Platelet-rich Fibrin Clot Research Articles

Effectiveness of platelet-rich fibrin in third molar extractions: a randomized controlled split-mouth study

ObjectivesTo date, studies have only investigated the use of platelet-rich fibrin (PRF) after removal of third molars from the mandible or maxilla. Removal of the upper and lower third molars is typically combined into one session per side; therefore, this study aimed to investigate influence on PRF.Materials and methodsThis prospective, single-blinded, randomized controlled, clinical trial (split-mouth design) included 25 patients. After third molar removal, the test group’s sockets were treated with solid PRF clots, whereas the control group’s sockets were conventionally treated. The primary outcome was swelling, which was measured digitally and analogously. Secondary outcomes included trismus, pus, hematoma, and clinical attachment loss (CAL) of the second molars on days 1, 3, 7, and 14. Patient-centered outcome measures and the consumption of painkillers and antibiotics were recorded on days 0–7. The t-test for paired samples, Wilcoxon test, and Chi-Square test were used for statistical analyses.ResultsSwelling was significantly lower on day 14 in the test group (p < 0.05). No statistically significant differences were observed in pain, trismus, and CAL. In the test group, the number of painkillers taken and the number of days of intake were significantly lower (p < 0.05).ConclusionsPRF caused a reduction of painkiller consumption and in the days painkillers were needed. PRF significantly considerably reduced swelling after 14 days. Owing to the lack of differences in other parameters, the integration of PRF application into routine wisdom tooth removal is critical.Clinical relevancePRF affects the long-term outcomes of third molar removal by reducing swelling and reducing as well as shortening painkiller consumption.Trial registrationclinicaltrials.gov (NCT05089812).

The effect of injectable platelet-rich fibrin in combination with autogenous bone grafts on bone healing in an ovariectomized osteoporotic rat model with critical-sized defects.

To assess the impact of autogenous graft materials, including autogenous bone graft (ABG) and injectable platelet-rich fibrin (I-PRF) clots, on bone defect regeneration in ovariectomized osteoporotic rats. Wistar rats (6-8 weeks old) were ovariectomized, and surgery began after 8 weeks. A 5-mm defect was created bilaterally in the parietal bones of 16 rats, which were divided into 4 groups. Group A (blank) had untreated defects; group B had defects filled with 0.1 ml of I-PRF, group C had defects filled with 0.1 ml of ABG, and group D had defects filled with a combination of 0.1 ml each of I-PRF and ABG. Four weeks post-surgery, the rats were euthanized. Bone regeneration was evaluated through histopathologic analysis and microcomputed tomography (micro-CT). In ovariectomized rats treated with ABG or I-PRF, bone regeneration was enhanced, with increased periosteal activity, osteoblast count, and new bone volume, as determined histologically. The ABG+I-PRF group had the highest periosteal vascularity, but the difference compared to the ABG group was not statistically significant (p>0.05). Osteoblast numbers were significantly higher in the ABG+I-PRF group than in the blank group (p<0.05). Micro-CT showed the highest mean new bone volume ratio in the ABG+I-PRF group, followed by the ABG group. The combined use of ABG and I-PRF enhances bone formation in osteoporotic rats following ovariectomy.

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

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

Fibrin Network Pattern Changes of Platelet-rich Fibrin in Chronic Periodontitis Patients with and without Diabetes Mellitus

