Injectable Platelet-rich Fibrin Research Articles

Comparison of growth factor levels in injectable platelet-rich fibrin obtained from healthy individuals and patients with chronic periodontitis: a pilot study

BackgroundThis study aimed to assess and compare the concentrations of growth factors, white blood cells (WBCs), and platelets in injectable platelet-rich fibrin (i-PRF) derived from people with healthy periodontal conditions and those with chronic periodontitis.MethodsVenous blood samples were obtained from 30 patients diagnosed with chronic periodontitis (test group) and 30 participants with healthy periodontal conditions (control group). The i-PRF was then acquired from centrifuged blood. The growth factors (VEGF, IGF-1, TGF-β1, PDGF-BB and EGF) released from the i-PRF samples were compared between groups with ELISA testing. The amounts of WBCs and platelets were also compared.ResultsNo significant differences in the concentrations of growth factors were found between the groups (the mean values for the control and test groups were, respectively: IGF: 38.82, 42.46; PDGF: 414.25, 466.28; VEGF: 375.69, 412.18; TGF-β1: 21.50, 26.21; EGF: 138.62, 154.82). The test group exhibited a significantly higher WBC count than the control group (8.80 vs. 6.60, respectively). However, the platelet count did not show a statistically significant difference between the groups (control group 242.0 vs. test group 262.50). No significant correlation was observed between WBC count and growth factor level in either group.ConclusionsThe growth factor levels in i-PRFs did not exhibit significant difference between the two groups. This suggests that the levels of these growth factors may be unaffected by the periodontal disease.

Injectable platelet-rich fibrin promotes proliferation and trichogenic inductivity of dermal papilla cells through activating TGF-β/Smad signaling pathway.

Dermal papilla cell (DPC) belongs to a specialized mesenchymal stem cell for hair follicle regeneration. Maintaining the ability of DPCs to stimulate hair in vitro culture is important for hair follicle morphogenesis and regeneration. As the third generation of platelet concentrate, injectable platelet-rich fibrin (i-PRF) is a novel biomaterial containing many growth factors and showing promising effects on tissue reconstruction. We aimed to explore the influences of i-PRF on the proliferative, migratory, as well as trichogenic ability of DPCs and compared the effects of i-PRF and platelet-rich plasma (PRP), the first generation of platelet concentrate. Both PRP and i-PRF facilitated DPCs proliferation, and migration, along with trichogenic inductivity as well as stimulated the TGF-β/Smad pathway, while the impacts of i-PRF were more significant than PRP. A small molecule inhibitor of TGF-beta receptor I, Galunisertib, was also applied to treat DPCs, and it rescued the impacts of i-PRF on the proliferative, migratory, trichogenic inductivity, and proteins-associated with TGF-β/Smad pathway in DPCs. These findings revealed that i-PRF had better effects than PRP in enhancing the proliferative, migratory, and hair-inducing abilities of DPCs by the TGF-β/Smad pathway, which indicated the beneficial role of i-PRF in hair follicle regeneration.

How effective are concentrated growth factor and injectable platelets in reducing complications following impacted third molar surgery?

This study examines the impact of injectable platelet-rich fibrin (iPRF) and concentrated growth factor (CGF) on postoperative pain, edema, trismus, and quality of life in impacted mandibular third molar surgery. The primary aim of this study was to minimize common sequelae following third molar surgery by using iPRF and CGF. Our secondary objective was to compare the postoperative effects of these products. This study represents a single-center, randomized prospective clinical trial conducted at the Ordu University Faculty of Dentistry. It involved patients who underwent third molar surgery for various reasons between July and October 2022. The predictor variable was the implementation of CGF, and i-PRF which was categorized as CGF, i-PRF and control groups. The outcome variables include pain levels and analgesic consumption measured on a VAS scale, distances between predetermined anatomical points, maximum mouth opening capacity, and data from the postoperative symptom severity (PoSSe) scale. Some statistical tests were performed with a 95% confidence interval, which was considered significant. Total analgesic use was notably lower in the CGF group (p = .044). CGF and iPRF outperformed the control group in all edema measurements by the 7th day (T-Pog, L-A, T-C; p<.05). CGF significantly reduced trismus on the 2nd and 7th days. Quality of life was notably higher in the CGF group than in the control group (p = .026), although iPRF group differences were not significant. The results of this study indicate that CGF has a limited impact on postoperative pain, but significantly reduces edema, trismus, and enhances quality of life. The iPRF group experienced positive effects on pain, edema, and trismus, although the statistically significant differences observed with CGF highlight its potential for use instead of iPRF after third molar surgery. An increased sample size is essential for more comprehensive results.

