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Sherif MA, Anter E, Graetz C, El-Sayed KF. Injectable platelet-rich fibrin with vitamin C as an adjunct to non-surgical periodontal therapy in the treatment of stage-II periodontitis: a randomized controlled clinical trial. BMC Oral Health 2025; 25:772. [PMID: 40410805 PMCID: PMC12100897 DOI: 10.1186/s12903-025-06115-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2024] [Accepted: 05/05/2025] [Indexed: 05/25/2025] Open
Abstract
BACKGROUND Injectable platelet-rich fibrin (I-PRF) is an autologous fibrin matrix rich in leucocytes, platelets and growth factors, and could serve as a sustained-release vehicle for a variety of active biomolecules. The aim of the current randomized controlled trial was to compare the effect of vitamin C (VitC) with I-PRF as a locally delivered adjunct to professional mechanical plaque removal (PMPR) versus PMPR with local delivery of I-PRF or PMPR alone on non-surgical periodontal treatment (NSPT) outcomes of stage-II periodontitis. METHODOLOGY Forty-five patients (n = 45) diagnosed with stage-II grade A periodontitis were randomly assigned into test (PMPR + I-PRF/VitC; n = 15) or control groups (PMPR + I-PRF; n = 15 and PMPR; n = 15). Bleeding on probing (BOP; primary outcome), probing depth (PD), clinical attachment level (CAL), gingival margin (GM), plaque index (PI) and radiographic bone gain/loss (horizontal, vertical and total) were assessed at baseline, three- and six-months post-treatment. Post-operative pain was further assessed at second- and third-day post-treatment. RESULTS Although BOP scores were lower in the PMPR + I-PRF/VitC group, the regression analysis revealed that gender was the only significant predictor for BOP, with females showing a reduced propensity (p < 0.05). Clinical and radiographic parameters significantly improved in all groups independently (p < 0.05). PD-reduction was 1.73 ± 0.59 mm, 1.67 ± 0.49 mm and 1.73 ± 0.59 mm, CAL-change was 1.33 ± 0.49 mm, 1.20 ± 0.56 mm and 0.93 ± 0.59 mm and GM-change was 0.40 ± 0.51 mm, 0.33 ± 0.49 mm and 0.73 ± 0.70 mm in the PMPR + I-PRF/VitC, PMPR + I-PRF and PMPR groups respectively. No intergroup differences were notable regarding BOP or changes in PD, CAL, GM, PI and radiographic bone measurements at three or six months relative to baseline (p > 0.05). Significantly lower pain scores at two and three days were notable in the PMPR + I-PRF/VitC and PMPR + I-PRF groups compared to the PMPR group (p < 0.05). CONCLUSIONS Apart from a positive effect on the patients' post operative pain perception, I-PRF with or without the addition of vitamin C does not additionally improve the clinical outcomes of PMPR alone in the NSPT of stage-II grade A periodontitis patients. TRIAL REGISTRATION Trial registration. The study was retrospectively registered in the US National Institutes of Health Clinical Trials Registry (NCT05129267) on 2021-11-10.
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Affiliation(s)
- Mohamed Abdulhakim Sherif
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Al Saraya Str. 11, Manial, Cairo, Egypt
| | - Enas Anter
- Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany
| | - Karim Fawzy El-Sayed
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Al Saraya Str. 11, Manial, Cairo, Egypt.
- Stem Cells and Tissue Engineering Research Unit, Faculty of Dentistry, Cairo University, Cairo, Egypt.
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Călin C, Dima O, Ancuta DL, Coman C, Pameijer CH, Paulsen F, Sprenger M, Nita T, Didilescu AC. Guided bone regeneration using beta-tricalcium phosphate and leucocyte platelet-rich fibrin versus a novel biodegradable urethane composite in critical-size osseous defects in rabbit tibia: Histologic results of a pilot study. Ann Anat 2025; 260:152672. [PMID: 40339925 DOI: 10.1016/j.aanat.2025.152672] [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: 11/28/2024] [Revised: 05/04/2025] [Accepted: 05/04/2025] [Indexed: 05/10/2025]
Abstract
BACKGROUND Insufficient bone volume is a major problem in implant dentistry, which can be counteracted by using guided bone regeneration technique. Among the materials recently tested, synthetic polymers have been recommended as showing excellent biocompatibility and biodegradability. OBJECTIVE The aim of this pilot study was to analyze and compare through means of histology the healing of the bone tissue in critical size osseous defects in New-Zealand rabbit tibiae after application of beta-tricalcium phosphate (β-TCP) alone, β-TCP combined with leucocyte platelet-rich fibrin (L-PRF) and an injectable experimental bone cement (EBC) represented by a dual-curable degradable synthetic polymer. METHODS Two New-Zealand rabbits were used. Three standardized osseous defects of 5 mm diameter were created in each tibia. Each defect was filled with either β-TCP alone (control), β-TCP combined with L-PRF (test) or with EBC (test). The animals were sacrificed at 25 and 70 days; the tibia samples were removed, fixed in 10 % formaldehyde and stained with AZAN. RESULTS While at 25 days β-TCP produced sparse bone formation, at 70 days mature bone formation was visible in all areas of the defect with minimum remaining graft particles; at 25 days, β-TCP combined with L-PRF produced broad areas of bone lamellae, while at 70 days bone tissue formation was limited; at both 25 and 70 days, the EBC was stable and not penetrated by bone cells, while a narrow band of connective tissue could be seen superjacent and inferior to it. CONCLUSIONS Among the tested biomaterials, β-TCP was capable of generating bone formation at both healing time-points, while the addition of L-PRF seemed to provide a synergistic effect only in the early phase of bone healing.
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Affiliation(s)
- Claudiu Călin
- Department of Embryology and Microbiology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
| | - Oana Dima
- Department of Embryology and Microbiology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
| | - Diana L Ancuta
- Cantacuzino National Institute for Medical-Military Research and Development, Bucharest, Romania
| | - Cristin Coman
- Cantacuzino National Institute for Medical-Military Research and Development, Bucharest, Romania.
| | - Cornelis H Pameijer
- Department of Reconstructive Sciences, School of Dental Medicine, University of Connecticut, Farmington, USA.
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich Alexander University Erlangen-Nürnberg, Germany.
| | - Maximilian Sprenger
- Institute of Functional and Clinical Anatomy, Friedrich Alexander University Erlangen-Nürnberg, Germany.
| | - Tiberiu Nita
- Department of Oral and Maxillofacial "Dan Theodorescu Hospital", Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
| | - Andreea C Didilescu
- Department of Embryology and Microbiology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
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Iao S, Ouyang X, Qiao J, Liu J, Liu W, Zhong J. Growth Factors Release in Concentrated Growth Factor and Advanced Platelet-Rich Fibrin Sticky Bone. Oral Dis 2025. [PMID: 40326479 DOI: 10.1111/odi.15325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2024] [Revised: 01/10/2025] [Accepted: 03/14/2025] [Indexed: 05/07/2025]
Abstract
OBJECTIVE Sticky bone, created from concentrated growth factor (CGF) or advanced platelet-rich fibrin (A-PRF), contains various growth factors. This study analyzed the release patterns of growth factors from CGF sticky bone (CGF-SB) and A-PRF sticky bone (A-PRF-SB) to inform their application in bone grafting. METHODS CGF, A-PRF, CGF-SB, and A-PRF-SB were incubated for 28 days, with supernatant collected on days 1, 7, 14, 21, and 28. Growth factors-platelet-derived growth factor-BB (PDGF-BB), vascular endothelial growth factor (VEGF), and basic fibroblast growth factor (bFGF)-were quantified using multiplex assays. Transforming growth factor-β1 (TGF-β1) and insulin-like growth factor-1 (IGF-1) were measured by ELISA. RESULTS CGF and A-PRF released more than half of their PDGF-BB, VEGF, and bFGF within day 1, followed by rapid declines. Differently, sticky bone released these growth factors more gradually, surpassing 50% cumulative release by day 7 and sustaining over time. IGF-1 and TGF-β1 in all groups reached 50% release by days 7 and 14, respectively. A-PRF-SB released significantly more PDGF-BB, bFGF, and TGF-β1 than CGF-SB (p < 0.05). CONCLUSIONS Both CGF-SB and A-PRF-SB exhibit slower and sustained growth factor release compared to CGF and A-PRF alone, with A-PRF-SB offering superior release profiles, highlighting its enhanced potential for bone grafting applications.
