Use Of Platelet-rich Fibrin Membrane Research Articles

Prevention and management of drug-induced osteonecrosis of the jaws using platelet-rich fibrin: A clinical feasibility study.

Although a standard treatment guideline has not been established to date, various treatment modalities have been described in the literature based on the staging of medication-related osteonecrosis of the jaw (MRONJ). The aim of this case series was to describe the outcomes of surgical intervention of MRONJ cases with the adjunctive use of platelet-rich fibrin (PRF). Thirteen patients under therapy with zoledronic acid, seven of them underwent surgical removal of necrotic bone with debridement, followed by placement of three to four PRF membranes and achieving primary closure. In six patients, PRF was used preventively to avoid MRONJ. The surgical treatment outcomes were successful in all patients, with a follow-up range of 12-48 months. In the presented cases, the intraoral evaluation showed excellent soft tissue healing except for one patient secondary wound healing was reported. Additionally, there was no recurrence of bone exposure in all cases. PRF membranes were comparatively effective in postsurgical pain control. The use of PRF could represent a valuable adjunct in the surgical management for advanced stages of MRONJ cases. This clinical case series describes the use of PRF membranes as a valuable adjunct in the surgical management of MRONJ patients, especially when treating advanced MRONJ cases. Moreover, PRF demonstrates usefulness in preventing such difficult complications from occurring.

Comparative analysis of platelet-rich fibrin membrane and 0.2% hyaluronic acid gel on healing following gingival depigmentation procedure.

Platelet-rich fibrin (PRF) accelerates wound healing by promoting faster cicatricial tissue remodeling and excellent neovascularization. Hyaluronic acid (HA) being biocompatible, anti-inflammatory, and proangiogenic leads to improvement in the rate of wound healing. The aim of this study was to compare the effect of PRF membrane and 0.2% HA gel on wounds after gingival depigmentation surgery. This study was carried out on 30 systemically healthy individuals recruited from the pool of patients who visited the department of periodontology. After depigmentation procedure in every patient, the sites were divided into three even groups. Group A received PRF membrane and periodontal dressing, Group B received 0.2% HA gel application and periodontal dressing, and Group C served as a control group in which only periodontal dressing was placed. The individuals were evaluated for the healing index (HI) and Numerical Rating Scale (NRS) on the 3rd and 5th day. Epithelialization test (ET) was performed on the 5th day. Gingival biotype was reassessed and compared to preoperative value after 3 months. The clinical trial was expressed in terms of mean and standard deviation. Intra-group comparison and inter-group comparison were done through the Kruskal-Wallis ANOVA test. All statistical tests were performed through SPSS version 25.0 (IBM). The inter-group statistical analysis concerning NRS, HI, and ET showed statistically significant results in Groups A and B compared to Group C (P < 0.05), while gingival biotype showed statistically significant results in Group A compared to Groups B and C. The use of PRF membrane and HA gel to protect the raw wound site of depigmented gingiva proved to be an effective approach, resulting in faster healing.

Is the use of platelet-rich fibrin effective in the healing, control of pain, and postoperative bleeding in the palatal area after free gingival graft harvesting? A systematic review of randomized clinical studies.

A systematic review (SR) was conducted to answer the following focused question based on PICO strategy: In patients who were submitted to harvesting palatal free gingival graft, could platelet-rich fibrin (PRF) application in comparison with another method improve the healing, pain, and control of postoperative bleeding in the palatal area in randomized clinical trials? A SR was conducted according to the PRISMA guidelines. The MEDLINE (PubMed), Scopus, Embase, and Web of Science databases were searched, and hand searches were made, covering the period up to August 2020, for randomized clinical trials (RCTs) reporting the effect of PRF membrane in postoperative palatal healing management compared with any other methods. The risk of bias (RoB) of the studies included was assessed by using the RoB 2 tool. The electronic search strategy identified 150 articles. After title screening and abstract reading, 141 studies were excluded, and 9 full-text publications were comprehensively evaluated. Finally, 8 articles were included in the systematic review. Six studies showed that the PRF membrane was effective in improving wound healing during the first 2 weeks. As regards patient-centered outcomes, five studies showed that PRF promoted less postoperative pain. Finally, five studies that evaluated bleeding showed that the PRF membrane improved control of postoperative bleeding. RoB was classified as low in 4 studies, 3 with some concerns, and only one study did not describe the outcome data, and as this was missing, it was not possible to verify the protocol of data analysis for this study; therefore, it was classified as having high RoB. Within the limitations of this study, the collective evidence emerging from this SR may support the use of PRF membrane in the palatal area after free gingival graft harvesting. The results of this review must be interpreted with caution, due to the low number of RCTs included and high degree of heterogeneity among the PRF protocols. Further well-designed RCTs with accurate protocol and standard PRF parameters are required in order to gain clear understanding of the influence of PRF on wound healing and patient-centered outcomes. The use of PRF membrane for the protection of the palatal donor site following free gingival graft harvesting procedures improves wound healing and patients' quality of life.

