Platelet-rich Fibrin Research Articles

A comparative study of efficacy of platelet rich fibrin and conventional saline dressing in chronic non-healing ulcers: A randomized controlled trial in a tertiary care centre, Chengalpattu, Tamil Nadu

Non-healing ulcers pose a significant risk for deformities and platelet-rich fibrin (PRF) emerges as a promising treatment modality with feasible, easy, cost-effective day care therapy for chronic non-healing ulcers, exhibiting notable improvement in these chronic conditions. This study aims at demonstrating the efficacy of PRF (platelet rich fibrin) dressing in chronic non- healing ulcers.A prospective study with Forty patients of chronic non-healing ulcer aged more than 18 years are recruited, treated with PRF dressing and normal saline dressing. PRF dressing is repeated every week for 4 weeks and for normal saline dressing it is done every alternate days for the same period. Photographs were taken before treatment and at every subsequent session and sizes are measured in baseline (1) and 2,3,4 weeks. Each patient was followed up after four weeks from the last visit.In this study, excellent improvement was seen in 57% of total ulcers, 15% have showed moderate improvement. PRF dressing have shown significant improvement with >75% improvement in the size of the ulcer in visit 3 where as normal saline have shown only 34% improvement in 3 visit. Depth of the ulcer improved to 100% and 35% in visit 3 for PRF and normal saline dressing respectively.This study have found that PRF dressing has shown significant reduction in the overall size of the ulcer and quality of life with minimal visits and without any adverse events.

Advancements and clinical applications of extended platelet-rich fibrin (E-PRF)

Extended platelet-rich fibrin (E-PRF) has emerged as a potent biological agent in regenerative medicine and dentistry. It leverages the natural healing capacities of growth factors and cytokines from platelets and leukocytes to promote tissue repair. This systematic review explores the role of E-PRF in various clinical applications, including wound healing, bone regeneration, and periodontal therapy. The findings indicate that E-PRF provides an enhanced bioactive matrix, supporting superior clinical outcomes compared to conventional treatments. Future studies should focus on optimizing E-PRF protocols and investigating its long-term effectiveness.

Recent advances in bioactive wound dressings.

Traditional wound dressings, despite their widespread use, face limitations, such as poor infection control and insufficient healing promotion. To address these challenges, bioactive materials have emerged as a promising solution in wound care. This comprehensive review explores the latest developments in wound healing technologies, starting with an overview of the importance of effective wound management, emphasising the need for advanced bioactive wound dressings. The review further explores various bioactive materials, defining their characteristics. It covers a wide range of natural and synthetic biopolymers used to develop bioactive wound dressings. Next, the paper discusses the incorporation of bioactive agents into wound dressings, including antimicrobial and anti-inflammatory agents, alongside regenerative components like growth factors, platelet-rich plasma, platelet-rich fibrin and stem cells. The review also covers fabrication techniques for bioactive wound dressings, highlighting techniques like electrospinning, which facilitated the production of nanofibre-based dressings with controlled porosity, the sol-gel method for developing bioactive glass-based dressings, and 3D bioprinting for customised, patient-specific dressings. The review concludes by addressing the challenges and future perspectives in bioactive wound dressing development. It includes regulatory considerations, clinical efficacy, patient care protocol integration and wound healing progress monitoring. Furthermore, the review considers emerging trends such as smart materials, sensors and personalised medicine approaches, offering insights into the future direction of bioactive wound dressing research.

The Effect of Platelet-Rich Fibrin (PRF) in Accelerating Periodontal Regeneration: A Randomized Controlled Clinical Trial

ABSTRACT Background: Regeneration of periodontal tissues is an essential component in treating periodontal disease, and there is an increasing focus on biological agents that might improve the healing process. Materials and Methods: The randomized controlled clinical study included a cohort of 60 individuals diagnosed with chronic periodontitis. Each participant was randomly allocated to one of two groups: the experimental group (n = 30), which underwent PRF in combination with traditional open flap debridement (OFD), and the control group (n = 30), which received OFD alone. Clinical criteria such as probing pocket depth (PPD), clinical attachment level (CAL), and bone fill percentage were assessed at baseline and after 6 months. Furthermore, cone-beam computed tomography (CBCT) was used to evaluate bone regrowth radiographically. Results: Following a period of 6 months, the experimental group had a notable decrease in postpartum depression (mean decrease of 4.2 mm) and an increase in central artery ligation (mean increase of 3.5 mm) compared to the control group, which had a mean decrease in postpartum depression of 2.8 mm and a mean increase in central artery ligation of 2.1 mm. The test group had a notably greater proportion of bone fill (45%) in comparison to the control group (30%). Further radiographic study verified enhanced bone regeneration in the areas treated with PRF. Conclusion: The use of Platelet-Rich Fibrin (PRF) in combination with traditional periodontal surgery greatly expedites the process of periodontal regeneration, as shown by notable enhancements in clinical indicators and bone regeneration.