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Affiliation(s)
- Siniong Iao
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Xiangying Ouyang
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Jing Qiao
- First Clinical Division, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Jianru Liu
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Wenyi Liu
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Jinsheng Zhong
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
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Alshirah AA, Elnaem MH, Al-Ani Z, Hudieb M, Hamilton J, Lowry D, McCarron PA. Tensile Strength, Cellular Content and Degradation properties in three generations of concentrated growth factors. BMC Oral Health 2025; 25:674. [PMID: 40312351 PMCID: PMC12044792 DOI: 10.1186/s12903-025-05825-6] [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: 01/04/2025] [Accepted: 03/17/2025] [Indexed: 05/03/2025] Open
Abstract
BACKGROUND Concentrated growth factors (CGF) is a biomaterial with regenerative potential, enriched with platelets, leukocytes, growth factors, and fibrin, but it degrades within 2-3 weeks. Albumin extends CGF stability, while silver nanoparticles (SNP) improve its mechanical and antibacterial properties. This in vitro and ex vivo study investigates the impact of albumin (Alb-CGF) and albumin with SNP (Alb-CGF-SNP) on CGF's mechanical properties, degradation rate, and cellular bioactivity. METHODS Blood samples were collected from 15 healthy volunteers who met specific inclusion criteria, with the sample size determined using G*Power software for power calculation. Three groups were prepared: control CGF, experimental Alb-CGF, and Alb-CGF-SNP. Membranes were produced using a Medifuge MF200 centrifuge and activated plasma albumin gel (APAG) device following standard settings. In experimental groups, the superficial 2.5 ml of plasma layer was heated at 75 °C for 10 min before combining with the buffy coat layer of CGF. Mechanical properties were tested using a texture analyzer, degradation rates were measured by weight loss percentage, and cellular bioactivity was evaluated with a Sysmex hematology analyzer. Data analysis was conducted using GraphPad Prism 8.0. Group differences were assessed via one-way ANOVA and Welch ANOVA, with Tukey's HSD test for post hoc paired group comparisons. RESULTS The control (CGF) showed the highest mechanical properties, with Ultimate Tensile Strength (UTS) (95.6 kPa), Modulus of Toughness (55.55 kJ/m3), and Young's Modulus (75.73 kPa; (P < 0.01). No significant differences were observed in the strain at break across groups (P > 0.90). Alb-CGF-SNP displayed superior degradation resistance, with 45.2% weight loss at day 60 versus 84.2% in CGF (P < 0.01). CGF had the highest WBC and platelet levels, with amounts of 2.25 and 3.11-fold, respectively (P < 0.01). CONCLUSION The modification of CGF with albumin and silver nanoparticles enhanced degradation resistance, although it did not reach the tensile strength and cellular content of unmodified CGF. Clinically, Alb-CGF and Alb-CGF-SNP serve as effective barrier membranes due to their prolonged stability, while CGF remains advantageous where high mechanical strength is required. Despite lower elasticity limiting suturing, their plasticity supports use as fillers or for tissue phenotype modification in regenerative applications.
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Affiliation(s)
- Akram A Alshirah
- Periodontology Department, College of Medicine and Dentistry, School of Pharmacy and Pharmaceutical Sciences, Faculty of Life & Health Sciences, Ulster University, Coleraine, BT52 1SA, UK.
| | - Mohamed H Elnaem
- School of Pharmacy and Pharmaceutical Sciences, Faculty of Life & Health Sciences, Ulster University, Coleraine, BT52 1SA, UK
| | - Ziad Al-Ani
- School of Medicine, Dentistry & Nursing, Glasgow Dental Hospital & School, G14 Level 5, 378 Sauchiehall Street, Glasgow, G2 3JZ, UK
| | - Malik Hudieb
- Department of Advanced Prosthodontics, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8549, Japan
| | - Jeremy Hamilton
- School of Engineering, Faculty of Computing, Engineering and Built Environment, Ulster University, 25-51 York Street, Belfast, BT15 1ED, UK
| | - Deborah Lowry
- School of Pharmacy and Pharmaceutical Sciences, Faculty of Life & Health Sciences, Ulster University, Coleraine, BT52 1SA, UK
| | - Paul A McCarron
- School of Pharmacy and Pharmaceutical Sciences, Faculty of Life & Health Sciences, Ulster University, Coleraine, BT52 1SA, UK.
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Kim J, Zhang Z, Albadawi H, Keum H, Mayer JL, Graf EH, Oklu R. Catheter Injectable Multifunctional Biomaterial for the Treatment of Infected Enterocutaneous Fistulas. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2025; 12:e2414642. [PMID: 39950851 PMCID: PMC12120755 DOI: 10.1002/advs.202414642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2024] [Revised: 01/24/2025] [Indexed: 05/31/2025]
Abstract
Enterocutaneous fistulas (ECF) are challenging to treat contributing to high morbidity and high mortality rates, significantly impacting the quality of life of the patients. Its susceptibility to antibiotic-resistant infections often leads to chronic inflammation, complicating treatment with conventional methods. Here, 18NC75-10P-1IL is reported, which is a multi-functional shear-thinning hydrogel comprised of gelatin and nanosilicates for injectability, an ionic liquid for bactericidal effects, and platelet rich fibrin fraction for pro-healing properties; this biomaterial is engineered for the treatment of ECFs. Through rigorous testing, the mechanical properties of 18NC75-10P-1IL were tailored for catheter injection to achieve durable occlusion of fistulous tracts under external pressures simulating clinical scenarios. 18NC75-10P-1IL demonstrated pro-healing effects and anti-microbial activity against highly resistant patient-derived bacteria known to be associated with ECF. Subcutaneous implantation and anorectal fistula models confirmed its biocompatibility, pro-healing, anti-inflammatory, and anti-microbial properties compared to control materials, suggesting promising potential for clinical translation in the treatment of human ECFs.
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Affiliation(s)
- Jinjoo Kim
- The Laboratory for Patient‐Inspired EngineeringMayo Clinic13400 East Shea Blvd.ScottsdaleAZ85259USA
| | - Zefu Zhang
- The Laboratory for Patient‐Inspired EngineeringMayo Clinic13400 East Shea Blvd.ScottsdaleAZ85259USA
| | - Hassan Albadawi
- The Laboratory for Patient‐Inspired EngineeringMayo Clinic13400 East Shea Blvd.ScottsdaleAZ85259USA
| | - Hyeongseop Keum
- The Laboratory for Patient‐Inspired EngineeringMayo Clinic13400 East Shea Blvd.ScottsdaleAZ85259USA
| | - Joseph L. Mayer
- The Laboratory for Patient‐Inspired EngineeringMayo Clinic13400 East Shea Blvd.ScottsdaleAZ85259USA
| | - Erin H. Graf
- Department of Laboratory Medicine and PathologyMayo Clinic5777 E Mayo BlvdPhoenixAZ85054USA
| | - Rahmi Oklu
- The Laboratory for Patient‐Inspired EngineeringMayo Clinic13400 East Shea Blvd.ScottsdaleAZ85259USA
- Division of Vascular & Interventional RadiologyMayo Clinic5777 E Mayo BlvdPhoenixAZ85054USA
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Costa De-Moraes SL, Lima FCA, Sartoretto SC, Ghiraldini B, Bezerra FJB, Nunes PS, de Freitas Farias Dos Santos CMS, Calasans-Maia MD, Granjeiro JM. Histomorphometric and microtomographic evaluation of hydroxyapatite coated implants and L-PRF in over drilled bone sites in sheep. Sci Rep 2025; 15:14761. [PMID: 40295611 PMCID: PMC12037916 DOI: 10.1038/s41598-025-98126-5] [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: 12/04/2024] [Accepted: 04/09/2025] [Indexed: 04/30/2025] Open
Abstract
Hydroxyapatite used as a coating for titanium dental implants reduces the time required for osseointegration. Platelet-rich fibrin (L-PRF) releases growth factors and cytokines, enhancing tissue healing and bone regeneration. This study aimed to evaluate histologically, histomorphometrically, and by microcomputed tomography an implant surface coated with nanostructured hydroxyapatite (HAnano), in comparison with a double acid-etched (DAA) surface, both with and without peri-implant grafting with L-PRF, installed in over-instrumented sites in a low-density bone. Five adult sheep (2-4 years old) received twenty 3.5 × 10 mm implants in the iliac crest. Bone-to-implant contact (BIC) and bone-occupied area fraction (BAFo) were evaluated histomorphometrically after an 8-week experimental period. Brown-Forsyth analysis of variance (ANOVA) and Welch's ANOVA test did not identify significant differences between the experimental groups. On average, BIC ranged from 44% (HAnano + L-PRF) to 63% (DAA + L-PRF). µCT analysis revealed that bone volume density in the peri-implant region ranged from 26% (HAnano + L-PRF) to 39% (DAA). No statistically significant differences were observed between the groups. Both implant surfaces studied allowed osseointegration in low bone density sites, independently of peri-implant grafting with L-PRF, after 8 weeks of implantation. While this model provided controlled conditions for evaluating early-stage osseointegration, the absence of functional loading and the relatively short follow-up period should be considered when extrapolating the findings to clinical applications. Future studies should assess these variables under load-bearing conditions with extended observation periods. All the sheep in this study remained alive.
