Platelet-rich Fibrin Matrix Research Articles

Evaluation of the Effect of Platelet-Rich Fibrin Matrix in the Correction of Periorbital Wrinkles: An Experimental Clinical Trial.

Skin rejuvenation techniques have gained substantial popularity due to increased life expectancy over recent years. Platelet-rich fibrin matrix (PRFM) is the new generation of platelet aggregate products that have surfaced in recent years to treat skin aging. We intend to use PRF to correct periorbital wrinkles in 15 volunteers and evaluate its effectiveness in this study. To evaluate the efficacy of PRFM intervention, eight men and women over the age of thirty entered our study. Blood samples were taken and were immediately centrifuged at 700rpm for 5 minutes. PRFM was extracted from the plasma and injected at the sub-dermis site in periorbital areas. The initial severity of periorbital wrinkles was determined by Visioface 1000D, and obtained data were delivered to the statistical unit for statistical analysis. Scoring and evaluation were based on tissue volume and depth and were measured before and twelve weeks after injection. Adverse effects were also taken into consideration. The results demonstrated noticeable improvement in deep, fine, and small wrinkles, periocular hyperpigmentation, and overall skin freshness of the injection site. The subjects had swelling in the injection site for up to one day after the injection, which resolved without complications. PRFM was observed to have potential in skin rejuvenation, demonstrating promising outcomes in terms of safety and long-term effects in improving skin condition.

Role of Sromal Vascular Fraction in Wound Bed Preparation in Post Traumatic Wound

Degloving Injury are major debilitating conditions and its treatment is also challenging. The treatment of post traumatic degloving injury requires a multimodal approach. Adjuvant platelet rich fibrin matrix can be tried for post traumatic wounds as a modality for wound bed preparation. In this study we share our experience regarding the use of stromal vascular fraction as an adjunct in the management of post-traumatic degloving wounds of the lower extremity.

Role of platelet rich fibrin matrix in wound bed preparation in degloving injury

Degloving Injury are major debilitating conditions and its treatment is also challenging. The treatment of post traumatic degloving injury requires a multimodal approach. Adjuvant platelet rich fibrin matrix can be tried for post traumatic wounds as a modality for wound bed preparation. In this study we share our experience regarding the use of platelet rich fibrin matrix as an adjunct in the management of post traumatic degloving wounds of the lower extremity.

Combined Effect of Platelet-Rich Fibrin Matrix (PRFM) and Demineralized Freeze-Dried Bone Allograft (DFDBA) in Immediate Implant Placement: A Single-Arm Clinical Trial

Introduction Placement of immediate implants in contrast to delayed implant placement may be favorable. The factors contributing to this are shortened overall treatment time, aid in ideal orientation andfixture placement, bone preservation following extraction, and achieving optimal aesthetics involving soft tissue. However,the gap distance between the surface of the implant and the buccal bony wall during implant placement is critical for subsequent bone healing in a fresh extraction socket. Considering that as the gap broadens, the amount of bone-to-implant contact (BIC) decreases, causing an apical shift of the highest bone-implant contact. Incorporating a bone substitute material (BSM) within the fixture-socket gap preserves alveolar ridge volume by minimizing socket remodeling and encouraging de-novo bone formation. Aim and objectives To evaluate the efficacy of platelet-rich fibrin matrix (PRFM) and demineralized freeze-dried bone allograft (DFDBA) in fresh extraction socket with simultaneous implant placement. Methods Implants were immediately placed in 12 patients following a two-stage submerged protocol. The combination of PRFM and DFDBA was used to fill the gap between the implant body and the surrounding socket wall. The final restoration was placed after 3 months following implant placement. The full mouth plaque, gingival bleeding index, and gingival esthetics scores were assessed at baseline, 3, and 6 months. The crestal changes were evaluated using intraoral periapical radiographs (IOPA) at baseline, 3, and 6 months. Cone beam computed tomography (CBCT) images were obtained at baseline and 6 months after implant loading to analyze the buccolingual changes. Results At 6 months follow-up, the coronal bone remodeling detected on CBCT revealed a minimal (0.1 mm) narrowing of the alveolar ridge in a buccolingual direction, with a mean bone loss of 0.10+0.09, which was statistically non-significant (p > 0.05). Implant success was 100% at 6 months after loading as determined by Akbrektsson's criteria for implant success. Conclusions The adjunctive use of PRFM with DFDBA following immediate implant placement yielded a significant reduction in bone resorption and maintenance of buccolingual dimensions.