Demineralized freeze-dried bone allograft with/without i-Platelet-rich fibrin in 3 wall intrabony defects

Demineralized freeze-dried bone allograft (DFDBA) contains bone morphogenetic proteins (BMPs), hence is osteoinductive. Autologous platelet concentrates exhibit a higher quantity of growth factors. Both these biomaterials aid in bone regeneration when placed in three-wall intrabony defects. However, their efficacy when used alone and in conjugation is not clear. Aim: To assess clinical and radiographic efficacy of injectable platelet-rich fibrin (i-PRF) with microsurgical access flap in the treatment of three-wall intrabony defects in chronic periodontitis patients. Methods: Thirty sites with three-wall intrabony defects were randomly assigned to control and test group by computer generated method. The test group obtained i-PRF mixed with DFDBA while the control group received only DFDBA. Clinical parameters such as site-specific Plaque index (PI), Radiographic intrabony defect depth (IBDD), modified- Sulcular bleeding index (mSBI), Clinical attachment level (CAL), and Probing pocket depth (PPD) were measured at baseline, three and six months. Results: Intragroup comparison within the control group and test group exhibited statistically highly significant variation of mean PI, mSBI, PPD, CAL, and IBDD score from baseline to 3 months and from 3-6 months (p&lt;0.001). However, intergroup comparison demonstrated no statistically significant variation of mean IBDD at all 3 intervals (p&gt;0.05). Conclusion: i-PRF combined with DFDBA enhanced the radiographic and clinical parameters as opposed to DFDBA alone. The role of i-PRF is promising in its capacity for easy obtainability and increased potential to aid in regeneration.

Use of Circularly Polarized Light on the Evaluation of Injectable Platelet Rich Fibrin in the Early Formation of Woven and Lamellar Bone: A Specific Method in the Study of Osseous Tissue

Purpose: In bone grafting, the goal is the formation of 100% vital bone. The ideal graft material is osteogenic, osteoconductive and osteoinductive and can be evaluated by histology and histomorphometric methods to calculate percentages of vital bone formation, residual graft material and connective tissue. Bone graft substitute materials currently used include allogeneic, xenogeneic and alloplastic materials. The goal of this study is a histological evaluation of the early effects of the liquid (injectable) form of Platelet Rich Fibrin (i-PRF) on the formation of woven and lamellar bone using Circularly Polarized Light (CPL). Patients and Methods: This is a retrospective cohort study of forty-two patients from 2021 to 2022 who completed bone grafting after a non-restorable endodontically treated molar tooth was extracted in preparation for future implant surgery. Each bone graft was augmented with i-PRF. To process i-PRF, Relative Centrifugation Force (RCF) was reduced from 2,700 RPM to 700 RPM (60 g). Centrifugation time was reduced from 12 minutes to 3 minutes. After an average bone graft healing time of 8 to 12 weeks, bone core samples were obtained at the time of implant surgery for histological and histomorphometric analysis. Bone cores were stained with Stevenel’s blue and van Gieson’s picrofuchsin for histologic analysis by means of brightfield and circular polarized light microscopic evaluation to evaluate the early effects of the liquid form of PRF on formation of woven and lamellar bone using allogeneic bone. Results: Forty-two bone cores were harvested at the time of implant surgery for histological and histomorphometric analysis. The liquid form of PRF resulted in greater percentages of vital bone formation (average 87.4 %) compared to the existing published literature. CPL analysis of forty-two bone core specimens showed the positive effects of i-PRF on de novo bone formation. Conclusion: The results of this study using circularly polarized light demonstrate that the liquid form of PRF (i-PRF) resulted in greater percentages of early, new vital bone formation compared to the published literature. Circularly polarized light should be considered as an adjunctive method to determine bone maturity and structure.