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Affiliation(s)
| | | | - Suelen Cristina Sartoretto
- Clinical Research Laboratory, Dentistry School, Universidade Federal Fluminense, Niteroi, 24220-140, Brazil
- Oral Surgery Department, Fluminense Federal University, Niteroi, 24220-140, Brazil
| | - Bruna Ghiraldini
- Dental Research Division, Dentistry School, Universidade Paulista, São Paulo, 04710-000, Brazil
| | | | - Pamella Santana Nunes
- Post-Graduation Program in Dentistry, Fluminense Federal University, Niteroi, 24220-140, Brazil
| | | | | | - Jose Mauro Granjeiro
- Clinical Research Laboratory, Dentistry School, Universidade Federal Fluminense, Niteroi, 24220-140, Brazil.
- National Institute of Metrology, Quality and Technology (INMETRO), Duque de Caxias, 25250-020, Brazil.
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Giammarinaro E, Baldini N, Covani U, Menini M, Pesce P, Marconcini S. Does platelet-rich fibrin enhance the outcomes of peri-implant soft tissues? A systematic review. BMC Oral Health 2025; 25:615. [PMID: 40264081 PMCID: PMC12016366 DOI: 10.1186/s12903-025-05922-6] [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: 10/05/2024] [Accepted: 03/31/2025] [Indexed: 04/24/2025] Open
Abstract
BACKGROUND Improving soft tissue quality and quantity around dental implants is crucial for successful outcomes. Platelet-Rich Fibrin (PRF) is showing promise in enhancing wound healing and implant stability. This systematic review aims to evaluate the clinical benefits of PRF in soft tissue regeneration around dental implants compared to standard methods. METHODS This systematic review adhered to the PRISMA guidelines and utilizing the PICO methodology, investigated the use of Platelet-Rich Fibrin (PRF) in soft tissue augmentation during implant therapy. The primary outcomes assessed include the width of keratinized mucosa and soft tissue thickness, comparing PRF interventions to standard techniques.The study included randomized controlled trials (RCTs) and comparative studies, focusing on human patients needing implant therapy with or without PRF. An extensive search of databases and manual references was conducted; data extraction involved assessing study quality and risk of bias, but due to high heterogeneity among studies, a meta-analysis was not feasible, leading to a systematic review of the available literature. RESULTS A total of 766 references were initially identified, with 29 being eligible after screening. Nine studies were included for detailed review. The findings revealed that PRF is effective in increasing the width of keratinized mucosa (KT) and soft tissue thickness (STT) around implants. Even if free gingival grafts (FGG) sometimes performed better. However, the differences between PRF and FGG were not clinically significant, and PRF offers lower cost, ease of use, and reduced morbidity. There was limited information on the esthetic outcomes of PRF, with only two studies addressing this aspect, showing mixed results. CONCLUSION Overall, PRF demonstrated positive effects on KT width and STT, but further research with rigorous methodology and larger sample sizes is needed to better understand its impact on implants health and esthetics.
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Affiliation(s)
- Enrica Giammarinaro
- Research fellow at the Department of Surgical Sciences (DISC), University of Genova, Genoa, Italy.
| | - Nicola Baldini
- Department of Biomedical and Medical Sciences, University of Siena, Viale Bracci, 16, Siena, 53100, Italy
| | - Ugo Covani
- Research fellow at the Department of Surgical Sciences (DISC), University of Genova, Genoa, Italy
| | - Maria Menini
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, Largo R. Benzi 10, Genova, 16132, Italy
| | - Paolo Pesce
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, Largo R. Benzi 10, Genova, 16132, Italy
| | - Simone Marconcini
- Research fellow at the Department of Surgical Sciences (DISC), University of Genova, Genoa, Italy
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Duarte ND, Frigério PB, Chica GEA, Okamoto R, Buchaim RL, Buchaim DV, Messora MR, Issa JPM. Biomaterials for Guided Tissue Regeneration and Guided Bone Regeneration: A Review. Dent J (Basel) 2025; 13:179. [PMID: 40277509 PMCID: PMC12026320 DOI: 10.3390/dj13040179] [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: 03/13/2025] [Revised: 04/09/2025] [Accepted: 04/17/2025] [Indexed: 04/26/2025] Open
Abstract
This review aims to provide an overview of the types of membranes, bone substitutes, and mucosal substitutes used for GTR and GBR and briefly explores recent innovations for tissue regeneration and their future perspectives. Since this is a narrative review, no systematic search, meta-analysis, or statistical analysis was conducted. Using biomaterials for GTR and GBR provides a reduction in postoperative morbidity, as it contributes to less invasive clinical procedures, serving as an alternative to autogenous grafts. Moreover, randomized clinical trials (RCTs) and systematic reviews are essential for the evaluation of new biomaterials. These studies provide more robust evidence and help guide clinical practice in the selection of safer and more effective biomaterials, allowing for the personalization of treatment protocols for each patient.
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Affiliation(s)
- Nathália Dantas Duarte
- Department of Diagnosis and Surgery, Araçatuba School of Dentistry (FOA-UNESP), São Paulo State University, Araçatuba 16015-050, Brazil; (N.D.D.); (P.B.F.)
| | - Paula Buzo Frigério
- Department of Diagnosis and Surgery, Araçatuba School of Dentistry (FOA-UNESP), São Paulo State University, Araçatuba 16015-050, Brazil; (N.D.D.); (P.B.F.)
| | - Gloria Estefania Amaya Chica
- Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirão Preto School of Dentistry (FORP-USP), University of São Paulo, Ribeirão Preto 14090-904, Brazil; (G.E.A.C.); (M.R.M.)
| | - Roberta Okamoto
- Department of Basic Sciences, Araçatuba School of Dentistry (FOA-UNESP), São Paulo State University, Araçatuba 16015-050, Brazil;
| | - Rogério Leone Buchaim
- Department of Biological Sciences, Bauru School of Dentistry (FOB-USP), University of São Paulo, Bauru 17012-901, Brazil;
- Graduate Program in Anatomy of Domestic and Wild Animals, Faculty of Veterinary Medicine and Animal Science, University of São Paulo (FMVZ/USP), São Paulo 05508-270, Brazil;
| | - Daniela Vieira Buchaim
- Graduate Program in Anatomy of Domestic and Wild Animals, Faculty of Veterinary Medicine and Animal Science, University of São Paulo (FMVZ/USP), São Paulo 05508-270, Brazil;
- Anatomy Department, Medical School, University Center of Adamantina (FAI), Adamantina 17800-000, Brazil
- Postgraduate Department, Dentistry School, Faculty of the Midwest Paulista (FACOP), Piratininga 17499-010, Brazil
| | - Michel Reis Messora
- Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirão Preto School of Dentistry (FORP-USP), University of São Paulo, Ribeirão Preto 14090-904, Brazil; (G.E.A.C.); (M.R.M.)
| | - João Paulo Mardegan Issa
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry (FORP-USP), University of São Paulo, Ribeirão Preto 14040-904, Brazil
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Chmielewski M, Pilloni A, Adamska P. Advanced Platelet-Rich Fibrin Plus (A-PRF+) as an Additive to Hard Tissue Managing Protocols in Oral Surgery: A Systematic Review. J Funct Biomater 2025; 16:145. [PMID: 40278253 PMCID: PMC12028204 DOI: 10.3390/jfb16040145] [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: 02/27/2025] [Revised: 04/14/2025] [Accepted: 04/17/2025] [Indexed: 04/26/2025] Open
Abstract
BACKGROUND Advanced platelet-rich fibrin + (A-PRF+) represents a third generation of autologous platelet derivatives. Appropriate centrifugation conditions cause the formation of a clot containing platelets, which slowly release growth factors that influence healing. The objective of this article was to undertake a review of the available literature on the effectiveness of A-PRF+ use in hard tissue procedures. MATERIALS AND METHODS In order to ensure the most accurate and relevant results, only randomized clinical trials regarding bone regeneration techniques/bone healing that compared the effect of the A-PRF+ addition in dentistry were included in this study. Articles taken into consideration for the review were published between the beginning of 2014 and 31 December 2024. The search of manuscripts for the review was conducted using the PubMed, Scopus, Google Scholar, and Cochrane databases. For this study, 10 articles focusing on A-PRF+ were qualified. RESULTS A-PRF+ was found to increase the post-surgical vertical and horizontal alveolar ridge dimensions. The bone formed in the surgical site presented a higher volume of vital and non-vital bone and a more optimal bone composition, at the same time providing a lower percentage of connective tissue inclusions. When combined with other grafting biomaterials, A-PRF+ enhanced their performance and integration. A-PRF+ did not have any significant effect on the mineral bone density compared with other grafting materials. Compared with PRF and other blood derived plasmas rich in growth factors, the performance of A-PRF+ was generally better, but often with no statistical significance. The treatment of periodontal defects measured by the reduction in pocket depth and clinical attachment level also fared better with the A-PRF+ addition, although there was no differences noted between A-PRF+ and biphasic calcium phosphate and xenograft. Finally, the A-PRF+ addition improved the primary implant stability in the evaluated studies. CONCLUSIONS The A-PRF+ addition to the surgical protocols significantly enhanced the healing of the bone and when combined with biomaterials improved their integration and increased the implant insertion torque, improving the primary and secondary stability. It may be a viable alternative for patients that express their concern towards human- and animal-derived biomaterials.
