Effect Of Platelet-rich Fibrin Research Articles

INFLUENCE OF PLATELET RICH FIBRIN ON BIOMECHANICAL PROPERTIES OF PRIMARY SUTURED CUTANEOUS INCISIONAL WOUNDS

The aim of the present study was to investigate the effect of platelet rich fibrin (PRF), a second generation platelet concentrate, on biomechanical properties of primary sutured cutaneous incisional wounds. Acute incisional wounds were made on the right and left side of the vertebral column of 15 adult mixed breed dogs. PRF membrane prepared from the venous blood of each animal was placed between the edges of the left side incisions while the right side incisions were used as controls. All incisions were sutured and skin samples were taken on days 3, 7 and 14 post-wounding for biomechanical analysis of wound strength. Mean breaking and tensile strength of PRF treated wounds were 48% and 52% greater than the control wounds at day 7 respectively which was statistically significant. Mean breaking stress of PRF treated wounds was also significantly greater than the controls at day 3 (16.42[Formula: see text][Formula: see text][Formula: see text]7.73 versus 9.823[Formula: see text][Formula: see text][Formula: see text]6.018). No significant difference in Young’s modulus of elasticity was observed between the treatment and control wounds. The results demonstrate that PRF improves the biomechanical properties of the healing incisional wounds especially in the first week. This could have positive implications particularly in patients suffering from conditions which adversely affect wound healing such as diabetes both in animals and humans although further studies are required.

Is Treatment of Gingival Recession Predictable?

The purpose of this study is to offer a method for prediction the result of treatment of gingival recessions using coronally advanced flap (CAF) and platelet rich fibrin membrane (PRFm) with CAF and connective tissue graft (CTG). The reported work gets answers to the following open questions: Is the treatment of mucogingival defects a predictable procedure? Is the jaw a factor affecting the outcome of coronally advanced flap root coverage procedure? To achieve this goal the authors followed the Creeping Attachment clinical parameter six months postoperatively. Keywords - Biostatistics, split mouth randomized controlled study, ANOVA-like model, Bayesian analysis, heterogeneous-variance model, two-way interactions. I. Introduction Gingival recession is a common manifestation in most populations. Gingival recession may be a concern for patients for a number of reasons such as root hypersensitivity, erosion, root caries, and aesthetics. Multiple gingival recessions may be a concern for patients with a high lip smile line. Studies on this surgical challenge mostly concern the treatment of recession defects. Multiple adjacent recession-type defects present a further challenge because several recessions must be treated at a single surgical session to minimize patient discomfort. Gingival recession affects a significant proportion of the adult population including those with a good standard of oral hygiene. In addition to its unfavorable effect on aesthetics and self-esteem, gingival recession also is associated with destructive periodontal diseases, root caries and fear of losing teeth. Clinical evaluations of the treatment of isolated and adjacent multiple gingival recessions based on both a Coronally Advanced Flap (CAF) alone or connective tissue graft (CTG) and in combination with a Platelet-Rich Fibrin (CAF + PRF) membrane are presented in (1-5). The aim of these studies was to determine whether the addition of an autologous platelet rich fibrin (PRF) membrane to a coronally advanced flap (CAF) would improve the clinical outcome in terms of root coverage in the treatment of isolated and adjacent multiple gingival recessions. Systemically healthy subjects each with single Miller's class I or II buccal recession defect were randomly assigned to control (CAF+CTG) or test (CAF + PRF) group. All patients who had been included in the study have received the treatment and turned up regularly for re-evaluation. Mean and standard deviation for the clinical variables have been calculated for each treatment. The aim of the study described in (4) and (9) was to determine whether the addition of an autologous platelet rich fibrin (PRF) membrane to a coronally advanced flap (CAF) would improve the clinical outcome in terms of root coverage in the treatment of isolated gingival recession. The result of this split mouth randomized controlled study evaluating the adjunctive effect of platelet rich fibrin to coronally advanced flap in Miller's class I or II recession defects is described in (3). The statistical analysis was performed using frequent statistics with R software. The significance of the difference within and between groups before and after treatment was evaluated with the paired t test. Differences were considered statistically significant at level of significance 0.05. II. Creeping Attachment Phenomenon Root coverage is a desired outcome of treatment. The root coverage may result from a mechanism known as creeping attachment, which is the postoperative migration of the gingival marginal tissue in a coronal direction over portions of a previously denuded root. This phenomenon can be detected up to 4 years after graft surgery. Gingival grafting is a well-established pure mucogingival procedure for increasing the width of attached gingiva. Since its introduction in 1963, the procedure has proven reliable in increasing attached gingiva and stopping progressive gingival recession. However, only a few cases of creeping attachment after gingival grafting have been reported in the dental literature. Matter and Cimasoni described 5 factors that seemed to have a definite influence on creeping attachment: width of the recession, position of the graft, interproximal bone resorption, position of the tooth and the patient's dental hygiene (6). Creeping attachment typically occurs within one to twelve months after the graft surgery. The amount of creeping attachment is unpredictable. In order to elucidate the mechanism of