Use of scaffolds and regenerative materials for the treatment of immature necrotic permanent teeth with periapical lesion: Umbrella review.

Current treatment of immature necrotic permanent teeth with a periapical lesion is regenerative endodontics, which is based on tissue engineering under the triade of stem cells, scaffolds and bioactive molecules. This Umbrella Review was aimed to evaluate the success of scaffold and regenerative materials used for the treatment of these teeth, in terms of apical closure, tooth length increase, widening of root canal walls, tissue vitality and periapical lesion repair. An extensive literature research was carried out in the Medline, ISI Web of Science, and Scopus databases for relevant systematic reviews matching the keyword search strategy. Based on inclusion and exclusion criteria, reviewers independently rated the quality of each study to determine their level of evidence. Methodological quality assessment of each article was obtained using A Measurement Tool to Assess Systematic Reviews (AMSTAR)-2 tool, and risk of bias was assessed with the Risk of Bias in Systematic Reviews (ROBIS) tool. After removing duplicates, 155 articles were found; from which 133 were excluded for being non-relevant and 15 other due to exclusion criteria. One more was discarded after methodological quality evaluation, for a total of six articles remaining. The most common scaffold used was the blood clot, others used were poly lactic-co-glycolic acid and platelet-rich fibrin matrix. The most common regeneration material used was Mineral Trioxide Aggregate (MTA), followed by Biodentine. An increase in tooth length and widening of root canal walls were reported in all selected studies with different proportions, as well as periapical lesion repair. ROBIS analysis showed that only one article had low bias, two were classified as unclear bias, while the remaining three had high risk of bias. An exhaustive literature search was carried out applying language filters, high-quality indexed journals, year of publication, which ensures the best quality articles were included. Blood clot was the most used scaffold as is the most easy to place inside the canal and does not require to extract blood from the patient. The use of MTA and Biodentine as sealing materials has been associated with thickening of canal walls, apical closure and reduced signs and symptoms of apical periodontitis. However, most of the included reviews assessed were case reports and only in a few of them were clinical trials included. There is also a lack of risk of bias analysis in most reviews. The blood clot is the most common scaffold used for inducing regeneration during the treatment of immature necrotic teeth. Tooth length increase and widening of root canal walls are the most common criteria used in the studies as success indicators. MTA and Biodentine did not show differences in the results analysed. Quality assessment and bias risk evaluation showed that it is necessary to design better studies with rigorous methodology to recommend a trustable and predictable protocol for the treatment of immature necrotic permanent teeth with periapical lesions. International Prospective Register of Systematic Reviews (PROSPERO) CRD42021248404.

A comparative evaluation of the effect of platelet rich fibrin matrix with and without peripheral blood mesenchymal stem cells on dental implant stability: A randomized controlled clinical trial

Technological advances in the field of implantology have led to the concept of surface modifications to enhance implant stability by utilization of current concepts of tissue engineering and materials such as platelet concentrates and stem cells. The purpose of the present randomized controlled clinical trial was to evaluate and compare the effect of platelet rich fibrin matrix (PRFM) with and without peripheral blood mesenchymal stem cells (PBMSCs) on implant stability; by assessing the bone to implant contact (BIC) using resonance frequency analysis (RFA), insertion torque and also to establish and correlate the same with implant stability quotient (ISQ). A total of 15 patients with 30 sites ensuring a minimum of two dental implants adjacently placed in an edentulous area; with the age group of 25-50years of both the sexes were categorized into Group 1 (dental implant with PRFM) and Group 2 (dental implant with PBMSCs embedded in PRFM). Insertion torque values at the time of dental implant placement and ISQ using RFA was recorded at 1week, 1month, and 3months post operatively. There was no significant difference (p=0.81) in Insertion torque values between both the groups (G1 and G2). Platelet rich fibrin matrix along with PBMSCs enhanced implant stability as higher and statistically significant ISQ values were noted at 1week (p=0.18), 1month (p≤0.001), and 3months (p≤0.001) intervals in the G2 group. Platelet rich fibrin matrix and PBMSCs showed promising results as a potential regenerative material for increasing and enhancing BIC and hence implant stability.