Introduction: Platelet-rich fibrin (PRF) has been widely applied for periodontal regeneration due to its simplicity, autologous nature and economics. This study aims to evaluate the variations in the fibrin network patterns of the PRF clot, which was isolated from chronic periodontitis patients with and without diabetes mellitus (DM). Materials and Methods: This study included 90 participants undergoing periodontal treatment therapy. The patients were divided into three groups: Group A (n = 30), chronic periodontitis patients without Type 2 DM; Group B (n = 30), chronic periodontitis patients with Type 2 DM (haemoglobin A1c [HbA1c], 6.5%–6.9%) and Group C (n = 30), chronic periodontitis patients with Type 2 DM (HbA1c ≥ 7%). The clinical parameters and blood samples were collected, and PRF preparation was done. Histological slide analysis was done in the stained section of the PRF clot and examined for the presence of dense and loose fibrin network patterns with the entrapments of platelets. Results: There was a significant difference in the dense and loose fibrin framework between chronic periodontitis patients without type 2 DM, chronic periodontitis patients with type 2 DM of 6.5–6.9 HbA1c and chronic periodontitis patients with type 2 DM of &gt;7 HbA1c. Conclusion: Within the limitations of this study, future studies are needed to find the clinical outcomes of various PRF preparations in diabetic patients and other systemic factors that influence the fibrin network pattern, so that better regenerative outcomes can be achieved in patients with systemic diseases.

Management of canine wounds using platelet-rich fibrin (PRF) biomaterial. A case series report.

The increasing interest in platelet-based therapies has underwritten the development of novel veterinary regenerative treatments. The haemoderivative platelet-rich fibrin (PRF) comprises abundant concentrations of platelets and leucocytes, above the physiologic baseline, which are considered essential elements for wound regeneration, stimulating local angiogenesis, cellular migration, proliferation and differentiation, considered essential for skin repair. This study aimed to describe the treatment of eight dogs with naturally occurring cutaneous wounds, where autologous PRF therapy was applied, using a protocol developed by our group. Eight dogs, aged between 7-month and 9-year old, from different breeds and sexes, were enrolled in this study. Four of these wounds were clinically infected. In three cases, two PRF treatments were performed during the first week of treatment, followed by single weekly treatments from the second week onwards, until exophytic granulation tissues were present. In each case, the treatment was finalized only when complete wound closure was achieved. Wounds did not receive topical antiseptics, antibiotics or topical drugs to promote wound healing during the treatment. PRF-grafting treatments were well tolerated in all treated wounds, inducing significant granulation tissue formation. PRF clots acted as a natural tissue filler, promoting epithelization and wound closure, without the requirement of topical antimicrobial/antiseptics application, or additional surgical debridement. Evident skin contraction was recorded in larger injuries and all the treatments resulted in vestigial aesthetic scars where hair growth was also observed. PRF-therapy obtained promising results, as an alternative wound treatment, revealing a biological regenerative action, prompting the natural skin healing process.

Augmentation of single tooth extraction socket with deficient buccal walls using bovine xenograft with platelet-rich fibrin membrane

BackgroundDifferent techniques and materials such as bone grafts and bioactive agents have been used for alveolar ridge augmentation in extraction sockets with a defective wall, there is not a specific material or technique that has resulted in superior outcomes or prevented total bone loss.ObjectivesThis clinical study aims to evaluate radiographically the effectiveness of using bovine xenograft with platelet-rich fibrin (PRF) membrane on vertical and horizontal alveolar ridge dimensional changes following tooth extraction that are complicated by buccal bone loss.Materials and methodsThis study was conducted in Egypt on fourteen patients with a single posterior tooth indicated for extraction. A preoperative cone-beam computed tomography (CBCT) scan confirmed more than 50% loss in buccal bone in each tooth. Extraction sockets were packed with minced PRF clots mixed with a bovine xenograft. Each extraction socket was sealed by PRF membranes. CBCT scans, performed before tooth extraction and after 6 months, were used to assess alveolar ridge changes both vertically and horizontally.ResultsThere was a significant gain in the buccal and middle of the extraction socket bone height, recording 86.01% (6.33 mm) and 206.45% (9.6 mm), respectively. There was an insignificant bone loss in the lingual bone height and width, recording − 8.49% (-1.06 mm) and − 13.39% (1.05 mm), respectively. The results also showed a non-significant decrease in alveolar bone density (-14.06%) between pre-operative bone present apical to the extraction socket and newly formed bone inside the socket.ConclusionsRidge preservation/augmentation techniques using a bone graft mixed with PRF and covered by PRF membranes in fresh extraction sockets complicated by the loss of buccal bone result in buccal bone augmentation and a reduction in horizontal and vertical ridge collapse after tooth extraction.Clinical relevanceThe bovine xenograft in conjunction with PRF can be used immediately after extraction for ridge preservation, providing adequate bone width and height for implant placement.