Translational implications of a novel combination of iPRF and collagen scaffold for proliferation of gingival mesenchymal stem cells.

"Tissue engineering," is a concept that involves the use of scaffolds, cells, and growth factors/signaling molecules in the field of regenerative medicine. The present study was carried out to evaluate the attachment and depth of penetration of the Gingival Mesenchymal Stem Cells (GMSCs) onto the collagen scaffold preconditioned with Fetal Bovine Serum (FBS), Injectable Platelet Rich Fibrin (i-PRF) and a combination of FBS with i-PRF using histological analysis and environmental scanning electron microscopy (ESEM) respectively. In the present study, commercially available collagen membranes were used as scaffolds and divided into 3 groups where Group I was preconditioned with FBS, Group II was preconditioned with i-PRF, and Group III with a combination of FBS and i-PRF. Scaffolds were then seeded with GMSCs and incubated in a CO2 incubator at 37 0C for 7 days. Both histological and ESEM analysis showed proliferation, attachment, and depth of penetration along with the combination of cell morphological changes in all the three groups. In group I cells showed mild depth of penetration along with a round morphological appearance. In group II the cells showed moderate depth of penetration and rounded morphology. In group III maximum depth of penetration was seen along with the round and spheroidal morphology of cells. The combination of the growth media showed the best effect on cell attachment, depth of penetration, and cell morphology. This is the first report demonstrating the effect of the combination of collagen and i-PRF supports the proliferation of GMSCs. Since FBS alone and i-PRF alone exhibited similar cell proliferation it is recommended that i-PRF could be used in clinical scenarios making it xenofree.

Impact of platelet-rich fibrin derivatives on patient morbidity and quality of life in palatal donor sites following free gingival graft surgery: a randomized clinical trial.

Platelet concentrates are biomaterials with significant potential in tissue regeneration, functioning as scaffolds with greater leukocyte inclusion and a flexible fibrin mesh. However these concentrates have different preparation methods and biological properties. The objective of this clinical investigation was to evaluate the effects of utilizing platelet-rich fibrin (PRF) materials (L-PRF and A-PRF) as a palatal bandage following free gingival graft (FGG) on patients' morbidity and oral health-related quality of life. Thirty-nine participants received FGG to promote keratinized tissue and treat gingival recession. Participants were randomly assigned to L-PRF, A-PRF, and control groups, with 13 participants in each. They used a visual analog scale (VAS) to rate their pain, analgesic medication use, dietary changes, discomfort, and bleeding at 1-7 days, 14 days and 1 month during the healing process. Patients' quality of life was assessed using the Oral Health Impact Profile (OHIP-14) at baseline, 1-7 days, 14 days, 1 month, and 6 months. There was no difference in anxiety levels between the all groups. (p > 0.05). The control group had higher OHIP-14 total scores than the other groups, but the differences were not statistically significant, especially in the first seven days (p > 0.05). In addition, the PRF groups showed an improvement in quality of life after 14 days, 1 month, and 6 months (p < 0.05). Patients' pain and suffering decreased with healing. The control group took more postoperative analgesics than PRF groups. In addition, there was a significant decrease in patient complaints about medicine intake, bleeding, pain, perceived sensitivity, and dietary modifications in all groups during follow-up. PRF palatal bandages may improve patient's quality of life, donor site healing, postoperative pain and morbidity. This study found that preserving the palate in FGG and employing PRF materials that speed palate healing reduce discomfort and morbidity.

