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Alghamdi A, Mominkhan D, Sabano R, Alqadi NF, Al-Habib M, Bukhari S, Howait M, Alsofi L. Factors Associated with Postsurgical Pain and Swelling Following Endodontic Microsurgery: The Role of Radiographic Characteristics. Healthcare (Basel) 2025; 13:995. [PMID: 40361773 PMCID: PMC12071530 DOI: 10.3390/healthcare13090995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2025] [Revised: 04/14/2025] [Accepted: 04/24/2025] [Indexed: 05/15/2025] Open
Abstract
Objectives: Endodontic microsurgery has become an integral part of daily endodontic practice. However, research on the correlation between the lesion characteristics observed via cone beam computed tomography (CBCT) and pain and swelling after endodontic microsurgery (EMS) is still lacking in the literature. The present study aims to examine the relationship between the radiographic characteristics of preoperative periapical lesions obtained from CBCT images and post-surgical symptoms such as pain and swelling. Materials and Methods: A total of 61 patients undergoing EMS utilizing modern techniques were asked to report their level of pain and swelling at 8, 24, 48, and 72 h after EMS using VAS. Independent variables such as age, gender, tooth location, CBCT periapical index, endodontic diagnosis, cortical bone perforation by the lesion, duration of the EMS, preoperative analgesic consumption, antibiotic prescription, and pre-/postoperative mouthwash were analyzed using the Fisher Exact test. Multivariate regression analysis was also conducted to determine the independent significant factors associated with pain and swelling. A p-value of ≤0.05 was considered statistically significant. Results: The maximum pain score was recorded at 8 h (4.26 ± 3.13), while peak swelling was measured after 24 h (6.46 ± 2.87). The risk of swelling was more likely to decrease by 75.7% for patients with a CBCT index score of >3 than those with a CBCT index score of ≤3 (AOR = 0.243; CI = 0.071-0.831; p = 0.024). The effects of all other factors on pain, including cortical bone perforation by the lesion (p = 0.290), swelling (p = 0.071), postoperative mouthwash use (p = 0.062), and swelling (p = 0.934), did not reach statistical significance. Conclusions: Patients with periapical lesions larger than 4 mm will likely experience less swelling after EMS, while pain is not affected by lesion size, cortical bone perforation, or mouthwash use. Clinical Relevance: This study identified a new predictor of swelling after EMS based on the size of the periapical lesion. These results will improve the management of post-surgical sequelae after EMS and support shared decision making.
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Affiliation(s)
- Abdulwahed Alghamdi
- Department of Endodontics, University Dental Hospital, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia; (A.A.); (R.S.)
| | - Dana Mominkhan
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Reem Sabano
- Department of Endodontics, University Dental Hospital, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia; (A.A.); (R.S.)
| | - Noha F. Alqadi
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia; (N.F.A.); (M.A.-H.); (S.B.); (M.H.)
| | - Mey Al-Habib
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia; (N.F.A.); (M.A.-H.); (S.B.); (M.H.)
| | - Sarah Bukhari
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia; (N.F.A.); (M.A.-H.); (S.B.); (M.H.)
| | - Mohammed Howait
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia; (N.F.A.); (M.A.-H.); (S.B.); (M.H.)
| | - Loai Alsofi
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia; (N.F.A.); (M.A.-H.); (S.B.); (M.H.)
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Giannelli A, Forte M, D’Albis G, Cianciotta G, Limongelli L, Stef L, Feier R, Alrashadah AO, Corsalini M, Capodiferro S. Utilization of Platelet-Rich Plasma in Oral Surgery: A Systematic Review of the Literature. J Clin Med 2025; 14:2844. [PMID: 40283674 PMCID: PMC12027928 DOI: 10.3390/jcm14082844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2025] [Revised: 04/17/2025] [Accepted: 04/18/2025] [Indexed: 04/29/2025] Open
Abstract
Introduction: The physiological process of wound healing is a complex and dynamic series of events that aims to restore damaged tissues to their original structure and function. Platelet-rich plasma (PRP), an autologous blood-derived product, is characterized by a high concentration of platelets suspended in a small volume of plasma, along with a complete array of coagulation factors at physiological concentrations. Beyond platelets, PRP contains a significant quantity of bioactive growth factors, such as platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and transforming growth factor-beta (TGF-β), all of which are crucial mediators of tissue repair and osteogenesis. Due to these properties, PRP has garnered considerable attention in oral surgery, where the efficient regeneration of both hard and soft tissues is critical for the optimal therapeutic outcomes. Objectives: This systematic review aimed to critically evaluate the efficacy of PRP in oral surgical procedures, with particular emphasis on its role in the regeneration of both soft and hard tissues, as well as its clinical outcomes. Furthermore, the review sought to identify the diverse surgical applications of PRP and assess the impact of its use in conjunction with grafting materials on regenerative outcomes. Methods: A comprehensive systematic review was conducted, analyzing articles published within the last decade regarding the application of PRP in oral surgery, specifically focusing on periodontal, regenerative, and implant-related procedures. Studies were selected based on rigorous inclusion criteria, assessing the utilization of PRP across different clinical settings. Results: Thirteen relevant studies were included, which were categorized as follows: three studies involving implant surgery, three studies focusing on third molar extractions, two studies on regenerative surgery, two studies addressing periodontal surgery, one study examining intrabony periodontal defects, and two studies on ridge augmentation procedures. The majority of studies reported modest improvements in clinical parameters such as periodontal probing depth and clinical attachment level (CAL). Furthermore, significant positive outcomes were observed in soft tissue healing, with notable enhancements in bone density. These results suggest that PRP may facilitate the healing process, particularly in soft tissues, while also promoting bone regeneration to a degree. Conclusions: The findings of this systematic review underscore the potential of PRP as a valuable adjunct in oral surgery, demonstrating significant benefits in the regeneration of soft tissues and, to a lesser extent, hard tissues. Notably, the standalone application of PRP did not yield substantial improvements in regenerative outcomes. However, when PRP was used in combination with grafting materials, more pronounced benefits were observed, indicating a synergistic effect that enhances both soft and hard tissue regeneration. These findings support the rationale for incorporating PRP into clinical practice, particularly in conjunction with grafting materials, to optimize patient outcomes in oral surgery. Further research, particularly involving larger sample sizes and long-term follow-ups, is necessary to fully elucidate the optimal clinical applications and mechanistic pathways of PRP in oral regenerative procedures.
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Affiliation(s)
| | - Marta Forte
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare, 11, 70124 Bari, Italy; (G.C.); (L.L.); (M.C.); (S.C.)
| | - Giuseppe D’Albis
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare, 11, 70124 Bari, Italy; (G.C.); (L.L.); (M.C.); (S.C.)
| | - Giulia Cianciotta
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare, 11, 70124 Bari, Italy; (G.C.); (L.L.); (M.C.); (S.C.)
| | - Luisa Limongelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare, 11, 70124 Bari, Italy; (G.C.); (L.L.); (M.C.); (S.C.)
| | - Laura Stef
- Faculty of Medicine, Lucian Blaga University Sibiu, 550169 Sibiu, Romania;
| | - Ramona Feier
- Faculty of Medicine, “Dimitrie Cantemir” University, 700115 Iasi, Romania;
| | | | - Massimo Corsalini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare, 11, 70124 Bari, Italy; (G.C.); (L.L.); (M.C.); (S.C.)
| | - Saverio Capodiferro
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare, 11, 70124 Bari, Italy; (G.C.); (L.L.); (M.C.); (S.C.)
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Sabeti M, Gabbay J, Ai A. Endodontic surgery and platelet concentrates: A comprehensive review. Periodontol 2000 2025; 97:308-319. [PMID: 39135355 DOI: 10.1111/prd.12593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 06/13/2024] [Accepted: 06/17/2024] [Indexed: 02/11/2025]
Abstract
While autologous platelet concentrates (APCs) have gained traction as promising regenerative materials in recent years, their impact on wound healing and tissue regeneration in periapical hard tissue defects remains controversial. Endodontic microsurgery (EMS) has embraced the potential of platelet concentrates, particularly L-PRF (Leucocyte-Platelet-Rich Fibrin) and PRP (Platelet-Rich Plasma), as regenerative tools. These concentrates, rich in growth factors and other bioactive molecules, are thought to enhance healing and treatment outcomes for various endodontic conditions. However, their effectiveness remains a subject of investigation. Despite encouraging 3-D cone beam computed tomography (CBCT) based evidence for PRP's effectiveness in complex lesions and apico-marginal defects, inconsistencies in its performance across preparation and application protocols raise questions about its superiority over existing options. More research is crucial to understand its full potential as a reliable regenerative tool in endodontics. L-PRF and its derivatives are particularly effective in treating apical-marginal defects. It enhances clinical attachment levels and reduces probing pocket depths, likely due to its slow and coordinated release of various growth factors. L-PRF has been shown to also improve patients' quality of life by reducing postoperative swelling and pain. However, more research is needed to standardize its preparation methods and confirm its long-term benefits. This paper aims to provide a comprehensive review of the current knowledge and recent advances in endodontic surgery and the use of platelet concentrates, focusing on their roles in managing periapical lesions and endo-perio lesions.
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Affiliation(s)
- Mohammad Sabeti
- Advanced Specialty Program in Endodontics, UCSF School of Dentistry, San Francisco, California, USA
| | - Julian Gabbay
- Advanced Specialty Program in Endodontics, UCSF School of Dentistry, San Francisco, California, USA
| | - Armin Ai
- Georgia School of Orthodontics, Atlanta, Georgia
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Ha S, Choi SM, Kim S, Song M, Hu K, Kim E. Accuracy of 3-dimensional surgical guide for endodontic microsurgery with a new design concept: A cadaver study. Int Endod J 2025; 58:295-304. [PMID: 39495167 PMCID: PMC11715136 DOI: 10.1111/iej.14161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 10/14/2024] [Accepted: 10/15/2024] [Indexed: 11/05/2024]
Abstract
AIM Despite the high success rate of endodontic microsurgery (EMS), it is difficult to suggest EMS as a general treatment option considering the difficulty of the procedure. A surgical guide has been proposed to overcome this problem. This study aimed to evaluate the stability of the surgical guide of a new design concept, as well as the accuracy of root resection, and to introduce the manufacturing method of the newly designed surgical guide. METHODOLOGY The experiment was conducted on 59 roots (9 in the maxillary and 50 in the mandibular region) of adult human cadavers. The surgical guide was designed using CAD/CAM design software based on cone-beam computed tomography (CBCT) images and optical scan files. Unlike conventional surgical guides, the surgical guide proposed herein was designed to act as a tooth-bone-supported removable appliance. Two different types of guides were prepared: the osteotomy guide (O guide) for separation of the cortical bone above the root tip with a trephine bur with an outer diameter of 6 mm and the root resection guide (R guide) for resection of the root tip with a trephine bur with an outer diameter of 4 mm. For stability evaluation, the guides were pressed at five predetermined locations after installation and checked for the presence of any movement. For accuracy evaluation, the length at which the root tip was cut was measured and examined by overlapping the preoperative and postoperative CBCT images. RESULTS Of the 15 R guides, 14 were stably installed without mobility. For the R guide group, the root tip was resected with an average of 3.2 mm, showing better results than the no-guide group with an average of 4.0 mm. CONCLUSIONS The newly designed surgical guide of this study can be applied more stably, enabling root resection to be performed more accurately and simply according to the preoperative plan than when performed without a guide.
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Affiliation(s)
- Se‐Won Ha
- Department of Conservative Dentistry and Oral Science Research Center, Microscope CenterYonsei University College of DentistrySeoulKorea
| | - Stephanie M. Choi
- Department of Conservative Dentistry and Oral Science Research Center, Microscope CenterYonsei University College of DentistrySeoulKorea
| | - Sunil Kim
- Department of Conservative Dentistry and Oral Science Research Center, Microscope CenterYonsei University College of DentistrySeoulKorea
| | - Minju Song
- Department of Conservative DentistryNational Health Insurance Service Ilsan HospitalGoyangKorea
| | - Kyung‐Seok Hu
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR ProjectYonsei University College of DentistrySeoulKorea
| | - Euiseong Kim
- Department of Conservative Dentistry and Oral Science Research Center, Microscope CenterYonsei University College of DentistrySeoulKorea
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Muthanna N, Guan X, Alzahrani F, Saif BS, Seyam A, Alsalman A, Alajami AE, Li A. Impact of regenerative procedure on the healing process following surgical root canal treatment: A systematic review and meta-analysis. PLoS One 2025; 20:e0312751. [PMID: 39746110 PMCID: PMC11695025 DOI: 10.1371/journal.pone.0312751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 10/12/2024] [Indexed: 01/04/2025] Open
Abstract
INTRODUCTION Different Guided Tissue Regeneration (GTR) procedures, such as membranes, bone substitute materials, and Autologous Platelet Concentrates (APCs), have been applied after surgical root canal treatment (SRCT), which produce different outcomes. This study aimed to evaluate the impact of regenerative procedures on the healing process following SRCT. METHODS A comprehensive search of PubMed, Embase, Scopus, Cochrane, and the Web of Science found Randomized Controlled Trials (RCTs) published until February 25, 2024. Manual searches were also conducted. Our main outcome was SRCT success or failure after GTR procedures. The Risk Ratio (RR) and failure rate meta-analysis used a fixed effects model with a 95% confidence interval (CI). Subgroup analyses were conducted based on the use of different GTR procedures for varying lesion types in SRCT. RESULTS Out of 1,605 records, 16 studies with 690 lesions were included. Overall, GTR procedures significantly improved healing after SRCT in both 2D (RR: 0.50; 95% CI, 0.34-0.73; P < 0.001) and 3D evaluation methods (RR: 0.36; 95% CI, 0.15-0.90; P < 0.001) with no significant difference between the two methods. CONCLUSION GTR significantly improved SRCT healing regardless of the evaluation method used. Combining collagen membranes with bovine bone-derived hydroxyapatite significantly enhanced the healing process. Additionally, GTR procedures significantly improve healing in through-and-through lesions.