Positive effect of platelet rich fibrin on osseointegration.

BackgroundLeukocyte-platelet rich fibrin (L-PRF) is a second generation platelet concentrate clinically used to accelerate tissue healing and bone regeneration. Achieving reduced implant osseointegration time could provide immediate or early loading of implants. The aim of this study was to evaluate the L-PRF-induced osseointegration and bone-implant contact (BIC) in an experimental animal model.Material and MethodsTwelve 4-month-old New Zealand white rabbits were used. Following general anesthesia, 3-5 mL of blood was obtained from the central artery in rabbit ear and L-PRF was prepared. Two implant cavities (5 mm long and 3 mm in diameter) were created in each tibia with a total of four cavities in each animal. Two of these cavities were selected and covered with PRF (test group). The remaining L-PRF was used to soak the implants placed into the L-PRF covered sockets. Other cavities were left as controls. In total, 48 implants were placed. Animals were sacrificed after two, three, or four weeks. Histological samples were obtained and peri-implant tissues were histomorphometrically evaluated for bone-to-implant contact and new bone formation.ResultsHistomorphometric analyses of the defects revealed that the L-PRF was detectable up to the second week. Application of L-PRF increased the rate and amount of new bone formation in the experimental group compared to the control group. Bone-to-implant contact was enhanced when the surface was pre-wetted with L-PRF (p<0.01).ConclusionsThe results of this study demonstrated that L-PRF application may increases amount and rate of new bone formation during the early healing period and provides a faster osseointegration around implants. Key words:Dental implants, platelet rich fibrin, osseointegration, bone regeneration, matrix for growth factors.

Enhancement of healing of donor hard palate site using platelet-rich fibrin

Gingival recession is not only an aesthetic concern but also often is associated with problems such as tooth hypersensitivity. Among various root coverage modalities, free soft-tissue gingival graft shows promising results, but is associated with patient discomfort due to the need for second surgical palatal donor site. The purpose of this case report is to evaluate the effectiveness of platelet-rich fibrin (PRF) at donor palatal site with root coverage procedure in the treatment of recession-type defects. This paper reports a case of a 31-year-old male with a root coverage procedure, and employing PRF at donor site has been discussed below. Hence, the employment of PRF at donor site not only enhances healing but also reduces patient discomfort that occurs due to palatal plate.

Nociceptive evaluation of the association between physical exercises and platelet-rich fibrin in Wistar rats submitted to median nerve compression

BACKGROUND AND OBJECTIVES: Platelet-rich fibrin is a new and promising technique to accelerate repair, with possible analgesic effects; however, there is still a gap with regard to peripheral nerve injury and the association with physical exercises. So, this study aimed at evaluating the effects of platelet-rich fibrin associated to physical exercises on nociception and edema in experimental median nerve compression model. METHODS: Thirty-six rats, all submitted to median nerve compression, were divided in six groups: G1: without additional manipulation; G2: compression and treated with platelet-rich fibrin; G3: compression and treated with free swimming; G4: compression and walking on a treadmill; G5: free swimming + platelet-rich fibrin; G6: walking on a treadmill + platelet-rich fibrin. Injury was induced by tying the median nerve with chrome plated catgut 4.0. Platelet-rich fibrin was obtained by centrifuging 1.5 mL of blood and positioning the fibrin clot directly on the compression region. Exercises were carried out during two weeks, between the 3rd and 14th postoperative days. Nociception and edema were evaluated, respectively, by flinch threshold and plethysmometer, in moments before injury and in the 3rd, 7th and 15th postoperative days. RESULTS: There have been no differences among groups, only among evaluations, showing increased nociception and edema, which has lasted or improved, respectively, over time. CONCLUSION: Platelet-rich fibrin alone or associated to physical exercises has not changed nociception and edema.