Use of platelet-rich fibrin membrane with tricalcium silicate in interdisciplinary management of fractured fused anterior teeth with periapical pathology

Use of platelet-rich fibrin membrane with tricalcium silicate in interdisciplinary management of fractured fused anterior teeth with periapical pathology

Use of Vestibular Incision Subperiosteal Tunnel Access Technique with Platelet Rich Fibrin in the Treatment of Miller Class I Gingival Recession: A Case Report

Gingival recession is defined as apical migration of gingival margins resulting in exposure of the root surface. It can be either localized or generalized, involving one or more than 1 surfaces and there by leading to functional & esthetic problems like hypersensitivity, cervical abrasions & root caries. Various techniques have been developed to achieve root coverage. The current case report describes treatment of multiple class I gingival recession using vestibular incision sub periosteal tunnel access (VISTA) technique and platelet rich fibrin (PRF) membrane. Position of gingiva was maintained using coronally anchored sutures during initial healing period. The use of PRF membrane along with the VISTA allows clinicians to successfully treat multiple gingival recession defects.

Clinical evaluation of coronally advanced flap with or without platelet-rich fibrin for the treatment of multiple gingival recessions.

The aim of this randomized, controlled study was to assess the clinical effect of platelet-rich fibrin (PRF) in combination with coronally advanced flap (CAF) on root coverage, esthetics, and patient satisfaction when compared to CAF alone for the treatment of multiple Miller class I recessions. A total of 24 patients with 52 Miller class I multiple recessions ≥3mm were included and divided into CAF + PRF and CAF groups. At baseline and 12months after surgery, recession height (RH), keratinized tissue height, gingival thickness (GT), and mean and complete defect coverage were evaluated. Patient satisfaction and root coverage esthetic scores were also assessed. Baseline RH in CAF + PRF and CAF groups was 3.15±0.24 and 3.36±0.34mm, respectively. Intragroup comparisons revealed significant differences at 12months for all parameters (p<0.05). RH reduction was 2.75±0.33 and 2.51±0.33mm (mean root coverage of 88.36 and 74.63%) in the CAF + PRF and CAF groups, respectively. Intergroup differences were found to be significant for GT gain (p<0.05). The additional use of PRF membrane did not provide additional benefits in terms of root coverage outcomes compared with CAF alone. The use of PRF membranes increased tissue thickness significantly.

Surgical treatment of osteonecrosis of the jaw with the use of platelet-rich fibrin: a prospective study of 15 patients

The objective of this study was to evaluate the outcome of the surgical treatment of osteonecrosis of the jaw (ONJ) with the additional use of autologous membranes of platelet-rich fibrin (PRF). The study population consisted of 15 patients with ONJ lesions in the maxilla (n=3), mandible (n=11), or both (n=1). Eight patients had malignant disease and were treated with high-dose anti-resorptive medication; seven were treated with low-dose anti-resorptive drugs for osteoporosis. Thirteen patients had grade 2 ONJ lesions and two had grade 3 lesions. The following standardized surgical technique was applied: resection of necrotic bone, mobilization of mucoperiosteal flaps, and multiple layer coverage of bone with PRF membranes. At follow-up 7–20 months after surgery, complete mucosal healing and an absence of symptoms were found in 14 of the 15 patients (93%). The patient with persistent bone exposure had a grade 3 ONJ lesion before surgery. This study suggests that the use of PRF membranes in the surgical treatment of grade 2 ONJ may be a contributing factor to a successful outcome.