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Affiliation(s)
- Nader Muthanna
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, Chin
- Department of Endodontic, College of Stomatology Xi’an Jiaotong University, Xi’an, China
| | - Xiaoyue Guan
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, Chin
- Department of Endodontic, College of Stomatology Xi’an Jiaotong University, Xi’an, China
| | - Fouad Alzahrani
- Pulp Biology and Endodontic Department, Al-Baha Dental Center, Al-Baha, Saudi Arabia
| | - Badr Sultan Saif
- Department of Orthodontics, College of Stomatology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Abdelrahman Seyam
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, Chin
- Department of Endodontic, College of Stomatology Xi’an Jiaotong University, Xi’an, China
| | - Ahmed Alsalman
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, Chin
- Department of Endodontic, College of Stomatology Xi’an Jiaotong University, Xi’an, China
| | - Ahmed Es Alajami
- Department of Oral Preventive, College of Stomatology Xi’an Jiaotong University, Xi’an, China
| | - Ang Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, Chin
- Department of Periodontology, College of Stomatology, Xi’an Jiaotong University, Xi’an, China
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Leketas M, Dvylys D, Sakalys D, Simuntis R. Different intra-articular injection substances following temporomandibular joint arthroscopy and their effect on early postoperative period: A randomized clinical trial. Cranio 2025; 43:85-90. [PMID: 35635335 DOI: 10.1080/08869634.2022.2081445] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To compare the effect of plasma rich in growth factors (PRGF), hyaluronic acid (HA), and saline intra-articular injections following temporomandibular joint arthroscopy on decreasing pain and increasing maximal mouth opening. METHODS Included patients were randomized into three groups: PRGF group, hyaluronic acid group, and control group. Intra-articular injections were done at the end of the arthroscopy. Pain was measured using the VAS scale preoperatively, 7 days, 1 month, and 6 months postoperatively. Maximal mouth opening was measured preoperatively and 7 days postoperatively. RESULTS There was a statistically significant decrease in pain in all groups, although, the decrease was significantly greater in the HA group following surgery. CONCLUSION A hyaluronic acid injection following temporomandibular joint arthroscopy can decrease pain better than saline and platelet-rich plasma during the first postoperative week. However, the results do not differ in later postoperative periods.
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Affiliation(s)
- Marijus Leketas
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Dovydas Sakalys
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Bernabeu-Mira JC, Peñarrocha-Diago M, Peñarrocha-Diago M, Romero-Gavilán F, Camacho-Alonso F, Peñarrocha-Oltra D. Comparison of patient-centered outcomes measures between low-speed drilling without irrigation and high-speed drilling with irrigation: A randomized clinical trial. Clin Oral Implants Res 2024; 35:21-30. [PMID: 37800659 DOI: 10.1111/clr.14189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 06/29/2023] [Accepted: 09/19/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVE To compare patient satisfaction during surgery, postoperative pain and inflammation and quality of life between high-speed drilling with irrigation and low-speed drilling without irrigation for implant bed preparation. MATERIALS AND METHODS Sixty-six posterior single edentulous patients were included in a randomized controlled clinical trial. Implant beds were created using high-speed drilling with irrigation (control group) or low-speed drilling without irrigation (test group). Patient satisfaction during surgery (in relation to drilling-time perception, vibration, pressure, noise, comfort, and drowning sensation) and postoperative pain and inflammation were evaluated using a 100-mm visual analogue scale (VAS)-based questionnaire. Quality of life was analyzed with a Likert scale (in relation to mouth opening, chewing, speaking, sleeping, daily routine, and job). The follow-up period was 7 days. RESULTS Patient satisfaction in relation to drilling-time perception, vibration, pressure, and noise did not show statistically significant differences (p > .05). The highest scores of drowning sensation (p < .05) were correlated (moderate correlation (r = .57)) with lowest scores of comfort (p < .005). Both postoperative pain and inflammation means were significantly higher in the control group than in the test group. No significant differences in quality of life were observed during the postoperative period (p > .05). CONCLUSION Low-speed drilling without irrigation for single implant site preparation was more comfortable for patients than high-speed drilling with irrigation, due to the correlation between important drowning sensation and low perceived comfort. Postoperative pain and inflammation were lower for low-speed drilling without irrigation. Further studies are needed to validate or refute these results.
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Affiliation(s)
- Juan Carlos Bernabeu-Mira
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Miguel Peñarrocha-Diago
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - María Peñarrocha-Diago
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Francisco Romero-Gavilán
- Department of Industrial Systems Engineering and Design, Universitat Jaume I, Castello de la Plana, Spain
| | | | - David Peñarrocha-Oltra
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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di Lauro AE, Valletta A, Aliberti A, Cangiano M, Dolce P, Sammartino G, Gasparro R. The Effectiveness of Autologous Platelet Concentrates in the Clinical and Radiographic Healing after Endodontic Surgery: A Systematic Review. MATERIALS (BASEL, SWITZERLAND) 2023; 16:7187. [PMID: 38005117 PMCID: PMC10672445 DOI: 10.3390/ma16227187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/11/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023]
Abstract
Regenerative techniques are increasingly applied in endodontic surgery, but different materials may have varying impacts on soft and hard tissue healing. This systematic review aims to evaluate the effectiveness of autologous platelet concentrates (APCs) in clinical and radiographic healing after endodontic surgery. The data for this systematic review were processed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for improving the reporting of systematic reviews and meta-analyses. A literature search was conducted until October 2023 on PubMed, Scopus, and Cochrane Databases. Randomized controlled trials and controlled clinical trials addressing the use of APCs in patients who presented persistent periapical lesions and needed periapical surgery were included. Dual publications, narrative reviews, systematic reviews, case series, questionnaires, animal studies, case reports, letters to the editor, in vitro studies, and abstracts were excluded. In total, the search resulted in 14 papers. Clinical and radiographical findings were reported, showing that when APCs were used, patients exhibited less pain and swelling and a greater reduction of apical radiolucency after 12 months follow-up on average. However, the moderate/high risk of bias of included studies and their high heterogeneity, do not allow one to draw definitive conclusions on the effectiveness of APC after endodontic surgery.
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Affiliation(s)
- Alessandro Espedito di Lauro
- Department of Neurosciences, Reproductive Sciences and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy; (A.E.d.L.); (A.V.); (A.A.); (M.C.); (R.G.)
| | - Alessandra Valletta
- Department of Neurosciences, Reproductive Sciences and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy; (A.E.d.L.); (A.V.); (A.A.); (M.C.); (R.G.)
| | - Angelo Aliberti
- Department of Neurosciences, Reproductive Sciences and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy; (A.E.d.L.); (A.V.); (A.A.); (M.C.); (R.G.)
| | - Mario Cangiano
- Department of Neurosciences, Reproductive Sciences and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy; (A.E.d.L.); (A.V.); (A.A.); (M.C.); (R.G.)
| | - Pasquale Dolce
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy;
| | - Gilberto Sammartino
- Department of Neurosciences, Reproductive Sciences and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy; (A.E.d.L.); (A.V.); (A.A.); (M.C.); (R.G.)
| | - Roberta Gasparro
- Department of Neurosciences, Reproductive Sciences and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy; (A.E.d.L.); (A.V.); (A.A.); (M.C.); (R.G.)
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M A, S T, P S, A G. Efficacy of mixture of injectable-platelet-rich fibrin and type-1 collagen particles on the closure of through-and-through periapical bone defects: A randomized controlled trial. Int Endod J 2023; 56:1197-1211. [PMID: 37418583 DOI: 10.1111/iej.13954] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 05/31/2023] [Accepted: 07/01/2023] [Indexed: 07/09/2023]
Abstract
AIM To determine the efficacy of a combination of injectable-platelet-rich fibrin and type-1 collagen particles on the healing of through-and-through periapical bone defect and subsequent closure of bony window. METHODOLOGY The clinical trial was registered in ClinicalTrials.gov (NCT04391725). Thirty-eight individuals with radiographic evidence of periapical radiolucency in maxillary anterior teeth and confirmed loss of palatal cortical plates in cone beam computed tomographic imaging were randomly assigned to either the experimental group (n = 19) or the control group (n = 19). A mixture of i-PRF and collagen as a graft was applied to the defect in adjunct to periapical surgery in the experimental group. No guided bone regeneration procedures were used in the control group. The healing was evaluated using Molven's (2D) and modified PENN 3D (3D) criteria. Percentage reduction of the buccal and palatal bony window area, and complete closure of through-and-through periapical bony window (tunnel defect) were assessed using Radiant Diacom viewer software (Version 4.0.2). The reduction in the periapical lesion area and volume was measured using Corel DRAW and ITK Snap software. RESULTS Thirty-four participants (18 and 16 in the experimental and control groups respectively) reported for follow-up at 12 months. There was 96.9% and 97.96% reduction of buccal bony window area in the experimental and control groups respectively. Similarly, palatal window showed 99.03% and 100% reduction in the experimental and control groups respectively. No significant difference in both buccal and palatal window reduction was noticed between the groups. A total of 14 cases (seven in the experimental group and seven in the control group) showed complete closure of through-and-through bony window. No significant difference in clinical, 2D and 3D radiographic healing, percentage reduction in area and volume was observed between the experimental and control groups (p > .05). Neither the area nor the volume of lesion, and the size of buccal or palatal window had significant effect on healing of through-and-through defects. CONCLUSION Endodontic microsurgery results in high success rate in large periapical lesions with through-and-through communication with more than 80% reduction in volume of lesion and size of both buccal and palatal window after 1 year. A mixture of type-1 collagen particles and i-PRF, adjunct to periapical micro-surgery did not improve the healing in through-and-through periapical defects.
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Affiliation(s)
- Arpitha M
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Tewari S
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Sangwan P
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Gupta A
- Department of Oral Medicine and Radiology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, India
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Sindhusha VB, Ramamurthy J. Comparison of Antimicrobial Activity of Injectable Platelet-Rich Fibrin (i-PRF) and Leukocyte and Platelet-Rich Fibrin (l-PRF) Against Oral Microbes: An In Vitro Study. Cureus 2023; 15:e46196. [PMID: 37905284 PMCID: PMC10613344 DOI: 10.7759/cureus.46196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
Aim Injectable platelet-rich fibrin (i-PRF) and leukocyte and platelet-rich fibrin (l-PRF) are both blood-derived products used in regenerative medicine and dentistry. They contain platelets, growth factors, and leukocytes, which can have antimicrobial properties to some extent, but their primary purpose is tissue regeneration and wound healing. i-PRF and l-PRF may have some indirect antimicrobial properties due to their composition and ability to enhance tissue healing and immune responses, and they are primarily used in dentistry for their regenerative and wound healing capabilities rather than as standalone antimicrobial agents. This study aims to compare the anti-microbial activity of i-PRF and l-PRF against oral microbes. Methodology This study included 30 patients who were selected using G*Power software version 3.1 (Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany) calculation with the population size. The plaque samples were collected from the subjects using area-specific Gracey curettes used for scaling and root planing to remove plaque and calculus from the teeth and root surfaces. The collected plaque samples were transferred to a tube containing 5 ml of saline (sterile saltwater). The purpose of using saline is to preserve the microbial content of the plaque sample without altering the microbial composition. To obtain a uniform solution, the samples in the saline-containing tube were vortexed for 5 minutes. After vertexing, a small amount of the suspension (0.1 ml) was taken for further analysis. The 0.1 ml suspension was used to plate blood agar using the streak method. A loop or needle is used to streak the sample back and forth across the surface of the agar, leading to the dilution and separation of the bacteria. Results Results state that i-PRF has a maximum zone of inhibition (2.19±0.47 mm) when compared with metronidazole (0.14±0.09 mm). It can be stated that platelet concentrates demonstrate better antimicrobial activity due to their higher oxygen metabolites which help in the aggregation and internalization of microorganisms, which enhances the clearance of pathogens from the bloodstream. Paired t-test has been used for the comparison between the two groups, and the p-value is >0.05 stating that the difference is statistically significant. Conclusion The present study states that i-PRF demonstrated better antimicrobial efficacy as compared to l-PRF. Hence, i-PRF helps in reducing microbial load at the periodontally infected sites when compared with l-PRF.
