The epineurectomized right nerve segment was wrapped with a combination of fat graft and platelet-rich fibrin (experimental group), while the left nerve segment did not receive any surgical procedure other than the epineurectomy (sham group). Notably, 12 randomly selected rats were sacrificed in the fourth week for histopathological examination of early results. The other 12 rats were sacrificed in the eighth week for late results. The formation of fibrosis, inflammation, and myelin degeneration were less common in the experimental group, while nerve regeneration was found to be higher at both 4 and 8 weeks. The intraoperative application of a combination of fat graft and platelet-rich fibrin appears to be effective on nerve healing after surgery at both the early and late periods.

Platelet-rich fibrin in combination with mandibular or maxillary non-vascularized bone graft: a systematic review

Platelet-rich fibrin in combination with mandibular or maxillary non-vascularized bone graft: a systematic review

Platelet-rich fibrin as a tissue engineering material in accelerate bone healing in rat bone defects: A systematic review and meta-analysis.

Various techniques for tissue engineering have been introduced to help regenerate damaged or lost bone tissue. This study aimed to see the potential implication of platelet-rich fibrin (PRF) to accelerate the bone healing process in rat bone defects. A systematic literature search was conducted from several electronic databases on subjects looking at the use of PRF in rat bone defects and their results in bone regeneration. Specific results compared PRF vs. other methods, PRF vs. control, and PRV vs. combination PRF and other methods. Science Direct, PubMed, and Cochrane Library were the main information sources. The Cochrane Collaboration method is employed to assess the risk of bias. A total of 483 rats were used in the twelve studies, and this meta-analysis showed that the PRF vs. other methods pooled odds ratio (OR) obtained was 0.92 (95% CI 0.42-2.04; p=0.29; I2=18%), PRF versus control OR obtained 9.45 (95% CI 4.68-19.08; P=0.01; I2=0%), the combination of PRF compared to PRF alone OR obtained 0.12 (95% CI 0.03-0.41; p=0.01; I2=0%). Platelet-rich fibrin accelerates the bone healing process in rat bone defects compared to physiologically. Platelet-rich fibrin combined with other methods can stimulate rat bone defects than utilization of platelet-rich fibrin only. The small number of articles assessed may cause limitations in sensitivity tests. This study was registered in the research registry (reviewregistry1341).

Synergistic Benefits on Combining Injectable Platelet-Rich Fibrin and Bone Graft Porous Particulate Materials

The main aim of this study was to perform an integrative review on the enhanced bone healing by combining a flowable (injectable) platelet-rich fibrin (PRF) and bone graft porous materials. A bibliographical search was carried out on several databases (PubMed, Embase, Cochrane, Scopus, and Web of Science) for relevant studies on the combined effect of platelet-rich fibrin and bone substitutes for bone healing. The chemical, biologic, and physical properties of flowable PRF combined with bone graft biomaterials were discussed in this review. The repair of different bone defects was reported such as alveolar cleft reconstruction, sinus floor elevation, socket preservation, jaw defects, and impacted teeth. Regarding studies evaluating alveolar cleft defects, results showed potential benefits of PRF to enhance bone formation when mixed with autogenous bone graft. Two studies on socket preservation found enhanced bone growth when combining PRF to bone substitutes, although one study found similar results with or without bone substitutes. Also, the addition of PRF to demineralized bovine bone mineral improved the bone healing in the repair of jaw defects. No synergistic effect was reported in bone formation when PRF was associated to particulate bone graft in sinus floor elevation. The combination of PRF and bone graft materials revealed significant outcomes when compared to solely use of bone graft materials in alveolar cleft and jaw defects. In socket preservation, bone healing was improved when PRF and bone graft materials were applied in comparison to the solely use of PRF. On the reconstruction of larger bone defects, PRF can be mixed with a low resorption rate graft material to maintain biological and mechanical stability into the bone defect. In fact, PRF and particulate graft materials appear to exhibit a synergistic effect during bone tissue healing.

Clinical, radiological and pathochemical substantiation of osteosubstitution by hydroxyapatite ceramics with β-tricalcium phosphate and platelet-enriched autofibrin in fragmentary bone fractures in dogs