Renewed Concept of Mastoid Cavity Obliteration with the Use of Temporoparietal Fascial Flap Injected by Injectable Platelet-Rich Fibrin after Subtotal Petrosectomy for Cochlear Implant Patients.

Background: The subtotal petrosectomy procedure may be useful for cochlear implantation in selected patient groups. Although it is highly effective, complications can arise, which may have economic implications for the patient due to the high cost of the device. Therefore, several authors have attempted to identify the most effective concept for obliteration. Methods: We present a pilot descriptive study of application techniques for obliterating cavities after subtotal petrosectomy using a temporoparietal fascial flap (TPFF) modified with injectable platelet-rich fibrin (IPRF+) for three cochlear implant (CI) patients. Results: Our concept preserves important anatomical structures, such as the temporalis muscle, which covers the CI receiver-stimulator. Injection of IPRF+ also increases the available tissue volume for obliteration and enhances its anti-inflammatory and regenerative potential. Conclusions: To the best of our knowledge, the use of TPFF for filling the cavity has not been adopted for CI with SP and for blind sac closure. Our literature review and our experience with this small group of patients suggest that this procedure, when combined with IPRF+ injections, may reduce the risk of potential infection in the obliterated cavity, particularly when used with CI. This technique is applicable only in cases when the surgeons are convinced that the middle ear cavity is purged of cholesteatoma.

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

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

The effect of injectable platelet rich fibrin as a nonsurgical treatment of the female stress urinary incontinence.

The complications of surgical treatments of stress urinary incontinence have led to the search for less invasive and safer treatment procedures. We aimed to investigate the efficacy of locally administered injectable platelet-rich fibrin (i-PRF), an autologous material that plays an important role in tissue regeneration, in women with stress urinary incontinence. Thirty-four women were included in this prospective, single-center, and interventional study, suffering from stress urinary incontinence refractory to conservative treatment. Three consecutive i-PRF injections were applied to the mid-urethra localization at anterior vaginal wall with an interval of 1month. ICIQ-SF, UDI-6, IIQ-7 and POPDI-6 questionnaires were used to measure pre‑treatment, 1month and 6months post‑treatment symptom severity and the clinical outcomes were recorded. The mean age of the patients was 51.5 ± 9.8years. ICIQ-SF, UDI-6, IIQ-7 and POPDI-6 questionnaires results revealed significant clinical improvement of stress urinary incontinence severity afer the administration of i-PRF (p < 0.001). The results at 1 and 6months after treatment did not change statistically significantly. This study demonstrated that locally administiration of i-PRF is efective in relieving SUI symptoms with high success rates without any adverse effects reported. i-PRF injection may have the potential to be a novel, minimally invasive, and low-risk procedure, that could be an alternative and simple treatment modality to surgery for female patients with stress urinary incontinence. Additionally, it may create new avenues for research on therapeutic implementation of i-PRF.

The Use of Injectable Platelet-Rich Fibrin As an Alternative Treatment for Interdental Papilla Reconstruction in Black Triangle Case

Introduction: Interdental papilla is triangular soft tissues that fill the gaps between teeth andfunction as protective periodontal tissues and are important in terms of aesthetics, ifinadequate, they will form black triangles, which are blackish areas between teeth. Non-surgical treatment of black triangle is preferred by patients as it is painless. Injectable Platelet-Rich Fibrin (i-PRF) is a platelet concentrate derived from the patient&amp;#39;s blood that does notcause immunological reactions and contains growth factors for remodeling the interdentalpapilla. Case Report: A 20-year-old female patient, systemically healthy, came to Prof.Soedomo UGM Dental Hospital with complaints that the gums of the middle part of her upperteeth had a blackish area and disturbed her confidence. An objective examination was carriedout including, gingival biotype, black triangle area, and radiographs, so it was concluded thatthe black triangle was classified as class I Nordland and Tarnow and interdental papillareconstruction to correct the black triangle could be planned. The patient refused surgery so i-PRF can be used as an alternative non-surgical treatment. The black triangle closed completelyafter the i-PRF injection was given. Discussion: I-PRF has the ability to accelerate cellproliferation and migration as well as angiogenesis so that it can modulate fibroblastregeneration in the interdental papilla area. Conclusion: The use of i-PRF can be an alternativenon-surgical option for the treatment of interdental papilla reconstruction.