Bioactive and degradable hydrogel based on human platelet-rich plasma fibrin matrix combined with oxidized alginate in a diabetic mice wound healing model

In the present study we developed an injectable, bioactive and degradable hydrogel composed of alginate at 2.5% oxidation degree and calcium-activated platelet rich plasma (PRP) for wound healing applications (PRP-HG-2.5%). The alginate gives mechanical support to the hydrogel while the activated PRP provides growth factors that enhance wound healing and fibrin which creates an adequate microenvironment for cell migration and proliferation. The rheological and mechanical properties of the hydrogel were characterized. Further characterization revealed that PRP-HG-2.5% showed a faster hydrolitic degradation rate than unmodified alginate and a similar platelet derived growth factor (PDGF-BB) release profile. In vitro efficacy studies, carried out in human fibroblasts and keratinocytes, showed that PRP-HG-2.5% was not cytotoxic and that it was able to promote cell adhesion and proliferation. Thereafter, in an in vivo full thickness wound healing study conducted in diabetic mice, no differences were found among PRP-HG-2.5% and its counterpart without PRP, likely due to the xenogeneic origin of the PRP. This hypothesis was validated in vitro, since a cytotoxic effect was observed after human PRP application to mouse fibroblasts. Therefore, PRP-HG-2.5% might be a promising strategy for chronic woundstreatment, although its effectiveness should be evaluated in a more reliable preclinical model.

Evaluation of Platelet-Rich Fibrin Matrix as a Regenerative Material in the Surgical Management of Human Periodontal Intraosseous Defects - A Randomized Controlled Trial.

Background: Platelet-rich fibrin matrix (PRFM) has not been extensively studied as other platelet concentrates such as Choukron's platelet-rich fibrin (PRF). This randomized controlled trial aimed to evaluate PRFM regenerative ability in human periodontal intrabony defects.Materials and Methods: Fifteen patients (age: 30–55 years) having probing pocket depth (PPD) ≥6 mm, and radiographic evidence of bilateral vertical intrabony defects were recruited. A split-mouth design was used in each patient; one quadrant of the arch was treated with open flap debridement (OFD) alone (control group) and the other quadrant with OFD + PRFM (test group). The PRFM was prepared by dual-spin technology using a patented thixotropic separator gel. Outcome measures comprising plaque index, gingival index (GI), PPD, clinical attachment level (CAL), depth of the defect, defect fill (DF), and percentage of DF (PDF) were recorded at baseline, after 3 months and 6 months. The parameters were applicably analyzed using the Friedman test, Fisher's exact test, t-test, paired t-test, repeated measures ANOVA, and Post Hoc-Bonferroni correction.Results: The GI, a net reduction in CAL, and PPD of the test group were significantly better than the control group at 3 months and 6 months (P < 0.05), while DF and PDF showed significant results at 6 months (P < 0.05). A consistent early wound healing index of 1 at 1 week was displayed in the test group (66.7%) in comparison to the control group (33.7%).Conclusion: PRFM can be a clinically significant periodontal regenerative material in the treatment of vertical intraosseous defects.

Comparison of Autologous Platelet-Rich Fibrin Matrix and Transplantation of Autologous Noncultured Epidermal Cell Suspension in the Treatment of Chronic Non Healing Ulcer: Randomized Comparative Study.

Chronic non-healing ulcer causes significant morbidity, high cost and reduced quality of life. To compare autologous platelet-rich fibrin matrix and transplantation of autologous non-cultured epidermal cell suspension in the treatment of chronic non-healing ulcers. The study was single-centre, prospective, randomised comparative study conducted in a tertiary care center in North India. Patients with chronic non-healing ulcer were included and randomly divided into two treatment groups- Group 1: Platelet-rich fibrin matrix (PRFM) procedure was done every 2 weeks with maximum three sittings and in Group 2: Transplantation of autologous noncultured epidermal cell suspension (NCES) procedure was done once. Follow-up was done every 2 weeks for 8 weeks then monthly for up to 5 months to evaluate the healing of the ulcer. The data were analysed by statistical package for social science (SPSS) trial version 22. To find out a significant difference in mean value between groups, the Chi-square test, student's t-test, and Mann-Whitney U test were used. A total of 41 patients were included in the study. Complete healing of ulcers occurred in 89.5% of the patients in the PRFM group and 93.8% of the patients in the NCES group at the end of 5 months (P = 0.33). The mean duration of complete healing in PRFM was 1.7 months and in NCES was 2.13 months (P = 0.20). Both procedures were effective, and there was no significant difference between the two procedures.

