Use Of PRF Research Articles

Utilização dos agregados plaquetários em cavidade cística – relato de caso

Currently, studies are focused on the clinical use of PRF, which deals with a fibrin membrane rich in platelets and leukocytes, a material rich in autologous platelets and with growth factors, which offers an osteoconductive framework and stimulates the patient’s own cells in order to a regenerative response, offering simplicity and predictability for a wide variety of treatments. The objective of the present study is to expose the clinic of the use of the PRF not filled with extensive bone cavities due to its bone regeneration capacity. Two parendodontic surgeries were performed on patient RCP, male, 30 years old, who presented radiolucent areas at the apex of the upper incisors, suggestive of periapical cyst. After 6 months, the cavity in quadrant 1, filled with PRF, showed satisfactory bone regeneration, despite its extension at the time of cyst removal. However, the quadrant 2 cavity, which was not filled with PRF, and was a much smaller cavity, had not completed bone regeneration after 6 months. As it is a technique that is easy to perform, low cost and with favorable results, it is observed in the report presented a faster bone improvement on the side where the PRF was used, however more studies are examined to prove the effectiveness of the biomaterial.

Platelet-rich fibrin for wound healing of palatal donor sites of free gingival grafts: Systematic review and meta-analysis.

BackgroundPlatelet-rich fibrin (PRF) has been referred to as a second-generation platelet concentrate, associated with improvements on the healing of palatal wounds followed by FGG harvesting. The aim of this systematic review and meta-analysis was to assess the complete wound epithelialization and postoperative pain when PRF was used in palatal wounds following free gingival graft (FGG) harvesting. Material and MethodsPubMed (Medline), EMBASE and Scopus were searched by two independent individuals up to and including March 2020 in order to identify controlled and randomized controlled clinical trials on the use of PRF at palatal donor sites of FGG. The outcomes assessed were epithelialization and postoperative pain. The risk of bias of the included studies was evaluated using Cochrane Collaboration’s domain-based two-part tool. Random effects meta-analyses were conducted with 95% confidence intervals. ResultsThe search strategy identified 555 potentially eligible articles, of which 6 randomized controlled clinical trials were included. In the qualitative analysis, most studies (83.3%) reported lower postoperative pain in treatment groups, while all studies accessing epithelialization demonstrated earlier complete wound closure in groups treated with PRF. The discomfort and complete re-epithelialization were more favorable in groups PRF when compared to control groups (P<0.00001). ConclusionsWithin the limits of the present study, it can be concluded that the use of PRF for wound healing of palatal donor sites of FGG may decrease postoperative pain and induce earlier complete wound epithelialization. Key words:Wound healing, oral surgery procedures, pain, postoperative.

THE SECOND-GENERATION PLATELET CONCENTRATES IN THE TREATMENT OF CHRONIC OSTEOMYELITIS: ONE MODERN REGENERATIVE SURGERY

Background: Hypothesis is that the use of fibrin rich in leukocytes and platelets advanced (A-PRF) in ulcer osteomyelitis on diabetic foot, allows recovery from this serious disease. In this study, the goal was to standardize the use of PRF in patients with osteomyelitis, to use this second-generation platelet concentrate, as a facilitator of healing.&#x0D; Methods: Authors produced and used peripheral blood A-PRF (1300 g × 8 min) membranes in 7 patients (all diabetic) with osteomyelitis and skin lesions for at least 6 months. Membranes, together with the supernatant liquid derived from compression, were inserted into the skin lesion down to the bone after surgical debridement. Evolution of the lesions over time was analyzed.&#x0D; Results: All seven patients had a positive Probe-to-Bone test, MRI detected cortico-periosteal thickening and/or foci of cortico-cancellous osteolysis adjacent to the ulcer. Gram-positive bacteria were found in our patients in 52% of cases. Cocci Gram +, such as S. Aureus (15.6%), S. -haemolytic (12.1%), S. Viridans (7.1%), and Bacilli Gram- such as Pseudomonas (10.6%), Proteus (7.8%), Enterobacter (5.7%) are present. Candida Albicans is present in 2.8%. Blood count showed no major changes.&#x0D; To date, skin lesions have healed in 6 of the seven patients treated (one patient for more than five years) with no signs of infection or recurrence.&#x0D; Conclusions: Results obtained on our patients suggest that PRF membranes may be a therapeutic option in this difficult to treat pathology.

