Titanium-prepared Platelet-rich Fibrin Research Articles

Clinical efficacy of titanium prepared platelet rich fibrin in periodontal regeneration: A systematic review and meta-analysis

Background Periodontal regeneration therapies frequently involve autologous platelet concentrates (APCs). They can be used in sinus lift surgeries and socket preservation, among other clinical settings. Platelet rich fibrin (PRF) membrane has been used to treat gingival recession in individuals or groups of individuals using a coronally progressed or lateral pedicle flap. In the treatment of mixed periodontic endodontic lesion/furcation defect, PRF functions as a healing and interpositional biomaterial, filling a cystic cavity. PRF is known to help the bone regeneration process. In the last few years, efforts have been made to enhance the PRFs characteristics and quality. One of them is titanium platelet rich fibrin (T-PRF). Third-generation platelet concentrate no longer contains silica, and its preparation in glass vacuum containers, that no longer creates any known concerns. The effectiveness PRF’s has been evaluated in connective tissue and bone repair. The aim of this study is to compare T-PRF to other platelet concentrates and different treatment modalities for periodontal regenerative procedures. Methods A protocol of this systematic review have been registered in prospero (CRD42022293545). The online database searched were PUBMED, COCHRANE for published articles up to November 2022 without language restrictions. Studies in trial registers, handsearching, bibliographic references of relevant articles were also checked. Data collection and analysis was done by individual authors. Independent eligibility assessments were conducted by four review authors. Then, using the standard Cochrane methodology, four review authors extracted the data and evaluated the risk of bias for individual studies. We developed “Summary of findings” tables and used GRADE to evaluate the evidence. Results Three studies were included for meta-analysis. Results of meta-analysis supported that T-PRF is effective for correction of both hard and soft tissue defects. Conclusions The overall qualitative and quantitative analysis suggest that T-PRF has superior structural properties and thicker fibrin network for ensuring predictable success periodontal regenerative procedures.

Comparative evaluation of titanium-prepared platelet-rich fibrin with and without herbal extract: A histological study

Background/Aim. Injecting herbal extract into platelet concentrates is one of the newer treatment protocols, which enables platelet concentrates to act as sustained drug delivery (DD) systems. Histological analysis of titanium- prepared platelet-rich fibrin (T-PRF) injected with herbal extract, could help assess the appearance (pattern) and structural changes of T-PRF. The aim of the study was to evaluate the appearance of the fibrin network, cellularity, and fibrin border area of T-PRF alone and T-PRF injected with herbal extract. Methods. A total of 40 histological slides were prepared from 10 mL of blood from each patient, 20 with T-PRF alone and 20 with TPRF+ herbal extract. The slides were divided into a group consisting of T-PRF injected with neem gel (test group) and a group consisting of T-PRF alone (control group). The preparation protocol was made according to Bankroft?s manual adapted for light microscopy. Results. Regarding the fibrin network features (dense vs. loose), no statistical significance was found among the studied groups (p = 0.172). A statistically significant difference was shown in the packeting (p = 0.018) and layered (p = 0.028) patterns of the fibrin network, and there was no statistically significant difference in the scattered (p = 0.749) pattern among the examined groups. Cellularity and cell pattern values were not statistically significantly different for both groups (p = 1.00, p = 0.3111, respectively). Moreover, the values determined for red blood cells, white blood cells, and platelets were not statistically significantly different (p = 0.147), as well as for the fibrin border area between cells and meshwork (p = 0.206). Conclusion. The obtained results could be useful for the development of a new treatment strategy in dentistry, by utilizing T-PRF with incorporated herbal extracts or antibiotics, as a local sustained DD system.

Comparison of the effectiveness of DFDBA and T-PRF in the regeneration of intra-bony defects- A randomized split-mouth study

