Efficacy Of Platelet-rich Fibrin Research Articles

Efficacy of Platelet Rich Fibrin versus chitosan as a hemostatic agent following dental extraction in patients on antiplatelet therapy

ObjectivesThe aim of this study is to compare the effectiveness of Platelet Rich Fibrin gel and Chitosan gel dressing in providing hemostasis in patients receiving Oral Antiplatelet Therapy and also to evaluate their surgical healing outcome following dental extractions. MethodologyA total of 60 patients under Oral Antiplatelet Therapy indicated for tooth extraction were included for treatment in the study without altering the oral antiplatelet regimens. Patients were allocated equally in two groups; Group A: where PRF gel was packed into the extraction socket, while Group B: Chitosan hydrogel was packed. Timing of hemostasis was noted for each patient of both the groups. Patients were examined for any pain/secondary bleeding/healing/soft tissue dehiscence/alveolar osteitis in the extraction site on first, third and seventh post-operative days. ResultsAll extraction sockets with Platelet-rich fibrin achieved hemostasis in 2.64 min and sockets with Chitosan hydrogel achieved hemostasis in 1.182 min (p < 0.001). Post-operative pain in Group A sites (3.2, 1.4, 0.37 on 1st, 3rd & 7th day respectively) was significantly lower than the control sites (3.4, 1.67, 0.53 on 1st, 3rd & 7th day respectively) p-value 0.001, 0.001 respectively. ConclusionIn this study, Chitosan hydrogel dressing thus proved to be a superior hemostatic agent compared to PRF gel, that significantly shortens the clotting time following dental extraction in patients under antiplatelet therapy. But, PRF gel has superior wound healing properties than Chitosan with less postoperative pain following minor oral surgical procedures under local anesthesia.

A Study to Evaluate the Efficacy of Platelet Rich Fibrin with Nanocrystalline Beta-Tricalcium Phosphate in the Treatment of Periodontal Intrabony Defects

Background: Presently, there is no gold-standard regenerative material for the treatment of periodontal intrabony defects. The use of bone grafts in combination with guided tissue regeneration membrane is a predictable treatment option but is expensive. Platelet concentrates are increasingly being used due to their ease of use and cost-effectiveness. Aims: The objective of the present study is to compare clinically and also by Cone Beam Computed Tomography (CBCT), the effect of platelet-rich fibrin combined with synthetic beta-tricalcium phosphate to synthetic beta-tricalcium phosphate alone in the treatment of periodontal intrabony defects. Materials and Methods: 10 patients possessing 2 almost identical interproximal intrabony defects in either side of mandible were selected and the defects were further divided into 2 groups randomly: Control Group A (Beta-tricalcium phosphate placed) and Test Group B (Beta-tricalcium phosphate with platelet-rich fibrin placed). Regeneration of soft tissue and hard tissue (using CBCT) were evaluated after 6 months from baseline in both groups. Statistical Analysis Used: The intragroup and intergroup comparisons were done using Paired and student t-test. Results: Intragroup showed significant improvement in both soft tissue and hard tissue parameters. Mean of all parameters was better in the test group; however, the intergroup difference was not statistically significant. Conclusions: Within the limitations of the present study, the use of beta-tricalcium phosphate bone graft combined with platelet-rich fibrin and beta-tricalcium phosphate bone graft alone are both equally effective for the treatment of periodontal intrabony defects.

Efficacy of Platelet-rich Fibrin in Interdental Papilla Reconstruction as Compared to Connective Tissue Using Microsurgical Approach.