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Affiliation(s)
- Vyshnavi B Sindhusha
- Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Jaiganesh Ramamurthy
- Periodontics, Saveetha Dental College and Hospitals, Saveetha institute of medical and technical sciences, Saveetha University, Chennai, IND
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11
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Khan A, Ali I, Pradhan H, Shamim Khan S, Tripathi A, Ali R. Platelet-Rich Fibrin-Enhanced Bone Healing Co-grafted With Either Hydroxyapatite and Beta Tricalcium Phosphate or Demineralized Freeze-Dried Bone in Small Maxillofacial Osseous Defects: A Clinical Comparison. Cureus 2023; 15:e44048. [PMID: 37746401 PMCID: PMC10517706 DOI: 10.7759/cureus.44048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/26/2023] Open
Abstract
INTRODUCTION This study was conducted to clinically compare a commercially available combination of 70:30 nanocrystalline hydroxyapatite (HA) and beta tricalcium phosphate (βTCP) along with platelet-rich fibrin (PRF) with demineralized freeze-dried bone (DFDB) grafts along with PRF in small maxillofacial osseous defects. MATERIALS AND METHODS Thirty patients with one osseous defect were randomly distributed into two groups of 15 each: Group A and Group B. Group A patients received HA+βTCP+PRF while Group B received DFDB + PRF. Postoperative pain, swelling, wound dehiscence, and the presence or absence of infection were evaluated at various intervals up to seven postop days and compared between the two groups and within either group. A technetium 99m methylene diphosphonate (MDP 99mTc) scan was also done for a representative patient of either group at the end of three months to evaluate the fate of the graft. RESULTS We found no significant difference between the two groups for any of our parameters. Significant improvements were noted for pain and swelling within either group at various intervals. The MDP 99mTc scan showed increased tracer uptake for the representing patient of either group. CONCLUSIONS HA+βTCP is more inexpensive than DFDB and more readily available and has no host incompatibility or infection potential, resulting in similar clinical postoperative states as DFDB when either is used with PRF.
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Affiliation(s)
- Arshad Khan
- Oral and Maxillofacial Surgery, Career Post Graduate Institute of Dental Sciences & Hospital, Lucknow, IND
| | - Iqbal Ali
- Oral and Maxillofacial Surgery, Career Post Graduate Institute of Dental Sciences & Hospital, Lucknow, IND
| | - Harsha Pradhan
- Oral and Maxillofacial Surgery, Career Post Graduate Institute of Dental Sciences & Hospital, Lucknow, IND
| | - Sameera Shamim Khan
- Oral and Maxillofacial Pathology and Oral Microbiology, Career Post Graduate Institute of Dental Sciences & Hospital, Lucknow, IND
| | - Ashish Tripathi
- Oral and Maxillofacial Surgery, Career Post Graduate Institute of Dental Sciences & Hospital, Lucknow, IND
| | - Rifaquat Ali
- Oral and Maxillofacial Surgery, Private Practice, Ghazipur, IND
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12
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Ng YL, Gulabivala K. Factors that influence the outcomes of surgical endodontic treatment. Int Endod J 2023; 56 Suppl 2:116-139. [PMID: 36710526 DOI: 10.1111/iej.13896] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023]
Abstract
Surgical endodontic treatment encompasses a broad spectrum of procedures, amongst which root-end cavity preparation and filling, retrograde root canal treatment and through-and-through endodontic surgery, may be classified under the umbrella term 'Root-end surgery'. This narrative review considers the available data on periapical healing, soft tissue healing, tooth survival and oral health-related quality of life (OHRQoL), following root-end surgery and the factors that affect its outcomes. The pooled periapical healed rate for the studies published up to 2021 was 69% (95% CI: 65%, 73%) but increased to 76% (95% CI: 66%, 86%) when only data from the 2020's studies were analysed. The prognostic factors consistently reported for periapical healing have included: pre-operative periapical lesion with complete loss of buccal plate, quality of root-end preparation, remaining thickness of apical root dentine and restorative status. Soft tissue healing of the reflected flap was found to have a positive association with periapical healing. The survival rates following root-end surgery range from 48% to 93%, with failure of periapical healing associated with root and crown fracture, being the predominant reasons for tooth extraction. The factors influencing impact of root-end surgery on patients' quality of life could not be adequately evaluated due to design flaws in the available studies. In conclusion, if root canal treatment failure due to leakage through cracks, fractures or restoration margin are excluded, the remaining cases may represent localized residual infection and inflammation at the periapex that should be amenable to predictable management with the aid of modern root-end surgery.
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Affiliation(s)
- Yuan-Ling Ng
- Unit of Endodontology, Department of Restorative Dentistry, UCL Eastman Dental Institute, London, UK
| | - Kishor Gulabivala
- Unit of Endodontology, Department of Restorative Dentistry, UCL Eastman Dental Institute, London, UK
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13
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Thakur V, Mittal S, Tewari S, Kamboj M, Duhan J, Sangwan P, Kumar V, Gupta A. Comparative histological evaluation of two PRF formulations (PRF High and PRF Medium) on quality of life and healing outcome of apicomarginal defects: A randomized clinical trial. J Craniomaxillofac Surg 2023; 51:166-177. [PMID: 36894343 DOI: 10.1016/j.jcms.2023.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/28/2023] [Accepted: 02/15/2023] [Indexed: 02/25/2023] Open
Abstract
The objective of this randomized clinical trial was to investigate the effects of two PRF formulations (PRF High and PRF Medium) on quality of life and healing outcome (2D and 3D) of apicomarginal defects. Patients presenting with endodontic lesions and concomitant periodontal communication were randomly allocated to PRF High and PRF Medium groups. The treatment protocol in each group included a periapical surgical procedure with placement of PRF clot and membrane in the bony defect and on the denuded root surface, respectively. Quality of life was assessed for 1 week after surgery following a modified version of the patient's perception questionnaire. Postoperative pain was assessed using a visual analog scale. Clinical and radiographic evaluations were performed using Rud and Molven 2D criteria and Modified PENN 3D criteria. Buccal bone formation was assessed using sagittal and corresponding axial sections in CBCT. Histological analysis was performed using hematoxylin and eosin (H and E) staining and attaching primary antibodies to tissue sections. In total, 40 patients were enrolled in the trial (N = 20 per group). PRF Medium group patients reported significantly less swelling on the 1st (p = 0.036), 2nd (p = 0.034), and 3rd (p = 0.023) days, and average pain on the 2nd (p = 0.031), 3rd (p = 0.03), and 4th (p = 0.04) days postoperatively. The difference in success rate for periapical healing was non-significant between the PRF Medium group (89.5%) and PRF High group (90%), in both 2D and 3D imaging (p = 0.957). The formation of buccal bone was observed in five cases (26.3%) and four cases (20%) in the PRF Medium and PRF High groups, respectively, with a non-significant difference (p = 0.575). PRF Medium clots had a loose fibrin structure with a significantly higher number of neutrophils (473.79 ± 82.89 per mm2) than PRF High clots, which had a dense structure and fewer neutrophils (253.15 ± 63.86 per mm2) (p = 0.001). Autologous platelet concentrates (APCs) promoted satisfactory periapical healing, with no significant difference between the groups. Within the limitations of the study, it seems that PRF Medium should be preferred over PRF High when the patients' quality of life is the priority.
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Affiliation(s)
- Vidhi Thakur
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences Rohtak (Haryana), India
| | - Shweta Mittal
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences Rohtak (Haryana), India.
| | - Sanjay Tewari
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences Rohtak (Haryana), India
| | - Mala Kamboj
- Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences Rohtak (Haryana), India
| | - Jigyasa Duhan
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences Rohtak (Haryana), India
| | - Pankaj Sangwan
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences Rohtak (Haryana), India
| | - Vinay Kumar
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences Rohtak (Haryana), India
| | - Ambika Gupta
- Department of Oral Medicine and Radiology, Post Graduate Institute of Dental Sciences Rohtak (Haryana), India
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Choudhary B, Goswami K, J Patel B, R Vaghani A, J D, Grandhi N, Singh Makkad R. Platelet-rich fibrin and titanium-prepared platelet-rich fibrin in endoperio lesion management. Bioinformation 2023; 19:133-137. [PMID: 37720281 PMCID: PMC10504503 DOI: 10.6026/97320630019133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 09/19/2023] Open
Abstract
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.
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Affiliation(s)
- Balram Choudhary
- Department of Dentistry, JLN Medical College and Hospital, Ajmer, Rajasthan, India
| | - Komal Goswami
- Department of Dentistry, Kshetrapal Hospital, Ajmer, Rajasthan, India
| | | | | | - Dhurubatha J
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kadapa, AP, India
| | - Nishita Grandhi
- Department of Conservative and Endodontics, New Horizon Dental college and Research institute, Bilaspur, Chhattisgarh, India
| | - Ramanpal Singh Makkad
- Department of Oral Medicine and Radiology, New Horizon Dental college and Research institute, Bilaspur, Chhattisgarh, India
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Gurusamy K, Duhan J, Tewari S, Sangwan P, Gupta A, Mittal S, Kumar V, Arora M. Patient-centric outcome assessment of endodontic microsurgery using periapical radiography versus cone beam computed tomography: A randomized clinical trial. Int Endod J 2023; 56:3-16. [PMID: 36135595 DOI: 10.1111/iej.13837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 09/16/2022] [Accepted: 09/18/2022] [Indexed: 12/13/2022]
Abstract
AIM This study aimed to evaluate whether utilizing additional cone beam computed tomography (CBCT) imaging has any effect on quality of life and healing outcome following periapical surgery compared with periapical radiographs (PR). METHODOLOGY The study was registered in ClinicalTrials.gov (NCT04333940). In this parallel group randomized controlled trial, 52 patients (88 teeth) with persistent apical periodontitis and periapical radiographic evidence of periapical lesion were randomly assigned to either PR or CBCT group. The primary predictor was the type of the imaging method (PR only or with additional CBCT). The primary outcome was patient's quality of life during the first week after periapical surgery and the secondary outcomes were duration of surgery and healing outcome at 12-month follow-up. Participants of both groups received periapical surgery based on the pre-surgical plan provided by the radiographic imaging methods. Quality of life (QoL) was assessed using Modified Shugars questionnaire. Radiographic analysis for healing was conducted using Molven's criteria and modified PENN 3D criteria. The categorical data between groups were analysed using the Chi-square test, whilst intragroup comparisons were analysed using the McNemar test. The average scores for each component of QoL (oral functions, general functions, pain, swelling and other symptoms), combined QoL scores (overall average of values of 13 variables) and analgesic usage on each day were calculated and analysed. RESULTS At 12 months of follow-up, fifty patients were evaluated. Participants in PR group reported significantly more swelling on first three days compared with CBCT group. The analgesic use was higher in the PR group on 2nd and 3rd day (Mann-Whitney U test with Bonferroni correction; p < .007). A significant difference in the limitation of general functions was observed at the second day (p < .07) with the higher values in the PR group. The combined QoL score between the two groups was found to be non-significant. However, none of the patients experienced intraoperative complications or neurovascular exposure. The mean surgical time was lesser in the CBCT group (p < .05). Radiographic healing revealed a success rate of 96.2% for the PR group and 95.8% for the CBCT group with no significant difference between the groups. CONCLUSION Participants in the CBCT group experienced substantially less early postoperative swelling and limitation in general functions, in comparison with the PR group. However, preoperative CBCT had no effect on other QoL parameters and intraoperative complications in medium-risk patients. Furthermore, CBCT did not exhibit any added advantage over periapical radiography in terms of assessing healing outcome following endodontic microsurgery. CBCT offered surgically relevant anatomic information for pre-surgical planning and ensured the treatment rendition with a significantly reduced operative time.