Mesenchymal stromal cells and platelet-riach fibrin membrane for the treatment of osteochondral defect in the rabbit

Cartilage has limited self-repair ability due to its complex structure and chondrocytes' relatively low metabolic activities. Functional repair of articular cartilage defects is a significant challenge for cartilage tissue engineering. Mesenchymal stromal cells (MSC) and platelet-rich fibrin membrane (PRFM) in repairing damaged articular cartilage in rabbit. They were subjected to osteochondral lesion and randomly into five groups: Group A, evaluated immediately after injury; Group B, natural evolution the injury; Group C, MSC; Group D, PRFM and Group E, MSC+ PRFM. Animals in Group A were euthanized after removing the cartilaginous flap, while animals in Groups B, C, D, and E were euthanized 60 days. The regeneration of the lesion was evaluated by analyzing its residual extension, as well as the density of chondrocytes and chondroblasts in the regenerated tissue adjacent to the lesion. Results, the Group E (MSC + PRFM) showed a greater reduction in the lesion size and a greater density of chondrocytes and chondroblasts in the regenerated and adjacent tissue compared to the other groups. Our results indicate that the combination of MSC and PRFM can successfully resurface the defect with cartilage and restore the subchondral bone in the specie studied, being effective in reducing hyaline cartilage defects; however, the combination of MSC and PRFM products might be more or less appropriate for treating different types of tissues and pathologies. The clinical efficacy of PRP remains under debate. Therefore, further research is needed at both the basic science and clinical levels.

Autologous platelet-rich fibrin enhances skin wound healing in a feline trauma model

Trauma is a common cause of cutaneous surgical disease with an increased risk of secondary infection in cat clinics. Platelet-rich fibrin (PRF), a platelet and leukocyte concentrate containing multiple cytokines and growth factors, is known to accelerate the healing of wounds. However, how PRF affects wound healing in the cat trauma model has not been fully investigated. The study aimed to examine the impact of PRF on skin wound healing in the cat trauma model. In this study, PRF from cats was successfully produced for our investigation. The models of feline trauma were effectively established. A total of 18 cats were randomly divided into 3 groups (n = 6): (1) Control group (CON); (2) PRF group; (3) Manuka honey group (MAN, as a positive control). Experiments were performed separately on days 7, 14, 21, and 28. Our results showed that PRF was a safe and efficient method of wound healing that did not influence the cat’s body temperature, respiration rate, and heart rate (HR). PRF accelerated skin wound healing in the cat trauma model based on the rate and histological observation of wound healing. In addition, PRF promoted the production of growth factors and suppressed inflammation during wound healing. PRF accelerated wound healing by increasing the formation of collagen fibers, as shown by Masson-trichrome staining. The outcomes of the PRF and MAN groups were comparable. In conclusion, PRF improves the healing of skin wounds in cats by boosting the synthesis of growth factors, reducing inflammation, and enhancing the synthesis of collagen fibers.Graphical

Advanced platelet-rich fibrin versus connective tissue graft in maxillary gingival recession management.

Platelet concentrates have gained significant attention in periodontology due to their regenerative properties. This randomized clinical trial was aimed to compare the clinical efficacy of advanced platelet-rich fibrin (A-PRF) and connective tissue graft (CTG) in the management of recession defects. The objectives were to compare changes in recession height and root coverage percentage between the groups. Systemically healthy individuals presenting Cairo's RT1/RT2 gingival recession defects in the maxilla (n = 40) were treated with either A-PRF or CTG in combination with coronally advanced flap (CAF). Clinical parameters were measured at baseline, 3 months, and 6 months. Mean and complete root coverage percentages were calculated at 3 and 6 months. In both the test (CAF + A-PRF) and control (CAF + CTG) groups, a statistically significant reduction in mean recession height was seen from baseline values of 2.90 ± 0.55mm and 3.15 ± 0.87mm to 0.80 ± 0.95mm and 0.15 ± 0.48mm at 6 months, respectively (p < 0.001). In the test group, 10 sites had complete root coverage at 6 months with mean root coverage of 73.76 ± 29.58%. In the control group, 18 of 20 sites had complete root coverage with mean root coverage of 93.35 ± 23.1%. The control sites had a significantly greater reduction in recession height and higher mean and complete root coverage percentages at 6 months (p < 0.05). The study findings suggest that, the CTG had resulted in superior outcomes than A-PRF along with CAF. Question: To compare the efficacy of advanced platelet-rich fibrin (A-PRF) with connective tissue graft (CTG) in the management of gingival recession defects. Both interventions showed satisfactory healing. At 6 months, the CTG group demonstrated superior results than the A-PRF group. Meaning: CTG has a greater therapeutic potential than A-PRF in the management of gingival recessions. Platelet-derived membranes are widely used in various dental therapies due to their healing properties. Limited studies have been conducted using the novel platelet preparations in the management of receding gums. This study compared the effects of advanced platelet-rich fibrin membrane with conventional soft tissue harvested from the palate in the treatment of gum recession. Twenty-three patients requiring gum augmentation were recruited and treated with either platelet-derived membrane (test group) or tissue harvested from their palate (control group). Clinical parameters were measured at baseline (before intervention), 3 months, and 6 months. Both treatment modalities resulted in significant gum coverage at the end of 6 months. On comparison, the control sites had significantly greater improvements in all the measured clinical parameters indicating that tissue obtained from the palate had superior therapeutic potential.