EVALUATION OF THE EFFECT OF PLATELET RICH FIBRIN ON BONE HEALING AFTER SURGICAL REMOVAL OF IMPACTED MANDIBULAR THIRD MOLAR

Introduction: Following the extraction of impacted mandibular third molars, there is a risk for developing new, or having persistentosseous periodontal defects on the distal aspects of the adjacent second molars.Objectives: To evaluate the effect of platelet rich fibrin (PRF) on bone healing distal to the second molar following removal ofimpacted mandibular third molar.Materials and methods: This was a parallel, controlled and randomized clinical trial. Twenty patients aged between 20-30 years,who have mesioangular position B impacted mandibular third molar indicated for surgical removal were selected for this study. Tenpatients were taken for the study group, where PRF was applied in the extraction socket of the mandibular third molar and 10 patientsfor the control group, where the extraction sockets were sutured without receiving PRF. The patients were evaluated clinically forpain, edema and trismus on the second, fourth and seventh day post-operatively and radiographically on the first, second and thirdmonth post-operatively. Standardized periapical x-ray films were taken for each patient preoperatively and on the first, second andthird postoperative months. Image-J Processing Program was used for the assessment of new bone formation at the distal surface ofthe second molar.Results: There was less pain and trismus in the study group than in the control group but the difference among them was notstatistically significant (p > 0.05). Edema was significantly lower in the study group than in the control group in the second andfourth postoperative days. There was significantly more bone density and higher bone level in the study group than in the controlgroup on the second and third postoperative months (p < 0.05).Conclusion: It is clear that PRF is biocompatible and can improve both soft tissue healing and bone regeneration after surgicalremoval of impacted mandibular third molar.

Platelet-rich fibrin: the benefits

Current published data presents confusing results about the effects of platelet-rich fibrin on bone, and there is a need for studies that throw light on its effect. Our main objective therefore was to evaluate (by fractal analysis) osseous regeneration in extraction sockets with and without platelet-rich fibrin in a study with a substantial sample and a reliable technique to calibrate its effects on bone cells. We also assessed the soft tissue response. Thirty-four patients had their bilaterally impacted third molars (68 surgical sites) extracted in this split-mouth study, following which platelet-rich fibrin was placed in one of the sockets. Patients were followed up clinically and radiographically, and a pain score and fractal analysis were used to evaluate healing of soft tissue and bone, respectively. We conclude that platelet-rich fibrin improves healing of both soft and hard tissues. Although osseous healing did not differ significantly between the groups, healing of soft tissue as judged by the pain score was significantly better in the experimental group.

The effect of platelet-rich fibrin on bone regeneration and angiogenesis in rabbit cranial defects

This study evaluated the effect of platelet-rich fibrin (PRF) on the osteogenesis and angiogenesis of rabbit calvarial defects. The calvarium of nine rabbits was exposed. In each rabbit, two circular bone defects, one on each side of the midline, were prepared using a reamer drill. While the experimental site received PRF, the control sites were left filled with blood. The animals were sacrificed after a period of 1 week (n=3), 2 weeks (n=3), and 4 weeks (n=3). The following histomorphometric data were recorded: 1) the area of the newly formed tissue relative to total bone defect (NT) and the area of newly formed osteoid relative to newly formed tissue (NB), 2) the longest and shortest vertical height of the newly formed tissue relative to the vertical height of normal tissue (LH, SH), 3) newly formed osteoid on the defect margin using region of interest (NBR), and 4) bony pontic formation from the margin was used to evaluate bone growth (OS). The expression of vascular endothelial growth factor (VEGF) was evaluated by immunohistochemical staining. The differences between groups were not significant at any experimental time point. However, a significant linear increase of NB and NBR including OS value according to time was observed in the PRF group. In addition, the intensity and percentage range of VEGF expression showed a significant linear decrease trend with the time in the PRF group. The results of this study suggest that PRF may enhance the quality of bone regeneration.