ObjectivesThis research intended to compare and evaluate the effectiveness of titanium-prepared platelet-rich fibrin (T-PRF) over demineralized freeze-dried bone allograft (DFDBA) in treating intra-bony defects based on the clinical and radiographic criteria. MethodsThis is a prospective randomized controlled, single-blinded split-mouth study where 15 patients with 30 intrabony defects were included. Subjects were randomly divided into T-PRF and DFDBA groups respectively. Plaque index (PI), Gingival index (GI), Probing pocket depth (PPD), Relative- clinical attachment- level (R-CAL), Defect depth, Linear amount of bone fill, Percentage of bone fill, Defect angle were assessed at baseline, 3, 6, and 9 months. For intra- and inter-group comparisons, paired and unpaired t-tests were executed. P<0.05 was set as statistically significant. ResultsThere were statistically significant differences (P<0.05) in clinical and radiographic parameters in both T-PRF and DFDBA groups from baseline values to 9 months in intragroup comparisons. However, on intergroup comparison, no statistical significance was seen. ConclusionThe clinical parameters and radiographic outcomes showed marked improvement at 9 months with both T-PRF and DFDBA in the treatment of intrabony defects from baseline values. Clinical relevanceT-PRF has shown favorable results that are comparable to DFDBA for the treatment of intrabony periodontal defects.

Preserving periodontal tissue in the treatment of a large peripheral ossifying fibroma: a case study.

Peripheral ossifying fibroma (POF) is a reactive, benign gingival enlargement. Its etiology is not fully known. It can be seen in many different sizes in the mouth. The histopathological appearance of POF is mineralized tissue and fibrous proliferation. All relevant soft and hard tissues must be removed to prevent recurrence. Periodontal tissue remaining after excision is important for tooth preservation. With large lesions, the loss of healthy periodontal tissue is also large. Periodontal surgical approaches are important to preserve the remaining periodontal tissue. The positive effects of autogenously obtained titanium-prepared platelet-rich fibrin (T-PRF) and connective tissue graft (CTG) on soft tissue are well known. A 34-year-old woman presented with a fibrous and pedunculated gingival mass in the upper left canine premolar region. The operation was performed with complete excision of the lesion down to the bone along with the surrounding healthy tissue. Periodontal treatment of the large defect created after excision of a large POF lesion was performed with laterally positioned flap, CTG and T-PRF. The periodontal tissue and defect were noted to heal in a healthy manner at the 6-month follow-up. POF is a benign lesion; however, it has a high recurrence rate. Complete elimination of the lesion is crucial to prevent recurrence. Periodontal surgical methods and biomaterials applied after surgical excision are significant to maintain the periodontal health of the remaining teeth and tissues.

Effects of T-PRF and A-PRF on the Osteogenic Biomarkers in Intrabony Defects of Periodontitis Patients

Background: Different derivatives of platelet-rich fibrin (PRF) have been developed but the efficacy of these derivatives in tissue healing and regeneration is still unclear. The aim of this study was to evaluate the effects of titanium-prepared PRF (T-PRF) and advanced PRF (A-PRF) on osteogenic biomarkers in gingival crevicular fluid (GCF) and clinical parameters. Methods: Seventeen systemically healthy participants with 30 bilateral infrabony defects were recruited. Following phase I periodontal therapy, intrabony defects were treated either with A-PRF+open flap debridement (OFD) or T-PRF+OFD. Plaque index (PI), gingival index (GI), pocket depth (PD), clinical attachment loss (CAL) was recorded at the baseline and 6th month after treatment. GCF samples were collected at the baseline and 3rd, 6th months after surgery. Nuclear factor receptor activator (RANK), receptor activator nuclear kappa-B ligand (RANKL), osteoprotegerin (OPG) and tumor necrosis factor alpha converting enzyme (TACE) in GCF samples were analyzed by human enzyme-linked immunosorbent assay (ELISA). Results: In both groups, statistically significant changes were observed in clinical parameters, however, there was no difference between the groups. In terms of osteogenic biomarkers in GCF, there were no statistically significant differences between and within the groups. Conclusion: Different derivatives of PRF can be used to enhance the clinical outcomes of intrabony defects in periodontitis.

Impact of titanium-prepared platelet-rich fibrin in type 1 fascia graft tympanoplasty on graft survival and hearing outcomes.