Due to the similarity of its composition to bone tissue, bioactive ceramics based on hydroxyapatite are considered the most promising for osteosubstitution of fragmentary fractures, and topical application of pharmacological agents and autologous agents bioactive substances, in particular, platelet-rich fibrin (PRF). The work aims to clinically and radiologically, and pathochemically substantiate osteosubstitution by hydroxyapatite ceramics with β-tricalcium phosphate and platelet-enriched fibrin for fragmentary bone fractures in dogs. A control and two experimental groups of animals were formed, including patients (n = 10) with humerus and forearm fractures. After general and local anesthesia and extracortical osteosynthesis, the first experimental group was injected with platelet-rich autofibrin between bone fragments. The second group was osteosubstituted with a combination of PRF and hydroxyapatite ceramics; in the control group, the defects remained without replacement. For biochemical studies, blood samples were taken after injury no later than 24 hours and on the 3rd, seventh, 14th, 21st, and 42nd day after osteosynthesis. In the postoperative period, clinical and radiological studies were performed. The activity of bone isoenzyme alkaline phosphatase (BAP), tartrate-resistant acid phosphatase (TrAP), the level of total calcium (Ca), inorganic phosphorus (P), and total protein were determined in blood serum. It was found that complete recovery of limb function in the experimental groups was 1.2–1.4 times faster (P &lt; 0.001) compared with the control group and radiologically confirmed earlier consolidation of fractures. In both experimental groups, the maximum activity of BAP was observed on the 14th day, in the absence of a significant difference between these groups, while in control – it peaked on the 21st day. In the case of bone injury, the level of TrAP decreased by 1.2 times (P &lt; 0.05) and then gradually increased, which was significant in the control group on the 42nd day, in the first experimental group on the 21st, and the second on the 14th day. On the third day after osteosynthesis, the concentration of P was still lower in the control (P &lt; 0.05) and the first experimental (P &lt; 0.01) group compared with clinically healthy animals. The concentration of Ca on the third day was reduced in all groups by 1.2 times (P &lt; 0.001) and then gradually returned to normal. The use of PRF with calcium-phosphate ceramics for osteosubstitution helps to optimize regeneration processes in the area of bone injury by activating osteoblastic cells and reducing the intensity of the osteoresorption reaction with an earlier reaction of bone regeneration remodeling.

Periodontal Treatment in Patients with Perio-Endo Lesions: A Case Report

Background: Periodontal tissue and pulp are interconnected anatomically. In some circumstances, the inflammation may extend from the periodontal region to the pulp or vice versa. In perio-endo lesions, an appropriate treatment plan is required to obtain a predictable and reliable treatment prognosis. The development and progression of these perio-endo lesions can be influenced by many factors such as bacteria, fungi, viruses, trauma, root resorption, perforation and dental malformations. An appropriate treatment plan for perio-endo lesions can provide a good prognosis.&#x0D; Objective: To describe periodontal treatments performed in patients with perio-endo lesions.&#x0D; Case Report: A 39-year-old man presented to Hasanuddin University Dental and Oral Hospital with a chief complaint of uncomfortable left posterior maxillary teeth during mastication. Clinical examination showed vital, non-caries, pocket depth of ±9mm on tooth 26. Radiographic examination showed a radiolucent lesion that extended to the apically. Regenerative periodontal treatment was performed using a combination of platelet-rich fibrin (PRF) with demineralized freeze-dried bone xenograft (DFDBX).&#x0D; Results: During the observation period, pocket depth was reduced, and the pain was absent.&#x0D; Conclusion: Periodontal inflammation that extends to the pulp tissue can be prevented by regenerative periodontal treatment using a combination of PRF and DFDBX, which shows promising results.&#x0D; Keywords: endo-perio lesions, periodontal regenerative, periodontal surgery

Biofunctionalization of Xenogeneic Collagen Membranes with Autologous Platelet Concentrate-Influence on Rehydration Protocol and Angiogenesis.

Background: The aim of this study was to analyze possible interactions of different xenogeneic collagen membranes (CM) and platelet-rich fibrin (PRF). PH values were evaluated in the CM rehydration process with PRF, and their influence on angiogenesis was analyzed in vivo. Materials and Methods: Porcine (Bio-Gide®, Geistlich)- and bovine-derived collagen membranes (Symbios®, Dentsply Sirona) were biofunctionalized with PRF by plotting process. PRF in comparison to blood, saline and a puffer pH7 solution was analysed for pH-value changes in CM rehydration process in vitro. The yolk sac membrane (YSM) model was used to investigate pro-angiogenic effects of the combination of PRF and the respective CM in comparison to native pendant by vessel in-growth and branching points after 24, 48 and 72 h evaluated light-microscopically and by immunohistochemical staining (CD105, αSMA) in vivo. Results: Significantly higher pH values were found at all points in time in PRF alone and its combined variants with Bio-Gide® and Symbios® compared with pure native saline solution and pH 7 solution, as well as saline with Symbios® and Bio-Gide® (each p < 0.01). In the YSM, vessel number and branching points showed no significant differences at 24 and 48 h between all groups (each p > 0.05). For PRF alone, a significantly increased vessel number and branching points between 24 and 48 h (each p < 0.05) and between 24 and 72 h (each p < 0.05) was shown. After 72 h, CM in combination with PRF induced a statistically significant addition to vessels and branching points in comparison with native YSM (p < 0.01) but not vs. its native pendants (p > 0.05). Summary: PRF represents a promising alternative for CM rehydration to enhance CM vascularization.

Salvage Through Endodontic and Periodontal Management – A Bold ACT.