To Compare the Efficacy and Safety of Autologous Non-cultured Non-trypsinized Keratinocyte and Melanocyte Grafting (Jodhpur Technique) with Autologous Platelet-Rich Fibrin Matrix (PRFM) in the Treatment of Chronic Non-healing Ulcer.

Background:Chronic non-healing ulcers (NHUs) are often associated with some underlying pathology which prevents timely healing thus increasing the patients morbidity and healthcare expenses. Autologous non-cultured non-trypsinized keratinocyte and melanocyte grafting also known as Jodhpur technique (JT), an epidermal graft and autologous platelet-rich fibrin matrix (PRFM) are newer modalities with promising results.Aims:To compare the efficacy and safety of JT and autologous PRFM in the treatment of chronic NHU. Design: A prospective hospital based interventional study conducted on 50 patients of chronic NHU attending the dermatology outdoor of a tertiary level government hospital.Materials and Methods:After taking clearance from the institutional ethical committee, the patients were enrolled into 2 groups of 25 each. JT was done on group A and autologous PRFM on group B and their efficacy and safety compared.Statistical Analysis:Chi square test was used to analyze categorical variables summarized as number and percentage while continuous variables were analyzed using student t-test for intergroup comparison.Results:In Group A, the mean time to ulcer healing was 6.17 ± 2.17 weeks while 6.43 ± 2.33 weeks in Group B. No side effects were found in either group.Conclusion:Both the techniques fair equally in terms of wound healing time and safety but required multiple sittings in group B and a single session in group A.

Evaluation of Effectiveness of Platelet Rich Fibrin Matrix (PRFM) Membrane and Platelet Rich Fibrin (PRF) Membrane using Vestibular Incision Subperiosteal Tunnel Access (VISTA) Approach Technique for the Treatment of Multiple Gingival Recession Defects in Humans – A Study Protocol

Background: To evaluate the effectiveness of Platelet Rich Fibrin Matrix (PRFM) membrane and Platelet Rich Fibrin (PRF) membrane using Vestibular Incision Subperiosteal Tunnel Access (VISTA) Approach method for the management of multiple gingival recession (GR) defects in humans.&#x0D; Methodology: 20 subjects with gingival recession will be enrolled. 10 patient will be randomly allotted to test group (PRFM membrane) or control group (PRF membrame). Primary outcome will be gain in root coverage (RC) and secondary outcome will be Plaque index (PI), Papillary bleeding index (PBI), probing pocket depth (PPD), relative attachment level (RAL), relative gingival margin level (RGML), recession depth (RD), gingival thickness (GT) and width of keratinized gingiva (WKG). Clinical evaluation will be performed at 3 &amp; 6 months of therapy.&#x0D; Expected Results: When all the parameters will be compared at 6 months post-operatively to baseline data, both the treatment group (test and control) will be expected to show significant gain in RC, RAL gain, PPD reduction, decrease in RD, increase in GT and WKG. PRFM membrane will result in significant gain in RC, RAL gain, PPD reduction, and decrease in reduction depth, increase in GT and WKG at 6 months when compared to PRF membrane.&#x0D; Conclusion: PRFM membrane will be effectual in management of gingival recession. PRFM membrane is expected to have significantly greater outcome as compared to PRF membrane group.