Type 1 fascia graft tympanoplasty (T1FGT) is the mainstay surgical approach for the treatment of tympanic membrane perforations. The most widely used graft material is temporal muscle fascia, and graft take rates are reported differently. The methods to enhance graft take are still being investigated. Aim: The aim of our study was to investigate the effect of titanium-prepared platelet-rich fibrin (T-PRF) on graft take and hearing outcomes in T1FGT. Fifty-seven ears eligible for T1FGT were involved in the study and prospectively evaluated. T-PRF was applied with T1FGT in 27 ears. Thirty ears in the other group underwent only T1FGT. The patients underwent an otomicroscopic and audiometric examination in preoperative and postoperative 2nd week, 1st month, and 6th month. Both groups were evaluated in terms of hearing levels, infection, and graft take rates. Two patients in the T1FGT + T-PRF group and seven patients in the T1FGT group had postoperative perforation (graft take rate: 92.6% versus 76.7%). The graft take rate was found to be increased in the T-PRF group although the difference was not statistically significant. In the T1FGT group, the percentage of infection was higher than in the T1FGT + T-PRF group. When the preoperative and postoperative 6th-month audiometry was compared, a statistically significant hearing gain was obtained for both groups. In the treatment of tympanic membrane perforations, T-PRF applied over the fascia graft was shown to increase graft take rates and decrease the probability of infection. Further studies with larger samples are needed to demonstrate the effects of PRF.

Evaluation of clinical effect of titanium-prepared platelet-rich fibrin and platelet- rich fibrin in treatment of gingival recession

Evaluation of clinical effect of titanium-prepared platelet-rich fibrin and platelet- rich fibrin in treatment of gingival recession

Clinical efficacy of titanium prepared platelet rich fibrin in periodontal regeneration: A systematic review and meta-analysis

Background: Periodontal regeneration therapies frequently involve autologous platelet concentrates (APCs). They can be used in sinus lift surgeries and socket preservation, among other clinical settings. Platelet rich fibrin (PRF) membrane has been used to treat gingival recession in individuals or groups of individuals using a coronally progressed or lateral pedicle flap. In the treatment of mixed periodontic endodontic lesion/furcation defect, PRF functions as a healing and interpositional biomaterial, filling a cystic cavity. PRF is known to help the bone regeneration process. In the last few years, efforts have been made to enhance the PRFs characteristics and quality. One of them is titanium platelet rich fibrin (T-PRF). Third-generation platelet concentrate no longer contains silica, and its preparation in glass vacuum containers, no longer creates any known concerns. The effectiveness PRF's has been evaluated in connective tissue and bone repair. The aim of this study is to compare T-PRF to other platelet concentrates and different treatment modalities for periodontal regenerative procedures. Methods: A protocol of this systematic review have been registered in prospero (CRD42022293545). The online database searched were PUBMED, COCHRANE for published articles up to November 2022 without language restrictions. Studies in trial registers, handsearching, bibliographic references of relevant articles were also checked. Data collection and analysis was done by individual authors. Independent eligibility assessments were conducted by four review authors. Then, using the standard Cochrane methodology, four review authors extracted the data and evaluated the risk of bias for individual studies. We developed "Summary of findings" tables and used GRADE to evaluate the evidence. Results: Three studies were included for meta-analysis. Results of meta-analysis supported that T-PRF is effective for correction of both hard and soft tissue defects. Conclusions: The overall qualitative and quantitative analysis suggest that T-PRF has superior structural properties and thicker fibrin network for periodontal regenerative procedures.

Platelet-rich fibrin and titanium-prepared platelet-rich fibrin in endoperio lesion management.

Endo-perio lesions involve a variety of therapy choices that will lead to the best possible elimination of infection. Various therapy approaches have been investigated for curing of patients affected by endo-perio abnormalities. One of the second-generation platelet derivatives is plasma enriched with platelet (PRP).They may aid in the healing of wounds. Enhanced with platelets cells and several growth factors, platelet-rich fibrin (PRF) promotes repair and healing and regeneration of tissue at the periapical area. Platelet cell and leukocyte cell enriched fibrin, prepared in conjunction with titanium (T-PRF), is analogous to fibrin made using the traditional PRF process.The current study was undertaken to compare PRF against T-PRF in the therapy of endo-perio abnormalities using the basic information that was available.280 patients of all sexes between the ages of 18 years and 58 years make up the study's participants. They were divided into two categories. In category I study participants PRF was employed to fill the defect created due to pathology and in category II patients, a T-PRF was used, accompanied by suturing. The one walled, two walled, and three-wall walled infrabony abnormalities were quantified on the digital images acquired using the grid. After three months and six months, the probing periodontal pocket depth in mm and level of attachment (RAL) in mm were measured. In category one, mean change at 3 months was 3.21mm accounting for 33.79% change in PPD. On the other hand mean change at 6 months was 3.61mm accounting for 43.79% change in PPD. When there was evaluation in study participants in category two then it was observed that mean change at 3 months was 2.02mm accounting for 34.79% change in PPD. On the other hand mean change at 6 months was 3.62 mm accounting for 44.79% change in PPD. There was reduction of depth of periodontal pocket at both 3 months follow up and 6 months follow in both categories; however there was no statistical significant variation observed between the two categories regarding decrease in the depth of periodontal pocket on analysis of intergroup variations. It was concluded that there was increase in periodontal attachment and decrease in depth of periodontal pocket in both PRF and T-PRF however there was no statistical substantial variation observed between the two categories regarding increase in the attachment level or decrease in depth of periodontal when intergroup variations between PRF and T-PRF were considered.