Aim:This study aims to evaluate autologous platelet-rich fibrin (PRF) and autogenous connective tissue graft (CTG) in interdental papilla (IDP) reconstruction with buccal and palatal split-thickness flap (STF) using microsurgical technique.Materials and Methods:Forty Class I or Class II open gingival or cervical embrasure in maxillary anterior region in 14 patients were surgical treated for the reconstruction of IDP. For experimental Group I (STF with PRF, n = 20), surgical site was flushed with PRF fluid. PRF was then placed under the buccal flap and in the IDP region and squeezed. For experimental Group II (STF with CTG, n = 20) after the preparation of recipient site, CTG procured from palate was trimmed to the desired size and shape and placed at the site. Clinical parameters and patient satisfaction response recorded were plaque index, gingival index, probing pocket depth, clinical attachment level, height of IPD, and papilla index score (PIS).Results:STF surgery in combination with PRF or CTG, are an effective procedure to increase IDP-height with mean values of 3.10 mm (87.3%) and 3.45 mm (95.8%) for Group I (STF + PRF) and Group II (STF + CTG), respectively. In terms of complete fill (CF) achieved at 3 months, in the present study, the result showed that 90% CF was obtained in Group I (STF + PRF) and 95% in Group II (STF + CTG). The patient response and acceptance for surgical treatment modality in terms of patient postsurgical discomfort score and patient esthetic score was higher for Group II (STF + CTG) than Group I (STF + PRF).Conclusion:Based on single-centered 3 months' follow-up, it may be concluded that STF surgery in combination with PRF or CTG is an effective procedure to increase IDP-height; however, a long-term multicentric randomized clinical trial may be necessary to evaluate the clinical outcome for autologous PRF in comparison to CTG with STF.

Efficacy of Platelet-Rich Fibrin in Bone Regeneration of the Jaws: A Systematic Review

5 RCTs were selected and analyzed qualitatively, 4 articles (1 RCT and 3 SRs) evaluated results in maxillary sinus lift surgery not showing differences using PRF compared to the traditional technique. For bone regeneration of the alveolar ridge, 2 RCTs indicated that PRF in combination with autogenous bone improves bone volume.

The efficacy of platelet-rich fibrin as a scaffold in regenerative endodontic treatment: a retrospective controlled cohort study

BackgroundBlood Clot (BC) or platelet concentrates have been used as scaffold in regenerative endodontic treatment (RET). The aim of this retrospective study was to compare the performance of platelet-rich fibrin (PRF) with BC in inducing root development and periapical lesion healing after tooth revascularization.MethodsFive patients receiving RET using PRF as a scaffold were matched 1:1 to a previous cohort of 5 patients who underwent tooth revascularization by provoking periapical bleeding. Clinical signs and symptoms were examined at follow-ups. Periapical lesion healing and root development were monitored radiographically. The resolution of clinical signs and symptoms as well as periapical radiolucency was observed in all patients (100%).ResultsRoot elongation, dentinal wall thickening and apex closure were found in most cases (80% in both groups). There was no significant difference between the groups in terms of clinical sign resolution, root development and periapical healing.ConclusionsWithin the limits of this study, PRF achieved comparable outcomes to BC in terms of clinical sign and symptom resolution, periapical lesion healing and continued root development in RET.

Efficacy of Platelet-rich Fibrin on Bile Duct Anastomosis in a Rat

Objectives The bile duct and the vascular endothelium are vulnerable to damaging effects of ischemic, immunologic, and preservation injuries. Therefore, biliary complications following liver transplantation are common and remain a major source of morbidity in liver transplant patients. Platelet-rich-fibrin (PRF) is a safe, autologuos and degredable material which contain high amount of plateletes and fibrin. Aim of the study was to evaluate the effect of PRF on bile duct anastomosis healing process in rats. Methods Thirty male Sprague Dawley (SD) rats were used for the study. The animals were allocated into three groups: Group I Control group(n=10): Anastomosis to common bile duct (CBD) over a stent. Group II PRF Group(n=10): Anastomosis to CBD over a stent and covered with PRF. Group III Sham Group(n=10):Preparation of common bile duct, no anastomosis. The animals were followed up for 1 month, then sacrificed. Study parameters were adhesions around the anastomosis, bridging bile duct tissue thickness over the stent and histopathologic examination of the bridging bile duct tissue. Results CBD anastomosis over a stend caused severe adhesion around the anastomosis, bridging bile duct tissues were weak and histopathologically healing were incomplet in most of the control animals. PRF application however, significantly reduced the adhesions, increased the quality of bridging bile duct tissues and caused complete healing histologically. Conclusion PRF is a safe, autologuos, easily prepared membrane. Our findings shows that PRF prevents local complications, and increases healing capacity of the bile duct after CBD anastomosis. Therefore it might be an alternative treatment option to prevent bile duct complications after liver transplantation patients.