Use of Platelet-Rich Fibrin Membrane in the Treatment of Gingival Recession: A Systematic Review and Meta-Analysis.

The aim of this systematic review is to evaluate the effects of platelet-rich fibrin (PRF) membranes on the outcomes of clinical treatments in patients with gingival recession. Articles that were published before June 2015 were searched electronically in four databases without any date or language restrictions and searched manually in regular journals and unpublished studies. The eligibility criteria comprised randomized controlled trials (RCTs) and prospective controlled trials with follow-up periods of ≥ 6 months that compared the performance of PRF to other biomaterials in the treatment of Miller Class I or II gingival recessions. For the meta-analysis, the inverse variance method was used in fixed- or random-effect models, which were chosen according to heterogeneity. The estimates of the intervention effects were expressed as the mean differences in percentages or millimeters. Six RCTs and one prospective clinical trial are included in this review. Root coverage (RC) and clinical attachment level (CAL) did not differ significantly between the analyzed subgroups (P = 0.57 and P = 0.50, respectively). The keratinized mucosa width (KMW) gain was significantly greater (P = 0.04) in the subgroup that was treated with connective tissue grafts. The results of the meta-analysis suggest that the use of PRF membranes did not improve the RC, KMW, or CAL of Miller Class I and II gingival recessions compared with the other treatment modalities.

Coronally Advanced Flap with Platelet Rich Fibrin, a Novel Approach for Root Coverage: A Case Report

Gingival recession remains a widespread finding in the general patient population. Predictable esthetic root coverage has always remained the dream of any dentist. The desire for improved aesthetics and the consequent need for cosmetic dentistry have increased tremendously in recent times making aesthetic procedures an integral part of periodontal treatment. A recent innovation in dentistry is the preparation and use of platelet-rich fibrin (PRF) for coverage of recession defects. This report presents a case with the use of PRF membrane prepared by a novel technique for root coverage.

Platelet‐Rich Fibrin–Reinforced Vestibular Incision Subperiosteal Tunnel Access Technique for Recession Coverage

Introduction: Gingival recession (GR) presents with breakdown of both soft and hard tissues and can cause major functional and esthetic problems. Treatment of GR, especially multiple recession defects, presents a challenge because several recession defects must be treated at a single surgical session to minimize patient discomfort. New materials and techniques are currently being developed to obtain predictable root coverage. This case series describes the use of the vestibular incision subperiosteal tunnel access (VISTA) technique in combination with platelet‐rich fibrin (PRF) membrane in the treatment of GR defects. To the best of the authors’ knowledge, this is the first report on the use of the PRF membrane–reinforced VISTA technique.Case Series: Four patients with multiple GRs were selected for this case series. The VISTA technique allowed coronal repositioning of the gingival margin, which was then stabilized by the coronally anchored suturing technique. PRF membrane was inserted inside the subperiosteal tunnel, and the vertical incision was sutured. Patients were kept under observation for 6 months.Conclusion: This use of PRF membrane along with the VISTA technique allows clinicians to successfully treat multiple GR defects.

Use of Platelet‐Rich Fibrin Membrane as a Palatal Bandage

Introduction: Free gingival grafting is one of the most common techniques used to increase the dimensions of keratinized tissue (KT). The palatal donor sites heal with secondary intention, require a longer time, and cause discomfort to patients. This case series describes the use of platelet‐rich fibrin (PRF) membrane as a palatal bandage to cover donor sites. To the best of the authors’ knowledge, this is the first report that describes the use of PRF membrane as a palatal bandage.Case Series: Five patients requiring augmentation of KT are described in this case series. The palatal donor sites of four of these patients were covered with PRF membranes as a palatal bandage. The donor site of the fifth patient was allowed to heal in a conventional way without PRF membrane to evaluate the difference in healing. The healing was evaluated visually by hydrogen peroxide test at days 12, 13, 18, 19, 24, 25, 30, and 31. Palatal donor sites covered with PRF membranes demonstrated considerably faster healing compared with the site not covered by PRF membrane.Conclusions: The superior healing observed at the PRF membrane sites supports its use in accelerating soft‐tissue healing. PRF membrane as a palatal bandage is an efficacious approach to protect the raw wound area of a palatal donor site to reduce healing time and patient discomfort.