Comparative Evaluation of Titanium-platelet-rich Fibrin and Leukocyte-platelet-rich Fibrin – A Scanning Electron Microscopic Study

ABSTRACT Background: Titanium-prepared platelet-rich fibrin (T-PRF), a new autologous platelet-rich fibrin (PRF) product, is based on the hypothesis that titanium tubes may be more effective in activating platelets when compared with Choukroun’s leukocyte and PRF (L-PRF) method. In this study, we aimed to define the structural characteristics under scanning electron microscopy of T-PRF and compare it with L-PRF. Materials and Methods: Blood samples were collected from 10 healthy volunteers. The blood samples were drawn using a 10 ml syringe. A volume of 9 ml was transferred to a dry glass tube, and 9 ml was transferred to a titanium tube and centrifuged. Half of each clot (i.e. after centrifugation, the T-PRF and L-PRF clots were collected) samples were processed with a scanning electron microscope analysis. Results: The T-PRF samples seemed to have a highly organized network with continuous integrity compared to the other L-PRF samples. Conclusion: Histomorphometry analysis showed that the T-PRF fibrin network covers a larger area than the L-PRF fibrin network, and also, fibrin seemed thicker in the T-PRF samples. The platelet activation by titanium seems to offer some high characteristics to T-PRF. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY Titanium-prepared platelet-rich fibrin (T-PRF), A new autologous platelet fibrin rich product can be used in regeneration of pulpal and periodontal tissues.

Effectiveness of Titanium Prepared Platelet Rich Fibrin Membrane vs Platelet Rich Fibrin Membrane in the Treatment of Multiple Gingival Recession Defects using M-VISTA Technique: Protocol for a Randomised Clinical Trial

Introduction: The focus of root coverage procedures is now shifting to minimally invasive surgical approaches. Periodontists are being required to adopt newer and more unique procedures to thoroughly cover the exposed roots. Due to the sensitivity of various techniques and the fact that it involves a wide variety of operations and their variants, periodontal plastic surgery provide a substantial challenge. A variety of minimally invasive techniques and platelet concentrates which are abundant in growth factors have been assimilated that provide the added benefit of better and rapid healing. Aim: This study aims to evaluate the effectiveness of TitaniumPrepared Platelet Rich Fibrin (T-PRF) and Platelet Rich Fibrin (PRF) membrane in Miller’s Class-I and Class-II multiple Gingival Recession (GR) using Modified-Vestibular Incision SupraPeriosteal Tunnel Access (M-VISTA) technique. Materials and Methods: The planned protocol would be randomised clinical trial and will be performed over a period of two years. Twenty-two patients will be selected according to the inclusion criteria, each having multiple GR (&gt;2 mm, Class I or II recession) on buccal/labial aspects of teeth in maxilla or mandible, and would be randomly distributed into the two groups (control and test). The M-VISTA technique would be carried out for root coverage using T-PRF (test group) and PRF (control), respectively as regenerative materials and their effectiveness will be compared by measuring the Pocket Probing Depth (PPD), Clinical Attachment Level (CAL), Relative Gingival Marginal Level (RGML), Recession Depth (RD) and Width of Keratinised Gingiva (WKG). Student’s paired and unpaired t-tests will be used to evaluate data from the baseline to 3 and 6 months for each group. Expected Results: The authors expect better results of root coverage using the M-VISTA technique in combination with T-PRF (test group). Better results in terms of PPD, CAL, RGML, RD, and increase in thickness of attached gingiva are expected. Conclusion: Combined effect of using T-PRF in the M-VISTA procedure is expected to improve the periodontal parameters including, the soft tissue outcomes and the plaque and bleeding index.