Comparative evaluation of pH and Ca + ion release from MTA on interaction with platelet-rich fibrin and blood clot: an in vitro study.

Background: 'Regenerative endodontics' using host-derived scaffolds and biomaterials (MTA) is popular in the management of teeth with open apex. Alkaline pH and bioactivity contribute to tissue healing and remineralization. We assessed the influence of PRF and Blood Clot on the pH and Ca + ion release from MTA. Methods: A total of 15 single-rooted human extracted teeth were sectioned at the level of the cementoenamel junction. Based on the type of scaffolds used, samples were divided into three groups. Group 1 (MTA+ PRF), Group 2 (MTA + Blood Clot), Group 3 (control MTA). The prepared specimens were transferred to a fresh falcon tube containing 10mL of distilled water and the collected solutions were analysed for pH and Ca + ion release at 3h, seventh day and 14 th day. Results: It was observed that the mean pH and Ca + ion release were significantly lower in the experimental groups as compared to the control group. Though there was an increase in the pH recorded in Group 1 and 2 at all time periods, the difference was not significant. Ca + ion release peaked at Day 7 (Group3 > Group2 > Group1) and reduced significantly on the 14 th day for all groups. Conclusions: Within the limitations of the study, it can be concluded that PRF and blood clot influence the pH and Ca + ion release from MTA.

Plasma-Rich Fibrin-Regenerative Material in Tympanic Membrane Surgery.

Background and Objectives: Platelet-rich fibrin (PRF) membrane plays an important role in cell proliferation and aids in healing. This study aimed to assess the safety and efficacy of the addition of PRF to the graft in tympanoplasty. Materials and Methods: A retrospective study was conducted involving 47 patients with chronic dry eardrum perforation, who were candidates for different types of tympanoplasty (type I-IV). The study took place in the ENT department, County Emergency Clinical Hospital of Cluj-Napoca. In group 1 (27 patients) tympanoplasty was performed with a cartilage graft, while in group 2 (20 patients) a cartilage graft was used with the addition of a PRF membrane. The PRF clot was extracted and transformed into a thin membrane. Postoperative evaluation included otoendoscopy and otomicroscopy at 1, 3, 6, and 12 months after surgery, as well as pure-tone audiometry at 12 months. Results: Postoperative follow-up at 1, 3, 6, and 12 months showed a higher rate of graft survival in the PRF group than in the non-PRF group. At the 12-month mark, a successful outcome was observed in 95.0% of patients in the PRF group, while the success rate in group 1 was 70.4% (p < 0.05). The postoperative hearing threshold value was statistically significantly lower in the group with PRF, compared to the non-PRF group, being 18.4 ± 10.4 dB and 27.6 ± 16.2 dB (p < 0.001), respectively. Although the postoperative air-bone gap value did not differ significantly between groups, there was a greater improvement in the PRF group (p < 0.7). The PRF was well tolerated, and the incisions healed perfectly. Conclusions: The PRF membrane increases the rate of autograft survival and is therefore an effective material for patients with chronic perforations of the tympanic membrane.