Effect of Platelet-rich Fibrin on Healing of Apicomarginal Defects: A Randomized Controlled Trial

IntroductionThe purpose of this prospective, randomized controlled trial was to evaluate the healing outcomes of platelet-rich fibrin (PRF) in periapical surgeries involving apicomarginal defects and to compare these results with surgeries not using any guided tissue regeneration techniques. MethodsThirty patients with suppurative chronic apical periodontitis and apicomarginal communication were randomly assigned to either the PRF or the control group. Clinical and radiographic parameters including pocket depth (PD), clinical attachment level, gingival marginal position, size of periapical lesion, and percentage reduction of the periapical radiolucency were recorded at baseline and at an interval of 3 months for a period of 12 months. ResultsThe overall success rate was 83.33%, with a success rate of 86.66% (13 of 15 teeth) for PRF group and 80% (12 of 15 teeth) for control group. Both the groups exhibited a significant reduction in PD, clinical attachment level, gingival marginal position, and size of periapical lesion at 12-month period. No significant differences were observed between the 2 groups for these parameters except PD, which showed a statistically significant reduction in the PRF group (P < .05). ConclusionsThe adjunctive use of regenerative techniques may not promote healing of apicomarginal defects of endodontic origin.

Evaluation of platelet-rich fibrin on alveolar bone height after removal of impacted lower third molar

ObjectivesThis study aimed to assess the effect of platelet-rich fibrin (PRF) on both bone and supporting tissue healing after surgical removal of impacted lower third molar using the digital panoramic bitewing technique.Patients and methodsTwenty patients complaining of a bilaterally impacted lower

Effect of Platelet Rich Fibrin (PRF) on Peri-implant Soft Tissue and Crestal Bone in One-Stage Implant Placement: A Randomized Controlled Trial.

The viability of Platelet Rich Fibrin (PRF) on enhancement of osseous and associated tissue healing has been substantiated well in literature. However, paucity in the applicability of PRF to enhance peri-implant healing in oral region is not well-corroborated. This prospective study evaluated the effect of Platelet PRF on peri-implant tissue response following one-stage implant placement with non-functional immediate provisionalization in maxillary anterior region. A Prospective, Randomized Controlled Trial (RCT) was conducted across 20 (15 male, 5 Female) systemically healthy subjects with maintainable oral hygiene. Subjects were broadly divided into two groups i.e. Study group (PRF group) and Control group (Non-PRF group). Twenty standard SLA- AB/AE (alumina oxide blasted/acid etched surface treated) tapered threaded dental implants were randomly placed with and without PRF and immediately provisionalized. The subjects were evaluated clinically and radiographically at baseline (at time of implant placement), one month and three month post-operatively for peri-implant soft tissue and crestal bone responses. At 3 months, all implants remained osseointegrated. The mean marginal bone changes were observed from baseline to 3 months in both groups with lesser changes observed in PRF Group. No significant differences in probing depth and bleeding on probing were noted during follow-up. Within the limitations of this study, PRF could be considered as a healing biomaterial with potential beneficial effect on peri-implant tissue and can be used as a therapeutic adjuvant in clinical scenario of one stage, single tooth implant placement procedure in maxillary anterior region.

Platelet Rich Fibrin in double lateral sliding bridge flap procedure for gingival recession coverage: An original study.

Background:Gingival recession is a common occurrence in periodontal disease leading to an unaesthetic appearance of the gingiva. The effect of platelet-rich fibrin (PRF), when used along with double lateral sliding bridge flap (DLSBF), remains unknown. The aim of this study is to evaluate the effect of PRF in conjunction with DLSBF for multiple gingival recessions.Materials and Methods:Twenty systemically healthy individuals exhibiting Grade II gingival recession on their mandibular central incisors were recruited in this study. These patients were randomly assigned into two groups: DLSBF and PRF + DLSBF. The clinical parameters that were evaluated in this study were gingiva recession height, gingiva recession width, width of keratinized gingiva, clinical attachment level, and probing depth. PRF was procured from the patient's blood at the time of the surgery and used for the procedure. The follow-up was performed at 12 and 24 weeks postsurgery.Results:Statistically significant difference was observed between the clinical parameters at baseline and 12 and 24 weeks within the groups. There was no statistically significant difference, between the groups. Mean root coverage (RC) was 80% ±29.1% in the DLSBF group and 78.8% ±37.6% in the DLSBF + PRF group with no statistically significant difference.Conclusion:From the results obtained in this study, the addition of PRF to DLSBF gives no additional benefits to the clinical parameters measured in RC.