Efficacy of platelet rich fibrin in myringoplasty

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Myringoplasty involves repair of tympanic membrane perforation with an autologous graft.The aim was to compare between myringoplasty with PRF and myringoplasty without fibrin.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This study was conducted from July 2016 to June 2017,100 patients were taken. In 50 patients platelet rich fibrin was placed over graft and external auditory canal during myringoplasty and 50 without PRF. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; It was seen in the study that PRF improves overall success rate of myringoplasty study and there was significant improvement in ABG at 500 hz, 1000 hz, 2000 hz frequencies.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The higher success rate of myringoplasty with PRF was seen as compared to myringoplasty without fibrin. There were no noticeable side effects.&lt;/p&gt;

To assess the efficacy of socket plug technique using platelet rich fibrin with or without the use of bone substitute in alveolar ridge preservation: a prospective randomised controlled study.

The purpose of this study is to evaluate the efficacy of Platelet Rich Fibrin (PRF) as a socket plug with or without use of Plaster of Paris (POP) as bone substitute to preserve the alveolar ridge post-extraction. A prospective randomised single blind controlled study, was conducted for 18 months from November 2014 to May 2016 on 48 patients requiring extraction. All teeth were extracted atraumatically using periotomes and luxators without raising mucoperiosteal flap. Sockets were randomly allotted to groups A, B and C. Group A sockets were chosen as control, where figure of eight suture was placed. In group B sockets, PRF obtained by centrifugation was used as a socket plug and stabilised with figure of eight suture. Group C sockets were filled with POP and then covered with PRF. The socket was then closed with a figure of eight suture. Patients were informed of need for 6months follow-up. Ninety sockets in 48 patients were subjected to our study. We found that results in the sockets where we have grafted POP showed better ridge preservation and post-operative comfort even though the difference in ridge resorption between the three groups was not statistically significant. Powered by Editorial Manager® and ProduXion Manager® from the Aries Systems Corporation. Atraumatic extraction may minimise the post-operative pain and discomfort to patient as well as the post-extraction alveolar height and width changes. The use of PRF and/or bone substitute even though clinically contributes to better post-operative healing and minimal loss of alveolar width and height, the values were not statistically significant.

Management of Facial Pyoderma Gangrenosum Using Platelet-Rich Fibrin: A Technical Report

This report describes a case of local pyoderma gangrenosum that was treated with short-term immunosuppressive therapy and the topical application of platelet-rich fibrin (PRF). Medical treatment included oral corticosteroid therapy and topical treatment with PRF in solid and liquid form. This therapy initially led to the reduction of the ulcer's size and an improvement in symptoms, until the ulcer was completely healed after a few weeks. A relapse was treated with only the application of PRF to the affected tissue with excellent recovery. The efficacy of PRF as a guide for wound healing is a result of the continuous release of growth factors involved in tissue repair mechanisms. PRF has proved to be suitable for the management of facial pyoderma gangrenosum while allowing a reduction in systemic corticosteroid therapy. The ease of preparation, low cost, and outpatient use make PRF an optimal scaffold for tissue healing processes.

Single-Stage Cartilage Repair Using Platelet-Rich Fibrin Scaffolds With Autologous Cartilaginous Grafts