In Vitro Assessment of Injectable Bone Marrow Aspirate Concentrates Compared to Injectable Platelet-Rich Fibrin.

Injectable platelet-rich fibrin (iPRF), a liquid form of PRF that is prepared from peripheral blood without anticoagulants, promotes tissue wound healing and regeneration. The present study focused on iPRF-like bone marrow aspirate concentrate (iBMAC) prepared without anticoagulant, and the regenerative potential of iPRF and iBMAC was compared in vitro. iPRF and iBMAC were prepared from the same New Zealand white rabbits. The cytocompatibility and regenerative potential of each concentrate were evaluated using primary rabbit gingival fibroblasts and osteoblasts. Both gingival fibroblasts and osteoblasts treated with each concentrate exhibited excellent cell viability. Interestingly, compared to cells treated with iPRF, cells treated with iBMAC demonstrated significantly greater migration potential. Furthermore, higher mRNA levels of transforming growth factor-β (TGF-β), vascular endothelial growth factor (VEGF), and collagen I (COL1) were observed in gingival fibroblasts treated with iBMAC than in those treated with iPRF. Compared with osteoblasts treated with iPRF, osteoblasts treated with iBMAC exhibited greater differentiation potential, as indicated by increased osteocalcin (OCN) expression and mineralization capability. The results of the in vitro study suggest that, compared with iPRF, iBMAC may promote wound healing and bone regeneration more effectively. However, further preclinical and clinical studies are needed to confirm the regenerative potential of iBMAC in the body.

Emerging therapeutic benefit of platelet-rich fibrin as novel platelet concentrates in tissue engineering

Background: Treating irreversible cardiomyocyte loss following myocardial infarction presents several therapeutic challenges. While cell therapy shows promise as a regenerative treatment for infarcted cardiac tissue, different cell sources vary in their therapeutic potential. Adipose-derived stem cells (ADSCs) have emerged as an attractive option due to their accessibility, but their limited differentiation capacity remains a significant constraint. Recent evidence suggests that injectable platelet-rich fibrin may enhance this process by stimulating the differentiation of ADSCs into cardiomyocyte-like cells. Objective: Analyse the benefit of injectable platelet-rich fibrin to accelerate the differentiation of adipose-derived mesenchymal stem cells into cardiomyocyte-like cells. Methods: This study is a true experimental randomized post-test design study. Adipose-derived mesenchymal stem cells were isolated from adipose tissue and expanded in culture through four passages. The characteristics of adipose-derived mesenchymal stem cells were measured by the expression of CD 34-, CD 45-, and CD 105+ using flowcytometry. The samples were divided into 3 groups, i.e. negative control (α-MEM), positive control (differentiation medium) and treatment group (platelet-rich fibrin). The assessment of GATA-4 marker expression was conducted using flowcytometry on the fifth day and troponin was conducted using immunocytochemistry on the tenth day to determine the differentiation to cardiomyocyte. Statistical analysis was performed using Student's t-tests and one-way ANOVA for data that demonstrated normal distribution as verified by the Shapiro-Wilk test. Results: Flowcytometry on GATA-4 expression revealed significant difference on addition of platelet-rich fibrin compared with negative and positive controls (68.20 ± 6.82 vs 58.15 ± 1.23; p&lt;0.05; 68.20 ± 6.82 vs 52.96 ± 2.02; p&lt;0.05). This was supported by the results of immunocytochemistry on troponin expression which revealed significant difference between platelet-rich fibrin group compared with negative and positive controls (50.66 ± 7.2 vs 10.73 ± 2.39; p&lt;0.05; 50.66 ± 7.2 vs 26.00 ± 0.4; p&lt;0.05). Conclusion: Injectable platelet-rich fibrin accelerates differentiation of adipose-derived mesenchymal stem cells into cardiomyocyte-like cells.