Comparative Evaluation of Injectable Platelet Rich Fibrin (I-PRF) with DFDBA and Titatium Prepared Platelet Rich Fibrin (T-PRF) with DFDBA In The Treatment of Infrabony Defects In Chronic Periodontitis Patients - A Clinico-Radiographical Study

Objectives: The main objective of this study was to evaluate the efficacy of Titanium prepared platelet-rich Fibrin (T-PRF) and Injectable Platelet Rich Fibrin (I-PRF) with demineralized freeze-dried bone allograft (DFDBA) in order to improve the clinical and radiographic results obtained in treatment of periodontal infrabony defects.&#x0D; Materials and Methods: This split-mouth randomized controlled clinical trial was conducted on 30 subjects with two comparable bilateral infrabony defects. Plaque Index(PI), Gingival Index(GI) Clinical attachment level (CAL), Periodontal Pocket depth (PD), as well as radiographic parameters IOPA including the radiographic defect size, were measured at six months post-operatively.&#x0D; Results: The mean reductions in PD and CAL were 4.0±0.77 mm and 2.5±0.68 mm in sites treated with I-PRF+DFDBA, respectively (P&lt;0.05); these reductions were 4.2±0.86 mm and 3.1±0.62 mm, respectively in T-PRF+DFDBA group (P&lt;0.05). Radiographic evaluation revealed reduction in the radiographic defect size in the I-PRF+DFDBA and T-PRF+DFDBA sites. Statistically, there were no significant differences between the two treatment modalities.?&#x0D; Conclusion: This study showed that both treatments resulted in significant improvement in the probing depth reduction, clinical attachment level gain and radiographic size of the infrabony defect at six months after surgery. I-PRF with DFDBA membrane in treatment of infrabony osseous defect showed more defect fill followed by T- PRF along with DFDBA membrane.

A neoteric platelet concentrate – Titanium-prepared platelet-rich fibrin

Titanium-prepared platelet-rich fibrin (TPRF) is the future of modern regenerative dentistry that has a wider application not only in the periodontic field and implant dentistry but also in oral surgery, endodontics, tissue engineering, and other medical fields including orthopedic and plastic surgery. It accelerates wound-healing properties along with its antibacterial and antihemorrhagic are beneficial for patients which attract more clinicians to adopt this technology. To discover the biological properties of TPRF and its broader applications in the area of periodontic and implant dentistry, TPRF is increasingly being investigated. Positive growth and improved healing results and less patient pain have been seen in current studies.

Evaluation of the Effectiveness of Titanium-prepared Platelet rich Fibrin (T-PRF) and Demineralized Freeze-dried Bone Allograft (DFDBA) in Socket Preservation Followed by Implant Placement Using Two Stage Approach

Background: The focus of the implant therapy is now shifting to a stable restoration rather than mere osseointegration. Placement of dental implants has become an indispensable part of mainstream dentistry, offering an improved quality of life to patients. One of the physiological changes that occurs after tooth extraction is alveolar ridge resorption. A variety of bone graft materials and platelet concentrates which are abundant in growth factors have been incorporated that provides the added effect of combination for early and better healing.&#x0D; Objectives: Evaluation of effectiveness of Titanium Prepared Platelet Rich Fibrin (T-PRF) and Demineralized Freeze-Dried Bone Graft (DFDBA) in socket preservation and simultaneous evaluation of implant stability three months after implant placement using two stage protocol.&#x0D; Methodology: Present study will be performed over one year period. Twelve patients, each having one tooth indicated for extraction in either of the arches will be selected. Atraumatic extraction will be done followed by socket preservation using combination of T-PRF and DFDBA to promote early healing followed by placement of implant.&#x0D; Expected Results: We expect early and better results of bone formation in healing sockets after preservation using T-PRF and DFDBA, which will be advantageous for implant placement. Better results in terms of bone volume, bone height, bone density and histomorphometry are expected.&#x0D; Conclusion: Combined effect of DFDBA and T-PRF is expected to improve the periodontal parameters including both soft tissue and hard tissue outcomes.

Ultrasonographic evaluation of the titanium-prepared platelet-rich fibrin effect in free gingival graft procedures.