A Comparative Study of The Effectiveness of Platelet Rich Fibrin on Bone Regeneration of Various Grafts in Sinus Floor Augmentation

The objective of this study was to evaluate the effectiveness of various grafting materials used for augmentation of the maxillary sinus floor in a rabbit model.

Role of platelet rich fibrin and platelet rich plasma in wound healing of extracted third molar sockets: a comparative study.

This prospective study was done to evaluate and compare the utility and effectiveness of platelet rich fibrin (PRF) with that of platelet rich plasma (PRP) on soft tissue healing and bone tissue healing of extracted third molar sockets. This study included split mouths of 20 patients who underwent bilateral extraction of impacted third molars. During the same appointment, following which PRF and PRP were prepared from patients' autologous blood and placed in right and left extracted sockets, respectively. The data for soft tissue healing were recorded at end of 1week, using healing index of Landry et al. and the data for bone tissue healing were recorded at the end of 4months using digitalized orthopantomogram images on Adobe Photoshop CS; which was then compared between the two sites of the same patient. The mean values of soft tissue healing collected at 1week post-operative, for PRF group were significantly higher as compared to PRP group. And the mean values of bone density collected at the end of fourth month post-operative, for PRF group were also significantly higher as compared to PRP group. Both tests showed p value of 0.00. PRF is significantly better in promoting soft tissue healing and also faster regeneration of bone after third molar extraction, in comparison with PRP. This could be attributed to simpler preparation protocols of PRF over PRP and the ability of PRF to release growth factors in a controlled way.

Comparative Evaluation of Platelet-rich Fibrin and Mineral Trioxide Aggregate as Pulpotomy Agents in Permanent Teeth with Incomplete Root Development: A Randomized Controlled Trial

IntroductionThe purpose of this study was to evaluate and compare, clinically and radiographically, the effects of platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA) as pulpotomy agents in permanent teeth with incomplete root development. MethodsA total number of 70 children requiring pulpotomy in 70 permanent molars with incomplete root development were screened. Sixty-two patients met the inclusion criteria and were enrolled in the study. The patients were randomly allocated equally in 2 treatment groups. MTA pulpotomy was performed in group A (the control group), and PRF pulpotomy was performed in group B (the experimental group). The treated teeth were restored with amalgam followed by stainless steel crowns. Clinical and radiographic evaluations were performed after 6, 12, and 24 months. Thus, the data obtained were blindly analyzed using the chi-square test. ResultsThere was no significant difference between the 2 groups in terms of clinical and radiologic success. Radiographically, all available cases (53 teeth) showed evidence of root growth and canal narrowing. Complete apical closure was observed in 88.8% in the PRF group (experimental group) and 80.07% of roots in the MTA group (control group), respectively, at 24 months. ConclusionsPRF could be used as a suitable biological and economic alternative to MTA in pulpotomy procedures of permanent teeth with incomplete root development.

The bone integration effects of platelet-rich fibrin by removal torque of titanium screw in rabbit tibia

Platelet-rich fibrin (PRF) is nowadays often used in various fields, but no removal torque studies have yet been done to evaluate the effects of the platelet-rich fibrin on the bone integration at the initial healing period. An experimental study have been performed in rabbits to evaluate whether the complete PRF clots can accelerate the bone integration of implants at the initial healing period after creating bone defects in tibias. The effec t of the complete PRF clots on bone integration was studied in two rabbit groups, 4-week group (group A) and 6-week group (group B) after preparing bony defects. Artificial bony defects were prepared in the tibias of rabbits. The complete PRF clots was applied to the defects in the experimental group, whereas the defects were unfilled in the control group. Four weeks later, machined implants were installed into the rabbit tibias (group A). Six weeks after installation, the removal torque from nine rabbits was measured to examine the bone healing effect of PRF. In another rabbits (group B), 6 weeks after preparing bony defects, installation was performed, and another 6 weeks after installation, the removal torque from nine rabbits was measured. The authors found a positive significant effect of the complete PRF clots on bone integration (higher bone density) in group A installed at 4 weeks after preparing bony defects (p = 0.008; t-test), but not in group B installed at 6 weeks after preparing bony defects (p = 0.677).