ПРИМЕНЕНИЕ СУБЭПИТЕЛИАЛЬНОГО ВАСКУЛЯРИЗИРОВАННОГО НЕБНОГО ЛОСКУТА И PRF В КОМПЛЕКСНОЙ ТЕРАПИИ ОСТРОГО ОДОНТОГЕННОГО ПЕРФОРАТИВНОГО ВЕРХНЕЧЕЛЮСТНОГО СИНУСИТА

Subject. The article presents the results of a comprehensive method for the treatment of acute perforated maxillary sinusitis using the developed surgical method for eliminating perforation with a subepithelial vascular palatal flap with simultaneous use of PRF. The effectiveness of the proposed method of treatment was confirmed by x-ray data characterizing the intensity of the inflammatory reaction caused by surgery, morphological parameters of soft tissues in the alveolar process of the upper jaw in the area of intervention and the state of the maxillary sinus before and 3 months after surgery. The aim of the study was to evaluate the effectiveness of the use of subepithelial vascular palatal flap and PRF in the complex treatment of acute odontogenic perforated maxillary sinusitis. Methodology. An assessment and comparative analysis of the activity of the inflammatory process caused by surgery, as well as the study and comparison of the morphological parameters of the alveolar ridge (the depth of the vestibule of the oral cavity, the width of the keratinized gums, and the thickness of the mucous membrane), the X-ray data evaluating the state of the maxillary sinus, before and after 3 months were carried out. after surgical procedures. The study involved 50 patients with acute perforated maxillary sinusitis (J01.0), who were divided into two groups: the main and comparisons. In the main group (25 people), a new developed method of surgical treatment was used (a method of subepithelial vascularized palatal flap with simultaneous use of PRF), in the comparison group (25 people), the traditional method of complex treatment, including a mobilized mucoperiosteal cheek flap to eliminate perforation of the maxillary sinus . Results. Based on the analysis of the data, pronounced manifestations of the inflammatory process of the postoperative period and negative treatment results using the traditional technique, which were absent in the treatment of patients with the developed surgical method, were revealed. Findings. An analysis of the results obtained during the study revealed the high efficiency of the developed method in comparison with the traditional one.

Evaluation of PRF Efficiency in the Treatment of Infrabony Defects.

The present study aimed to investigate the effectiveness of PRF in the treatment of infrabony defects in patients with chronic periodontitis by evaluating the clinical outcome through periodontal depth, clinical attachment level at the baseline, 6 and 9 months post operatively. Sixty infrabony defects with probing depth ≥ 5 mm were treated. The inclusion criterion was the necessity for surgical bilateral maxillary treatment. By using split-mouth study design, each patient had one side treated with conventional flap surgery and the other side with conventional flap surgery and PRF. Clinical parameters, such as probing depth (PD) and clinical attachment lost (CAL), were recorded in both groups at baseline, 6 and 9 months post operatively. Positive effects for all clinical and radiographic parameters were evident in the group with PRF. Mean PD reduction demonstrated statistically significant greater results in the test group (4.00±1.07 mm) compared to the control one (4.83±0.99 mm), p = 0.003 after 9 months postoperatively. After 9 months, there were better results in the test group compared to the control group for CAL (5.60±1.61 mm, 6.20±1.58 mm), but statistically not significant. Additional use of PRF in the conventional surgical treatment of infrabony defects demonstrated better parameters than the open flap debridement alone.

The Use of PRF in the Management of Soft Tissue Healing

The Use of PRF in the Management of Soft Tissue Healing

Platelet-Rich Fibrin as an Aid to Soft- and Hard-Tissue Healing.