A comparative clinico-radiographic analysis of regenerative endodontic procedure on immature necrotic permanent teeth using blood clot and PRF as scaffold: A retrospective study

ObjectivesTo evaluate the clinical and radiographic success rate of blood clot and platelet rich fibrin (PRF) as a scaffold system in regenerative endodontic procedure in immature traumatized necrotic teeth.. Materials and methodsThis retrospective study examined the records of 28 subjects with necrotic immature open apex due to trauma treated with blood clot or PRF as a scaffold in regenerative endodontic procedure. The disinfection was carried out with calcium hydroxide as an intra-canal medicament. The clinical outcome was recorded using a binary variable of presence or absence of pain and intra-oral swelling. The radiographic outcome was recorded for periapical healing using Ørstavik’s Periapical Index and apical response using Chen and Chen index. Comparison of frequencies of categories of variables with groups was done using the chi-square test. The pairwise comparison of time intervals was done using Wilcoxon Signed Ranks Test. ResultsIntra-group comparison of pain and intra-oral swelling had highly significant (p = 0.000) results for both groups over a period of 12 months. Inter-group comparison for clinical outcomes was insignificant. For the radiographic outcome, there was a statistically non-significant difference for periapical healing and apical response for both intra-group and inter-group comparisons. ConclusionBoth PRF and blood clot have a favourable outcome for a regenerative endodontic procedure with a disinfectant protocol using calcium hydroxide as intracanal medicament. Considering the cumbersome procedure involved in procuring PRF scaffold, especially in children, inducing bleeding can be considered a recommended method for a regenerative endodontic procedure.

Comparative evaluation of pH and Ca+ ion release from MTA on interaction with platelet-rich fibrin and blood clot: an in vitro study

Background: ‘Regenerative endodontics’ using host-derived scaffolds and biomaterials (MTA) is popular in the management of teeth with open apex. Alkaline pH and bioactivity contribute to tissue healing and remineralization. We assessed the influence of PRF and Blood Clot on the pH and Ca+ ion release from MTA. Methods: A total of 15 single-rooted human extracted teeth were sectioned at the level of the cementoenamel junction. Based on the type of scaffolds used, samples were divided into three groups. Group 1 (MTA+ PRF), Group 2 (MTA + Blood Clot), Group 3 (control MTA). The prepared specimens were transferred to a fresh falcon tube containing 10mL of distilled water and the collected solutions were analysed for pH and Ca+ ion release at 3h, seventh day and 14th day. Results: It was observed that the mean pH and Ca+ ion release were significantly lower in the experimental groups as compared to the control group. Though there was an increase in the pH recorded in Group 1 and 2 at all time periods, the difference was not significant. Ca+ ion release peaked at Day 7 (Group3 &gt; Group2 &gt; Group1) and reduced significantly on the 14th day for all groups. Conclusions: Within the limitations of the study, it can be concluded that PRF and blood clot influence the pH and Ca+ ion release from MTA.

Platelet-rich fibrin vs. buccal advancement flap for closure of oroantral communications: a prospective clinical study

ObjectivesThe primary aim was to evaluate the success of the defect closure (tight or open) of oroantral communications (OAC) after treatment with platelet-rich fibrin (PRF) clots or a buccal advancement flap (BAF). Secondary outcome measurements were the evaluation of the wound healing, the displacement of the mucogingival border (MGB), and the pain level.Material and methodsFifty eligible patients with an OAC defect larger than 3 mm were randomly assigned to either PRF (test group, n = 25) or BAF (control group, n = 25) for defect closure. In a prospective follow-up program of 21 days, the defect closure healing process, the wound healing course using Landry’s wound healing index (score: 0–5), the displacement of the MGB, and the postoperative pain score were evaluated.ResultsFive patients in each group were lost to follow-up resulting in 40 patients (20 in each group) for continuous evaluation. On postoperative day 21 (study endpoint), no difference regarding success rate (defined as closure of OAC) was noticed between the test (90%; 18/20) and control group (90%; 18/20). A univariate analysis showed significant differences for age and defect size/height for the use of PRF between successful-tight and open–failed defect healing. At the final evaluation, a significantly (p = 0.005) better wound healing score, a lower displacement of the MGB as well as lower pain-score were seen for the use of PRF.ConclusionsBased on the findings of the current study, the use of platelet-rich fibrin represents a reliable and successful method for closure of oroantral communications. The use of PRF clots for defect filling is associated with lowered pain levels and less displacement of the mucogingival border.Clinical relevanceThe defect size should be taken into account when choosing the number and size of PRF plugs.