Management of Oblique Root Fracture Using Mineral Trioxide Aggregate: A Case Report

Management of Oblique Root Fracture Using Mineral Trioxide Aggregate: A Case Report

The use of autologous platelet-rich fibrin matrix combined with meniscal repair in the treatment of parameniscal cyst: clinical results and cyst recurrence after 2-year of follow up

PurposeParameniscal cysts are associate with horizontal meniscal tears. Arthroscopic meniscal repair and the excision of the cyst by mini-open approach represent a valid treatment. However, the recurrence of cyst is still a current issue. Therefore, biological factors may be considered to promote the biological repair and avoid recurrence. The aim of the present study was to report the clinical results and the rate of recurrence of the cyst after minimum 2-year of follow up in a cohort of patients treated by meniscal repair and autologous platelet-rich fibrin matrix augment.MethodsPatients with lateral parameniscal cyst undergoing arthroscopic meniscal repair and autologous platelet-rich fibrin matrix augment between 2016 and 2019 were retrospectively reviewed in March 2021. Inclusion criteria were absence of prior surgery on the affected knee with minimum 2-year of follow-up. Exclusion criteria were concomitant ligament lesions, rheumatic diseases and knee osteoarthritis. After reviewing the database, each selected patient was contacted and asked to participate in the study; at the follow-up evaluation all patient signed an informed consent. Tegner-Lysholm knee score, IKDC and NRS were collected before surgery and at follow-up.ResultsThis study included 15 patients (8 male) with mean age of 32.8 years old. No recurrence of the cysts was observed. The Tegner-Lysholm knee score and IKDC subjective scores increased respectively from 41.3 ± 5.4 and 37.6 ± 5.1 at baseline to 92.3 ± 4.6 and 89.4 ± 2.6 at the final follow up. Concerning pain relief, the Numeric Pain Rating Scale (NRS) displayed a significant improvement reaching at the follow up a score of 1,3 ± 1.1 in comparison to 6.8 ± 0.9 at the baseline.ConclusionSurgical management of symptomatic lateral parameniscal cyst with cyst excision, autologous PRP membrane application and meniscus repair demonstrated excellent subjective clinical outcome with any cyst reoccurrence.Level of evidenceIII, retrospective cohort study.

Platelet-Rich Plasma in Facial Rejuvenation: A Systematic Appraisal of the Available Clinical Evidence.

PurposePlatelet-rich plasma (PRP) is a promising noninvasive technique for facial rejuvenation. This systematic literature review aims to appraise the nature and quality of published evidence evaluating the effectiveness and safety of PRP in facial rejuvenation.Patients and MethodsA systematic literature review was conducted with the search string “Platelet-rich plasma AND Facial rejuvenation” in PubMed and Embase. Clinical studies evaluating the outcomes after PRP-based facial rejuvenation either as monotherapy or in combination with other treatment modalities were included. Studies evaluating wound-healing properties of PRP were excluded. The outcomes included both patient-reported and physician-assessed outcomes. Nonstatistical synthesis of evidence was performed by qualitative assessment. The results are reported by the Synthesis Without Meta-analysis (SWiM) reporting standard.ResultsA total of 36 studies that included a total of 3172 patients were considered for the evidence synthesis. The number of patients in the included studies ranging from 11 to 2005 with a median of 27.5 patients that reflects the challenges in clinically assessing the aesthetic outcomes after PRP-based facial rejuvenation. Among the 36 studies, 17 were observational studies and 18 were interventional studies with 1 being case report PRP was evaluated either alone or in combination with hyaluronic acid, lipofilling, micro-needling technique, and laser-based interventions. Among the studies, 1 study reported the enhanced platelet concentrate in a fibrin matrix to be relatively safe and effective with a maximum benefit observed at 12 weeks suggesting the platelet-rich fibrin matrix may provide desired aesthetic outcomes and it requires further studies to substantiate.ConclusionThe results suggest very limited clinical evidence, and further clinical studies are warranted to establish the effectiveness of PRP in facial rejuvenation. Furthermore, a consensus for end points used for establishing clinical utility in patients requiring facial rejuvenation is warranted.

Treatment of diabetic neuropathy induced non healing foot ulcer using merisistm supercellplatelet rich fibrin matrix: a clinical study

Objective: Non healing foot ulcers are a major debilitating condition in diabetic patients which leads to limb amputation.In this study we discuss the use ofMERISISTM Supercell plus Platelet Rich Fibrin Matrix (PRFM) kitfor point of care treatments towards limb salvation. Method: We selected diabetic mellitus patients havingDiabetic foot ulcer (DFU) grade 1 or higher. Use of MERISISTM Supercell plus PRFM is a biological matrix of extracellular matrix (ECM) protein plus growth factors derived from peripheral blood to treat the DFU 45 days over. Result: Following treatment the patients showed quick recovery and complete healing of the ulcers. Conclusion: Supercellplus PRFM therapy promotes wound healing in patients suffering from chronic non-healing diabetes foot ulcers. Supercells plus PRFM dressing is a safe and effective treatment modality to promote wound contraction in patients suffering from non-healing diabetic foot ulcers.