Efficacy of Injectable Platelet-Rich Fibrin (I-PRF) in Managing Temporomandibular Joint Pain: A Prospective Clinical Study.

Temporomandibular joint (TMJ) pain is a common condition that can significantly impact an individual's quality of life. Current treatment options often fall short of providing long-lasting relief. So, this prospective clinical study aimed to investigate the efficacy of injectable platelet-rich fibrin (I-PRF) in mitigatingTMJpain. A total of 68 participants, aged 18-60 years, clinically diagnosed with TMJ pain, were recruited from dental clinics and specialist referrals. Participants were randomly assigned to either the intervention group (I-PRF injections) or the control group (placebo). Primary outcome measures included TMJ pain intensity and jaw function, assessed using the Visual Analog Scale and functional examinations, respectively. Secondary outcomes comprised patient-reported outcomes (PROs) on quality of life and satisfaction. Data were collected at baseline and six, 12, and 24 weeks post intervention. Baseline characteristics demonstrated successful randomization, with no significant differences in age, gender, or TMJ pain duration between groups. Post intervention, the intervention group exhibited a significant and sustained reduction in TMJ pain intensity compared to controls (p<0.001). Improvements in jaw function were also notable in the intervention group at all follow-up time points (p<0.001). PROs related to quality of life and satisfaction substantially increased in the intervention group compared to controls (p<0.001). I-PRF demonstrated significant efficacy in reducing TMJ pain intensity, improving jaw function, and enhancing PROs. These findings support the consideration of I-PRF as a valuable therapeutic intervention for individuals with TMJ pain.

Effects of injectable platelet-rich fibrin (i-PRF) on pterygium surgery with conjunctival autograft.

To investigate the effects of subconjunctival injectable platelet-rich fibrin (i-PRF) injection on healing and complication rates after pterygium surgery with conjunctival autograft. This retrospective and comparative study evaluated 31 eyes that received i-PRF injections under the donor and graft conjunctiva following pterygium surgery, while 34 eyes did not receive i-PRF after the pterygium surgery. The patients' follow-up period was for 12months. Postoperative recurrence, epithelial healing time, postoperative pain score, graft edema, and sliding of the graft (need for re-suturation) data were evaluated. For the 12months after surgery, one eye (3.2%) in the i-PRF group had developed corneal recurrence, and five eyes (14.7%) in the non-i-PRF group had developed recurrence. The mean corneal epithelial healing time was 2.96 ± 0.70days in the i-PRF group and 3.58 ± 0.70days in the non-i-PRF group (p = 0.001). The mean healing time of the donor conjunctiva epithelium was 3.84 ± 0.70days in the i-PRF group, whereas it was 4.44 ± 0.74days in the non-i-PRF group (p = 0.006). The mean postoperative pain score was 4.45 ± 1.52 in the i-PRF group and 5.08 ± 1.40 in the non-i-PRF group. In the non-i-PRF group, three cases (8.8%) required re-suturation, whereas, in the i-PRF group, no one required re-suturation. Thanks to its platelets-derived growth factors, i-PRF can be a safe and effective adjuvant therapy for faster healing of conjunctival autograft and in the prevention of recurrence.

Rejuvenation of bone volume with CGF and i-PRF in intra-osseous defects.

The risk of further periodontal breakdown increases with a deep intrabony defect. Non-surgical periodontal therapy could pose a challenge and surgical intervention is mainly required to manage the defect. Autologous platelet concentrates such as Injectable platelet rich fibrin (i-PRF) and concentrated growth factor (CGF) may improve surgical outcome due to its enrichment with growth factors. Total of 04 patients involved in this study. After conventional flap debridement of intrabony defects, CGF is placed in 2 patients and the other 2 patients received i-PRF in their respective intrabony defects. Volumetric analysis was done pre-operative and 6 months post operatively in both the groups. Bone volume is significantly increased in both CGF and i-PRF group but higher in CGF group when compared to i-PRF group has high regenerative and reconstructive growth factors which helps aids in early and high bone fill when compared to i-PRF.