Effect of platelet rich fibrin and beta tricalcium phosphate on bone healing. A histological study in pigs

To investigate the effect of platelet rich fibrin (PRF) and beta tricalcium phosphate (β-TCP), alone or in combination, on bone regeneration in pig tibial defects. Four standardized defects were prepared in both tibias of three adult male pigs. The first defect was left unfilled as a control; the others were grafted with either PRF, β-TCP or PRF mixed with β-TCP. All animals were sacrificed on the 12th postoperative week and the tibial bones were removed, histologic sections were prepared and the experimental sites were examined microscopically and stereologically. Histologic and stereologic examination revealed more new bone formation in the defects filled with PRF mixed β-TCP than in the defects grafted with either β-TCP or PRF alone. The platelet rich fibrin and beta tricalcium phosphate combination effectively induces new bone formation.

Labial-cervical-vertical groove: A silent killer-Treatment of an intrabony defect due to it with platelet rich fibrin

A 47-year-old male patient reported to the Department of Periodontology, with a chief complaint of pus discharge from maxillary left central incisors with dull intermittent pain. On clinical examination, a localized gingival inflammation was present with soft edematous tissue with the accumulation of plaque and calculus with #11 and #21. Periodontal examination depicts a periodontal pocket depth of 11 mm on mesial aspect and 8 mm on midbuccal aspect of #21 with no mobility. On radiographic examination, a tear-shaped radiolucency was present with localized bone loss in #21. On careful examination, labial-cervical-vertical groove (LCVG) was found on #21 which was extending into gingival sulcus. This article reports the effectiveness of platelet rich fibrin for the treatment of intrabony defect associated with labial-cervical-vertical groove of #21.

The effect of platelet rich fibrin on growth factor levels in urethral repair

AimPlatelet rich fibrin (PRF) is an autologous source of growth factors and promotes wound healing. An experimental study was performed to evaluate the effect of PRF on growth factor levels in urethral repair. Materials and MethodsEighteen Wistar albino rats were included in the study. Rats were allocated in three groups (n:6): control (CG), sham (SG), and PRF (PRFG). In SG, a 5mm vertical incision was performed in the penile urethra and repaired with 10/0 Vicryl® under a microscope. In PRFG, during the urethral repair as described in SG, 1cc of blood was sampled from each rat and centrifuged for 10minutes at 2400rpm. PRF obtained from the centrifugation was placed on the repair site during closure. Penile urethras were sampled 24hours after PRF application in PRFG and after urethral repair in SG. Transforming growth factor beta receptor (TGF-β-R-CD105), vascular endothelial growth factor (VEGF) and its receptor (VEGF-R), as well as endothelial growth factor receptor (EGFR), were evaluated in subepithelia of the penile skin and urethra. Groups were compared for growth factor levels and growth factor receptor expression with the Kruskal Wallis test. ResultsTGF-β-R levels were significantly decreased in SG when compared to CG (p<0.05). In PRFG, TGF-β-R was increased in both subepithelia of penile skin and urethra with respect to SG (p<0.05). When VEGF levels and its receptor expression were compared between SG and PRFG, VEGF levels were found to be increased in penile skin subepithelium, whereas VEGF-R expressions were decreased in urethral subepithelia in PRFG (p<0.05). There was no difference between groups for EGFR levels (p>0.05). ConclusionUse of PRF after urethral repair increases TGF-β-R and VEGF expressions in urethral tissue. PRF can be considered as an alternative measure to improve the success of urethral repair.

Effects of platelet-rich fibrin and bone marrow mononuclear cells on the bone regeneration: a histological and histomorphometric study in rat calvaria

Effects of platelet-rich fibrin and bone marrow mononuclear cells on the bone regeneration: a histological and histomorphometric study in rat calvaria