The Efficacy of Advanced Platelet-rich Fibrin in Revascularization of Immature Necrotic Teeth

The present study aims to compare advanced platelet-rich fibrin (A-PRF) and conventional blood clot as scaffolds in the regenerative endodontic procedure (REP) and to evaluate their effectiveness in the development of traumatized nonvital immature teeth roots. Regenerative endodontic procedure was carried out on 20 traumatized nonvital immature maxillary incisors of 17 patients between the ages of 8 and 12 years. Irrigation with 1.5% sodium hypochlorite (NaOCl) and 17% ethylene diamine tetra-acetic acid was done following minimal mechanical debridement. Canal disinfection was achieved using calcium hydroxide paste. According to the scaffold type, teeth were randomly allocated into A-PRF (n = 10) and conventional blood-clot groups (n = 10). Apical width and root dimensions (length and thickness) were analyzed radiographically and statistically after 3-, 6-, and 12-month follow-up. Fifteen patients with 18 teeth (A-PRF n = 9, blood clot n = 9) completed the follow-up, and 2 patients were excluded. Patients in both groups were asymptomatic. There was a significant increase within each group in respect to root length, root thickness at one- and two-thirds, and root apex width for all timepoints. While percent of change between the two groups was statistically insignificant. Regenerative endodontic procedure for traumatized immature nonvital teeth with either conventional blood clot or A-PRF as scaffold was comparable, except in cases where adequate bleeding cannot be achieved. Advanced platelet-rich fibrin provides a suitable scaffold that can be used in REP of teeth with close proximity to vital structures such as inferior alveolar nerve (IAN) or mental nerve, where using a sharp instrument to induce bleeding can cause damage and also in cases where adequate bleeding cannot be achieved.

Assessment of Bone Density around Dental Implants Using Two Platelet-Rich Fibrin Protocols (A Comparative Clinical Study)

Aims: The current study aimed to compare bone density means around dental implants covered with one of two platelet rich fibrin preparation protocols (Standard-Platelet Rich Fibrin and Advanced-Platelet Rich Fibrin) using standard intraoral digital periapical radiographs. Materials and methods: A total of ten male patients with an age range of 28-51 years participated in this split-mouth clinical study. The patients were divided into two groups based on the platelet rich fibrin (PRF) protocol to be used with dental implant insertion into positive control (S-PRF) and study group (A-PRF). Each patient represented the two groups in which he received 2 dental implants; ten implants for each group (a total of 20 dental implants) of standard length and diameter in the posterior mandibular extraction sites of ipsilateral or contralateral side. In the positive control group, the standard PRF protocol was to be used to prepare the PRF clot. In the study group, the advanced PRF protocol was to be used to prepare the PRF clot. Both PRF membranes were to be instilled inside the osteotomy bed during dental fixture installation. Following the installation of dental implants and as a basis for comparison between both groups, densitometric analysis of bone around dental implants at immediate, four, eight and twelve weeks scheduled visits were made. Results: Total densitometric analysis results showed no significant difference within S-PRF group, within A-PRF group and between both groups, with the highest mean (167.07) being at twelve weeks after surgery in the A-PRF group. Conclusions: Both S-PRF and A-PRF, similarly enhanced and maintained bone density (synergistic effect) throughout the of study and as disclosed by densitometric values. The use of PRF in its current forms seems to be an accepted minimally invasive approach with good clinical results.

The effect of resting and compression time post-centrifugation on the characteristics of platelet rich fibrin (PRF) membranes.