Contemporary published data present confounding results on use of PRF in soft- and hard-tissue healing in the oral cavity, and many authors have suggested for further studies to reach the definitive conclusion. Our main objective therefore was to evaluate soft-tissue healing and osseous regeneration (by using VIXWIN PRO software) in extraction sites of mandibular third molars with substantial sample size to understand the effect of PRF in bony defects. Sixty patients had their bilaterally impacted third molars (120 sites) extracted in the split mouth study, following which platelet-rich fibrin was placed in one of the sockets. Patients were followed up clinically and radiographically, and pain score, presence of infection, exudation of graft and VIXWIN PRO software were used to evaluate healing of soft tissue and bone. Our study advocates the use of PRF for enhanced soft- and hard-tissue healing. Though the osseous regeneration could be differentiated in both the groups at second month interval only, pain scores were better with PRF at most instances. Subsequent phase to the research should include histopathological investigations for ancillary support.

Platelet Concentrates in Oral Surgery: Indications and Limits. A Literature Review

&lt;P&gt;Background: Platelet concentrates (PC) are blood-derived products for local application able to stimulate regeneration in soft and hard tissues, mimicking the physiological healing process. Their efficacy in oral surgical procedures is controversial and limited. &lt;/P&gt;&lt;P&gt; Objective: The study aims to critically analyze the available evidence for the effect of autogenous PC on wound healing of different oral surgical sites reported by more recent clinical studies. &lt;/P&gt;&lt;P&gt; Methods: Electronic and manual searches in three databases (Medline, Web of Science, Scopus) were performed to identify the clinical studies from January 2017 to December 2017 which reported the actual oral surgical indications and the benefit of local application of PC. All human studies evaluating PRP or PRF in a randomized controlled trial, case series, case report and systematic review were included. All animal, histologic and in vitro studies were excluded. &lt;/P&gt;&lt;P&gt; Results: Fifty-two studies were selected. The use of PRF was proposed in treating many oral surgical sites. Data availability with regard to the effect of PRF on new bone formation in GBR and horizontal/ vertical bone augmentation procedures varied from abundant to absent. Positive results concerning the effect of PRF on potential post-surgical complication (pain, swelling and trismus) were reported. &lt;/P&gt;&lt;P&gt; Conclusion: Few clinical indications could be determined: the literature on the topic was contradictory and the published data were difficult to interpret. Positive results were generally recorded for soft tissues and periodontal wound healing. No real benefit of PC application on bone regeneration was evidenced.&lt;/P&gt;

Combining platelet rich fibrin with different bone graft materials: An experimental study on the histopathological and immunohistochemical aspects of bone healing

AimThe current study was based on the hypothesis that the use of PRF with bone graft materials might increase bone regeneration and focus on the histopathological and immunohistochemical aspects following application of PRF with autogenous graft, xenograft and B-TCP in a rabbit model. Material and methodsThis study was performed on the twenty-eight male New Zealand divided into four group. Two defects with a diameter 10 mm were opened in calvarium. After PRF preparation, right defects were evaluated as empty defect or graft group, and left defects were evaluated as PRF test group. All animals were sacrificed at the end of 8 weeks and specimens were examined histopathologically and immunohistochemically. ResultsThe most superior histopathological results were obtained in the autograft group. The combination of β-TCP-PRF could not provide superiority over the β-TCP group. The immunohistochemical results showed that, in the PRF/BTCP group, the expression of osteopontin and osteonectin was relatively higher compared to the only-BTCP group. ConclusionIn terms of new bone formation, autograft combined with PRF yielded superior results but the combination of β-TCP-PRF had no effect compared to the only-BTCP group. However, further experimental and clinical studies might be beneficial to clarify the exact mechanism and results of combining PRF with bone grafts on bone healing process.