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Affiliation(s)
| | - Andrea Pilloni
- Section of Periodontics, Department of Oral and Maxillo-Facial Sciences, Sapienza Unviersity of Rome, 00-185 Rome, Italy;
| | - Paulina Adamska
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland
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10
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Li P, Jin R. Effects of platelet-rich plasma, platelet-rich fibrin and concentrated growth factor on flap survival: a study in a rat dorsal cross-region perforator flap model. Med Mol Morphol 2025:10.1007/s00795-025-00436-0. [PMID: 40237837 DOI: 10.1007/s00795-025-00436-0] [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: 02/02/2025] [Accepted: 04/03/2025] [Indexed: 04/18/2025]
Abstract
BACKGROUND With the extensive application of flap surgery in clinical practice, it has been a matter of great concern to improve the survival rate of flap surgery for a long time. This study compared and explored the effect of the three generations of platelet concentrates (PCs), including platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and concentrated growth factor (CGF), on flap survival. METHODS After PRP, PRF, and CGF gels were observed by scanning electron microscope (SEM), their vascularizing effect were assessed by infrared thermal imager, flap survival experiment, arterial perfusion angiography, and immunohistochemical staining in a rat dorsal cross-region perforator flap model. RESULTS The fibrin of PRP gel showed irregular clumps and loose structure, while that of PRF and CGF gels formed 3D network structure with orderly arrangement and compact structure. In animal models, the use of all the three PCs can increase the number of vessels and the amount of blood perfusion in choke zones (all P < 0.05), thus improving the flap survival rate. Moreover, the effects of CGF and PRF were obviously better than those of PRP (all P < 0.05), but there was no significant difference between CGF and PRF (P > 0.05). CONCLUSIONS PRP, PRF, and CGF all have a good effect on promoting vascularization, and can significantly improve the survival rate of dorsal cross-region perforator flap in rat model. Besides, PRF and CGF have greater potential in promoting vascularization than PRP.
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Affiliation(s)
- Peiwen Li
- Department of Burn and Plastic Surgery, General Hospital of Central Theater Command, Wuhan, 420000, China
| | - Ruiqi Jin
- Department of Plastic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.
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11
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Abuhashema RAIH, Essa MES, Ibrahim SH, Safwat OM. Clinical and radiographic assessment of mineral trioxide aggregate with platelet rich fibrin as pulp capping biomaterials: a 12-month randomized trial. Sci Rep 2025; 15:12874. [PMID: 40234535 PMCID: PMC12000502 DOI: 10.1038/s41598-025-96056-w] [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: 12/11/2024] [Accepted: 03/25/2025] [Indexed: 04/17/2025] Open
Abstract
This study aimed to comparatively assess the clinical success and radiographic regenerative dentin formation of Platelet Rich Fibrin (PRF) and mineral trioxide aggregate (MTA) when used as direct pulp capping agents. This double-blinded two parallel armed randomized controlled clinical trial comprised the allocation of 108 patients with traumatically exposed dental pulp during the management of deep carious lesions by undergraduate students after fulfilling inclusion and exclusion criteria. Patients were randomized into two groups (n = 54 in each group) using computer-generated simple randomization, wherein one group Platelet Rich Fibrin (PRF) was prepared from patients' blood samples and applied directly over exposed pulp followed by MTA application and in the other group MTA was applied directly over pulp exposure. In both groups, cavities were restored with resin-modified glass ionomer liner and resin composite restoration. The overall success of treatment was calculated at 6 and 12 months after assessing pulp sensibility, history of pain, tenderness on percussion and the existence of any periapical pathosis using in periapical radiographs. Moreover CBCT was used at 12 months to determine the presence or absence of dentin bridge as a secondary outcome. After 12 months follow-up, there was no statistically significant difference in overall success of pulp capping in both groups. As the both groups showed 92.59% success rate. CBCT evaluation of dentin bridge formation by Platelet Rich Fibrin (PRF) demonstrated a significantly higher percentage than that formed in cases treated with MTA alone (p < 0.001). Direct pulp capping with Platelet Rich Fibrin (PRF) exhibited a clinical and radiographic success rate comparable to that of MTA. Platelet Rich Fibrin (PRF) can be implemented as a direct pulp capping agent in forthcoming clinical applications.
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Affiliation(s)
- Rahma Ahmed Ibrahem Hafiz Abuhashema
- Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
- Conservative Dentistry Department, Faculty of Dentistry, Beni-Suef University, Beni-Suef, Egypt
| | - Mona El Saied Essa
- Conservative Dentistry Department, Faculty of Dentistry, Beni-Suef University, Beni-Suef, Egypt
| | - Shereen Hafez Ibrahim
- Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
| | - Omaima Mohamed Safwat
- Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
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12
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Kelemen K, König J, Váncsa S, Szabó B, Hegyi P, Gerber G, Schmidt P, Hermann P. Efficacy of different intraarticular injection materials in the arthrocentesis of arthrogenic temporomandibular disorders: A systematic review and network meta-analysis of randomized controlled trials. J Prosthodont Res 2025; 69:203-214. [PMID: 39756891 DOI: 10.2186/jpr.jpr_d_23_00272] [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] [Indexed: 01/07/2025]
Abstract
PURPOSE Arthrogenic temporomandibular disorders (TMDs) that do not respond to conservative treatment necessitate the use of semi-conservative methods, such as arthrocentesis. However, the ranking of intraarticular devices used in arthrocentesis remains controversial. Therefore, a network meta-analysis and systematic review were conducted to compare the different materials used for arthrocentesis. STUDY SELECTION Databases of Cochrane Library, EMBASE, PubMed, and Web of Science were searched systematically to retrieve randomized controlled trials (RCTs) published in English comparing the efficacy of different intraarticular materials used for arthrocentesis. The mean differences (MD) and 95% confidence interval (CI) were calculated for maximum mouth opening (MMO) and pain perception using Bayesian network meta-analysis. RESULTS Among the 7674 studies retrieved, 13 RCTs were included in the quantitative synthesis. Evaluation of the short-term follow-up (1-3 months) outcomes revealed that saline-platelet-rich plasma (saline-PRP) and saline-steroid yielded the greatest improvement in MMO, with MDs of 3.49 (CI: -4.23, 10.81) and 3.36 (CI: -4.70, 10.46), respectively. Saline-PRP exhibited improvement in terms of pain reduction (MD=-2.72 (CI: -5.80, 0.35). Evaluation of the long-term follow-up outcomes revealed that saline-PRP yielded promising results for both outcomes: MD of 1.58 (CI: -6.84, 9.92) and -2.79 (CI: -9.44, 3.60) for MMO and pain reduction, respectively. CONCLUSION Saline-PRP injection led to a clinically noticeable shift in MMO and pain perception in the short term; in contrast, the results of saline-PRP, saline-hyaluronic acid (HA), and saline steroids were statistically insignificant. Saline-HA and saline-steroid effectively increased MMO in the long term, whereas saline-PRP yielded the most distinct reduction in pain.
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Affiliation(s)
- Kata Kelemen
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - János König
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Szilárd Váncsa
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Bence Szabó
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Gábor Gerber
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Péter Schmidt
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Péter Hermann
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
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13
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Huang LR, Zheng XF, Feng ZR, Wu HK, Mo AC. Hydraulic sinus floor elevation using advanced platelet-rich fibrin: A randomized clinical trial with two-dimensional radiographic results. J Prosthodont Res 2025; 69:275-284. [PMID: 39384385 DOI: 10.2186/jpr.jpr_d_24_00065] [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] [Indexed: 10/11/2024]
Abstract
PURPOSE To assess the radiographic outcomes, complications, and implant survival rates of advanced platelet-rich fibrin versus xenografts in hydraulic sinus floor elevation. METHODS In this randomized trial, 40 patients with 46 implants were divided into two groups: a test group (advanced platelet-rich fibrin alone) and a control group (xenograft alone). The key outcome measures included bone regeneration, implant survival, and complications. RESULTS Both groups achieved 100% implant survival. One case of maxillary sinus infection occurred in the control group after surgery. There was no significant difference in bone regeneration between the two groups at 6 months post-surgery and 12 months post-load (P > 0.05). The residual bone height and sinus width at the apex of the implant were significant negative predictors of bone regeneration (P < 0.05), whereas the presence of adjacent teeth was a significant positive predictor (P < 0.05). CONCLUSIONS Both advanced platelet-rich fibrin and xenografts effectively enhanced bone growth at sinus floor elevation, achieving high implant survival rates over one year. Advanced platelet-rich fibrin alone may be a viable xenograft alternative, necessitating further long-term studies to confirm its efficacy. The study was registered in the Chinese Clinical Trial Registry (http://www.chictr.org.cn/) with the registration number ChiCTR2100042060. This clinical trial was not registered before participant recruitment or randomization.