Platelet-rich fibrin for rehydration and pre-vascularization of an acellular, collagen membrane of porcine origin

ObjectivesPre-vascularization of the collagen membranes with autologous platelet concentrates is a standard procedure in oral and maxillofacial surgery. This study analyzed the possible interaction of an acellular collagen membrane of porcine origin (NM) with platelet-rich fibrin (PRF) regarding its rehydration protocol with differences in pH values and effect on angiogenesis.Materials and methodsNM was analyzed alone and combined with solid PRF by plotting or co-culturing with injectable PRF. Different media (venous blood, buffer solution with a fixed pH value of 7, saline solution, and injectable PRF) were used to analyze the influence on pH value during rehydration. Chorion allantois membrane assay (CAM) was applied to check pro-angiogenic effects after 24, 48, and 72 h, followed by immunohistochemical analysis.ResultsRehydration in injectable PRF showed acidity over time (p < 0.05). A definite pro-angiogenic effect of NM alone was found regarding neo-vessel formation supported by the respective light microscopically analysis without significant differences to PRF alone (p > 0.005). This pro-angiogenic effect could not be exaggerated when NM was combined with liquid/solid PRF (each p > 0.005).ConclusionsRehydration with liquid PRF of the collagen membrane results in acidity compared to a saline solution or patient’s blood. The significant pro-angiogenic potential of the membrane alone resulted in enhanced neo-vessel formation that could not be optimized with the addition of PRF.Clinical relevance statementUsing injectable PRF for rehydration protocol of the collagen membrane leads to acidosis that can ultimately optimize wound healing. Differences in the physio-mechanical interplay of collagen matrices and autologous platelet concentrates must result in clinical algorithms if pre-vascularization can maximize outcomes.

Effectiveness of Injectable Platelet-Rich Fibrin in the Treatment of Oral Lichen Planus: A Systematic Review and Meta-Analysis.

Oral lichen planus (OLP) is a chronic inflammatory condition affecting the oral mucosa. The current reviewinvestigated the potential effectiveness of injectable platelet-rich fibrin (i-PRF) as a treatment for OLP when compared to other interventions. The current review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search strategy was implemented across databases such as PubMed, Embase, Scopus, Web of Science, CINAHL, and Google Scholar. The search utilized a combination of Boolean operators (AND, OR) and Medical Subject Headings (MeSH) terms to capture relevant studies. Comparative clinical studies focusing on i-PRF as a treatment for OLPand other interventions were included. Outcomes assessed were pain, surface area of lesions, and patient satisfaction. Review Manager 5.4 was used for statistical analysis. The Risk of Bias 2.0 (RoB 2.0) tool was used to assess the methodological quality of the studies. Three studies were included for the final analysis. The findings indicated that both the i-PRF and comparison treatment groups demonstrated reductions in pain and lesion size. The post-treatment Visual Analogue Scale (VAS) scores showed a decrease in pain intensity, and there was an improvement in lesion extension in the i-PRF-treated sites. The results also revealed increased patient satisfaction with i-PRF treatment. Adverse effects were not reported or specified in the included studies. Quantitative analysis for pain (VAS) showed a mean difference of 0.38 (95% CI: 0.63-1.40), but there was no significant difference between the i-PRF and control groups at p=0.46. Though intragroup differences showed statistically significant differences between pre and post intervention, intergroup differences were not significant for any of the assessed outcomes. The findings from this study suggest that i-PRF holds promise as a potential treatment for OLP. The use of i-PRF resulted in pain reduction, lesion size improvement, and increased patient satisfaction. However, it is important to consider the limitations of the included studies, such as variability in study designs, small sample sizes, and the limited number of studies.