Assessment of Osteocalcin in Gingival Crevicular Fluid Around Bony Defect Treated with Platelet Rich Fibrin system

Purpose: to evaluate the effect of PRF system (PRF mixed with bone graft) in the regeneration of intra-bony defects by assessing osteocalcin in gingival Crevicular fluid. This study was accomplished on periodontal clinical and Radiographic evaluation.Subjects and Methods: A randomized double blind, split-mouth study was undergone on 12 patients with twenty four intrabony defects the selected defects were randomly divided into Group I (Test group): including eight defects that received PRF mixed with grafting material. Group II (Collagen group): including eight defects that received collagen membrane and PRF mixed with grafting material and Group III (Control group): including eight defects that received open flap debridement only. All subjects were put on a recall schedule where the clinical parameters (PI, GI, PD and CAL) and radiographic assessment(Alveolar bone height and bone density) were measured and recorded at base line and six months postoperatively. Results: Clinical outcomes in defects treated with collagen membrane and PRF mixed with grafting material (group II) showed more pocket reduction, greater gain in attachment level compared to other groups. However, better improvement in radiographic parameters was observed in defects treated with PRF mixed with grafting material (group I). Regarding mean osteocalcin concentration, defects treated with collagen membrane and PRF mixed with grafting material (group II) reported maximum reduction at the end of the study. Conclusions: The use of PRF as a regenerative material in managing periodontal intrabony defects resulted in pocket depth reduction, clinical attachment gain and defect fill with comparable results to bone graft and collagen membrane.

MODERN VIEW ON THE EXPERIMENTAL AND CLINICAL JUSTIFICATION FOR THE USE OF PRF IN THE PROCESSES OF REPARATIVE SKIN REGENERATION

The article describes the use of fibrin glue, which is quite common in modern medical practice. It can be synthesized from the patient's venous blood or used as ready-made preparations.&#x0D; Among fibrin clots, depending on the method of their preparation, one can distinguish:&#x0D; &#x0D; PRF which is an ordinary fibrin clot and is prepared in vacuum tubes with a plasma activator and centrifuged for about 8-12 minutes at a rate of 3000-3500 revolutions per minute.&#x0D; A-PRF (advanced) - in this cluster, growth factors have a higher concentration and a more even distribution, which helps reduce the speed of the centrifuge to 2,000 revolutions per minute, while the centrifugation time is 8-12 minutes.&#x0D; i-PRF (injectable) is a fibrinous clot formed after a few minutes after receiving blood plasma by centrifugation. The speed is 1500-2000 rpm, the centrifugation time is 3 minutes.&#x0D; Stickybone is a blood plasma that turns into a clot due to the content of fibrin in the plasma itself. The preparation is similar to the usual PRF, but due to the absence of the coagulant activator in the vial, the rate of formation of the fibrin clot is much lower.&#x0D; &#x0D; The PRF contains an autologous fibrin matrix that is rich in leukocytes, platelets and cytokines, and has a tetramolecular structure that acts as a biodegradable framework. This matrix not only stimulates the development of the microvascular mesh, but also directs the migration of epithelial cells to the surface.&#x0D; The effect of PRF and fat cells on the repair of defects in soft tissue of the maxillofacial area was investigated in pigs. It has been found that combined use of PRF and fat cells contributes to more efficient reparative regeneration processes than their single use.&#x0D; The use of PRF is common in mucoadhesive surgery, mainly in donor areas, due to the possibility of leaving the fibrin membrane exposed, which stimulates the rapid healing of the wounds with a secondary tension. Also, PRF is used locally for gum recession. According to research by S.K. Agarwa PRF stimulates the increase in the width of the keratinous mucous membrane to 0.8-1.0 mm, reducing the gum recession, which in turn greatly enhances the aesthetics of the patient. The use of PRF is clinically grounded in the surgical treatment of pigmented gum area.&#x0D; There was a wide use of PRF in cases of surgical treatment of radicular jaw cysts, including odontogenic facial granulomas, to replace the defect of bone tissue. The use of PRF promotes accelerated bone regeneration within 3 months after surgery. Radiologically, after 6 months, there is a complete recovery of bone tissue and a probable increase in bone density. The use of the PRF membrane helps to prevent inflammatory complications during tooth extraction, such as after an alveolus extraction, and can be used to break down the wall of the alveoli, which accelerates the processes of reparative regeneration in this area and creates better prospects for further dental implantation.&#x0D; It is proved that the use of PRF causes the acceleration of the processes of reparative regeneration in various types of tissues, contributing to the improvement of treatment results.