To evaluate the effect of resting and compression time after centrifugation on the physical properties of platelet rich fibrin (PRF) membranes, and to provide optimal guidance regarding the clinical preparation of PRF. A total of 12 volunteers enrolled in this study divided into 2 groups equally. For each volunteer, 6 tubes of 10mL venous whole blood was drawn. To evaluate the influence of resting time after centrifugation, PRF clots were taken out 0, 1, 3, 5, 7, and 10min from tubes following centrifugation, and then the weight, size, maximum stress, and maximum strain of each group were measured. To evaluate the influence of compression time on the preparation of PRF membranes, the weight ratio of PRF membranes to PRF clots was calculated by compression for 10s, 30s, 60s, 90s, 120s, and 180s, respectively. Scanning electron microscopy was performed to observe the cross-linking of the fibers within membranes, and the maximum stress and strain of PRF membranes were tested followed by stress-strain curve analysis. The weight and volume of PRF clots and PRF membranes increased in size and weight reached the top at 3min, followed by a decrease after 7-min resting. The maximum strain of the PRF membranes after 10min decreased significantly compared to the 3-min and 5-min groups. The maximum stress was found at 3min followed by a statistical decrease when resting time went on. Scanning electron microscopy demonstrated that the internal fibrous structure of the PRF membranes was looser when the compression time was less than 60s when comparing the 90-s group. The maximum stress of PRF membranes was shown using a wait period of 3min post-centrifugation followed by compression for 120s. The findings from the present study demonstrate that the time post-centrifugation of PRF membranes showed a maximum weight, volume, and mechanical properties after resting for 3-5min in the tube post-centrifugation followed by a compression time of 120s. Although research to date has focused primarily on centrifugation protocols, this study revealed for the first time that the resting time post-centrifugation greatly affected the mechanical properties of PRF. This study demonstrated that the resting and compression time after centrifugation influences the mechanical strength of PRF membranes, which might explain differences in PRF characteristics prepared by different clinicians that may provide a standard guide for preparation of PRF membranes.

Simultaneous Implant Placement and Sinus Lift Using Leukocyte-Platelet Rich Fibrin: A Retrospective 40-Month Study.

The aim of this study was to report the 40-month clinical radiographical outcomes of maxillary sinus floor augmentation using leukocyte-platelet rich fibrin (L-PRF) as a single graft in combination with immediately placed implants. Twenty partially edentulous individuals with missing teeth in the region associated to maxillary sinus were included in this retrospective study. A lateral sinus floor elevation was performed considering a complete wear of the bone wall of the maxillary sinus and immediately placing the implant and filled the maxillary sinus with L-PRF clots as a single graft. After 5 months, all the implants received single screwed implant-supported prostheses. Subsequent evaluation was every 4 months assessing the success rate and biological complications. Two maxillary sinus membrane were perforated and covered with L-PRF clots. The mean bone height gain was 62.6%, observing a 100% of success and that in all the cases achieved at least the implant height. In conclusion, the use of platelet-rich fibrin clot as a single graft biomaterial during the maxillary sinus lift procedure combined with immediate implant placement may be a reliable clinical alternative, even to repair the sinus membrane.

A Standardized g-Force Allows the Preparation of Similar Platelet-Rich Fibrin Qualities Regardless of Rotor Angle.