Background: To avoid complicated procedures requiring in vitro chondrocyte expansion for cartilage repair, the development of a culture-free, 1-stage approach combining platelet-rich fibrin (PRF) and autologous cartilage grafts may be the solution. Purpose: To develop a feasible 1-step procedure to combine PRF and autologous cartilage grafts for articular chondral defects. Study Design: Controlled laboratory study Methods: The chemotactic effects of PRF on chondrocytes harvested from the primary culture of rabbit cartilage were evaluated in vitro and ex vivo. The rabbit chondrocytes were cultured with different concentrations of PRF media and evaluated for their cell proliferation, chondrogenic gene expression, cell viability, and extracellular matrix synthesis abilities. For the in vivo study, the chondral defects were created on established animal models of rabbits. The gross anatomy, histology, and objective scores were evaluated to validate the treatment results. Results: PRF improved the chemotaxis, proliferation, and viability of the cultured chondrocytes. The gene expression of the chondrogenic markers, including type II collagen and aggrecan, revealed that PRF induced the chondrogenic differentiation of cultured chondrocytes. PRF increased the formation and deposition of the cartilaginous matrix produced by cultured chondrocytes. The efficacy of PRF on cell viability was comparable with that of fetal bovine serum. In animal disease models, morphologic, histological, and objectively quantitative evaluation demonstrated that PRF combined with cartilage granules was feasible in facilitating chondral repair. Conclusion: PRF enhances the migration, proliferation, viability, and differentiation of chondrocytes, thus showing an appealing capacity for cartilage repair. The data altogether provide evidence to confirm the feasibility of 1-stage, culture-free method of combining PRF and autologous cartilage graft for repairing articular chondral defects. Clinical Relevance: The single-stage, culture-free method of combining PRF and autologous cartilage is useful for repairing articular chondral defects. These advantages benefit clinical translation by simplifying and potentiating the efficacy of autologous cartilage transplantation.

Platelet-rich fibrin might not provide a benefit in healing and complications after third-molar extraction

Al-Hamed FS, Tawfik MA, Abdelfadil E, Al-Saleh MA. Efficacy of platelet-rich fibrin after mandibular third molar extraction: a systematic review and meta-analysis [published online ahead of print February 1, 2017]. J Oral Maxillofac Surg. http://dx.doi.org/10.1016/j.joms.2017.01.022.

Versatility of platelet rich fibrin in the management of alveolar osteitis—A clinical and prospective study.

ObjectiveTo assess the efficacy of Platelet Rich Fibrin (PRF) on the pain and healing of the extraction socket associated with Alveolar Osteitis (Dry Socket, AO) after removal of maxillary and mandibular molars. Study design100 adult patients with age group ranging from 18 to 40 years along with established dry socket after maxillary and mandibular molar extractions who have not received any treatment for the same were included in the study. PRF was placed in the maxillary and mandibular molar extraction sockets after adequate irrigation of the socket. All the patients evaluated for the various study variables which include pain, degree of inflammation, and healthy granulation tissue formation at 1st, 3rd, 7th, and 14th post operative day. Data were analyzed using Shapirowilk’s test, chi square test and/or student-t test, Friedman’s test, Wilcoxson’s signed rank test, and Bonferroni test, with the significance level set at P<0.05. ResultsThere was significant reduction in pain associated with AO at the 3rd and 7th postoperative day along with better wound healing by the end of 2nd week. ConclusionUse of PRF in this study illustrates the promising results in terms of reduced pain and better healing in the patients with Alveolar Osteitits.

Effect of Autologous Platelet Rich Fibrin in Human Mandibular Molar Grade II Furcation Defects- A Randomized Clinical Trial.

The Furcation of multirooted teeth is difficult region to gain access for treatment due to their complex anatomy. Modifications have been made in the periodontal instrument armamentarium to facilitate treatment of furcations. Moreover, many new materials have been introduced to attempt regeneration in the furcation defects. This study evaluated the role of Platelet Rich Fibrin (PRF) in comparison with allograft and Guided Tissue Regeneration (GTR) in the treatment of Grade II mandibular molar furcations. This was a parallel arm prospective randomized, interventional trial (NCT 02430519) conducted on 22 patients, with Grade II mandibular furcation defects. Patients were divided into two equal groups. Group A, were treated by the placement of PRF as a graft and as a membrane while in Group B, the defects were treated by the placement of allograft and Healiguide collagen membrane. Clinical parameters {Plaque Index (PI), Probing Depth (PD), Relative Vertical Clinical Attachment Level (RVCAL), Relative Horizontal Clinical Attachment Level (RHCAL), Gingival Marginal Level(GML), and amount of Bonefill using Radio-Visiography (RVGBF)}, were estimated at baseline and nine months postoperatively. Comparison between the groups was analysed by using independent sample t-test, whereas, paired t-test was used to assess the mean values within the groups. The intergroup comparison for PI, PD, RHCAL, GML, was statistically not significant. Pertaining to RVCAL, there was a statistically significant difference at nine months (p-value=0.04) in Group A. Also, there was a statistically significant difference related to RVGBF (p-value=0.006) in Group A at nine months. The efficacy of PRF should be ascertained by conducting more studies with a larger sample size, on a long term basis, in patients with molar Grade II furcation defects.