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Affiliation(s)
- Keerthana Gurusamy
- Department of Conservative Dentistry & Endodontics, Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Jigyasa Duhan
- Department of Conservative Dentistry & Endodontics, Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Sanjay Tewari
- Department of Conservative Dentistry & Endodontics, Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Pankaj Sangwan
- Department of Conservative Dentistry & Endodontics, Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Ambika Gupta
- Department of Oral Medicine & Radiology, Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Shweta Mittal
- Department of Conservative Dentistry & Endodontics, Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Vinay Kumar
- Department of Conservative Dentistry & Endodontics, Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India
| | - Mayank Arora
- Department of Conservative Dentistry & Endodontics, Postgraduate Institute of Dental Sciences (PGIDS), Rohtak, India
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Johri S, Verma P, Tikku AP, Bains R, Kohli N. Effect of amniotic membrane and platelet-rich fibrin membrane on bone healing post endodontic surgery: An ultrasonographic, randomized controlled study. J Tissue Eng Regen Med 2022; 16:1208-1222. [PMID: 36401577 DOI: 10.1002/term.3362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/07/2022] [Accepted: 10/17/2022] [Indexed: 11/21/2022]
Abstract
The use of membrane barriers and bone grafting materials in endodontic surgery promotes healing by regeneration rather than repair by scar tissue. Due to its valuable regenerative and therapeutic properties, the human amniotic membrane can support ideal periapical rehabilitation and promote better healing after surgery. The current trial aimed to evaluate the amniotic membrane's healing potential and compare it with platelet-rich fibrin using color doppler sonography. The current study is a randomized, double-blinded, parallel-group, single-center study. Thirty-four systematically healthy individuals requiring endodontic surgery who fulfilled all inclusion and exclusion criteria were selected and randomly placed in two groups. Surgical curettage of the bony lesion was performed and filled with hydroxyapatite graft. Amniotic membrane (Group 1) and platelet-rich fibrin (Group 2) were placed over the bony crypt, and the flap was sutured back. The lesion's surface area and vascularity were the parameters assessed with ultrasound and color doppler. and observations: The groups found a significant difference in mean vascularity at 1 month and mean vascularity change from baseline to 1 month (p < 0.05). Mean surface area had no statistically significant difference between the groups. However, in terms of the percentage change in surface area, a significant difference was found from baseline to 6 months (p < 0.05). Amniotic membrane was a significantly better promoter of angiogenesis than platelet-rich fibrin in the current trial. The osteogenic potential of both materials was similar. However, the clinical application, availability, and cost-effectiveness of amniotic membrane support it as a promising therapeutic alternative in clinical translation. Further large-scale trials and histologic studies are warranted.
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Affiliation(s)
- Saumya Johri
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Promila Verma
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Aseem Prakash Tikku
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Rhythm Bains
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Neera Kohli
- Department of Radiodiagnosis, King George's Medical University, Lucknow, India
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Shah PK, El Karim I, Duncan HF, Nagendrababu V, Chong BS. Outcomes reporting in systematic reviews on surgical endodontics: A scoping review for the development of a core outcome set. Int Endod J 2022; 55:811-832. [PMID: 35553439 DOI: 10.1111/iej.13763] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Evidence-informed decision-making in health care relies on the translation of research results to everyday clinical practice. A fundamental requirement is that the validity of any healthcare intervention must be supported by the resultant favourable treatment outcome. Unfortunately, differences in study design and the outcome measures evaluated often make it challenging to synthesize the available research evidence required for secondary research analysis and guideline development. Core outcome sets (COS) are defined as an agreed standardized set of outcomes, which should be measured and reported as a minimum in all clinical trials on a specific topic. The benefits of COS include less heterogeneity, a reduction in the risk of reporting bias and ensuring all trials contribute data to facilitate meta-analyses; given the engagement of key stakeholders, it also increases the chances that clinically relevant outcomes are identified. The recognition of the need for COS for assessing endodontic treatment outcomes leads to the development of Core Outcome Sets for Endodontic Treatment modalities (COSET) protocol, which is registered (No. 1879) on the Core Outcome Measures in Effectiveness Trials (COMET) website. OBJECTIVES The objectives of this scoping review are to: (1) identify the outcomes assessed in studies evaluating surgical endodontic procedures; (2) report on the method of assessment used to measure the outcomes; (3) and assess selective reporting bias in the included studies. The data obtained will be used to inform the development of COS for surgical endodontics. METHODS A structured literature search of electronic databases and the grey literature was conducted to identify systematic reviews on periradicular surgery (PS), intentional replantation (IR) and tooth/root resection (RR), published between January 1990 and December 2020. Two independent reviewers were involved in the literature selection, data extraction and the appraisal of the studies identified. The type of intervention, outcomes measured, type of outcomes reported (clinician- or patient-reported), outcome measurement method and follow-up period were recorded using a standardized form. RESULTS Twenty-six systematic reviews consisting of 19 studies for PS, three studies for IR and four studies for RR were selected for inclusion. Outcome measures identified for PS and IR included pain, swelling, mobility and tenderness, outcomes related to periodontal/soft tissue healing (including sinus tract), periradicular healing, tooth survival, life impact (including oral health-related quality of life), resource use and/or adverse effects. For RR, in addition to tooth survival, endodontic complications and adverse effects, the outcome measures were primarily periodontal-related, including pocket depth reduction, attachment gain, periodontal disease and periodontic-endodontic lesions. The majority of outcome measures for PS, IR and RR were assessed clinically, radiologically and/or via patient history. Specific tools such as rating scales (Visual Analog Scale, Verbal Rating Scale, Numerical Rating Scale and other scales) were used for the assessment of pain, swelling and tenderness, and validated questionnaires were used for the assessment of oral health-related quality of life. The range of follow-up periods was variable, dependent on the outcome measure and the type of intervention. CONCLUSIONS Outcome measures, method of assessment and follow-up periods for PS, IR and RR were identified and categorized to help standardize the reporting of outcomes for future research studies. Additional outcome measures that were not reported, but may be considered in the COSET consensus process, include loss of root-end filling material, number of clinic visits, surgery-related dental anxiety and mucogingival aesthetic-related measures, such as scarring, black triangles, root surface exposure and tissue discoloration. REGISTRATION COMET (No. 1879).
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Affiliation(s)
- Pratik Kamalkant Shah
- Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Ikhlas El Karim
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Henry F Duncan
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Bun San Chong
- Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
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18
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PROMs Following Root Canal Treatment and Surgical Endodontic Treatment. Int Dent J 2022; 73:28-41. [PMID: 35871899 PMCID: PMC9875275 DOI: 10.1016/j.identj.2022.06.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 01/29/2023] Open
Abstract
The FDI is currently working on developing a tool to encompass patient-reported outcome measures (PROMs) within the overall assessment of outcomes of endodontic treatment. The outcome of endodontic treatment has traditionally been determined by various clinical and radiographic criteria. However, these parameters do not address the impact of treatment on a patient's oral health-related quality of life (OHRQoL). OHRQoL, a crucial PROM, can be used to understand treatment outcome from a patient-centred perspective, thus improving clinician-patient communication whilst guiding decision-making. This focussed review aims to recount the OHRQoL of patients following nonsurgical root canal treatment and surgical endodontic treatment, with a specific focus on the minimal important difference (MID; the minimum score changes of an outcome instrument for a patient to register a clinically significant change in their OHRQoL and/or oral condition) and the methods used to determine it. The current evidence indicates that the OHRQoL of patients requiring root canal treatment is poorer than those without such need. Accordingly, the literature suggests that OHRQoL improves following nonsurgical or surgical endodontic treatment. However, study methodologies vary widely, and conclusions cannot be drawn with high confidence, nor can MID recommendations be provided. Well-designed clinical studies with baseline measurements and appropriate follow-up time frames are therefore needed. Despite that the literature is rife with outcome studies, research on PROMs is an area that deserves greater attention, particularly in relation to the MID. Determining the MID will facilitate the understanding of changes in outcome scores from the patients' perspective, thus allowing for more informed decision-making in clinical practice.
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19
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Pires MD, Martins JNR, Baruwa AO, Pereira B, Ginjeira A. Leukocyte platelet-rich fibrin in endodontic microsurgery: a report of 2 cases. Restor Dent Endod 2022; 47:e17. [PMID: 35692226 PMCID: PMC9160763 DOI: 10.5395/rde.2022.47.e17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/13/2021] [Accepted: 10/06/2021] [Indexed: 11/21/2022] Open
Abstract
Endodontic microsurgery is a predictable treatment option when orthograde treatment or retreatment is unsuccessful or unfeasible. However, when there is a gross compromise of periapical bone, achievement of bone regeneration after the surgical procedure may be hampered. In such cases, the application of guided tissue regeneration principles, with adjunctive use of leukocyte platelet-rich fibrin to fill the bone defect as a bone substitute and as a membrane to cover the site, provides a cost-effective solution with the benefits of accelerated physiological healing and reduced post-surgical pain and discomfort. This case report presents 2 cases of endodontic microsurgery of the upper lateral incisors with loss of buccal cortical plate, where platelet-rich fibrin was successfully applied.
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Affiliation(s)
- Mariana Domingos Pires
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Jorge N R Martins
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal.,Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Abayomi Omokeji Baruwa
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Beatriz Pereira
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - António Ginjeira
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal.,Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
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Platelets' Role in Dentistry: From Oral Pathology to Regenerative Potential. Biomedicines 2022; 10:biomedicines10020218. [PMID: 35203428 PMCID: PMC8869410 DOI: 10.3390/biomedicines10020218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/08/2022] [Accepted: 01/19/2022] [Indexed: 02/06/2023] Open
Abstract
Platelets are a cellular subgroup of elements circulating in the bloodstream, responsible for the innate immunity and repairing processes. The diseases affecting this cellular population, depending on the degree, can vary from mild to severe conditions, which have to be taken into consideration in cases of minor dental procedures. Their secretion of growth factors made them useful in the regenerative intervention. The aim of this review is to examine the platelets from biological, examining the biogenesis of the platelets and the biological role in the inflammatory and reparative processes and clinical point of view, through the platelets' pathology and their use as platelets concentrates in dental regenerative surgery.
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The platelet-rich plasma lysate use in the treatment of persistent epithelial defects after keratoplasty. OPHTHALMOLOGY JOURNAL 2021. [DOI: 10.17816/ov62857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
AIM:to evaluate the effectiveness of the platelet-rich plasma lysate (PRP lysate) use in the treatment of persistent epithelial defects (PED) after keratoplasty.
MATERIALS AND METHODS:In the study, 60 patients with PED after keratoplasty were included. The 1st group (24 cases)included patients after keratoplasty with low risk of rejection, and the 2nd group 36 cases after keratoplasty with highrisk of rejection. Each group was divided into two subgroupscontrol subgroups 1a (cases 10) and 2a (cases 16), where patients received only standard postoperative therapy, and the main subgroups 1b (cases 14) and 2b (cases 20), in which PRP lysate was prescribed against the background of standard therapy, starting from the Day 15 post-op. As the criterion for effective treatment, complete persistent epithelialization after keratoplasty was considered.
RESULTS:The effectiveness of the use of PRP lysate in the subgroup 1b was 85.7%, while complete epithelialization in the control subgroup 1a was recorded in 70%; in the subgroup 2b, complete epithelialization was observed in 55%, in the control subgroup 2ain 43.75%.
CONCLUSION:The use of PRP lysate in the treatment of PED after corneal transplantation as an adjuvant therapy is effective and safe in both high and low risk keratoplasty. In the examined category of patients, treatment with blood derivatives increases the frequency and rate of complete epithelialization.
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Effect of the Piezoelectric Device on Intraoperative Hemorrhage Control and Quality of Life after Endodontic Microsurgery: A Randomized Clinical Study. J Endod 2021; 47:1052-1060. [DOI: 10.1016/j.joen.2021.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/11/2021] [Accepted: 04/13/2021] [Indexed: 11/17/2022]
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Gaviño-Orduña JF, Fernández-Guallart I, Caviedes-Bucheli J, Espadas-García M, López-López J. Regenerative endodontic procedure combined with apical surgery of a necrotic permanent incisor with extensive periapical lesion using plasma rich in growth factors (PRGF): A Case report with 6 years post-op evaluation using CBCT. J Clin Exp Dent 2021; 13:e620-e625. [PMID: 34188770 PMCID: PMC8223161 DOI: 10.4317/jced.58113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/23/2021] [Indexed: 01/09/2023] Open
Abstract
Background The aim of this case report is to describe the step-by step and outcomes of a treatment approach which simultaneously combines a Regenerative Endodontic Procedure (REP) and apical surgery using PRGF as treatment of a post-traumatic necrotic permanent central incisor with extensive periapical lesion and undeveloped apex in a 16 years-old patient.
Case description A 16 years-old patient with an extensive periapical lesion in the maxillary central incisor was treated with a combination of REP and periapical surgery in the same visit. A Bi- antibiotic paste (BAP) was used to priorly disinfect the canal, which was posteriorly sealed with MTA placed over a PRGF clot at the same time that the periapical lesion was surgically debrided, removed and grafted, The radiographic and CBCT follow-up results showed a complete healing of the radiolucent lesion, which was replaced with bone-like tissue in two years and well preserved until six years later.
Practical implications A combined approach of a Regenerative Endodontic Procedure and apical surgery using PRGF may be a good treatment modality in cases of extensive periapical lesions in necrotic teeth with open apexes. PRGF has shown to act as an ideal autologous matrix because it is stable, provides growth factors and bioactive molecules, and stimulates collagen production, angiogenesis, and cell differentiation. Key words:Regenerative endodontic procedure, open apex necrotic tooth, periodontal apical lesion, growth factors, apical surgery.