Clinical efficacy of platelet-rich fibrin, injectable platelet-rich fibrin, and advanced platelet-rich fibrin in regenerative endodontics: A case series

Background: This series investigates the efficacy of regenerative endodontic therapy (RET) using various platelet-rich fibrin (PRF) formulations in treating apical periodontitis and necrotic pulp in immature permanent teeth. Aim: This study aims to evaluate the effectiveness of different PRF formulations in RET. Materials and Methods: Three cases involving patients aged 15–16 with immature teeth and necrotic pulp were treated with RET using PRF, injectable PRF, and advanced PRF. The procedure included inducing bleeding with a Hedstrom file, applying PRF variants, and sealing with mineral trioxide aggregate and composite resin. Patients were followed up at 1, 3, 6, 12 and 18 months. Results: Radiographic evidence showed apical closure, root maturation, and healing of periapical tissues in all cases. However, pulp sensibility tests were negative. Conclusion: RET using PRF variants promotes root development and apical healing in immature teeth. Further research with larger sample sizes is needed to understand these therapies’ potential and limitations.

Update on Platelet-Rich Plasma and Platelet-Rich Fibrin for Dermatologic Surgery: Addressing Knowns and Unknowns.

Autologous and allogeneic platelet-rich plasma (PRP) in addition to its derivatives, such as platelet-rich fibrin (PRF), are broadly accepted therapeutic approaches in orthopedics, otolaryngology, sports medicine, plastic surgery, and oral and maxillofacial surgery. However, the absence of expert consensus, standardized protocols, and varying outcomes pose challenges to their broader acceptance in cosmetic dermatology and dermatologic surgery. To offer a contemporary literature overview of PRP and PRF, focusing on fundamental aspects of the technology, diversity of commercially accessible systems, and shed light on present-day controversies within the field. A systemic review of PRP and PRF literature was conducted, utilizing search engine databases: Cochrane Database of Systematic Reviews, Embase, Ovid MEDLINE, and PubMed. Emphasis was placed on scrutinizing higher level-of-evidence articles, specifically randomized control trials, systematic reviews, and meta-analyses (Level 1A-2A), with particular emphasis on recent data that have not been well reviewed in other publications from January 2022 to May 2024. An increasing body of literature affirms advantages of PRP products in dermatology, spanning wound care, facial rejuvenation, scar revision, and hair growth. A foundational understanding of variation in preparation protocol, outcomes, and timing of administration is needed to better comprehend market dynamics, patient demand, and strategies for integrating PRP into dermatologic practice.

The Effect of Advanced Platelet-Rich Fibrin Plus (A-PRF+) on Graft Stability in Dental Implants and Alveolar Ridge Augmentation Procedures: A New Low-Speed Standardized Centrifugation Protocol

Background: Platelet-rich fibrin (PRF) is a concentrate derived from autologous blood, containing platelets, fibrin, and growth factors (GF) obtained through centrifugation. PRF can be mixed with bone replacement material to form sticky bone, which is then introduced into the desired area for stabilizing and graft-covering. Depending on the centrifugation protocol, the effectiveness of the end products can vary. This controlled clinical study examines the impact of our established PRF protocol in alveolar augmentation and dental implant placement on vertical bone loss. Materials and Methods: A total of 362 implants were performed in 170 patients at the Department of Oral and Maxillofacial Surgery at the University Hospital Innsbruck between 2018 and 2021. After accounting for lost implants, we retrospectively evaluated a radiological vertical bone loss exceeding 1 mm in the first year as the primary endpoint. Results: The use of PRF was significantly associated with vertical bone loss &gt; 1 mm (OR = 0.32, 95% CI (0.13–0.81), p = 0.016). There were no significant associations between PRF and the number of implants lost, the type of augmentation, or bone loss. Discussion: A-PRF+ sticky bone grafts, when combined with bone graft materials, show reduced resorption rates, indicating their potential to enhance graft stability in oral implantology. Our data indicate that the Medifuge MF 100 (Silfradent srl, Forlì, Italy) is effective in producing A-PRF+.