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Affiliation(s)
- Li-Rong Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Geriatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiao-Fei Zheng
- Stomatology Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ze-Ru Feng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hong-Kun Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Geriatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - An-Chun Mo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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14
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Lasheen LR, Gawdat SI, Lutfy RA. Success Rate of Single Versus Two-Visit Regenerative Treatment Protocol in Non-Vital Mature Anterior Teeth (A Preliminary Randomised Clinical Trial). AUST ENDOD J 2025. [PMID: 40219648 DOI: 10.1111/aej.12943] [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: 10/08/2024] [Revised: 03/02/2025] [Accepted: 03/27/2025] [Indexed: 04/14/2025]
Abstract
This study compared the success rate following single-visit versus two-visit regenerative endodontic procedures of non-vital mature anterior teeth with periapical lesion. Thirty-two patients were randomly assigned into two groups: group A: single visit and group B: two visit. All assigned teeth were chemo-mechanically prepared. For group A, platelet rich fibrin was placed into the root canal followed by the placement of Biodentine and final restoration. For group B, calcium hydroxide was placed for 3 weeks, followed by the same regenerative procedures in the second visit. Follow-up visits were at 3, 6, 9 and 12 months, and periapical lesion was assessed by CBCT at the beginning and 12 months after treatment. There was no statistical difference between the success rate of group A (28.6%) and group B (64.3%). Regenerative endodontic procedure can be a promising treatment for mature non-vital teeth with further investigations needed for the single-visit protocol. Trial Registration: Registered at www.clinicaltrials.com NCT03717337.
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15
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Paglianiti M, Togni L, Monarchi G, Betti E, Mascitti M, Balercia A, Santarelli A, Consorti G. Efficacy of concentrated growth factor in the surgical treatment of postanaesthetic palatal necrosis. Minerva Dent Oral Sci 2025; 74:107-113. [PMID: 39945589 DOI: 10.23736/s2724-6329.24.05109-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2025]
Abstract
BACKGROUND Although uncommon, adverse local and systemic reactions to local anesthetic administration can occurred. The postanesthetic necrosis is a rare complication which usually involved the palatal region. The wound healing is a complex process regulated by a range of growth factors. Concentrated growth factor (CGF) is the latest generation of autologous platelet concentrate which has been widely used in the repair and regeneration of oral soft and hard tissue. The study aims to analyses the clinical benefit of CGF in the treatment of postanesthetic necrosis of the hard palate. METHODS The study included all patients referred to the Department of Maxillo-Facial Surgery, Marche University General Hospital, between 2020 and 2022, for aseptic ulcer of the hard palate due to local anesthetic administration. For each patient, the surgical debridement of the necrotic tissue and a peripheral blood sample were performed. The CGF was obtained by a centrifuge device and sutured in the affected site. The greasy gauze, placed to prevent the matrix detachment, was removed seven days post-operative. RESULTS Seven patients (M:F=4:3, mean age 48.6±5.1 years) were enrolled in the study. After 7 days post-operative, no infection, discomfort, or dysphagia were reported. Moreover, 4 patients (57%) showed a total re-epithelialization, while 3 patients (43%) with larger defects, displayed a partial re-epithelialization. A complete recovery occurred in all cases 15 days after surgery. CONCLUSIONS CFG represents a promising potential preparation for the oral mucosa wound healing able to promote the granular tissue formation and the mucosa re-epithelialization.
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Affiliation(s)
- Mariagrazia Paglianiti
- Unit of Maxillofacial Surgery, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Division of Maxillofacial Surgery, Department of Neurological Sciences, Umberto I Marche University Hospital, Ancona, Italy
| | - Lucrezia Togni
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy -
| | - Gabriele Monarchi
- Unit of Maxillofacial Surgery, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Enrico Betti
- Division of Maxillofacial Surgery, Department of Neurological Sciences, Umberto I Marche University Hospital, Ancona, Italy
| | - Marco Mascitti
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Andrea Balercia
- Division of Maxillofacial Surgery, Department of Neurological Sciences, Umberto I Marche University Hospital, Ancona, Italy
| | - Andrea Santarelli
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
- Dentistry Clinic, National Institute of Health and Science of Aging, IRCCS INRCA, Ancona, Italy
| | - Giuseppe Consorti
- Division of Maxillofacial Surgery, Department of Neurological Sciences, Umberto I Marche University Hospital, Ancona, Italy
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
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16
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Erismen Agan B, Uyanık LO, Donmezer CM. Comparison of the postoperative effect of low laser therapy and platelet rich fibrin on mandibular third molar surgery: a randomized study. BMC Oral Health 2025; 25:427. [PMID: 40134000 PMCID: PMC11934512 DOI: 10.1186/s12903-025-05828-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2024] [Accepted: 03/17/2025] [Indexed: 03/27/2025] Open
Abstract
BACKGROUND This study investigates the postoperative benefits of low-level laser therapy (LLLT) and platelet-rich fibrin (PRF) in enhancing patient comfort and reducing complications after mandibular third molar extractions. METHODS Sixty patients with vertically impacted mandibular third molars were randomly assigned to one control and three test groups (n = 15 each). In Group 1, PRF was applied to the socket post-extraction. In Group 2, PRF was combined with LLLT (B-Cure Dental Laser, 808 nm wavelength, 4 J/cm² energy density, continuous wave) applied extra-orally for three days post-surgery. Group 3 received LLLT alone. Group 4 (control group) underwent traditional osteotomy without additional treatments. All patients were prescribed 875/125 mg amoxicillin/clavulanic acid twice daily for five days. RESULTS Postoperative parameters such as pain, swelling, analgesic use, and trismus were assessed on days 1, 2, 3, and 7. Significant improvements in pain, swelling, and trismus were observed in Groups 2 and 3 compared to the control (p < 0.001). Swelling was also significantly reduced in Group 1 compared to the control. CONCLUSIONS The study demonstrated favorable clinical outcomes in the LLLT and PRF groups, suggesting that both treatments could be promising strategies for improving postoperative recovery in terms of comfort and reduced complications. TRIAL REGISTIRATION Clinicaltrials.gov ID: NCT06262945. The trial was first registered on 16/02/2024. Retrospectively registered.
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Affiliation(s)
- Beste Erismen Agan
- Department of Oral and Maxillofacial Surgery, Near East University Faculty of Dentistry, Nicosia, Mersin-10, Turkey.
| | - Lokman Onur Uyanık
- Department of Oral and Maxillofacial Surgery, Near East University Faculty of Dentistry, Nicosia, Mersin-10, Turkey
| | - Ceren Melahat Donmezer
- Department of Oral and Maxillofacial Surgery, Near East University Faculty of Dentistry, Nicosia, Mersin-10, Turkey
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17
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Farshidfar N, Amiri MA, Estrin NE, Ahmad P, Sculean A, Zhang Y, Miron RJ. Platelet-rich plasma (PRP) versus injectable platelet-rich fibrin (i-PRF): A systematic review across all fields of medicine. Periodontol 2000 2025. [PMID: 40125556 DOI: 10.1111/prd.12626] [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: 01/10/2025] [Revised: 02/13/2025] [Accepted: 03/02/2025] [Indexed: 03/25/2025]
Abstract
This systematic review aimed to evaluate all available evidence across all fields of medicine regarding the comparative effectiveness of platelet-rich plasma (PRP) versus injectable platelet-rich fibrin (i-PRF). A comprehensive search was conducted in PubMed, Scopus, and Web of Science up to September 30, 2024. Following a thorough screening process, studies were divided into in vitro, in vivo, and clinical studies based on their tissue/clinical indications. The initial search generated 2192 articles, of which 23 met the inclusion criteria. The findings demonstrated that i-PRF yielded higher platelet concentrations and offered a more sustained, long-term release of growth factors over time when compared to PRP. Overall, it was determined from in vitro studies that i-PRF significantly improved the activity of many cell types, including for skin, cartilage, periodontal, bone, soft tissue around dental implants, and pulp cells. In vivo outcomes also generally indicated that i-PRF outperformed PRP in cartilage and testicular regeneration. However, in orthodontic tooth movement, PRP was found to lead to superior short-term effects, while i-PRF showed more beneficial long-term effects. Clinical studies also found superior outcomes of i-PRF in skin regeneration, cartilage, and pulp regeneration. Outcomes regarding orthodontic tooth movement utilizing i-PRF or PRP remain controversial. In 72% of studies, i-PRF was found to lead to better outcomes across the various fields of medicine when compared to PRP, whereas 24% found no differences between the groups. Reasons and inconsistencies across the studies may be attributed to protocol differences and tissue types. Overall, additional clinical studies are needed with well-designed research and centrifugation protocols to better understand the regenerative potential of platelet concentrates in medicine. i-PRF offers a more sustained and prolonged release of growth factors and was favored in the majority of studies over PRP and should, therefore, be favored for the majority of medical and dental applications.