Platelet-rich fibrin (PRF) is an autologous blood concentrate that supports tissue regeneration. The effect of the centrifuge rotor angle in the fabrication of PRF is still not fully elucidated. The hypothesis of this study is: When applying the same g-force (relative centrifugal force [RCF]) and centrifugation time, PRF components and bioactivity are not modified using either a swing-out rotor or a fixed angle rotor. For this purpose, peripheral blood samples (from five donors) were used to gain solid (710 ×g, 8 min) and liquid (44 ×g, 8 min) PRF matrices using three different centrifuges (one fixed angle as a control and two different swing-out rotor centrifuges). The physical characteristics of the solid PRF were measured to evaluate the clot formation and cellular distribution. The liquid PRF was used to evaluate the cell number, bioactivity, and influence on primary human osteoblasts (pOBs) and primary human fibroblasts (pHFs) in vitro. Solid PRF clots were significantly larger in the group of fixed rotor centrifuges compared with either of the two evaluated swing-out rotor centrifuges. No differences were observed when evaluating the cellular distribution within the solid PRF. No statistically significant differences were documented in the cell's density in liquid PRF samples (platelets, lymphocytes, neutrophils, eosinophils, and basophils) among the differently gained PRF samples. No statistically significant differences were documented for the released growth factors (vascular endothelial growth factor, epidermal growth factor, and transforming growth factor beta 1) over 7 days. pOBs and pHFs viability after treatment with PRF conditioned media showed no statistically significant differences between the evaluated groups. However, the number of adherent cells treated with PRF obtained with the use of the fixed angle rotor was significantly higher when compared with those treated with PRF obtained by using the swing-out rotors. The presented results confirm that regardless of the centrifuge rotor used, the components and bioactivity of solid and liquid PRF matrices are modified by the applied RCF and centrifugation time. These findings are of great importance for highlighting the essential role of adapting the centrifugation protocols when using different centrifuges and to correctly report the used centrifugation protocols in scientific research to allow for reproducible results. Impact statement Platelet-rich fibrin (PRF) is prepared from autologous peripheral blood and is widely applied in research and clinical treatments. The centrifugation parameters used during the preparation of PRF directly influence its components and bioactivity. By using a standardized protocol, the present study demonstrated that adapting various centrifuges to a standardized relative centrifugal force and centrifugation protocol resulted in reproducible PRF matrices with similar bioactivity, regardless of the centrifuge rotor angle. These findings underline the necessity to carefully adapt and correctly report the used centrifuge and centrifugation protocols in scientific research to allow reproducible results.

Standardized Platelet-Rich Fibrin (PRF) from canine and feline origin: An analysis on its secretome pattern and architectural structure.

Platelet-rich fibrin (PRF) has been incorporated in surgical procedures to promote tissue and bone healing, particularly in human medicine. The rationale for the use of platelet-based products stems from the fact that platelets, after being activated, release growth factors (GFs) and other active molecules such as cytokines, that modulate inflammation and tissue repair. Although PRF has been advanced as a therapeutic treatment for veterinary use, namely in canine and feline patients (following human medicine developments), to our knowledge a full characterization of PRF therapeutic effectors has never been performed. Herein, we studied the biological properties and release profile of GFs and other cytokines throughout ten days in in vitro culture conditions, in order to investigate the potential therapeutic ability of PRF for canine and feline practice. A protocol for obtaining PRF from whole blood without anti-coagulant from both species was optimized, originating large and homogenous PRF clots. Then, PRF clots obtained from four dogs and four cats were incubated in culture medium to assess the temporal release of platelet-derived growth factor-BB (PDGF-BB), vascular endothelial factor-A (VEGF-A), transforming growth factor β-1 (TGF-β1), and interleukin-8 (IL-8). Furthermore, morphological characterization of PRF clots, fresh and after 10days of incubation, was performed by histology and high-resolution field emission electron scanning microscopy. In standard culture conditions, PRF clots from both species released PDGF-BB, TGF- β1 and VEGF-A, in a sustained manner, up to day 10. Moreover, PRF presents an initial burst release of IL-8, a mediator of inflammatory response which plays a key role in neutrophil recruitment and degranulation. Overall, our findings show that PRF clots may be an efficient therapeutic strategy in canine and feline clinical practice, accelerating the local healing mechanism, through the sustained delivery of signalling molecules involved in the healing cascade.

Anterior Cruciate Ligament Reconstruction: Is Biological Augmentation Beneficial?