Evaluation of Crestal Bone Loss after Placement of Bone Graft around the Oral Implant with/without Platelet-rich Plasma.

The current investigation aimed to evaluate the crestal bone loss after placement of bone graft around the oral implant with/without platelet-rich plasma (PRP). Forty patients seeking for crown supported by dental implants to replace at least one lost tooth were included in the present study. The participants were divided into two groups at random (n = 20): Group I: Received tricalcium phosphate (TCP) along with PRP and group II: Received TCP without PRP. Digital radiographs were used to quantify the crestal bone levels on the mesial, distal, buccal, and lingual side of each implant after surgery, also at 3 months and 6 months follow-up period. Data were recorded and subjected to statistical analysis. After 3 months, the crestal bone level in TCP with PRP group, mesial side was 1.02 ± 0.18, distal was 1.14 ± 0.11, buccal was 1.18 ± 0.12 and lingual was 1.16 ± 0.16. In only TCP group, mesial side was 1.14 ± 0.02, distal was 1.24 ± 0.10, buccal was 1.38 ± 0.12 and lingual was 1.30 ± 0.08. There was a statistically significant difference between the two groups. After 6 months, the crestal bone level in TCP with PRP group, mesial side was 1.26 ± 0.02, distal was 1.38 ± 0.14, buccal was 1.44 ± 0.09, and lingual was 1.52 ± 0.12. In only TCP group, mesial side was 1.40 ± 0.10, distal was 1.56 ± 0.12, buccal was 1.62 ± 0.06, and lingual was 1.84 ± 0.04. There was a statistically significant difference between the two groups at 3 and 6 months. On conclusion, considerable crestal bone loss was observed in both treatment regimens. But TCP bone graft with PRP group found decreased bone loss around the dental implants than only TCP bone graft group. The most important aspects of controlling crestal bone loss are choosing the right implant design and bone transplant materials. Also, platelet-rich fibrin plays an important role in accelerating the healing process, improving bone regeneration, and repairing as it contains a high amount of growth factors and inflammatory chemicals. How to cite this article: Jalaluddin M, Awasthi A, Aljulayfi IS, et al. Evaluation of Crestal Bone Loss after Placement of Bone Graft around the Oral Implant with/without Platelet-rich Plasma. J Contemp Dent Pract 2024;25(7):645-648.

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 Human Blood and Platelet-rich Fibrin on the Surface Microhardness of Hydraulic Calcium Silicate-based Cements

Objectives: This study aimed to compare the effect of human blood and platelet-rich fibrin (PRF) on the surface microhardness of hydraulic calcium silicate-based cements (OrthoMTA and RetroMTA). Materials and Methods: Two types of mineral trioxide aggregate, OrthoMTA and RetroMTA, were mixed and placed into cylindrical molds. The lower surfaces of all cements were exposed to saline. The upper surfaces of cements were exposed to human blood, PRF, or phosphate buffer saline (PBS). After storage for 7 days in fully saturated humidity at 37°C, the microhardness of cement surface exposed to blood, PRF, or PBS was measured using the Vickers microhardness test. The data were analyzed using two-way analysis of variance and post hoc Tamhane’s T2 test. The significance level was set at P&lt;0.05. Results: Exposure to blood and PRF significantly decreased the surface microhardness of OrthoMTA and RetroMTA. The microhardness of PBS-contacted cements was significantly higher than that of blood or PRF groups (P&lt;0.001). The microhardness values for OrthoMTA exposed to PRF were significantly higher than the blood group (P=0.020). There were no significant differences between RetroMTA contacted with blood or PRF groups (P=0.985). When exposed to blood or PBS, RetroMTA had a significantly higher microhardness than OrthoMTA (P&lt;0.001 for blood, P=0.002 for PBS). Conclusion: Exposure to blood or PRF decreased the surface microhardness of both cements. Blood-contaminated RetroMTA showed significantly higher surface microhardness than OrthoMTA contacted with blood. No significant difference was found between PRF-contacted OrthoMTA and RetroMTA.

Investigating the Biological Efficacy of Albumin-Enriched Platelet-Rich Fibrin (Alb-PRF): A Study on Cytokine Dynamics and Osteoblast Behavior.