Clinical and Histological Evaluation of Postextraction Platelet-rich Fibrin Socket Filling

The aims were to investigate whether the use of platelet-rich fibrin membranes (PRF) for socket filling could improve microarchitecture and intrinsic bone tissue quality of the alveolar bone after premolar extraction and to assess the influence of the surgical procedure before implant placement. Twenty-three patients requiring premolar extraction followed by implant placement were randomized to three groups: (1) simple extraction and socket filling with PRF, (2) extraction with mucosal flap and socket filling with PRF, and (3) controls with simple extraction without socket filling. Implant placement was performed at week 8, and a bone biopsy was obtained for histomorphometric analysis. Analysis by microcomputed tomography showed better bone healing with improvement of the microarchitecture (P < 0.05) in group 1. This treatment had also a significant effect (P < 0.05) on intrinsic bone tissue quality and preservation of the alveolar width. An invasive surgical procedure with a mucosal flap appeared to completely neutralize the advantages of the PRF. These results support the use of a minimally traumatic procedure for tooth extraction and socket filling with PRF to achieve preservation of hard tissue.

The use of platelet-rich fibrin membrane in gingival recession treatment

Fibrin, fibronectin, platelet derived growth factor, and transforming growth factors from platelet concetrate are crucial for tissue reparation and regeneration. This study was designed to evaluate clinical effectiveness of activated platelet-rich fibrin (PRF) membrane in treatment of gingival recession. 19 gingival recessions Miller class I or II were treated with a coronally advanced flap and the PRF membrane (PRF group). Following the elevation of the flap, bone and root surfaces were covered with the PRF membrane. After suturing, the PRF membrane was covered with a coronally advanced flap. In the same patients, 19 other gingival recessions were treated with CTG in combination with the coronally advanced flap (the CTG group). Clinical recordings were made of vertical recession depth (VRD), probing depth (PD), clinical attachment level (CAL) and keratinized tissue width (KTW) before and 12 months after mucogingival surgical treatment. Clinical evaluation of healing events was estimated with recordings of the healing index (HI). Recordings of HI were performed in the 1st, 2nd and 3rd week post-surgically. Mean root coverage was significant in both groups (the PRF group 79.94% and the CTG group 88.56% %; p < 0.01). The difference between the two tested groups was not statistically significant. Results of the keratinized tissue width showed significant increase (p < 0.05) 12 months after the surgery in both, the PRF and CTG groups. Results of KTW showed statistical significance of recorded differences obtained in the two evaluated groups (p < 0.05). There was no statistical significance in reduction of PD and CAL recorded in the PRF and CTG groups. The values of HI recorded in the 1st and 2nd week postoperatively were significantly enhanced in the PRF group (p < 0.05). Results of this study confirm both procedures as effective with equivalence of clinical results in solving gingival recession problems. The utilization of the PRF resulted in a decreased postoperative discomfort and advanced tissue healing.

Platelet-rich-fibrin: A novel root coverage approach

Treatment of gingival recession has become an important therapeutic issue due to increasing cosmetic demand. Multiple surgical procedures have been developed to obtain predictable esthetic root coverage. More specifically, after periodontal regenerative surgery, the aim is to achieve complete wound healing and regeneration of the periodontal unit. A recent innovation in dentistry is the preparation and use of platelet-rich plasma (PRP), a concentrated suspension of the growth factors, found in platelets. These growth factors are involved in wound healing and postulated as promoters of tissue regeneration. This paper reports the use of PRF membrane for root coverage on the labial surfaces of the mandibular anterior teeth. This was accomplished using laterally displaced flap technique with platelet rich fibrin (PRF) membrane at the recipient site.