The use of platelet-rich fibrin with platelet-rich plasma support meniscal repair surgery

IntroductionPlatelet-rich fibrin (PRF) is the only autologous blood product that releases growth factors and has scaffolding properties. We hypothesized that the use of PRF and Platelet-rich plasma (PRP) would improve operative results, including the recovery of function and repaired meniscus. Materials and MethodsSeventeen patients underwent arthroscopic meniscus repair with PRF and PRP (PRF group) using our novel device for the injection of the PRF into the joint. Another five patients as a control group underwent meniscal repair without PRF and PRP (non-PRF group). The groups were compared in terms of clinical results (Tegner Activity Level Scale, Lysholm Knee Scoring Scale, and International Knee Documentation Committee [IKDC] scores) and changes in magnetic resonance imaging (MRI) findings before surgery and 6 months after surgery. ResultsThe Lysholm and IKDC scores improved in all patients postoperatively. However, there was no significant differencies in the postoperative score between the PRF group and the non-PRF group. Follow-up MRI findings did not clearly show improvements. ConclusionsPRF and PRP are autologous, safe, and cost-effective sources of growth factors. Therefore, we propose a new application of PRF and PRP for autologous transplantation in meniscus repair surgery.

Fibrina rica em plaquetas: preparo, definição da qualidade, uso clínico

Introduction: Platelet Rich Fibrin is a platelet concentrate, extemporaneously prepared and autologous, whose purpose is to improve and accelerate the cicatrizing and repair of surgical lesions, originally used for oral surgeries. Objective: To analyze the preparation, quality control and clinical use of PRF, to understand and discuss the practical and regulatory aspects of its use. Method: This work was elaborated as an integrative review, by the survey of scientific articles and current legislation on the clinical use of PRF. Results: PRF consists of a matrix of fibrin with a large quantity of platelets, which release numerous pro-regenerative mediators. Its preparation is done in a surgical center or dental office, and the dental surgeon is responsible for the procedures and the final product. The used equipment and materials must be compatible with the standards approved for the PRF preparation methods. Conclusion: The use of the PRF by dental surgeons is regulated by the Resolution of the Federal Council of Dentistry (CFO) 158/2015, June 08, 2015. There is no regulation for the use of PRF by the Federal Council of Medicine (CFM). PRF preparation and use are not considered to be a part of Advanced Therapies.

Gingival crevicular fluid levels of cathelicidin and alpha-defensins in smokers and non-smokers with chronic periodontitis

Gingival crevicular fluid levels of cathelicidin and alpha-defensins in smokers and non-smokers with chronic periodontitis

Assessment of quantitative relationship between blood and PRF for periodontal surgeries

Aim: The aim of study is to measure the amount of PRF obtained from different quantity of blood withdrawn from patients &amp; the amount of PRF and its use in different periodontal surgical procedures.Materials and method: 15 subjects undergoing regenerative periodontal surgical therapy in whom use of PRF was indicated were included in the study. 15 subjects were divided into 3 three groups. In group A: 5ml of blood was withdrawn from 5 subjects. In group B: 10ml of blood was withdrawn from 5 subjects. In group C: 12ml of blood was withdrawn from 5 subjects. The steps involved were as follows:1)Â Â Â Â Â Blood specimen was withdrawn from the patient,2)Â Â Â Â Â The blood specimen was immediately placed in the centrifuge and was allowed to spin for 10mintes at 3000RPM,Weight of obtained PRF was measured by using weighing scale and also length, depth &amp; width was measured by using UNC 15 probe.Result and Conclusion: The amount of PRF obtained depends upon the quantity of blood withdrawn. Thus, result of the present study is helpful to the operator to decide the quantity of blood to be withdrawn for particular patient to obtain desired amount of PRF.