Autologous Platelet-Rich Fibrin Matrix–Augmented Repair for Parameniscal Cysts: Surgical Technique

Parameniscal cysts are defined as an internal disorder of the knee joint. It is known that parameniscal cysts are associated with horizontal meniscal tears that could lead to the collection of synovial fluid within the cyst. Despite the treatment of meniscal tears, cyst recurrence is still an issue that needs to be addressed. In this regard, there has been an increasing interest in the use of biologic agents to enhance the vascularity and healing of the meniscus. Preliminary results for biologic therapeutic agents, such as growth factors, bone marrow, and aspirate concentrate, have been encouraging. However, these options are more demanding in regards to time, financial burden, resources, and so on. Autologous platelet-rich plasma is readily available, easy to use, affordable, and minimally invasive. This Technical Note will describe a step-by-step and reproducible technique for the harvesting, preparation, and use of an autologous platelet-rich fibrin matrix used to augment the healing of meniscal repairs.

A Modified Preparation Method of Ideal Platelet-Rich Fibrin Matrix From Whole Blood.

One bioproduct that is widely used in the wound healing process is platelet-rich plasma (PRP). PRP is a liquid solution with high autologous platelet concentration, making it a good source of growth factors to accelerate wound healing. Recent development in PRP had created a new product called platelet-rich fibrin matrix (PRFM), which has a denser and more flexible structure. PRFM is the newest generation of platelet concentrate with a fibrin matrix that holds platelet in it. The key concept in creating PRFM from PRP is the addition of CaCl2 followed by centrifugation, which converts fibrinogen to fibrin, and the fibrin cross-links to form a matrix that contains viable platelets. There are many commercially available kits to create PRFM, but they are often expensive and uneconomical. This research will test a modified method of making ideal PRFM from PRP without any commercial kits. The modified method will include determining the minimum level of CaCl2 used, the type of centrifuge, and the speed and duration of centrifugation. By performing a modified preparation method on five samples of whole blood, it was found that the ideal PRFM could be made by mixing PRP with 25 mM CaCl2 and centrifuging it at a speed of 2,264 × g for 25 min at room temperature. The PRP and PRFM platelet counts of this method tend to be lower than the platelet counts found in other studies. Although visually comparable, further study is needed to compare the performance of PRFMs made with this method and PRFMs made with commercial kits.

An individual randomised efficacy trial of autologous blood products, leukocyte and platelet-rich fibrin (L-PRF), to promote ulcer healing in leprosy in Nepal: the TABLE trial protocol

BackgroundLeprosy is curable with multidrug therapy and treatment in the early stages can prevent disability. However, local nerve damage can lead to injury and consequently recurring and disfiguring ulcers. The aim of this study is to evaluate the treatment of leprosy ulcers using an autologous blood product; leukocyte and platelet-rich fibrin (L-PRF) to promote healing.MethodsThis is a single-centre study in the Anandaban Hospital, The Leprosy Mission Nepal, Kathmandu, Nepal. Consenting patients (n=130) will be individually randomised in a single-blinded, controlled trial. Participants will be 18 years of age or older, admitted to the hospital with a clean, dry and infection-free chronic foot ulcer between 2 and 20 cm2 in size. If the ulcer is infected, it will be treated before enrolment into the study. The intervention involves the application of leukocyte and platelet-rich fibrin (L-PRF) matrix on the ulcer beds during twice-weekly dressing changes. Controls receive usual care in the form of saline dressings only during their twice-weekly dressing changes. Primary outcomes are the rate of healing assessed using standardised photographs by observers blind to allocated treatment, and time to complete re-epithelialization. Follow-up is at 6 months from randomisation.DiscussionThis research will provide valuable information on the clinical and cost-effectiveness of L-PRF in the treatment of leprosy ulcers. An additional benefit is the evaluation of the effects of treatment on quality of life for people living with leprosy ulcers. The results will improve our understanding of the scalability of this treatment across low-income countries for ulcer healing in leprosy and potentially other conditions such as diabetic ulcers.Trial registrationISRCTN14933421. Registered on 16 June 2020

Antibacterial and Antifungal Efficacy of Platelet-Rich Fibrin and Platelet-Rich Fibrin Matrix against Root Canal Microflora.