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Affiliation(s)
- Nima Farshidfar
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Mohammad Amin Amiri
- Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nathan E Estrin
- Lake Erie College of Osteopathic Medicine School of Dental Medicine, Bradenton, Florida, USA
| | - Paras Ahmad
- Department of Research, Advanced PRF Education, Jupiter, Florida, USA
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Yufeng Zhang
- Department of Oral Implantology, University of Wuhan, Wuhan, China
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
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18
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Chuang HN, Pei W, Kuo TF, Liu YH, Wang CY, Chang YW, Chuang C, Yang CH, Chuang MH. Effect of injecting adipose stem cells combined with platelet-rich fibrin releasate at Shenshu acupoint (BL23) on acute kidney injury in rabbits. Front Pharmacol 2025; 16:1409056. [PMID: 40144656 PMCID: PMC11936987 DOI: 10.3389/fphar.2025.1409056] [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: 09/24/2024] [Accepted: 02/19/2025] [Indexed: 03/28/2025] Open
Abstract
Introduction Acute kidney injury (AKI) is a major and unmet medical need, characterized by a sudden onset of kidney dysfunction that often occurs within 7 days. Adipose-derived stem cells (ADSCs) are known for their regenerative, differentiative, and repair abilities, making them a promising therapeutic option for kidney injury. Platelet-rich fibrin releasate (PRFr), derived from platelet-rich fibrin after static incubation, contains numerous growth factors that may promote the differentiation and proliferation of stem cells. Additionally, acupoints such as Shenshu (BL23) have been used in clinical practice and experimental settings, particularly in renal failure treatments. Methods This study aimed to evaluate the synergistic effects of ADSCs and PRFr, administered separately or in combination, at the Shenshu acupoint (BL23) in New Zealand white rabbits with acute kidney injury. The treatment groups were injected with ADSCs, PRFr, or a combination of both. Serum creatinine (CRE) and blood urea nitrogen (BUN) levels were measured to assess kidney function. Additionally, histological examination of kidney tissue was performed to observe morphological changes and tissue repair. Results The PRFr + ADSCs treatment group exhibited a significant reduction in CRE and BUN levels during the second week following transplantation. After 7 weeks of treatment, the PRFr + ADSCs group showed the most favorable kidney repair outcomes, with intact glomeruli, no edema or vacuole-like changes in the renal tubular epithelial cells, and no significant infiltration of inflammatory cells in the surrounding tissues. Discussion The administration of PRFr, ADSCs, and their combination at the Shenshu acupoint (BL23) demonstrated a potential therapeutic effect in repairing damaged renal cells, improving kidney function, and reducing serum CRE and BUN levels. These findings suggest that injection of PRFr, ADSCs, and their combination at the Shenshu acupoint (BL23) can effectively repair damaged renal cells and improve kidney function in AKI. The observed synergistic effect indicates that this approach holds potential as a novel therapeutic strategy for kidney injury. Further research is needed to optimize treatment protocols and elucidate the underlying mechanisms.
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Affiliation(s)
- Hsin-Ni Chuang
- Ph.D. Program of Management, Chung Hua University, Hsinchu, Taiwan
| | - Wen Pei
- College of Management, Chung Hua University, Hsinchu, Taiwan
| | - Tzong-Fu Kuo
- School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Hao Liu
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chia-Yih Wang
- Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen-Wei Chang
- Department of Physical Education, Asia University, Taichung, Taiwan
| | | | - Chang-Huan Yang
- Gwo Xi Stem Cell Applied Technology Co., Ltd., Hsinchu, Taiwan
| | - Ming-Hsi Chuang
- College of Management, Chung Hua University, Hsinchu, Taiwan
- Gwo Xi Stem Cell Applied Technology Co., Ltd., Hsinchu, Taiwan
- Institute of Biopharmaceutical Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei City, Taiwan
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19
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Valenzuela-Mencia J, Manzano-Moreno FJ. Applications of Platelet-Rich Fibrin (PRF) Membranes Alone or in Combination with Biomimetic Materials in Oral Regeneration: A Narrative Review. Biomimetics (Basel) 2025; 10:172. [PMID: 40136826 PMCID: PMC11940760 DOI: 10.3390/biomimetics10030172] [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: 02/01/2025] [Revised: 03/05/2025] [Accepted: 03/10/2025] [Indexed: 03/27/2025] Open
Abstract
Platelet-rich fibrin (PRF) membranes are a biomaterial derived from the patient's own blood, used in different medical and dental areas for their ability to promote healing, tissue regeneration, and reduce inflammation. They are obtained by centrifuging the blood, which separates the components and concentrates the platelets and growth factors in a fibrin matrix. This material is then moulded into a membrane that can be applied directly to tissues. The use of these PRF membranes is often associated with the use of different biomimetic materials such as deproteinized bovine bone mineral (DBBM), β-tricalcium phosphate (β-TCP), enamel matrix derivative (EMD), and hydroxyapatite (HA). Different indications of PRF membranes have been proposed, like alveolar ridge preservation, alveolar ridge augmentation, guided tissue regeneration (GTR), and sinus floor augmentation. The aim of this narrative review is to check the state-of-the-art and to analyze the existing gaps in the use of PRF membranes in combination with biomimetic materials in alveolar ridge preservation, alveolar ridge augmentation, guided tissue regeneration (GTR), and sinus floor augmentation.
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Affiliation(s)
- Javier Valenzuela-Mencia
- Department of Stomatology, Colegio Máximo de Cartuja s/n, University of Granada, 18071 Granada, Spain;
| | - Francisco Javier Manzano-Moreno
- Department of Stomatology, Colegio Máximo de Cartuja s/n, University of Granada, 18071 Granada, Spain;
- Biomedical Group (BIO277), University of Granada, 18071 Granada, Spain
- Instituto Investigación Biosanitaria, ibs.Granada, 18012 Granada, Spain
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20
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Sá-Oliveira JA, Vieira Geraldo M, Marques M, Luiz RM, Krasinski Cestari F, Nascimento Lima I, De Souza TC, Zarpelon-Schutz AC, Teixeira KN. Bioactivity of dressings based on platelet-rich plasma and Platelet-rich fibrin for tissue regeneration in animal model. World J Biol Chem 2025; 16:98515. [PMID: 40070854 PMCID: PMC11891554 DOI: 10.4331/wjbc.v16.i1.98515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 10/14/2024] [Accepted: 12/05/2024] [Indexed: 03/05/2025] Open
Abstract
BACKGROUND Skin wounds are common injuries that affect quality of life and incur high costs. A considerable portion of healthcare resources in Western countries is allocated to wound treatment, mainly using mechanical, biological, or artificial dressings. Biological and artificial dressings, such as hydrogels, are preferred for their biocompatibility. Platelet concentrates, such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), stand out for accelerating tissue repair and minimizing risks of allergies and rejection. This study developed PRF and PRP-based dressings to treat skin wounds in an animal model, evaluating their functionality and efficiency in accelerating the tissue repair process. AIM To develop wound dressings based on platelet concentrates and evaluating their efficiency in treating skin wounds in Wistar rats. METHODS Wistar rats, both male and female, were subjected to the creation of a skin wound, distributed into groups (n = 64/group), and treated with Carbopol (negative control); PRP + Carbopol; PRF + Carbopol; or PRF + CaCl2 + Carbopol, on days zero (D0), D3, D7, D14, and D21. PRP and PRF were obtained only from male rats. On D3, D7, D14, and D21, the wounds were analyzed for area, contraction rate, and histopathology of the tissue repair process. RESULTS The PRF-based dressing was more effective in accelerating wound closure early in the tissue repair process (up to D7), while PRF + CaCl2 seemed to delay the process, as wound closure was not complete by D21. Regarding macroscopic parameters, animals treated with PRF + CaCl2 showed significantly more crusting (necrosis) early in the repair process (D3). In terms of histopathological parameters, the PRF group exhibited significant collagenization at the later stages of the repair process (D14 and D21). By D21, fibroblast proliferation and inflammatory infiltration were higher in the PRP group. Animals treated with PRF + CaCl2 experienced a more pronounced inflammatory response up to D7, which diminished from D14 onwards. CONCLUSION The PRF-based dressing was effective in accelerating the closure of cutaneous wounds in Wistar rats early in the process and in aiding tissue repair at the later stages.