Complications after free gingival graft (FGG) operations are generally related to the donor site. The titanium-prepared, platelet-rich fibrin (T-PRF) placement in the donor site accelerate the wound healing and prevent postoperative complications such as pain and hemorrhage. We aim to evaluate the effect of T-PRF regarding vascularization and tissue thickness and to report the advantages of the ultrasonography (US) in FGG. Ten individuals were divided into two groups as T-PRF and control. While the T-PRF membrane was placed at the donor site in the T-PRF group, a gelatin sponge was placed in the control group. All patients underwent US examination in terms of vascularization and tissue thickness of left and right donor sites. The correlation between the right and left donor sites was analyzed with the Pearson correlation test. Tissue thicknesses and pulsatility index (PI) were analyzed with independent samples t-test. The results were evaluated statistically at the P<0.05 significance level. The T-PRF group showed increased vascularity which can be interpreted to improve healing in soft tissue. However, not a difference, but a positively very high correlation was observed between the right and left tissue thicknesses (P=0,00; r=+0902). Evaluation of tissue thickness and vascularization density of donor sites with US not only increases clinical success rate but also reduces the risk of complications during surgery and postoperative pain in FGG. Studies evaluating T-PRF membrane as palatal dressing after FGG are only clinical, however, the efficiency of T-PRF was evaluated radiologically in this study for the first time.

Management of Maxillary Radicular Cyst by Using the Titanium-Prepared Platelet-Rich Fibrin (T-PRF): A Case Report

Radicular cysts are the most common inflammatory cysts of the jaws. Surgical intervention aims to eliminate periapical pathology in order to allow bone regeneration and healing of periapical tissues. Autologous platelet-rich fibrin is a healing biomaterial in oral surgical defects with the new perspective of accelerated healing. Titanium-prepared platelet rich fibrin (T-PRF) is a third-generation platelet concentrate developed to overcome the harmful effects of silica in glass tubes and also has a longer resorption rate. The purpose of this case report is to present the effects of T-PRF applied to the bone defect that occurs after the enucleation of the radicular cyst. A significant increase in bone density was observed after eight months of follow-up. T-PRF has been shown to be effective in the treatment of bone defects. Therefore, it is thought that it can be used as the only regenerative material in the treatment of bone defects.

Comparative assessment of titanium-prepared platelet-rich fibrin, EndoSequence root repair material, and calcium hydroxide as pulpotomy agents in permanent teeth with irreversible pulpitis: A randomized controlled trial.

Context:Pulpotomy is a procedure in which part of an exposed vital pulp is removed, usually as a means of preserving the vitality and function of the remaining part.Aim:The aim is to compare the effectiveness of Dycal (CH), EndoSequence, and Titanium-prepared platelet-rich fibrin with EndoSequence (T-PRF) as pulpotomy agents in mature permanent molars with irreversible pulpitis.Settings and Design:Sixty permanent mandibular molars with carious exposure and symptoms of irreversible pulpitis were randomly allocated to three groups.Subjects and Methods:Full pulpotomy was performed using Dycal, EndoSequence, and T-PRF with EndoSequence as pulpotomy agents. Pain intensity was analyzed using a Numeric Rating Scale score at baseline 24 h, 7 days, 6 months, and 1 year. The clinical and radiographic evaluations were done at 6 months and 1 year.Statistical Analysis:Nonparametric tests (Kruskal–Wallis, Chi-square) were applied to analyze the data as the normality test does not follow a normal distribution.Results:T-PRF and EndoSequence showed effective results when compared clinically, and there was no significant difference between radiographic success rates among the three groups at (P = 0.325 at 6 months, 0.466 at 12 months) follow-up.Conclusion:T-PRF and EndoSequence showed higher success rates among Dycal, EndoSequence as pulpotomy agents in teeth with irreversible pulpitis.

Effects of titanium prepared platelet rich fibrin on facial nerve regeneration: an experimental study

IntroductionFacial nerve damage is a condition that causes functional, psychological, and cosmetic problems; and treatment methods need to be improved. ObjectiveWe investigated the efficacy of titanium-prepared platelet-rich fibrin as a healing enhancer at the region of transection of the facial nerve. MethodsTwenty-seven New Zealand male rabbits were used in this study, divided into three experimental groups. Group 1, the sham group (n=7); Group 2, the suture group (n=10); and Group 3, the suture+T-PRF group (n=10). In Group 1, the facial nerve trunk was dissected, and no additional surgical intervention was performed. For Group 2, a transection was made to the facial nerve trunk and the nerve endings were sutured together. In Group 3, nerve endings were sutured after transection, and a titanium-prepared platelet-rich fibrin membrane was wrapped in a tube around the damaged area. All animals were followed up weekly for the presence of corneal reflex, whisker movement and low ears. Bilateral facial electromyography was performed both preoperatively and postoperatively at the 1st, 3rd, 5th, 7th, 10th weeks. Tissue samples obtained at the 10th week were histopathologically examined, and intra-group and inter-group comparisons were performed. ResultsSubjects in Group showed improvement in whisker movement and ear drop one week earlier than Group 2. In Group 3, the nerve stimulation threshold required to trigger the compound muscle action potential had returned to values similar to the preoperative control values (11.31±2.16V) by 5 weeks postoperatively (12.51±3.97V), (p=0.249). ConclusionTitanium-prepared platelet-rich fibrin administration contributed to partial nerve healing both on a functional and an electrophysiological level.