Comparison between Injectable Platelet Rich Fibrin with Collagen Carrier and β-Tricalcium Phosphate in Lateral Maxillary Sinus Lift with Simultaneous Implant Placement

Comparison between Injectable Platelet Rich Fibrin with Collagen Carrier and β-Tricalcium Phosphate in Lateral Maxillary Sinus Lift with Simultaneous Implant Placement

Piroxicam gel versus injectable platelet rich fibrin in the treatment of stage III periodontitis

Background In view of the importance and prevalence of chronic periodontitis, there is still an urgent need to search for an effective therapy that is less expensive, easy to use, and readily available with no side effects. Injectable platelet rich fibrin (i-PRF) and piroxicam were considered as possible treatment options of periodontitis. Aim To evaluate the efficacy of piroxicam gel versus i-PRF in treatment of stage III periodontitis. Materials and method The current study was carried out as a randomized clinical trial. The participants diagnosed as having stage III, grade B periodontitis were selected from the patients attending Department of Periodontology and Oral Medicine, Faculty of Dentistry, Tanta University. The selected individuals randomly assigned into two groups (by means of a sealed envelope via masked supervisor): group I and group II. Forty sites (the deepest periodontal pockets) were selected. Twenty sites from GI was treated by piroxicam gel and 20 sites in GII were treated by i-PRF. The application was done 2 weeks after scaling and root planing and applied for five times one application every 2 weeks over 10 weeks. The comparison was assessed clinically and immunologically. Clinically, via recorded: probing pocket depth, clinical attachment loss, and bleeding on probing. Immunologically, via measuring: the levels of matrix metalloproteinases-8 in gingival cervical fluid samples. Clinical and immunological were recorded at baseline (before scaling and root planing), 4 weeks (2 weeks after first application), 8 weeks (at fourth application), and 12 weeks (2 weeks after the last application). Results Both groups showed significant improvement in all clinical and immunological parameters. Comparing GI and GII at each follow-up time point, there was significant amelioration in all assessed parameters in favor to GII. Conclusion The use of i-PRF is preferred over the use of piroxicam gel in the treatment of stage III chronic periodontitis, as it gives better clinical and immunological results.

A Case Report of Periodontal Regeneration in Failing Tooth by Single Flap Approach Using Sticky Bone and Platelet-rich Fibrin Membrane

Periodontal regeneration aims to regenerate the diseased or lost periodontium. Regenerative periodontal therapy utilises growth factors, autogenous soft and hard tissue grafts for the purpose of regeneration. Platelet-rich Fibrin (PRF) is an autologous biomaterial which works on the principle of centrifugation. The injectable PRF (i-PRF) that is formed when centrifuged at low Revolutions Per Minute (RPM) produces an excellent matrix when mixed with bone graft called “sticky bone”. Sticky bone possesses the property of mouldability along with its inherent potential of bone formation. The PRF matrix also enhances the wound healing through the release of various growth factors. PRF membranes which are obtained at higher centrifugation levels also act as a substitute to augment the soft-tissues. The present case is that of a 45-year-old male, who underwent a one-year follow-up for the management of endodontic periodontal lesion in the lower left first molar with sticky bone and PRF membrane by single flap approach. The patient was periodically reviewed clinically and radiographically and prosthetic restoration was given on accessing the radiographic bone fill after six months. After six months there was a significant difference in the radiographic bone fill, along with the reduction in the probing pocket depth from 7 mm to 4 mm and clinical attachment from 9 mm to 7 mm. The results indicate that sticky bone and PRF membrane serves as a predictable source for the management of intrabony defects.