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Affiliation(s)
- João Abel Sá-Oliveira
- Programa Multicêntrico de Pós-graduação em Bioquímica e Biologia Molecular - Setor Palotina, Universidade Federal do Paraná, Palotina 85950-000, Paraná, Brazil
| | | | - Milena Marques
- Campus Toledo, Universidade Federal do Paraná, Toledo 85919-899, Paraná, Brazil
| | - Rafael Messias Luiz
- Campus Toledo, Universidade Federal do Paraná, Toledo 85919-899, Paraná, Brazil
| | | | | | | | - Ana Carla Zarpelon-Schutz
- Campus Toledo, Universidade Federal do Paraná, Toledo 85919-899, Paraná, Brazil
- Programa de Pós-graduação em Biotecnologia-Setor Palotina, Universidade Federal do Paraná, Palotina 85950-000, Paraná, Brazil
| | - Kádima Nayara Teixeira
- Programa Multicêntrico de Pós-graduação em Bioquímica e Biologia Molecular - Setor Palotina, Universidade Federal do Paraná, Palotina 85950-000, Paraná, Brazil
- Campus Toledo, Universidade Federal do Paraná, Toledo 85919-899, Paraná, Brazil
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Eken S, Guler Ayyıldız B, Altay B, Arı NS, Özatik O. Clinical, Radiological, and Histomorphometric Comparison of the Use of Deproteinized Bovine Bone Mineral and Titanium-Prepared Platelet-Rich Fibrin in Maxillary Sinus Augmentation: A Split-Mouth Randomized Controlled Clinical Study. J Oral Maxillofac Surg 2025; 83:322-331. [PMID: 39638292 DOI: 10.1016/j.joms.2024.11.006] [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: 07/17/2024] [Revised: 11/13/2024] [Accepted: 11/13/2024] [Indexed: 12/07/2024]
Abstract
BACKGROUND Maxillary sinus augmentation (MSA) is a standard and predictable procedure to increase bone height in the atrophic posterior maxilla. Many biomaterials are employed in this technique; however, autologous platelet concentrates have been found to reduce clinical recovery time and improve bone gain in MSA. PURPOSE This study aimed to compare the radiographic, histomorphometric, and implant stability outcomes of titanium-prepared platelet-rich fibrin (T-PRF) and deproteinized bovine bone mineral (DBBM) in a two-stage MSA technique. STUDY DESIGN, SETTING, SAMPLE This randomized controlled split-mouth study included patients requiring bilateral two-stage MSA at the Periodontology Department of Kutahya Health Sciences University between March 2022 and April 2023. Patients with systemic comorbidities and residual bone height >5 mm in the bilateral posterior maxilla were excluded. PREDICTOR VARIABLE The predictor variable was the two-stage MSA technique. Each surgical site was randomly assigned to the T-PRF or DBBM group for two-stage MSA. MAIN OUTCOME VARIABLES The primary outcome was the histomorphometric evaluation of the percentage of new bone between the 2 groups. Secondary outcomes included radiographic evaluation of total bone height (ToBH), bone gain, bone density (BD), and graft volume (GV) on cone-beam computed tomography 6 months post-MSA, clinical assessment of primary implant stability at implant placement and secondary stability 3 months postplacement, and histomorphometric evaluation of the percentage of residual particles, percentage of connective tissue, and percentage of blood vessels from bone biopsy samples collected 6 months after MSA. COVARIATES Age, sex, periodontitis susceptibility, and smoking status were treated as covariates. ANALYSES The Wilcoxon signed-rank test was used for bivariate comparisons between 2 groups, and the Pearson or Spearman test was used to analyze correlations of variables within groups. A P value ≤ .05 was considered statistically significant. RESULTS The sample was composed of 10 patients with bilateral maxillary sinuses, 20 MSA regions, 8 (80%) males and 2 (20%) females with a mean age of 51.30 (9.06) year. The percentage of new bone was 19.48 ± 14.60 μm2 in the T-PRF group and 8.31 ± 5.47 μm2 in the DBBM group, and there was no statistically significant difference between the groups (P = .074). Radiographic measurements showed ToBH, GV, and BD values of 10.64 ± 3.96 mm, 989.89 ± 523.07 mm3, and 192.09 ± 127.90 hounsfield unit in the T-PRF group and 14.25 ± 1.65 mm, 1,519.39 ± 432.61 mm3, and 492.77 ± 117.35 hounsfield unit in the DBBM group, respectively. ToBH, GV, and BD values were statistically significant between the groups (P = .01 and P = .00). Primary and secondary implant stability in the T-PRF group were 71.11 ± 12.48 implant stability quotient (ISQ) and 68.03 ± 6.81 ISQ, respectively, compared with 67.94 ± 19.84 ISQ and 72.46 ± 11.21 ISQ in the DBBM group. The difference was not statistically significant between the groups (P = .41 and P = .33). CONCLUSION AND RELEVANCE Although T-PRF demonstrated inferior radiographic outcomes compared with DBBM during the initial6-month healing phase, both techniques yielded comparable results regarding new bone formation and implant stability. Further research is warranted to explore the efficacy of different T-PRF applications in MSA. This trial is registered at ClinicalTrials.gov (NCT05596084).
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Affiliation(s)
- Seyma Eken
- Lecturer, Oral Health Department, Tavsanlı Vocational School of Health Services, Kutahya Health Sciences University, Kutahya, Türkiye.
| | - Berceste Guler Ayyıldız
- Associate Professor, Department of Periodontology, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Türkiye
| | - Berkan Altay
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kirikkale University, Kirikkale, Türkiye
| | - Neziha Senem Arı
- Assistant Professor, Department of Histology and Embryology, Faculty of Medicine, Kutahya Health Sciences University, Kutahya, Türkiye
| | - Orhan Özatik
- Professor, Department of Histology and Embryology, Faculty of Medicine, Kutahya Health Sciences University, Kutahya, Türkiye
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Xu C, Pei Y, Wang Y, Li W, Yang L, Chai A, Wang Y, Fan W, Tan H. Progress in the application of auto-concentrated growth factor (CGF) in wound repair. J Biomater Appl 2025; 39:819-827. [PMID: 39648295 DOI: 10.1177/08853282241305362] [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] [Indexed: 12/10/2024]
Abstract
Auto-concentrated growth factor (CGF) constitutes the latest generation of plasma extract, and has high concentrations of growth factors and white blood cells. Due to the continuous variable speed centrifugation used during preparation, the tensile strength of the fibrin is also higher. CGF preparation does not involve the use of animal serum, minimizing the risk of infection and immune rejection. Therefore, it has wide potential applications in various fields of regenerative medicine. This paper summarizes the history behind CGF development, reviews the clinical applications and research progress concerning single CGF therapy and CGF used in combination with other treatments in multiple wound repair, and summarizes its potential value as therapeutic agent. Finally, some constructive suggestions and research perspectives for the application of CGF in wound healing are put forward. The available evidence indicates that CGF can promote the healing of chronic refractory wounds and acute wound, promote the growth of granulation, accelerate the speed and improve the quality of wound healing, reduce scar formation, minimize the need for repeated wound dressing, and ameliorate the pain experienced by patients.
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Affiliation(s)
- Chao Xu
- Department of Plastic Surgery, Zibo Central Hospital, Zibo, China
| | | | - Yanli Wang
- Department of Plastic Surgery, Zibo Central Hospital, Zibo, China
| | - Wenpeng Li
- Department of Plastic Surgery, Zibo Central Hospital, Zibo, China
| | - Liu Yang
- Department of Plastic Surgery, Zibo Central Hospital, Zibo, China
| | - Aimei Chai
- Wuxi Chuangmeng Precision Medicine Technology Co., Ltd, Wuxi, China
| | - Ying Wang
- Shandong Airuida Guoke Medical Technology Co., Ltd, Jinan, China
| | | | - Huiquan Tan
- Shandong Airuida Guoke Medical Technology Co., Ltd, Jinan, China
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Yang M, Deng B, Hao W, Jiang X, Chen Y, Wang M, Yuan Y, Chen M, Wu X, Du C, Armstrong DG, Guo L, Deng W, Wang H. Platelet concentrates in diabetic foot ulcers: A comparative review of PRP, PRF, and CGF with case insights. Regen Ther 2025; 28:625-632. [PMID: 40166040 PMCID: PMC11955794 DOI: 10.1016/j.reth.2025.02.005] [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: 09/27/2024] [Revised: 01/20/2025] [Accepted: 02/12/2025] [Indexed: 03/14/2025] Open
Abstract
Diabetic foot ulcers (DFUs) are severe complications of diabetes, often leading to chronic wounds, amputations, and increased mortality risk. Platelet concentrates (PCs)-natural biomaterials utilized in regenerative medicine-have garnered attention for their capacity to enhance tissue repair and wound healing. This study reviews the preparation methods, biological mechanisms, and clinical efficacy of three generations of PCs: platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and concentrated growth factors (CGF). Comparative analysis reveals that PRP, the first generation, provides abundant growth factors but relies on anticoagulants, which may hinder fibrin formation and tissue adhesion. PRF, as the second generation, eliminates anticoagulants, forming a fibrin matrix that sustains growth factor release and enhances cell migration. CGF, the latest advancement, employs refined centrifugation to achieve higher growth factor concentrations and a denser fibrin matrix, accelerating tissue regeneration. Case series results demonstrated superior wound healing outcomes with CGF, including faster epithelialization and reduced healing time compared to PRP and PRF. These findings underscore CGF's potential as the most effective PC for managing DFUs, supporting its broader clinical adoption in advanced wound care.