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Affiliation(s)
| | - Inés Fernández-Guallart
- DDs, MsC Dentist. Department of Odonto-Stomatology, School of Dentistry, University of Barcelona
| | - Javier Caviedes-Bucheli
- DDs, MsC Centro de Investigaciones Odontologicas (CIO) Pontificia Universidad Javeriana Bogota Colombia
| | - Manuel Espadas-García
- MD, DDS, Dentist. Department of Odonto-Stomatology, School of Dentistry, University of Barcelona
| | - José López-López
- PhD, MD, DDS, Dentist. University of Barcelona. Spain. Professor of Oral Patholoy. School of Dentistry, Barcelona University / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona 08907, Spain
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Mozzati M, Gallesio G, Menicucci G, Manzella C, Tumedei M, Del Fabbro M. Dental Implants with a Calcium Ions-Modified Surface and Platelet Concentrates for the Rehabilitation of Medically Compromised Patients: A Retrospective Study with 5-Year Follow-Up. MATERIALS 2021; 14:ma14112718. [PMID: 34064086 PMCID: PMC8196782 DOI: 10.3390/ma14112718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 01/07/2023]
Abstract
Background: Platelet concentrates are biological, autologous products obtained from the patient’s whole blood, consisting of a supraphysiological concentration of platelets and growth factors, that have proved beneficial in different applications in the medical and dental fields. They are used in several medical and dental applications to enhance tissue healing. Previous evidence shows that platelet concentrates may be beneficial in patients with compromised systemic conditions, in which the healing process is impaired. Aim: To evaluate the 5-year clinical outcome of implant treatment using acid-etched implants with calcium ions-modified surface in association with plasma rich in growth factors, in patients with systemic diseases of a different nature. Methods: Charts of 99 medically compromised patients, who had received a total of 224 dental implants from January 2013 to June 2013, were retrospectively evaluated. Patients were divided into four groups, according to their condition: diabetes (n = 39 patients), osteoporosis (n = 36), lupus erythematosus systemic (n = 5), rheumatoid arthritis (n = 19). The main outcomes were implant survival, marginal bone level (MBL) change and complications throughout follow-up. Results: Mean follow-up was 63.06 ± 1.90 months (range 60.1 to 66.4 months). In total, eight implants failed in 6 diabetic patients and 4 in 3 patients with rheumatoid arthritis. Overall 5-year implant survival was 94.6%. In total, 30 complications occurred in 24 patients, mostly transient, and no severe adverse event occurred. Overall MBL change was 0.45 ± 0.12 mm, with no significant differences among groups. Conclusions: In the present sample of medically compromised patients, rehabilitation with calcium ions-modified surface implants associated with plasma rich in growth factors proved to be a safe and effective treatment. The satisfactory results achieved after 5-year follow-up are comparable to those historically reported for healthy patients.
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Affiliation(s)
- Marco Mozzati
- Private Practitioner, SIOM Oral Surgery and Implantology Center, 10126 Turin, Italy; (M.M.); (G.G.)
| | - Giorgia Gallesio
- Private Practitioner, SIOM Oral Surgery and Implantology Center, 10126 Turin, Italy; (M.M.); (G.G.)
| | - Giulio Menicucci
- Prosthodontic Department, School of Dentistry, University of Turin, 10124 Turin, Italy; (G.M.); (C.M.)
| | - Carlo Manzella
- Prosthodontic Department, School of Dentistry, University of Turin, 10124 Turin, Italy; (G.M.); (C.M.)
| | - Margherita Tumedei
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti, 66100 Chieti, Italy;
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, 20122 Milan, Italy
- IRCCS Orthopedic Institute Galeazzi, Dental Clinic, 20161 Milan, Italy
- Correspondence: ; Tel.: +39-02-50319950
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Liu TJ, Zhou JN, Guo LH. Impact of different regenerative techniques and materials on the healing outcome of endodontic surgery: a systematic review and meta-analysis. Int Endod J 2021; 54:536-555. [PMID: 33159322 DOI: 10.1111/iej.13440] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/02/2020] [Accepted: 11/04/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Regenerative techniques are increasingly applied in endodontic surgery, but different materials used in regenerative techniques may have varying impacts on wound healing. OBJECTIVES This study evaluated the effects of different regenerative techniques and materials on the outcome of endodontic surgery. PARTICIPANTS patients with persistent periapical lesions, treated with root-end surgery. CONTROL endodontic surgery without the use of regenerative techniques/materials. INTERVENTION endodontic surgery with the use of regenerative techniques/materials. OUTCOME combined clinical and radiographic results. METHODS PubMed, Web of Science, Embase, SinoMed and the CENTRAL Cochrane were searched up to 10th July 2020, followed by a manual search. Detailed eligibility criteria were applied. Cochrane's risk-of-bias tool 2.0 was used to assess the risk of bias of the eligible studies. Meta-analysis was conducted using RevMan software. Subgroup analyses were performed based on the regenerative materials used in endodontic surgery. RESULTS Eleven eligible randomized controlled trials (RCTs) were included in the meta-analysis: two had a low risk of overall bias, and nine had some concerns of overall bias. Generally, the use of regenerative techniques significantly improved the outcome of endodontic surgery (risk ratio [RR]: 0.42; 95% confidence interval [CI], 0.26-0.68; P < 0.001). On subgroup analysis, the use of expanded polytetrafluoroethylene (e-PTFE) membranes alone had no added benefits (RR: 2.00; 95% CI, 0.22-18.33; P = 0.54). The application of collagen membranes or autologous platelet concentrates (APCs) alone was associated with a trend for better outcomes (RR: 0.51; 95% CI, 0.20-1.25; P = 0.14) (RR: 0.55; 95% CI, 0.18-1.71; P = 0.30). The combined use of collagen membranes and bovine-derived hydroxyapatite significantly improved the outcome (RR: 0.35; 95% CI, 0.17-0.75; P = 0.007). DISCUSSION This systematic review evaluated the effects of collagen membranes, e-PTFE membranes, APCs and bone grafting materials, providing detailed information about the risks and benefits of using each regenerative technique/material or its combination in endodontic surgery. CONCLUSIONS Regenerative techniques improve periapical lesion healing after endodontic surgery. The combined use of collagen membranes and bovine-derived hydroxyapatite may be beneficial as an adjunct to endodontic surgery. In contrast, the positive efficacy of e-PTFE membranes or APCs alone remains doubtful.
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Affiliation(s)
- T J Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - J N Zhou
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - L H Guo
- Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
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Effect of periapical surgery on oral health-related quality of life in the first postoperative week using the Dutch version of Oral Health Impact Profile-14. Oral Maxillofac Surg 2021; 25:549-559. [PMID: 33761022 PMCID: PMC8571148 DOI: 10.1007/s10006-021-00954-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/21/2021] [Indexed: 11/09/2022]
Abstract
Objective To evaluate whether periapical surgery affects oral health-related quality of life (OHRQoL) within the first postoperative week. Study design The primary outcomes in 133 patients (54 men, 79 women; mean age 50.8 years) undergoing periapical surgery were the Oral Health Impact Profile-14 (OHIP-14) score and postoperative sequelae, including pain, analgesic intake, swelling, limited mouth opening, chewing difficulties, and postoperative infection. Results We found a significant effect on OHIP-14, pain, and analgesics, which decreased throughout the week. We found no significant differences in mean OHIP-14, pain scores, or analgesic use for gender, medical history, surgical flaps, operation time, or location of the operated teeth. Younger patients had a higher OHIP-14 score in the first 2 days after surgery and more pain on the first postoperative day. Women experienced more pain during the first 3 days. Smokers had a higher OHIP-14 score on the first postoperative day and greater pain during the first 3 days compared to non-smokers. Conclusion We identified a low incidence of pain and reduced OHRQoL following periapical surgery. The postoperative reduction in OHRQoL and pain were of short duration, with maximum intensity in the early postoperative period and rapidly decreasing with time.
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Concentrated Growth Factors vs. Leukocyte-and-Platelet-Rich Fibrin for Enhancing Postextraction Socket Healing. A Longitudinal Comparative Study. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10228256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Platelet concentrates (PCs) have been used for over 20 years in dentistry, as an adjunct to oral surgery procedures, to improve hard and soft tissue healing and control postoperative symptoms. Among various PCs, Leukocyte and Platelet-Rich Fibrin (L-PRF) has become very popular due to its excellent cost-effectiveness ratio, and to the simple preparation protocol, but comparative clinical studies with other PCs are lacking. The aim of this split-mouth cohort study was to evaluate the effect of Concentrated Growth Factors (CGF), a recently introduced PC, as compared to L-PRF for enhancing post-extraction socket healing. Methods: Patients in need of bilateral tooth extractions were included. Each side was treated with either CGF or L-PRF. Pain, socket closure and healing index were the main outcomes. Results: Forty-five patients (24 women), aged 60.52 ± 11.75 years (range 37–87 years) were treated. No significant difference in outcomes was found, except for Pain at day 1 (p < 0.001) and socket closure in the vestibulo-palatal/lingual dimension at day 7 post-extraction (p = 0.04), both in favor of CGF. Conclusions: based on the present results, CGF proved to be as effective and safe as L-PRF, representing a valid alternative option for improving alveolar socket healing and reducing postoperative discomfort.
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Impact of Platelet-rich Plasma in the Healing of Through-and-through Periapical Lesions Using 2-dimensional and 3-dimensional Evaluation: A Randomized Controlled Trial. J Endod 2020; 46:1167-1184. [DOI: 10.1016/j.joen.2020.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/28/2020] [Accepted: 06/07/2020] [Indexed: 12/11/2022]
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Solakoglu Ö, Heydecke G, Amiri N, Anitua E. The use of plasma rich in growth factors (PRGF) in guided tissue regeneration and guided bone regeneration. A review of histological, immunohistochemical, histomorphometrical, radiological and clinical results in humans. Ann Anat 2020; 231:151528. [PMID: 32376297 DOI: 10.1016/j.aanat.2020.151528] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/23/2020] [Accepted: 04/07/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Modern surgeries have advanced toward personalized minimal-invasive treatments with a high rate of clinical healing that facilitates the regeneration of tissues. One of the leading approaches to deliver endogenous plasma- and platelet-derived growth factors is the plasma rich in growth factors (PRGF). This narrative review determines the effects of using PRGF in different oral surgical procedures including alveolar ridge augmentation, socket preservation, sinus floor augmentation and periodontal regeneration. METHODS For this narrative review, a literature search was conducted using PubMed and Researchgate. A combination of the following text words was used to maximize search specificity and sensitivity: "platelet-rich plasma", "PRP", "PRGF", "Platelet-rich growth factor", "socket preservation", "Extraction", "infra-bony pockets", "sinus floor augmentation", "randomized clinical controlled trials", "Alveolar osteitis", "Periodontal regeneration", "guided bone regeneration", "guided tissue regeneration". RESULTS Investigations have generally agreed that PRGF can promote and accelerate the healing process. PRGF optimizes the patient's quality of life by reducing pain, swelling and inflammation rate and also accelerates regeneration of soft tissue and bone tissue regeneration as well. CONCLUSIONS There is increasing evidence to support the use of PRGF in oral surgical procedures in order to improve the healing processes of the oral soft and hard tissues.
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Affiliation(s)
- Önder Solakoglu
- Dental Department of the University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Specialty Dental Practice Limited to Periodontology and Implant Dentistry, Hamburg, Germany.
| | - Guido Heydecke
- Department of Prosthodontics Dental Department of the University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Niusha Amiri
- Specialty Dental Practice Limited to Periodontology and Implant Dentistry, Hamburg, Germany
| | - Eduardo Anitua
- University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain; BTI Biotechnology Institute, Vitoria, Spain
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Mathew MG, Soni AJ, Khan MM, Kauser A. A novel approach to regenerate bone loss in an adolescent using concentrated growth factors: One-year follow-up. J Family Med Prim Care 2020; 9:428-431. [PMID: 32110631 PMCID: PMC7014901 DOI: 10.4103/jfmpc.jfmpc_919_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/05/2019] [Accepted: 12/17/2019] [Indexed: 11/05/2022] Open
Abstract
Destructive periodontal diseases are rare occurrences in the paediatric population. Moreover, the regenerative potential of the periodontal tissues and supporting structures of teeth is even rare, once irreversible damage has occurred. The aim of this paper is to discuss the regeneration of alveolar bone defect in a 14-year-old using concentrated growth factors (CGF). Following crown removal, scaling, debridement and site preparation, CGF was placed and secured in one-walled defect in the mesial side of the lower right permanent molar. The crown was replaced on to the tooth and the patient was followed up at 1, 3, 6, 9 and 12 months for clinical and radiographic evaluation. After 12 months, the radiographic evaluation revealed the defect to be filled with alveolar bone and probing pocket depth had reduced significantly. Thus, CGF can be an effective agent and can act as a potential scaffold for periodontal regeneration in adolescents with bone loss.