Effectiveness of Non-Surgical Procedures for the Treatment of Black Triangle Cases in the Aesthetic Zone on the Height of the Interdental Papilla: Narrative Review

Background: The black triangle is a cervical embrasure to the proximal contact that is not filled with gingival tissue. Until, the treatment of black triangle cases has evolved to offer non-surgical procedures such as hyaluronic acid injection, Injectable Platelet Rich Fibrin (i-PRF), and photobiomodulation therapy. Various studies have also reported the use of hyaluronic acid, i-PRF and photobiomodulation therapy to increase the height of the interdental papillae.Method: Literature searches were carried out systematically from various international databases such as PubMed, ScienceDirect, Google Scholar, and Semantic Scholar. The literature selection stages are carried out through the process of identifying articles, screening, and fulfilling inclusion criteria. A total of 52 articles were published in 2012 – 2022 and have met the criteria for data extraction examination of various clinical parameters from the black triangle case.Result: The results of the review showed that the use of hyaluronic acid injection, i-PRF and photobiomodulation therapy showed significant treatment results in cases of black triangle class I and II. Conclusion: It was reported that the non-surgical procedure for the treatment of black triangle cases produce better result and predictable results, an easy technique, more effective time than surgical procedures and reduced discomfort and met the aesthetic demands of patients based on clinical parameters after 6 month injection.

Clinical and patient-reported outcomes of periodontal phenotype modification therapy using injectable platelet rich fibrin with microneedling and free gingival grafts: A prospective clinical trial

BackgroundTo evaluate the clinical non-inferiority of injectable platelet-rich fibrin and micro-needling (iPRF+MN) with free gingival grafting (FGG) in periodontal phenotype modification therapy. MethodologyTwenty participants with a gingival thickness (GT)<0.8 mm in the mandibular anterior region were included. The participants were randomly allocated into i-PRF+MN and FGG groups. i-PRF injection was done, and MN was done with the help of a lancet in the i-PRF+MN group. The clinical parameters, i.e., GT and Keratinized tissue width (KTW), were evaluated at baseline, 3 and 6 months post-operatively. Patient-reported outcomes (PROs), i.e., discomfort and esthetic satisfaction, were assessed using the visual analogue score(VAS) at one week and 3 months of re-evaluation, respectively. ResultsBoth groups showed a significant increase in GT and KTW with no intergroup variation (P-0.32, 0.48respectively) at the end of 6 months. However, the i-PRF+ MN group showed better PROs, i.e., less discomfort(1.11±0.60) and better esthetic satisfaction(8.77±0.44). ConclusionThe non-invasive treatment of i-PRF+MN may lead to non-inferior clinical outcomes after 6 months with better PROs compared to more invasive FGG protocols in phenotype modification therapy.

Evaluation of microneedling with and without injectable-platelet rich fibrin for gingival augmentation in thin gingival phenotype-A randomized clinical trial

ObjectiveThe purpose of the current study was to investigate the effect of micro needling (MN) on gingival thickness (GT) and keratinized tissue width (KTW) in individuals with thin gingival phenotypes, either with or without injectable platelet-rich fibrin (i-PRF). Materials and methodsIn this randomized, split-mouth clinical trial, 15 systemically healthy patients, with thin gingival phenotype (<1.5 mm) were randomly treated with MN + i-PRF and MN. MN was performed on one side, and MN + i-PRF on the contralateral side of the same arch at 4 sessions with 10-day intervals. GT; KTW the primary outcome and Plaque index; gingival index Secondary outcome were assessed at baseline and at 1st, 3rd, and 6th months post-treatment. ResultsThe results of the present study showed that both techniques demonstrated a statistically significant increase in GT. GT showed a statistically significant increase from baseline (0.453 ± 0.069 mm in MN, 0.451 ± 0.069 mm in MN + i-PRF) (p = 0.81) to 1 month (0.567 ± 0.075 mm in MN, 0.649 ± 0.075 mm in MN + i-PRF) (p < 0.001*). A follow-up at 3rd month (0.566 ± 0.076 mm in MN, 0.647 ± 0.091 mm in MN + i-PRF) (p < 0.001*) and 6th month (0.564 ± 0.076 mm in MN, 0.644 ± 0.089 mm in MN + i-PRF) (p < 0.001*) showed a statistically significant increase. Intergroup comparison showed a statistically significant GT increase in MN + i-PRF sites at all the time intervals. No, statistically significant difference in KTW was observed in both groups from baseline to 6 months. ConclusionsThe utilization of MN + i-PRF stands as a minimally invasive, non-surgical method to improve GT. Interestingly, using i-PRF as an additional component demonstrated more favorable outcomes compared to using MN alone in enhancing tissue thickness.