Platelet rich fibrin in the management of established dry socket.

ObjectivesDry socket may occur secondary to the removal of any tooth. However, most dry socket cases develop in the third molar region. Dry socket is multifactorial in nature and has been treated using various modalities with varying success rates. This study assessed the efficacy of platelet rich fibrin (PRF) in established dry socket.Materials and MethodsTen patients of either sex aged from 41 to 64 years with established dry socket according to established criteria were treated using PRF. Evaluation was performed by observing the reduction of pain using visual analogue scale, analgesic tablet use over the follow-up period, and healing parameters.ResultsPain was reduced on the first day in all patients with decreased analgesic use. Pain was drastically reduced during follow-up on the first, second, third, and seventh days with a fall in pain score of 0 to 1 after the first day alone. The pain scores of all patients decreased to 1 by the first day except in one patient, and the scores decreased to 0 in all patients after 48 hours. Total analgesic intake ranged from 2 to 6 tablets (aceclofenac 100 mg per tablet) over the follow-up period of 7 days. Healing was satisfactory in all patients by the end of the seventh day.ConclusionPRF showed early pain reduction in established dry socket with minimal analgesic intake. No patients had allergic reactions to PRF as it is derived from the patient's own blood. PRF showed good wound healing. Our study suggests that PRF should be considered as a treatment modality for established dry socket.

A Comparative evaluation of platelet-rich fibrin with metronidazole and platelet-rich fibrin alone in the treatment of intrabony periodontal defects: A clinical and radiographical study

Aim: The study comparatively evaluated the efficacy of platelet rich fibrin (PRF) with metronidazole and PRF alone in the treatment of intrabony periodontal defects both clinically and radiographically. Methods: A total no. of 20 subjects maintaining good oral hygiene with minimum two sites having vertical bony defects were selected using CBCT. All subjects were randomly assigned to anyone of the two groups (group A PRF+MTZ ; group B PRF only) using lottery system. All subject underwent open flap debridement and placement of either of the material mentioned above and a periodic follow-up at 6 and 9 months. Results: Improvement in clinical parameters (Plaque index, gingival index, probing depth, relative attachment level) as well as in radiographic parameters (defect depth and defect volume) as compared to baseline in both the groups was observed with group A exhibiting higher statistically significant values as compared to group B. Conclusion: The combination of PRF+MTZ were proven to be better than PRF alone. Further, long term clinical trials with larger samples of various drug concentrations and longer duration should be carried out to assess a complete periodontal regeneration rather than bone regeneration.

Platelet rich fibrin as a sole grafting material For the treatment of periodontal Intrabony defects.

Platelet-rich fibrin (PRF) is a second-generation platelet concentrate enriched with platelets and growth factors which found to be beneficial for periodontal regeneration. The purpose of this case report is to clinically and radiographically evaluate the efficacy of PRF for the treatment of periodontal intrabony defects (IBD). A 38- year old Indian female presented with periodontal IBD in relation to 21. The probing pocket depth (PPD), clinical attachment level (CAL) and Mean bone defect were found to be 13mm,14mm and 17.30 mm respectively in relation to 21. The affected lesion was treated surgically by placement of PRF which showed significant reduction in PPD, gain in CAL and radiographic bone formation after six months, thus supporting the role of various growth factors present in the PRF in accelerating the soft and hard tissue healing.

Efficacy of platelet rich fibrin in the treatment of human intrabony defects with or without bone graft: A randomized controlled trial.