Surgical reconstruction in anterior cruciate ligament (ACL) ruptures has proven to be a highly effective technique that usually provides satisfactory results. However, despite the majority of patients recovering their function after this procedure, ACL reconstruction (ACLR) is still imperfect. To improve these results, various biological augmentation (BA) techniques have been employed mostly in animal models. They include: (1) growth factors (bone morphogenetic protein, epidermal growth factor, granulocyte colony-stimulating factor, basic fibroblast growth factor, transforming growth factor-β, hepatocyte growth factor, vascular endothelial growth factor, and platelet concentrates such as platelet-rich plasma, fibrin clot, and autologous conditioned serum), (2) mesenchymal stem cells, (3) autologous tissue, (4) various pharmaceuticals (matrix metalloproteinase-inhibitor alpha-2-macroglobulin bisphosphonates), (5) biophysical/environmental methods (hyperbaric oxygen, low-intensity pulsed ultrasound, extracorporeal shockwave therapy), (6) biomaterials (fixation methods, biological coatings, biosynthetic bone substitutes, osteoconductive materials), and (7) gene therapy. All of them have shown good results in experimental studies; however, the clinical studies on BA published so far are highly heterogeneous and have a low degree of evidence. The most widely used technique to date is platelet-rich plasma. My position is that orthopedic surgeons must be very cautious when considering using PRP or other BA methods in ACLR.

Non‐surgical management of oro‐antral communication using platelet‐rich fibrin: A review of the literature

AbstractOro‐antral communication (OAC) is an opening between the maxillary sinus and the oral cavity, which can provide a pathway to cause an infection of the maxillary sinus. Although surgical techniques propose many advantages, several drawbacks have been reported in the previous studies. Bioactive modifiers such as platelet‐rich fibrin (PRF) are widely being used in oral surgery. Various studies have been conducted for closure of OACs using PRF. Due to the heterogeneity of the techniques found, we opted for a literature review to highlight the variety of techniques discussed in the literature. A comprehensive search of the PubMed, Google Scholar and Cochrane databases was performed for published articles between 2014 and 2021. Keywords for OAC management and repair and inclusion criteria were used to screen articles for final review. Out of 195 articles found, 12 articles were included to the study. Eight studies performed simple direct application of PRF clots, 2 studies used PRF in combination with collagen membrane and in 2 studies the treatment plan was to use buccal advancement flap reinforced by PRF. There were several variations among approaches to the closure of OAC using PRF in terms of treatment planning, pre‐ and post‐operative medication and preparation of PRF. Despite the mentioned variations, review of recent studies showed that all of the cases experienced full epithelialisation of OAC. This technique, without manipulation of any additional flaps and auto‐grafts, has several advantages. However, further research, both experimental and clinical, is necessary to unravel the success rate of using PRF in the management of OACs.

Advanced Platelet-Rich Fibrin as a Therapeutic Option in the Treatment of Dry Socket: Literature Review and Case Series

Alveolar osteitis (AO) is one of the complications that occur after tooth extraction. The aim of this study has been to evaluate the efficacy of Advanced Platelet-rich Fibrin (A-PRF) in the management of pain and the acceleration of wound healing in the treatment of AO. Consecutive patients who were diagnosed with AO, recruited from patients referred to the Oral Surgery Department of the University of Naples Federico II, were enrolled. After local anesthesia, the dry socket was curetted and irrigated with saline. The Platelet-rich Fibrin (PRF) clot was placed in the socket and then covered with an A-PRF membrane. Clinical parameters, such as the degree of pain and rate of granulation tissue (GT) formation, were measured before treatment and after 1, 3, 7, 14, and 21 days. The Friedman test for dependent samples was used to detect the treatment and time effect. Four patients with established AO were included. On all the examination days, the post-operative recovery was uneventful. The pain scores progressively reduced, from an average of 8.5 before treatment to 0.25 on the third day, and the GT formation improved over time. The use of A-PRF in the treatment of AO significantly reduced the pain level and enhanced the wound-healing process.