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Affiliation(s)
- Mebin George Mathew
- Department of Pedodontics and Preventive Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Ashu Jagdish Soni
- Department of Pediatric Dentistry, Dr. Ashu's Dental Clinic, Vadodara, Gujarat, India
| | - Md Muzammil Khan
- Department of Pedodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Afreen Kauser
- Department of Orthodontics, College of Dental Sciences, Davangere, Karnataka, India
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Neelakantan P, Liu P, Dummer PMH, McGrath C. Oral health-related quality of life (OHRQoL) before and after endodontic treatment: a systematic review. Clin Oral Investig 2020; 24:25-36. [PMID: 31712982 DOI: 10.1007/s00784-019-03076-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 09/13/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This systematic review was undertaken to determine the oral health-related quality of life (OHRQoL) before and after endodontic treatment. MATERIALS AND METHODS Based on the PRISMA guidelines, electronic databases (n = 7) were searched and from 1038 citations, 16 papers were included in this review. Information on study design, sample size, intervention/treatment modality, methods of assessing OHRQoL, and the key findings were extracted and analyzed. RESULTS Among the 16 studies, 3 were cross-sectional surveys, 9 were longitudinal studies, and 4 were randomized clinical trials. The cross-sectional studies reported improvements in OHRQoL following root canal treatment. Comparative longitudinal studies did not identify a significant association between improvements in OHRQoL and the method of root canal instrumentation or number of instruments used. Clinical trials found that improvements in OHRQoL were significantly associated with instrumentation technique, surgical-incision approach, and the application of platelet-concentrate during surgery. Several methods of assessing OHRQoL were employed with the most common being the Oral Health Impact Profile (OHIP), albeit using different versions. CONCLUSIONS The results of this systematic review indicate that the QoL of patients improved after endodontic treatment. Nevertheless, these results are limited to patients who seek endodontic treatment and cannot be generalized. The lack of well-designed observational studies with standardized assessment approaches, coupled with heterogeneity of study design and interventions, precluded quantitative synthesis. CLINICAL RELEVANCE Pragmatic clinical trials are more meaningful to understand patient-centered outcomes of treatment. This review shows that endodontic treatment does improve the QoL. However, future studies should use standardized tools and data reporting, which are critical to make meta-analyses possible.
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Affiliation(s)
- Prasanna Neelakantan
- Discipline of Endodontology, Faculty of Dentistry, The University of Hong Kong, 34, Hospital Road, Sai Ying Pun, Hong Kong, Hong Kong.
| | - Pei Liu
- Discipline of Dental Public Health, Faculty of Dentistry, The University of Hong Kong, 34, Hospital Road, Sai Ying Pun, Hong Kong, Hong Kong
| | - Paul M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Colman McGrath
- Discipline of Dental Public Health, Faculty of Dentistry, The University of Hong Kong, 34, Hospital Road, Sai Ying Pun, Hong Kong, Hong Kong.
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Soto-Peñaloza D, Peñarrocha-Diago M, Cervera-Ballester J, Peñarrocha-Diago M, Tarazona-Alvarez B, Peñarrocha-Oltra D. Pain and quality of life after endodontic surgery with or without advanced platelet-rich fibrin membrane application: a randomized clinical trial. Clin Oral Investig 2019; 24:1727-1738. [DOI: 10.1007/s00784-019-03033-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 07/16/2019] [Indexed: 12/21/2022]
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Prospective Clinical and Histologic Evaluation of Alveolar Socket Healing Following Ridge Preservation Using a Combination of Hydroxyapatite and Collagen Biomimetic Xenograft Versus Demineralized Bovine Bone. J Craniofac Surg 2019; 30:1089-1094. [PMID: 30839465 DOI: 10.1097/scs.0000000000005416] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This prospective study is aimed at investigating clinically and histologically the effectiveness of a biomimetic magnesium-enriched-hydroxyapatite (MgHA)/collagen-based bone substitute for alveolar socket preservation. MATERIALS Patients scheduled for posterior single tooth extraction were included. The alveolar socket was filled either with MgHA or deproteinized bovine bone matrix (DBBM). In DBBM group, a punch of mucosa was taken from the palate and used to cover the graft. Vertical and horizontal dimensional changes of the alveolar process were assessed clinically with a periodontal probe and with 3-dimensional (3D) analysis of a cast model. Postoperative quality of life was assessed through a questionnaire. After 6 months of healing, an alveolar tissue biopsy was taken for histologic and histomorphometric analysis of the newly formed tissue. After checking normality of the distributions, parametric or nonparametric tests were used for statistical comparisons. RESULTS Twenty patients (12 males, 8 females, mean age 42.8 ± 5.1 years, range 33-50 years) were treated. After 6 months, vertical and horizontal alveolar ridge resorption was similar in the 2 groups. The 3D analysis of the models showed a significantly higher resorption at the buccal side than at the palatal/lingual side. Histomorphometric analysis showed similar new bone formation for MgHA group (23.07 ± 10.3%) and DBBM (22.77 ± 6.95%), and a significantly higher residual material% for DBBM (15.77 ± 1.95%) than MgHA (5.01 ± 1.04%). Significantly less pain was reported in the first 3 days after surgery in patients of the MgHA group. CONCLUSION The MgHA was as safe and effective as DBBM and may represent a feasible bone substitute for alveolar socket preservation.
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Panda S, Karanxha L, Goker F, Satpathy A, Taschieri S, Francetti L, Das AC, Kumar M, Panda S, Fabbro MD. Autologous Platelet Concentrates in Treatment of Furcation Defects-A Systematic Review and Meta-Analysis. Int J Mol Sci 2019; 20:ijms20061347. [PMID: 30884920 PMCID: PMC6470588 DOI: 10.3390/ijms20061347] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 11/21/2022] Open
Abstract
Background: The aim of this review was to evaluate the adjunctive effect of autologous platelet concentrates (APCs) for the treatment of furcation defects, in terms of scientific quality of the clinical trials and regeneration parameters assessment. Methods: A systematic search was carried out in the electronic databases MEDLINE, SCOPUS, CENTRAL (Cochrane Central Register of Controlled Trials), and EMBASE, together with hand searching of relevant journals. Two independent reviewers screened the articles yielded in the initial search and retrieved the full-text version of potentially eligible studies. Relevant data and outcomes were extracted from the included studies. Risk of bias assessment was also carried out. The outcome variables, relative to baseline and post-operative defect characteristics (probing pocket depth (PPD), horizontal and vertical clinical attachment loss (HCAL, VCAL), horizontal and vertical furcation depth (HFD, VFD) were considered for meta-analysis. Results: Ten randomized trials were included in this review. Only one study was judged at high risk of bias, while seven had a low risk, testifying to the good level of the evidence of this review. The meta-analysis showed a favorable effect regarding all outcome variables, for APCs used in adjunct to open flap debridement (p < 0.001). Regarding APCs in adjunct to bone grafting, a significant advantage was found only for HCAL (p < 0.001, mean difference 0.74, 95% CI 0.54, 0.94). The sub-group analysis showed that both platelet-rich fibrin and platelet-rich plasma in adjunct with open flap debridement, yielded significantly favorable results. No meta-analysis was performed for APCs in combination with guided tissue regeneration (GTR) as only one study was found. Conclusion: For the treatment of furcation defects APCs may be beneficial as an adjunct to open flap debridement alone and bone grafting, while limited evidence of an effect of APCs when used in combination with GTR was found.
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Affiliation(s)
- Sourav Panda
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20122, Italy.
- Institute of Dental Science and SUM Hospital, Siksha O Anusandhan University, Bhubaneswar 751003, India.
| | - Lorena Karanxha
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20122, Italy.
| | - Funda Goker
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20122, Italy.
| | - Anurag Satpathy
- Institute of Dental Science and SUM Hospital, Siksha O Anusandhan University, Bhubaneswar 751003, India.
| | - Silvio Taschieri
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20122, Italy.
- Dental Clinic, IRCCS Istituto Ortopedico Galeazzi, Milan 20161, Italy.
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20122, Italy.
- Dental Clinic, IRCCS Istituto Ortopedico Galeazzi, Milan 20161, Italy.
| | - Abhaya Chandra Das
- Institute of Dental Science and SUM Hospital, Siksha O Anusandhan University, Bhubaneswar 751003, India.
| | - Manoj Kumar
- Institute of Dental Science and SUM Hospital, Siksha O Anusandhan University, Bhubaneswar 751003, India.
| | - Sital Panda
- Department of Public Health, Regional Medical Research Center, Bhubaneswar 751003, India.
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20122, Italy.
- Dental Clinic, IRCCS Istituto Ortopedico Galeazzi, Milan 20161, Italy.
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Fernando de Almeida Barros Mourão C, Calasans-Maia MD, Del Fabbro M, Le Drapper Vieira F, Coutinho de Mello Machado R, Capella R, Miron RJ, Gomes Alves G. The use of Platelet-rich Fibrin in the management of medication-related osteonecrosis of the jaw: A case series. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 121:84-89. [PMID: 30794883 DOI: 10.1016/j.jormas.2019.02.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/27/2019] [Accepted: 02/10/2019] [Indexed: 02/02/2023]
Abstract
Medication related osteonecrosis of the jaw (MRONJ) is characterized by exposed necrotic bone in the maxillofacial region that persists for more than eight weeks in patients taking antiresorptive or antiangiogenic drugs for bone metastasis or osteoporosis. The management of such condition depends on several factors, among which the staging of MRONJ. Though, a specific gold standard treatment has not been established to date. The aim of this case series is to describe the outcome of surgical treatment of MRONJ with the adjunct of Platelet-rich Fibrin (PRF). Eleven patients under therapy with alendronate underwent surgical removal of necrotic bone and debridement, followed by placement of PRF membranes in the bone defect. The outcome of the surgical treatment was successful in all patients, in a follow-up range from 12 to 36 months. In the cases presented, the macroscopic evaluation showed excellent and fast soft tissue healing, with no recurrence of bone exposure and no signs of infections. PRF membranes were also effective for postsurgical pain control. The use of PRF may represent a valuable adjunct in the surgical management of MRONJ.
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Affiliation(s)
- C Fernando de Almeida Barros Mourão
- Department of Molecular and Cell Biology, Institute of Biology, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; Department of Oral Surgery, Dentistry School, Estácio de Sá University, Rio de Janeiro, Brazil; Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.
| | - M D Calasans-Maia
- Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - M Del Fabbro
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy; IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - F Le Drapper Vieira
- Department of Oral Surgery, Dentistry School, Vassouras University, Vassouras, Rio de Janeiro, Brazil
| | | | - R Capella
- Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - R J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - G Gomes Alves
- Department of Molecular and Cell Biology, Institute of Biology, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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Lei L, Yu Y, Ke T, Sun W, Chen L. The Application of Three-Dimensional Printing Model and Platelet-Rich Fibrin Technology in Guided Tissue Regeneration Surgery for Severe Bone Defects. J ORAL IMPLANTOL 2019; 45:35-43. [PMID: 30044706 DOI: 10.1563/aaid-joi-d-17-00231] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A 36-year-old male patient diagnosed with severe chronic periodontitis was treated with novel surgery for his maxillary right lateral incisor. Preoperatively, a 3D printer was used, based on CBCT datasets, to produce a photosensitive resin bony anatomy replica. The patient's blood was centrifuged to obtain advanced platelet-rich fibrin (A-PRF) and injected platelet-rich fibrin (I-PRF), then mixed with Bio-Oss and packed onto the 3D replica to form the ideal shape. The replica was positioned at the planned sites without changes. The A-PRF membrane was applied over the replica as well as a Bio-Gide collagen membrane. Fifteen months after the surgery, clinical and radiographic followup revealed greatly reduced pocket depths and significant 3D alveolar bone fill at the treatment site. Based on these short-term results, the initial 3D printing surgical temple assisted guided tissue regeneration method resulted in significant clinical and radiographic improvements; A-PRF/I-PRF should be considered an ideal biomaterial for regenerative periodontal therapy.
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Affiliation(s)
- Lihong Lei
- Department of Periodontics, Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou 310009, China
| | - Yuanyuan Yu
- Department of Periodontics, Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou 310009, China
| | - Ting Ke
- Department of Periodontics, Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou 310009, China
| | - Weilian Sun
- Department of Periodontics, Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou 310009, China
| | - Lili Chen
- Department of Periodontics, Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou 310009, China
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Concentrated Growth Factors as an Ingenious Biomaterial in Regeneration of Bony Defects after Periapical Surgery: A Report of Two Cases. Case Rep Dent 2019; 2019:7046203. [PMID: 30805222 PMCID: PMC6362495 DOI: 10.1155/2019/7046203] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 11/30/2018] [Accepted: 12/27/2018] [Indexed: 12/16/2022] Open
Abstract
The overall success of a periapical surgery is assessed in terms of regeneration of functional periradicular tissues. The regenerative potential of platelets has been well documented. This article describes the use of concentrated growth factors (CGF), a new family of autologous platelet concentrates, as a sole material for bone regeneration after periapical surgery. 32- and 35-year-old female patients diagnosed with Ellis Class IV, an open apex in 11 with apical periodontitis in 11 and 12 and previously root canal-treated 31 and 41 with a chronic apical abscess, respectively, were managed with endodontic surgery. Subsequent to apicectomy and retrograde filling, the CGF fibrin block and membrane were used before suturing. There was uneventful healing during the immediate post-op and the subsequent follow-up periods. CGF is produced by a differential centrifugation process that results in the formation of a denser fibrin matrix richer in growth factors than those observed in PRF. Reasonable osseous healing was seen as early as 6-month follow-up, thereby recommending the use of CGF as an alternative to bone grafts and membranes in extensive periapical lesions to enhance bone regeneration and to decrease the healing time.