The development of effective biomaterials for tissue regeneration has led to the exploration of blood derivatives such as leucocyte- and platelet-rich fibrin (L-PRF). A novel variant, Albumin-Enriched Platelet-Rich Fibrin (Alb-PRF), has been introduced to improve structural stability and bioactivity, making it a promising candidate for bone regeneration. This study aimed to evaluate Alb-PRF's capacity for cytokine and growth factor release, along with its effects on the proliferation, differentiation, and mineralization of human osteoblasts in vitro. Alb-PRF membranes were analyzed using histological, scanning electron microscopy, and fluorescence microscopy techniques. Cytokine and growth factor release was quantified over seven days, and osteoinductive potential was evaluated with MG-63 osteoblast-like cells. Structural analysis showed Alb-PRF as a biphasic, highly cellularized material that releases lower levels of inflammatory cytokines and higher concentrations of platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) compared to L-PRF. Alb-PRF exhibited higher early alkaline phosphatase activity and in vitro mineralization (p < 0.05) and significantly increased the OPG/RANKL mRNA ratio (p < 0.05). These results indicate that Alb-PRF has promising potential as a scaffold for bone repair, warranting further in vivo and clinical assessments to confirm its suitability for clinical applications.

Treatment of Oroantral Communication and Fistulas with the Use of Blood-Derived Platelet-Rich Preparations Rich in Growth Factors: A Systematic Review.

The formation of an oroantral communication (OAC) or fistula (OAF) is a rare complication resulting from the presence of processes in the lateral parts of the maxilla or for iatrogenic reasons. The most common causes of OAC or OAF are tooth extraction with periapical lesions. The aims of this systematic review were to assess the use of platelet-derived preparations rich in growth factors in the treatment of OAC or OAF, to determine the success of treating the communication or fistula, as well as impact on postoperative complications and the course of healing. The study was performed following PRISMA guidelines (PROSPERO: CRD42024570758). The inclusion criteria were as follows: at least ten patients, the presence of oroantral communication or oroantral fistula, treatment with platelet-derived preparations rich in growth factors, and information regarding the response to treatment. In order to find relevant studies, international databases, including PubMed, Google Scholar, Web of Science Core Collection, MDPI, Wiley, and Cochrane Library were searched. The last search was performed on 31 August 2024. Seven articles were included in the systematic review. In total, platelet-derived preparations rich in growth factors were used in 164 patients. Only studies in which OAC was treated and with platelet-rich fibrin (PRF) met the inclusion criteria. Only PRF was used as the sole treatment method in three studies. When OAC is greater than 5 mm, platelet-derived preparations rich in growth factors should be considered adjuncts to treatment, not the sole treatment method. The success rate of OAC treatment was 90-100%. The use of blood products to close OAC may be an effective therapeutic alternative. Proper patient qualification and the use of an appropriate protocol are crucial. There is a need for future well-designed case-control or cohort studies as well as randomized controlled trials to provide the required level of evidence.

Effect of Ethyl-Cyanoacrylate and Platelet-Rich Fibrin on Fresh Sockets of Rabbits Subjected to Anticoagulant Therapy.

Objectives: There are no studies related to the use of PRF associated with cyanoacrylates in fresh post-extraction sockets. Thus, the aim of this study was to assess the effect of ethyl-cyanoacrylate combined with PRF in fresh sockets of rabbits subjected to anticoagulant therapy. Methods: Twelve adults rabbits were selected and premedicated with heparin 1 week before surgery to induce and simulate anticoagulant therapy. Upper and lower first premolars on the right side were extracted and then were divided into four groups of three animals each, with the groups distributed according to the type of intervention in the sockets (n = 6): (1) clot and suture (control); (2) PRF and suture; (3) clot and ethyl-cyanoacrylate; (4) PRF and ethyl-cyanoacrylate. At 12 weeks, the animals were sacrificed and the sockets were analyzed histologically and quantitatively. Total bone area, inflammation infiltrate, and adhesive remnants were assessed. Results: No remnants of adhesive were found in the samples. Groups 1 and 2 showed the highest bone area (G1 = 37.87% ± 17.86; G2 = 30.31 ± 9.36) with significant differences to those treated with ethyl-cyanoacrylate adhesive (G3 = 26.6% ± 11.82; G4 = 24.29% ± 6.25). Conclusions: The groups that used ethyl-cyanoacrylate as a closure method in sockets exhibited less bone area than the groups that used sutures. Both groups that used PRF as therapy did not show a significant improvement in bone healing at 12 weeks compared with the clot groups.