Aim:To evaluate the efficacy of platelet rich fibrin (PRF) with or without bone graft [demineralized bone matrix (DBM) graft] in the treatment of intrabony defects based on clinical and radiographic parameters.Materials and Methods:Thirty six intrabony defects in 36 patients were randomly divided into three different groups and were treated with group A (PRF with DBM) or group B (PRF alone) or group C [open flap debridement (OFD)]. Clinical parameters such as plaque index (PI), gingival index (GI), probing depth (PD), relative attachment level (RAL), and gingival recession (GR) were assessed at baseline and 9 months postoperatively; radiographic parameters such as linear bone growth (LBG) and percentage in bone fill (%BF) were calculated by using the image analysis software. Comparisons of groups were analyzed using Kruskal–Wallis analysis of variance test. Pair-wise comparison of groups was done by Mann-Whitney U test.Results:Mean PD reduction and RAL gain were greater in group A (4.25 ± 1.48, 3.92 ± 0.90) and group B (3.82 ± 0.75, 3.27 ± 0.65) than control (3.00 ± 1.21, 2.25 ± 0.62). Furthermore, statistically significant improvement in LBG and %BF was found in group A (3.47 ± 0.53, 61.53 ± 4.54) compared to group B (2.55 ± 0.61, 49.60 ± 14.08) and group C (1.21 ± 0.80, 24.69 ± 15.59).Conclusions:The study demonstrated that PRF improves clinical and radiological parameters compared to OFD alone in intrabony defects. Addition of DBM enhances the effects of PRF in RAL gain and radiographic defect fill.

Autologous platelet concentrate as a potential regenerative biomaterial in the treatment of endo-perio lesion

Endo-perio lesions are common clinical finding in the day-to-day dentistry. The treatment approach with respect to periodontal regeneration still remains point at issue. Endodontic treatment not always leads to complete healing of periapical and periodontal tissue. In literature, surgical periodontal intervention along with the use of bone grafts, guided tissue regeneration has been attempted for regeneration. Recently, use of platelet concentrates such as platelet-rich fibrin (PRF) releasing growth factors is extensively used in dentistry for periodontal regeneration. This case report aims at evaluating the efficacy of PRF as regenerative biomaterial in the treatment of Endo-perio lesion.

Efficacy of platelet rich fibrin in the reduction of the pain and swelling after impacted third molar surgery: randomized multicenter split-mouth clinical trial.

BackgroundImpacted third molar removal is a routine procedure in oral and maxillofacial surgery. Platelet-rich fibrin (PRF) is a second generation platelet concentration which is produced by simplified protocol. The aim of this study was to assess the effectiveness of PRF in the healing process by evaluating the changes in pain and swelling after third molar surgery.MethodsFifty-six patients (23 male, 33 female) who provide the inclusion criteria were selected to participate in this study. The evaluation of the facial swelling was performed by using a horizontal and vertical guide. The pain was evaluated in the postoperative period using a visual analog scale (VAS) of 100 mm.ResultsHorizontal and vertical measurements showed more swelling at the control side (without PRF) in 3th day postoperatively (p < 0.05). There were no statistically significant differences regarding pain among the groups.ConclusionAs a conclusion, PRF seems to be effectiveness on postoperative horizontal swelling after third molar surgery. PRF could be used on a routine basis after third molar extraction surgery.

Platelet rich fibrin as a membrane for coverage of immediate implants: Case-series study on eight patients

PurposeTo evaluate the efficacy of platelet rich fibrin as a membrane for coverage of immediate implants in the maxillary anterior region. Patients and methodsTwelve implants were inserted into eight adult patients indicated for extraction & immediate implant insertion in one or more of the upper anterior teeth. A venous blood sample of 10 cc was obtained for each single implant. After implant placement, the peri-implant defect was filled with a mixture of autogenous bone (collected from the chin) and fibrin. A platelet rich fibrin membrane was used to cover the implant site. Clinical & radiographic evaluation was performed immediately, 3 and 6 months postoperatively to evaluate soft tissue healing & crestal bone stability. ResultsAfter 6 months, the marginal bone was stable in 83% of cases. Clinically, good soft tissue coverage was obtained. Radiographically, bone height showed a statistically significant decrease in the distal side while there was no statistically significant decrease at the mesial side. The change in defect depth was limited to 2 mm. ConclusionPlatelet rich fibrin provided good soft tissue coverage over the immediate implants and it enhanced bone stability. The technique was easy to perform with good esthetic results.