Background:Binding of such proteins with a developing fibrin mesh or to the extracellular matrix has the ability to create chemotactic gradients aiding the recruitment of stem cells, thereby, stimulating cell migration and differentiation this may promotes repair and regeneration. There is a unique concept in platelet concentrates called platelet-rich fibrin matrix (PRFM) which is processed using higher attraction without the utilization of bovine thrombin.Aim and Objectives:The aim of this study is to evaluate the antibacterial and antifungal effects of platelet-rich fibrin (PRF) and PRFM against root canal microflora.Materials and Methods:Blood samples were taken from 20 adults, age ranging from 20 to 40 years who were systemically healthy, nonsmokers with no symptoms of infection, or on antibiotics at least 3 months before experiments. The procedures and the protocols involved in the study were accepted by the Institutional Ethical Committee. Written informed consent was obtained from the donors and patients. Approximately 10 ml of blood was collected from each donor. 5 ml of blood was used for the preparation of PRF and 5 ml for PRFM.Results:The antifungal scores among the groups. The highest antifungal scores were seen in metapex followed by PRF and PRFM group. Kruskal–Wallis test was applied to check the statistical difference among the groups, and there was a statistically significant difference seen among the groups (P = 0.00). The antibacterial scores among the groups. The highest antibacterial scores were seen in Metapex followed by PRF group and PRFM group Kruskal–Wallis test was applied to check the statistical difference among the groups, and there was a statistically significant difference seen among the groups.Conclusion:PRF demonstrated antibacterial activity against passage isolates but had no antifungal efficacy. This antibacterial property may be a valuable adjunct when using PRF for regenerative procedures in endodontics. Both PRF and PRFM have to be analyzed for antimicrobial properties for extended duration and various other clinical strains with larger sample size.

Obsidian ASG® Autologous Platelet-Rich Fibrin Matrix and Colorectal Anastomotic Healing: A Preliminary Study

Introduction: Anastomotic leakage (AL) following colorectal resection is a devastating complication affecting morbidity, mortality, and quality of life of patients in the long term. Different tissue sealants and biologic glues were tested showing conflicting results regarding their influence on anastomotic healing and leak prevention. Application of autologous platelet-rich fibrin (Vivostat A/S, Alleroed, Denmark), which acts as a source of angiogenic growth factors and cytokines, showed promising results in an in-vivo porcine model. Herein, we present the first human study of stapled colorectal anastomoses supplemented with an autologous-derived platelet-rich fibrin matrix (Obsidian ASG®, Rivolution GmbH, Rosenheim, Germany and Vivostat A/S, Alleroed, Denmark). Materials and Methods: A retrospective analysis of prospectively accumulated data was performed in two colorectal centers (Linz, Vienna) on patients undergoing left-sided colorectal or coloanal stapled anastomosis between October 2018 and December 2019. The Obsidian ASG® Matrix was applied to the rectal stump, and after closure with the circular stapling device, at the circumference of anastomosis in every single case. Anastomoses were supplemented with intra- and extra-anastomotic application (IAA—intra-anastomotic application developed by Rivolution GmbH, Rosenheim, Germany) of Obsidian ASG® Matrix. The primary endpoints were incidence of perioperative complications and anastomotic leak rate. Results: Two-hundred-sixty-one (138 female) patients underwent left-sided colonic (n=177) or rectal resection (n=84). In 253 (96.9%) cases, a laparoscopic or robotic-assisted approach was used. There were no complications attributable to the intraoperative application of the Obsidian ASG® Matrix. All intraoperative leak tests were negative. Overall, anastomotic leak rate accounted for 2.3% (6/261). AL following colonic and rectal resection was seen in 2.3% (4/177) and 2.4% (2/84), respectively. Complication and leak rate was similar in the two participating centers. Postoperative fever and elevated CRP levels were significantly correlated to AL. There was no significant risk factor for AL on multivariate analysis. Conclusion: Application of an autologous-derived platelet-rich fibrin matrix (Obsidian ASG®) at anastomotic site following colorectal resection is safe and associated with a low rate of anastomotic leakage.