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Meschi N, Fieuws S, Vanhoenacker A, Strijbos O, Van der Veken D, Politis C, Lambrechts P. Root-end surgery with leucocyte- and platelet-rich fibrin and an occlusive membrane: a randomized controlled clinical trial on patients’ quality of life. Clin Oral Investig 2018. [DOI: 10.1007/s00784-018-2343-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Kour P, Pudakalkatti PS, Vas AM, Das S, Padmanabhan S. Comparative Evaluation of Antimicrobial Efficacy of Platelet-rich Plasma, Platelet-rich Fibrin, and Injectable Platelet-rich Fibrin on the Standard Strains of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. Contemp Clin Dent 2018; 9:S325-S330. [PMID: 30294166 PMCID: PMC6169270 DOI: 10.4103/ccd.ccd_367_18] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Context: Platelet concentrates are commonly used to promote periodontal soft- and hard-tissue regeneration. Recently, their antimicrobial efficacy is also explored. Various platelet concentrates have evolved which differ in the centrifugation protocols. Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) have been found to have an important role in periodontal pathology. Aims: In this study, PRP, PRF, and I-PRF are compared for their antibacterial effect against Pg and Aa. Materials and Methods: Blood samples were obtained from ten systemically and periodontally healthy individuals. Platelet concentrates were prepared using standardized centrifugation protocol. Antimicrobial activity was examined on standard strains of Pg and Aa using well diffusion method. Statistical Analysis Used: Means for the width of zones of inhibition were calculated along with standard deviations, and the comparison was made using Wilcoxon signed-rank test. Results: In case of Pg, I-PRF had the widest zone of inhibition which was significantly wider as compared to PRF. Furthermore, PRP had significantly wider zone of inhibition against PRF. In case of Aa, PRP had wider zone of inhibition which was significantly wider as compared to that of PRF and I-PRF. Conclusions: All the three platelet concentrates PRP, PRF, and I-PRF have antibacterial activity, but PRP and I-PRF are more active as compared to PRF. I-PRF being autologous and easy to prepare can be a very useful adjunct to the surgical therapy in bringing down the bacterial count helping in wound healing and regeneration.
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Affiliation(s)
- Prabhdeep Kour
- Department of Periodontology, Maratha Mandal NGHIDS and Research Centre, Belagavi, Karnataka, India
| | - Pushpa S Pudakalkatti
- Department of Periodontology, Maratha Mandal NGHIDS and Research Centre, Belagavi, Karnataka, India
| | - Ancia M Vas
- Department of Periodontology, Maratha Mandal NGHIDS and Research Centre, Belagavi, Karnataka, India
| | - Swetalin Das
- Department of Periodontology, Maratha Mandal NGHIDS and Research Centre, Belagavi, Karnataka, India
| | - Sreeshma Padmanabhan
- Department of Periodontology, Maratha Mandal NGHIDS and Research Centre, Belagavi, Karnataka, India
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Taschieri S, Lolato A, Testori T, Francetti L, Del Fabbro M. Short dental implants as compared to maxillary sinus augmentation procedure for the rehabilitation of edentulous posterior maxilla: Three-year results of a randomized clinical study. Clin Implant Dent Relat Res 2017; 20:9-20. [PMID: 29193558 DOI: 10.1111/cid.12563] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/17/2017] [Accepted: 11/03/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Several treatment options exist for the implant-supported rehabilitation of edentulous posterior maxilla. PURPOSE To compare maxillary sinus floor augmentation associated to standard length implants, with direct placement of implants of reduced length in the available residual bone. MATERIALS AND METHODS Patients with edentulous posterior maxilla and a residual height of 4-7 mm were randomly allocated to the test (short implants [SIs], 6.5 to 8.5mm long) or the control (sinus augmentation [SA] and implants ≥10mm long) group. Anorganic bovine bone was the grafting material for the control group. In both groups pure platelet-rich plasma was used to bioactivate implant surface prior to insertion. Implant and prosthesis survival, clinical variables, radiographic bone level change, quality of life, and patient satisfaction were assessed. RESULTS Twenty-five patients were treated in the control group (58 standard length implants) and 27 in the test group (42 SIs). After 3 years of follow-up no implant failure and biological or mechanical complications were recorded. Marginal bone loss, soft tissue, and oral hygiene parameters were similar in the 2 groups at both 1 and 3 years' follow-up. Postoperative pain, swelling and other symptoms and daily activities were better in the SIs group than in the SA group, while patients' satisfaction after 1 year was similar. CONCLUSIONS In spite of comparable medium-term clinical and radiographic outcomes, when the residual ridge height is sufficient for a safe placement, SIs may be preferred due to simplified protocol, less invasiveness, shorter treatment time, and reduced postoperative discomfort as compared to SA.
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Affiliation(s)
- Silvio Taschieri
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Dental Clinic, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
| | | | - Tiziano Testori
- Dental Clinic, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
| | - Luca Francetti
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Dental Clinic, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Dental Clinic, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
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Torabinejad M, Parirokh M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part II: other clinical applications and complications. Int Endod J 2017; 51:284-317. [PMID: 28846134 DOI: 10.1111/iej.12843] [Citation(s) in RCA: 223] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/22/2017] [Indexed: 12/16/2022]
Abstract
Mineral trioxide aggregate (MTA) is a dental material used extensively for vital pulp therapies (VPT), protecting scaffolds during regenerative endodontic procedures, apical barriers in teeth with necrotic pulps and open apices, perforation repairs as well as root canal filling and root-end filling during surgical endodontics. A number of bioactive endodontic cements (BECs) have recently been introduced to the market. Most of these materials have calcium and silicate in their compositions; however, bioactivity is a common property of these cements. These materials include the following: BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, Neo MTA Plus, Ortho MTA, Quick-Set, Retro MTA, Tech Biosealer, and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA but without the drawbacks. In Part I of this review, the available information on the chemical composition of the materials listed above was reviewed and their applications for VPT was discussed. In this article, the clinical applications of MTA and other BECs will be reviewed for apexification, regenerative endodontics, perforation repair, root canal filling, root-end filling, restorative procedures, periodontal defects and treatment of vertical and horizontal root fractures. In addition, the literature regarding the possible drawbacks of these materials following their clinical applications is reviewed. These drawbacks include their discolouration potential, systemic effects and retreatability following use as a root filling material. Based on selected keywords, all publications were searched regarding the use of MTA as well as BECs for the relevant clinical applications. Numerous publications were found regarding the use of BECs for various endodontic applications. The majority of these investigations compared BECs with MTA. Despite promising results for some materials, the number of publications using BECs for various clinical applications was limited. Furthermore, most studies had several methodological shortcomings and low levels of evidence.
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Affiliation(s)
- M Torabinejad
- Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
| | - M Parirokh
- Endodontology Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Taschieri S, Lolato A, Ofer M, Testori T, Francetti L, Del Fabbro M. Immediate post-extraction implants with or without pure platelet-rich plasma: a 5-year follow-up study. Oral Maxillofac Surg 2017; 21:147-157. [PMID: 28168420 DOI: 10.1007/s10006-017-0609-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 01/30/2017] [Indexed: 06/06/2023]
Abstract
PURPOSE The purpose of this study was comparison of clinical and radiographic outcomes of immediate post-extraction implants with or without the use of pure platelet-rich plasma (P-PRP) in the short- and medium-term follow-up. METHODS A retrospective analysis was performed to assess soft tissue healing, implant and prosthesis survival, marginal bone level changes and biological complications. RESULTS A total of 109 partially edentulous patients with 126 implants were included in this analysis. At 4-5 years after loading, cumulative survival rate in test group was 97.4% and in control group was 97.8%, with no significant differences. After 5 years of function, marginal bone loss (MBL) in test group was 0.8 ± 0.35 and 1.02 ± 0.27 mm for immediate and delayed loading, respectively, and in control group was 0.6 ± 0.16 and 0.8 ± 0.89 mm for immediate and delayed loading, respectively. No significant differences in MBL were observed intragroups and intergroups at any time point considered. Soft tissue healing score was significantly higher in test group compared to the control at 3 and 7 days after surgery, with significant differences. CONCLUSIONS P-PRP implant group showed a better soft tissue management and wound healing in the first 7 days after surgery compared to non-P-PRP implant group. In the medium-term follow-up, comparable clinical and radiographic outcomes were noticed between two groups.
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Affiliation(s)
- Silvio Taschieri
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Alessandra Lolato
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Moses Ofer
- Department of Periodontology & Dental Implantology, School of Dental Medicine, University of Tel Aviv, Tel Aviv-Yafo, Israel
| | - Tiziano Testori
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Luca Francetti
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Massimo Del Fabbro
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Milan, Italy.
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
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Predictors of clinical outcomes in endodontic microsurgery: a systematic review and meta-analysis. GIORNALE ITALIANO DI ENDODONZIA 2017. [DOI: 10.1016/j.gien.2017.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Karde PA, Sethi KS, Mahale SA, Khedkar SU, Patil AG, Joshi CP. Comparative evaluation of platelet count and antimicrobial efficacy of injectable platelet-rich fibrin with other platelet concentrates: An in vitro study. J Indian Soc Periodontol 2017; 21:97-101. [PMID: 29398852 PMCID: PMC5771122 DOI: 10.4103/jisp.jisp_201_17] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Platelet concentrates are used in various medical procedures to promote soft- and hard-tissue regeneration. In recent times, their antimicrobial efficacy is also explored. However, various platelet concentrates have evolved which differ in the centrifugation protocols. One such recently introduced platelet concentrate is injectable platelet-rich fibrin (i-PRF) concentrate. Hence, the aim was to evaluate the antimicrobial property, and platelet count of i-PRF in comparison to other platelet concentrates, i.e., PRF, platelet-rich plasma (PRP), and control (whole blood). Materials and Methods: Blood samples were obtained from 10 chronic generalized marginal gingivitis patients. Platelet concentrates were prepared using standardized centrifugation protocol. Platelet count was evaluated by manual counting method using smear preparation of each sample. Subsequently, antimicrobial activity against oral bacteria was examined on blood agar using disc diffusion method to quantify the inhibitory effects. Results: Statistical significance was analyzed by one-way analysis of variance (ANOVA). P <0.05 was considered statistically significant. Mean zone of inhibition around i-PRF (P < 0.01) and PRF (P < 0.05) showed statistical significance. Although a distinct zone of inhibition was seen with PRP, it was not statistically significant (P > 0.05). i-PRF showed statistically significant difference (P < 0.001) in platelet count when compared to control. It was also significant when compared to PRP (P < 0.01), PRF (P < 0.001). Conclusion: i-PRF has maximum antimicrobial efficacy and higher platelet count in comparison to other platelet concentrates, thereby indicating to have a better regenerative potential then others.