Surgical management of radicular cyst and use of prf and bone graft for endodontic regeneration: A case report

Surgical management of radicular cyst and use of prf and bone graft for endodontic regeneration: A case report

Use of autologous platelet-rich fibrin in osseous regeneration after cystic enucleation: A clinical study

Aims and objectivesThe aim of this study was to evaluate the efficacy of PRF in osseous regeneration after enucleation of cystic lesions. The objectives of this study were as follows: (1) to evaluate osseous regeneration radiographically with the use of PRF in intrabony defects after cystic enucleation. (2) To evaluate the degree of bone density in intrabony defects with the use of PRF postoperatively after 1st, 3rd, and 6th months. Subjects and methods20 cases of cystic lesions were treated using PRF after cystic enucleation. Follow-up radiographs (orthopantomogram) were taken 1st, 3rd, and 6th months postoperatively. Bone density was measured with grayscale histogram using Adobe Photoshop 7.0 software. ResultsThe subsequent follow-up examinations revealed progressive, predictable, and significant radiographic osseous regeneration. ConclusionThe use of PRF in management of cystic lesions seems to be a novel therapeutic approach promoting faster osseous regeneration within 6 months postoperatively; however, further study is required with larger sample size and with a control group.

Platelet rich fibrin: a panacea for lost interdental papilla

Introduction: Loss of interdental papilla marks phonetics, functional and esthetic problem. Surgical techniques are diverse, but none have given predictable results. Aim: The purpose of this case report is to present reconstruction of papilla by using platelet rich fibrin membrane in maxillary anterior region. Methodology: 30yr old male patient reported with an unesthetic smile due to loss of interdental papilla in the maxillary left central and lateral incisor region since 6 months. The treatment was planned for reconstruction of lost interdental papilla using PRF. A pouch was created with a semilunar incision, PRF was prepared and inserted into the pouch and the entire gingivopapillary unit was displaced coronally. Conclusion: Optimal fill was noted at 1, 3 and 6 months postoperatively with excellent esthetic outcome. Use of PRF and proper technique may thus be the panacea for interdental papilla augmentation. Keywords: PRF, Interdental papilla, Esthetics, Maxillary anterior, Black triangle

English

One of the most difficult and elusive goals of Periodontics in the field of reconstruction and regeneration is the surgical reconstruction of the lost interdental papilla. This clinical and aesthetic dilemma demands more attention from the clinician. Several non-surgical and surgical techniques have been proposed to manage the interproximal space. Non-surgical approaches modify the interproximal space and the surgical techniques aim to re-contour, preserve and reconstruct the soft tissue between the teeth. Platelet rich fibrin has been extensively used in hard and soft tissue augmentation, but not tried for augmenting interdental papilla. The purpose of this case series is to describe a novel approach of papilla reconstruction in the maxillary anterior region with the use of platelet rich fibrin. This procedure obtained optimal fill in all the cases postoperatively. Thus, the use of PRF may be the panacea for interdental papilla augmentation.

Zucchelli′s technique combined with platelet-rich fibrin for root coverage

Desire for improved esthetics and the consequent need for cosmetic dentistry have increased tremendously in recent times making esthetic procedures an integral part of periodontal treatment. The treatment of choice for recession coverage should address the biological as well as the patient's esthetic demands. Zucchelli and Sanctis (2000) proposed a modification in the coronally advanced flap technique for treatment of multiple recession defects in esthetic areas. A recent innovation in dentistry is the preparation and use of platelet-rich fibrin for recession defects. This case report highlights the Zucchelli's technique along with the use of PRF for root coverage in multiple recession defects.