COWHIDE GELATIN NANOPARTICLES AND TITANIUM-PREPARED PLATELET-RICH FIBRIN POTENTIAL IN PERIODONTITIS HEALING PROCESS

Introduction: Based on epidemiological data, the periodontitis prevalence in Indonesia reached 96.58%. Periodontitis is a periodontal disease caused by specific microorganisms causing attachment loss, alveolar bone resorption, and periodontal pocket. The pocket which is more than 6 mm couldn’t be carried out using standard care. Therefore bone grafting is needed to fix the bone defect. Cowhide Gelatin nanoparticle (GNPs) combined with Titanium-Prepared Platelet-Rich Fibrin (T-PRF) is an innovative healing of periodontitis. Objective: To review the potential of cowhide gelatin nanoparticles combined with titanium-prepared platelet-rich fibrin (T-PRF) as an innovation in the healing of periodontitis defects. Literature review: Cowhide GNPs are the main ingredients for the bone replacement, which are nano-sized, biocompatible, bioactive, osteoconductive, non-toxic, and have a porous structure that supports the drug-delivery process. T-PRF contains platelets, fibrin, growth factors that can stimulate bone regeneration. Discussion : GNPs support the attachment and proliferation of osteoblast cells and the formation of mineralized bone matrix. The contents of T-PRF, which are fibrin, platelets, and growth factors, one of TGF-β1 will produce bone formation and periodontal healing in the large number. Moreover, T-PRF has leukocyte-fibrin, which may give an antibacterial effect. Thus, GNPs combined with T-PRF have more potent properties that support each other in carrying out their functions to stimulate the healing process. Conclusion: The combination of cowhide gelatin nanoparticles (GNPs) and titanium-prepared platelet-rich fibrin (T-PRF) has the potential to be effective in bone regeneration in periodontitis defects.

Titanium-Prepared Platelet-Rich Fibrin Versus Connective Tissue Graft on Peri-Implant Soft Tissue Thickening and Keratinized Mucosa Width: A Randomized, Controlled Trial

The health of peri-implant tissues is associated with the peri-implant soft tissue thickness (STT) and keratinized tissue width (KTW). Resorptive changes in the crestal bone around implant sites will be affected by the STT. The present randomized prospective study compared the effectiveness of titanium-prepared platelet-rich fibrin (T-PRF) with that of connective tissue graft (CTG) on peri-implant STT, KMW, and crestal bone level. Through simultaneous augmentation of the soft tissue using T-PRF or CTG, 30 implants were placed in 30 patients. The implants were placed in thin, soft tissue areas and thickened simultaneously with a T-PRF membrane in the test group and a CTG in the control group. During surgery (T0) and at 3months postoperatively (T1), the KTW and peri-implant STT were measured at 3 points: occlusal part of the alveolar crest (OAC), midbuccal mucosa level (MBML), and 1mm above the mucogingival junction (MGJ1). The crestal bone changes were evaluated from a periapical radiograph at 3months postoperatively. The baseline STT and KTW measurements showed no significant differences between the 2 groups (P<.05). Comparison of the T0 and T1 measurements from the 2 groups showed a significant increase in KTW and STT (P<.001). Compared with the test group, the control group showed a highly significant increase in the peri-implant STT at the MBML, MGJ1, and KTW levels (P<.05). No significant difference was found between the 2 groups in terms of the OAC changes (P>.05). No crestal bone loss was observed in any of the dental implants. Both groups experienced a greater increase in peri-implant STT at the OAC level, and T-PRF can be considered as an autogenous alternative to CTG. Also, peri-implant STT might prevent crestal bone resorption in the osseointegration period.