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Affiliation(s)
- Prerna Ashok Karde
- Department of Periodontics, MGV'S KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Kunal Sunder Sethi
- Department of Periodontics, MGV'S KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Swapna Arunkumar Mahale
- Department of Periodontics, MGV'S KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Smita Uday Khedkar
- Department of Microbiology, MGV'S KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Agraja Ganpat Patil
- Department of Periodontics, MGV'S KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Chaitanya Pradeep Joshi
- Department of Periodontics, MGV'S KBH Dental College and Hospital, Nashik, Maharashtra, India
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Del Fabbro M, Corbella S, Sequeira‐Byron P, Tsesis I, Rosen E, Lolato A, Taschieri S, Cochrane Oral Health Group. Endodontic procedures for retreatment of periapical lesions. Cochrane Database Syst Rev 2016; 10:CD005511. [PMID: 27759881 PMCID: PMC6461161 DOI: 10.1002/14651858.cd005511.pub3] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND When primary root canal therapy fails, periapical lesions can be retreated with or without surgery. Root canal retreatment is a non-surgical procedure that involves removal of root canal filling materials from the tooth, followed by cleaning, shaping and obturating of the canals. Root-end resection is a surgical procedure that involves exposure of the periapical lesion through an osteotomy, surgical removal of the lesion, removal of part of the root-end tip, disinfection and, commonly, retrograde sealing or filling of the apical portion of the remaining root canal. This review updates one published in 2008. OBJECTIVES To assess effects of surgical and non-surgical therapy for retreatment of teeth with apical periodontitis.To assess effects of surgical root-end resection under various conditions, for example, when different materials, devices or techniques are used. SEARCH METHODS We searched the following electronic databases: the Cochrane Oral Health Trials Register (to 10 February 2016), the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1), MEDLINE Ovid (1946 to 10 February 2016) and Embase Ovid (1980 to 10 February 2016). We searched the US National Registry of Clinical Trials (ClinicalTrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing trials (to 10 February 2016). We placed no restrictions regarding language and publication date. We handsearched the reference lists of the studies retrieved and key journals in the field of endodontics. SELECTION CRITERIA We included randomised controlled trials (RCTs) involving people with periapical pathosis. Studies could compare surgery versus non-surgical treatment or could compare different types of surgery. Outcome measures were healing of the periapical lesion assessed after one-year follow-up or longer; postoperative pain and discomfort; and adverse effects such as tooth loss, mobility, soft tissue recession, abscess, infection, neurological damage or loss of root sealing material evaluated through radiographs. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data from included studies and assessed their risk of bias. We contacted study authors to obtain missing information. We combined results of trials assessing comparable outcomes using the fixed-effect model, with risk ratios (RRs) for dichotomous outcomes and mean differences (MDs) for continuous outcomes, and 95% confidence intervals (CIs). We used generic inverse variance for split-mouth studies. MAIN RESULTS We included 20 RCTs. Two trials at high risk of bias assessed surgery versus a non-surgical approach: root-end resection with root-end filling versus root canal retreatment. The other 18 trials evaluated different surgical protocols: cone beam computed tomography (CBCT) versus periapical radiography for preoperative assessment (one study at high risk of bias); antibiotic prophylaxis versus placebo (one study at unclear risk); different magnification devices (loupes, surgical microscope, endoscope) (two studies at high risk); types of incision (papilla base incision, sulcular incision) (one study at high risk and one at unclear risk); ultrasonic devices versus handpiece burs (one study at high risk); types of root-end filling material (glass ionomer cement, amalgam, intermediate restorative material (IRM), mineral trioxide aggregate (MTA), gutta-percha (GP), super-ethoxy benzoic acid (EBA)) (five studies at high risk of bias, one at unclear risk and one at low risk); grafting versus no grafting (three studies at high risk and one at unclear risk); and low energy level laser therapy versus placebo (irradiation without laser activation) versus control (no use of the laser device) (one study at high risk).There was no clear evidence of superiority of the surgical or non-surgical approach for healing at one-year follow-up (RR 1.15, 95% CI 0.97 to 1.35; two RCTs, 126 participants) or at four- or 10-year follow-up (one RCT, 82 to 95 participants), although the evidence is very low quality. More participants in the surgically treated group reported pain in the first week after treatment (RR 3.34, 95% CI 2.05 to 5.43; one RCT, 87 participants; low quality evidence).In terms of surgical protocols, there was some inconclusive evidence that ultrasonic devices for root-end preparation may improve healing one year after retreatment, when compared with the traditional bur (RR 1.14, 95% CI 1.00 to 1.30; one RCT, 290 participants; low quality evidence).There was evidence of better healing when root-ends were filled with MTA than when they were treated by smoothing of orthograde GP root filling, after one-year follow-up (RR 1.60, 95% CI 1.14 to 2.24; one RCT, 46 participants; low quality evidence).There was no evidence that using CBCT rather than radiography for preoperative evaluation was advantageous for healing (RR 1.02, 95% CI 0.70 to 1.47; one RCT, 39 participants; very low quality evidence), nor that any magnification device affected healing more than any other (loupes versus endoscope at one year: RR 1.05, 95% CI 0.92 to 1.20; microscope versus endoscope at two years: RR 1.01, 95% CI 0.89 to 1.15; one RCT, 70 participants, low quality evidence).There was no evidence that antibiotic prophylaxis reduced incidence of postoperative infection (RR 0.49, 95% CI 0.09 to 2.64; one RCT, 250 participants; low quality evidence).There was some evidence that using a papilla base incision (PBI) may be beneficial for preservation of the interdental papilla compared with complete papilla mobilisation (one RCT (split-mouth), 12 participants/24 sites; very low quality evidence). There was no evidence of less pain in the PBI group at day 1 post surgery (one RCT, 38 participants; very low quality evidence).There was evidence that adjunctive use of a gel of plasma rich in growth factors reduced postoperative pain compared with no grafting (measured on visual analogue scale: one day postoperative MD -51.60 mm, 95% CI -63.43 to -39.77; one RCT, 36 participants; low quality evidence).There was no evidence that use of low energy level laser therapy (LLLT) prevented postoperative pain (very low quality evidence). AUTHORS' CONCLUSIONS Available evidence does not provide clinicians with reliable guidelines for treating periapical lesions. Further research is necessary to understand the effects of surgical versus non-surgical approaches, and to determine which surgical procedures provide the best results for periapical lesion healing and postoperative quality of life. Future studies should use standardised techniques and success criteria, precisely defined outcomes and the participant as the unit of analysis.
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Affiliation(s)
- Massimo Del Fabbro
- Università degli Studi di MilanoDepartment of Biomedical, Surgical and Dental SciencesIRCCS Galeazzi Orthopaedic InstituteVia Riccardo Galeazzi 4MilanItaly20161
| | - Stefano Corbella
- Università degli Studi di MilanoDepartment of Biomedical, Surgical and Dental SciencesIRCCS Galeazzi Orthopaedic InstituteVia Riccardo Galeazzi 4MilanItaly20161
| | - Patrick Sequeira‐Byron
- University of BernDepartment of Preventive, Restorative and Pediatric DentistryFreiburgstrasse 7BernBernSwitzerlandCH‐3010
| | - Igor Tsesis
- Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv UniversityDepartment of EndodontologyTel AvivIsrael
| | - Eyal Rosen
- Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv UniversityDepartment of EndodontologyTel AvivIsrael
| | - Alessandra Lolato
- Università degli Studi di MilanoDepartment of Biomedical, Surgical and Dental SciencesIRCCS Galeazzi Orthopaedic InstituteVia Riccardo Galeazzi 4MilanItaly20161
| | - Silvio Taschieri
- Università degli Studi di MilanoDepartment of Biomedical, Surgical and Dental SciencesIRCCS Galeazzi Orthopaedic InstituteVia Riccardo Galeazzi 4MilanItaly20161
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Meschi N, Castro AB, Vandamme K, Quirynen M, Lambrechts P. The impact of autologous platelet concentrates on endodontic healing: a systematic review. Platelets 2016; 27:613-633. [PMID: 27658056 DOI: 10.1080/09537104.2016.1226497] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The current literature was reviewed to determine the impact of autologous platelet concentrates (APCs) on endodontic healing. All types of clinical study designs concerning any kind of endodontic treatment involving the application of APCs were included. Two independent reviewers searched three databases (PubMed, Embase, and Cochrane Library) for studies, complemented by hand search, until 16/1/2016. From the 423 identified records, 48 articles met the inclusion criteria. Selected randomized controlled clinical trials (RCTs) underwent Cochrane Collaboration's risk-of-bias assessment and data extraction. Only two RCTs showed low risk of bias. There was considerable heterogeneity between the RCTs with regard to the type of therapy, type of APCs, assessment method, and study quality, and therefore the data could not be analyzed quantitatively. The included case reports/series and non-randomized comparative studies underwent qualitative analysis with the revised Methodological Index for Non-Randomized Studies (MINORS) and data extraction. The two comparative non-randomized studies scored qualitatively high, though the MINORS-scores of the case series and reports were dispersed. APCs were involved in five endodontic treatment modalities, namely apexification, regenerative endodontic procedures, pulpotomy, apical surgery, and treatment of endo-perio/perio-endo lesions. APCs seem to accelerate postoperative bone healing, augment the patients' postoperative quality of life, aid further root development, and support maintenance/regaining of pulp vitality. No adverse events were reported. APCs in endodontic treatments seem to contribute to the healing of soft and hard tissues, though there is a lack of long-term high quality clinical trials and standardized treatment protocols.
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Affiliation(s)
- Nastaran Meschi
- a Department of Oral Health Sciences, Endodontology , KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Ana B Castro
- b Department of Oral Health Sciences , Periodontology, KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Katleen Vandamme
- c Department of Oral Health Sciences , Restorative Dentistry, KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Marc Quirynen
- b Department of Oral Health Sciences , Periodontology, KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Paul Lambrechts
- a Department of Oral Health Sciences, Endodontology , KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
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47
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Taschieri S, Del Fabbro M, El Kabbaney A, Tsesis I, Rosen E, Corbella S. Microsurgical re-treatment of an endodontically treated tooth with an apically located incomplete vertical root fracture: a clinical case report. Restor Dent Endod 2016; 41:316-321. [PMID: 27847754 PMCID: PMC5107434 DOI: 10.5395/rde.2016.41.4.316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 04/25/2016] [Indexed: 11/17/2022] Open
Abstract
Although it is challenging, the early diagnosis of a vertical root fracture (VRF) is crucial in order to ensure tooth preservation. The purpose of this clinical case report was to describe reparative surgery performed to treat a tooth affected by an incomplete VRF. A 26 year old male patient was suspected to have a VRF in a maxillary left central incisor, and an exploratory flap was performed in order to confirm the diagnosis. After detecting the fracture, the lesion was surgically treated, the fracture and the infected root-end were removed, and a platelet-rich plasma membrane was used to cover the defect in order to prevent bacterial migration. A 24 month clinical and radiological follow-up examination showed that the tooth was asymptomatic and that the healing process was in progress. The surgical approach described here may be considered an effective treatment for a combined endodontic-periodontal lesion originating from an incomplete VRF and a recurrent periapical lesion.
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Affiliation(s)
- Silvio Taschieri
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | - Massimo Del Fabbro
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | - Ahmed El Kabbaney
- Conservative Dentistry and Endodontic Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Igor Tsesis
- Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Rosen
- Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Stefano Corbella
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
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48
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Lolato A, Bucchi C, Taschieri S, Kabbaney AE, Fabbro MD. Platelet concentrates for revitalization of immature necrotic teeth: a systematic review of the clinical studies. Platelets 2016; 27:383-92. [DOI: 10.3109/09537104.2015.1131255] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Alessandra Lolato
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milano, Italia
- IRCCS Istituto Ortopedico Galeazzi, Università degli Studi di Milano, Milano, Italia
| | - Cristina Bucchi
- Facultad de Odontología, CICO Research Center, Universidad de La Frontera, Temuco, Chile
| | - Silvio Taschieri
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milano, Italia
- IRCCS Istituto Ortopedico Galeazzi, Università degli Studi di Milano, Milano, Italia
| | - Ahmed El Kabbaney
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milano, Italia
- Conservative Dentistry and Endodontic Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Massimo Del Fabbro
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milano, Italia
- IRCCS Istituto Ortopedico Galeazzi, Università degli Studi di Milano, Milano, Italia
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49
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Pasqualini D, Corbella S, Alovisi M, Taschieri S, Del Fabbro M, Migliaretti G, Carpegna GC, Scotti N, Berutti E. Postoperative quality of life following single-visit root canal treatment performed by rotary or reciprocating instrumentation: a randomized clinical trial. Int Endod J 2015; 49:1030-1039. [DOI: 10.1111/iej.12563] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 10/12/2015] [Indexed: 12/01/2022]
Affiliation(s)
- D. Pasqualini
- Department of Surgical Sciences; Dental School; University of Turin; Turin Italy
| | - S. Corbella
- Department of Biomedical; Surgical and Dental Sciences; Oral Health Research Centre; Università degli Studi di Milano; Milan Italy
- IRCCS Istituto Ortopedico Galeazzi; Milan Italy
| | - M. Alovisi
- Department of Surgical Sciences; Dental School; University of Turin; Turin Italy
| | - S. Taschieri
- Department of Biomedical; Surgical and Dental Sciences; Oral Health Research Centre; Università degli Studi di Milano; Milan Italy
- IRCCS Istituto Ortopedico Galeazzi; Milan Italy
| | - M. Del Fabbro
- Department of Biomedical; Surgical and Dental Sciences; Oral Health Research Centre; Università degli Studi di Milano; Milan Italy
- IRCCS Istituto Ortopedico Galeazzi; Milan Italy
| | - G. Migliaretti
- Department of Public Health and Microbiology; University of Turin; Turin Italy
| | - G. C. Carpegna
- Department of Surgical Sciences; Dental School; University of Turin; Turin Italy
| | - N. Scotti
- Department of Surgical Sciences; Dental School; University of Turin; Turin Italy
| | - E. Berutti
- Department of Surgical Sciences; Dental School; University of Turin; Turin Italy
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50
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Application of platelet-rich fibrin in endodontic surgery: a pilot study. GIORNALE ITALIANO DI ENDODONZIA 2015. [DOI: 10.1016/j.gien.2015.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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