Periapical surgery is an important treatment alternative in the presence of a large periapical cyst. To achieve regeneration and optimal healing of the bone different bone substitutes can be used. A 25 year old male patient reported with the chief complaint of mobile teeth in maxillary anterior tooth region with 21 labially placed. He had a history of trauma 5 years back. The clinical and radiographic diagnosis of infected periapical cyst with 21,22; Endodontic treatment was performed with 21, 22 followed by periapical curettage. Platelet rich fibrin (PRF) was mixed with Metronidazole gel and used as a regenerative biomaterial in the periapical defect. 6 months follow up shows satisfactory healing and regeneration of periapical region. There is considerable clinical interest in using PRF in combination with Metronidazole Gel. In conclusion, the results of the present study indicate that metronidazole gel along with PRF has a beneficial effect on healing of periapical defects.&#x0D; Keywords: Growth factor, Platelet rich fibrin, Regeneration.

The Evidence-based Effect of Platelet-rich Fibrin in Osteogenesis: A Systematic Review and Meta-analysis

ABSTRACT&#x0D; Background: Platelet Rich Fibrin (PRF) is a growth factor concentration functioning as an initiator of wound healing and bone regeneration, and it is mainly reported in dentistry rehabilitation and rejuvenation.&#x0D; Objective: summarize and analyze the evidence based on the effect of PRF on the bone osteogenesis&#x0D; Methods: A comprehensive search was conducted on the bibliographic databases or Medical Subject Headings in the PubMed. The search was conducted among articles that were published between 2010 and 2021. Required article information was extracted from each article by abstract and full paper availability that focuses on the Platelet-Rich Fibrin (PRF) And Osteogenesis. We recruited studies with the design was employed clinical trials with in vitro and in vivo approaches. The only study that provided osteogenesis outcome proceeded to the quantitative analysis.&#x0D; Results: Regarding literature search and screening processes, it yielded 24 studies for qualitative assessment and eleven studies for quantitative analysis. Most of the studies performed a combination of PRF with other materials such as Mg ring, BMSCs, Gold nanoparticles, and PDLSCs. It showed that PRF combined with other materials enhanced the osteogenic ability. The assessment of PRF only showed the various result in multiple outcome markers. For the ALP, the mean difference is 1.40 [1.14-1.67] p-value 0.001. It indicates there is a significant effect of PRF application with the increase of ALP. For the RUNX2, there is a significant effect of PRF application with the increase of RUNX2 1.10 [0.93, 1.26]. For OCN, the mean difference of PRF in OCN is 0.77 [0.43, 1.12] p=0.001. It showed a significant effect of PRF application with the increase of OCN. There is also a significant effect of PRF application for TRAP with the declining number of TRAP is -1.59 [-2.96, -0.22] p=0.001.&#x0D; Conclusion: PRF combined with other materials showed more promising results rather than PRF only. Moreover, in the assessment of PRF only, it was found that PRF has a significant effect in accelerating bone osteogenesis.&#x0D; Keywords:&#x0D; PRF, Platelet-Rich Fibrin, Osteogenesis

Geriatrik Hasta Popülasyonunda Ciddi Atrofik Posterior Maksillaya Dental İmplant Yerleştirmesini Takiben Trombositten Zengin Fibrin ve Allojenik Kemik Grefti Karışımı Kullanılarak Yapılan Sinüs Tabanı Ögmentasyonunun Hacimsel Değerlendirmesi Kohort Araştırması (Retrospektif)

Objective: We aimed to retrospectively evaluate the volume of new bone formed following sinus floor augmentation with simultaneous dental implant placement in severely atrophied residual alveolar ridges using a combination of platelet-rich fibrin and demineralized cortico-cancellous bone allograft in a geriatric population. Material and Methods: The clinical and radiological data of patients who underwent sinus floor augmentation using a combination of platelet-rich fibrin and demineralized cortico-cancellous bone allograft with simultaneous dental implant placement between 01 April 2013 and 01 August 2020 were retrieved from the archives. The main inclusion criteria for the study were age >60 years and a residual ridge height <2 mm. For each patient, cone-beam computed tomography (CBCT) scans were performed preoperatively, and 6 months after surgery. The volume of the maxillary sinus cavity preoperatively and postoperatively was measured using CBCT. The volume of the newly regenerated bone was calculated by subtracting the post-operative total sinus volume from the pre-operative total sinus volume. Residual and postoperative ridge heights were measured on the mid-coronal and mid-sagittal sections of preoperative and postoperative cone beam computed tomography images, respectively. Results: Fourteen patients with 19 sinus augmentations were included in the study. Thirty-two dental implants were placed with simultaneous sinus floor augmentation. All cases showed new bone formation on axial, coronal, and sagittal sections of postoperative CBCT scans. Conclusion: The combination of plateletrich fibrin and demineralized cortico-cancellous bone allograft used in sinus flor augmentation may promote the formation of healthy new bone that supports the simultaneous placement of dental implants in the elderly population with severely atrophic alveolar ridges.