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Affiliation(s)
- Mengling Yang
- Department of Endocrinology and Metabolism, School of Medicine, Chongqing University Central Hospital, Chongqing Emergency Medical Centre, Chongqing University, Chongqing 400014, China
| | - Bo Deng
- Department of Endocrinology and Metabolism, School of Medicine, Chongqing University Central Hospital, Chongqing Emergency Medical Centre, Chongqing University, Chongqing 400014, China
- Chongqing Key Laboratory of Emergency Medicine, Chongqing, China
| | - Wei Hao
- Department of Endocrinology and Metabolism, School of Medicine, Chongqing University Central Hospital, Chongqing Emergency Medical Centre, Chongqing University, Chongqing 400014, China
| | - Xiaoyan Jiang
- Department of Endocrinology and Metabolism, School of Medicine, Chongqing University Central Hospital, Chongqing Emergency Medical Centre, Chongqing University, Chongqing 400014, China
| | - Yan Chen
- Department of Endocrinology and Metabolism, School of Medicine, Chongqing University Central Hospital, Chongqing Emergency Medical Centre, Chongqing University, Chongqing 400014, China
| | - Min Wang
- Department of Endocrinology and Metabolism, School of Medicine, Chongqing University Central Hospital, Chongqing Emergency Medical Centre, Chongqing University, Chongqing 400014, China
| | - Yi Yuan
- Department of Endocrinology and Metabolism, School of Medicine, Chongqing University Central Hospital, Chongqing Emergency Medical Centre, Chongqing University, Chongqing 400014, China
| | - Meirong Chen
- Department of Endocrinology and Metabolism, School of Medicine, Chongqing University Central Hospital, Chongqing Emergency Medical Centre, Chongqing University, Chongqing 400014, China
| | - Xiaohua Wu
- Department of Endocrinology and Metabolism, School of Medicine, Chongqing University Central Hospital, Chongqing Emergency Medical Centre, Chongqing University, Chongqing 400014, China
| | - Chenzhen Du
- Department of Endocrinology and Metabolism, School of Medicine, Chongqing University Central Hospital, Chongqing Emergency Medical Centre, Chongqing University, Chongqing 400014, China
| | - David G. Armstrong
- Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA 90033, USA
| | - Lian Guo
- Chongqing University Three Gorges Hospital, Chongqing University, Chongqing, China
| | - Wuquan Deng
- Department of Endocrinology and Metabolism, School of Medicine, Chongqing University Central Hospital, Chongqing Emergency Medical Centre, Chongqing University, Chongqing 400014, China
- Department of Population Health Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Hongyan Wang
- Department of Endocrinology and Metabolism, School of Medicine, Chongqing University Central Hospital, Chongqing Emergency Medical Centre, Chongqing University, Chongqing 400014, China
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Thapa N, Kattel B, Kumar A, Shrestha S. Mucosal Fenestration Closure: A Case Report on Regenerative Therapeutic Strategies. Clin Case Rep 2025; 13:e70334. [PMID: 40104080 PMCID: PMC11913724 DOI: 10.1002/ccr3.70334] [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: 08/22/2024] [Revised: 02/23/2025] [Accepted: 03/05/2025] [Indexed: 03/20/2025] Open
Abstract
Mucosal fenestration, a condition that poses risks to dental integrity, requires effective management to prevent complications such as unwanted tooth loss. The integration of guided tissue regeneration (GTR), Platelet-rich fibrin (PRF), and bone grafts is an effective strategy for managing mucosal fenestration, ensuring optimal tissue regeneration and long-term success.
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Affiliation(s)
- Nabin Thapa
- Department of Periodontology and Oral Implantology BP Koirala Institute of Health Sciences Dharan Nepal
| | - Bibek Kattel
- College of Dental Surgery BP Koirala Institute of Health Sciences Dharan Nepal
| | - Abhishek Kumar
- College of Dental Surgery BP Koirala Institute of Health Sciences Dharan Nepal
| | - Sajeev Shrestha
- Department of Periodontology and Oral Implantology BP Koirala Institute of Health Sciences Dharan Nepal
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Baadsgaard Bruun L, Waskiw Hardon TA, Havnsøe Krogh AK, Qvortup K, Heegaard S, Thuri Kristensen A, Henriksen MDL. The use of a "horizontal centrifugation protocol" to prepare autologous platelet-rich fibrin membranes for corneal reconstruction surgery in dogs with complicated corneal ulcerations: A case series. Vet Ophthalmol 2025; 28:175-189. [PMID: 37721981 PMCID: PMC11911980 DOI: 10.1111/vop.13148] [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: 05/24/2023] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE The purpose of this case series was to describe the effect of autologous PRF membrane for corneal reconstruction surgery in dogs. PRF membranes made from two healthy dogs unrelated to the current case series were used for PRF histologic analyses. ANIMALS Seven dogs with complicated corneal ulcerations. PROCEDURE A complete ophthalmic examination, hematology, and fibrinogen analysis were performed pre-surgery. A PRF clot was made from autologous blood in a serum tube after centrifugation in a horizontal Bio-PRF® Centrifuge at 700 × g for 8 min. The PRF clot was processed in a PRF-Box® into a PRF membrane. The PRF membrane was sutured to the corneal ulcer bed. Each dog had a follow-up at days 5-7, 12-14, and 30-40 post-surgery. A final long-term follow-up was performed as well. RESULTS A positive outcome with healing and a "good" quality PRF membrane was seen in six out of seven dogs. One dog had a fibrinogen level below normal range and the PRF membrane was of "poor" quality. This dog developed a descemetocele 13 days post-surgery and needed rescue surgery. Mean healing time for all dogs was 9 ± 5.5 days. Minimal scarring, corneal pigmentation, and vascularization were observed at the final long-term follow-up 288 ± 44 days post-surgery. CONCLUSION PRF membrane was successful as graft material for corneal ulceration reconstruction surgery. Low fibrinogen appeared to have negative effect on the quality of the PRF membrane, showing the importance for the surgeon to evaluate the quality of the PRF membrane prior to surgery.
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Affiliation(s)
- Louise Baadsgaard Bruun
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Anicura Aarhus Veterinary HospitalAarhusDenmark
| | - Tommy A. Waskiw Hardon
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Haslev Veterinary ClinicHaslevDenmark
| | - Anne K. Havnsøe Krogh
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Klaus Qvortup
- Departmnent of Biomedical Science, Core Facility for Integrated Microscopy, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Steffen Heegaard
- Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Annemarie Thuri Kristensen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Michala de Linde Henriksen
- Comparative Ophthalmology, Department of Clinical Sciences, College of Veterinary MedicineNorth Carolina State UniversityRaleighNorth CarolinaUSA
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Almoliky N, Hosny M, Elbattawy W, Fawzy El-Sayed K. Low-Speed Platelet-Rich Fibrin Membrane in Conjunction With Demineralized Freeze-Dried Bone Allograft (DFDBA) Compared to Collagen Membrane With DFDBA in Noncontained Intraosseous Defects of Stage III Periodontitis: A Randomized Controlled Clinical Trial. Int J Dent 2025; 2025:6393105. [PMID: 40028653 PMCID: PMC11872290 DOI: 10.1155/ijod/6393105] [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: 11/24/2023] [Revised: 11/22/2024] [Accepted: 01/30/2025] [Indexed: 03/05/2025] Open
Abstract
Aim: Noncontained (1- or combined 1- to 2-wall) periodontal intraosseous defects represent challenging clinical situations with unpredictable surgical therapeutic outcomes. This randomized clinical trial assessed demineralized freeze-dried bone allograft (DFDBA) with low speed-platelet-rich fibrin (PRF) membrane compared to DFDBA with collagen membrane (CM) in the surgical periodontal therapy of noncontained intraosseous defects of stage III periodontitis patients. Methodology: Twenty-two stage III periodontitis patients with noncontained intraosseous defects measuring ≥3 mm and clinical attachment loss ≥5 mm were randomly allocated into two groups: test group (low-speed PRF membrane + DFDBA) and control group (CM + DFDBA), with 11 participants per group. Clinical and radiographic assessments were conducted at baseline, 3, 6, 9, and 12 months for clinical attachment level (CAL; primary outcome), gingival recession depth (GRD), probing depth (PD), full mouth bleeding score (FMBS) and full mouth plaque score (FMPS), radiographic bone fill and radiographic linear defect depth (RLDD; all secondary outcomes). Results: The mean (±SD) CAL-gain for the test group was 2.45 (±1.51), 2.91 (±1.70), 2.91 (±1.87), and 2.82 (±1.83) mm, while for the control group 2.82 (±1.25), 3.27 (±1.27), 3.00 (±1.41), and 2.64 (±1.50) mm at 3, 6, 9, and 12 months, respectively, with no significant intergroup differences (p > 0.05). Despite the absence of significant intergroup differences, both groups demonstrated significant intragroup improvement in CAL- and PD-gain, and RLDD-reduction at 3, 6, 9, and 12 months as well as RLDD improvement at 12 months (p < 0.05). Conclusion: PRF membranes, in conjunction with DFDBA, show significant improvement of periodontal clinical and radiographic parameters, comparable to CMs with DFDBA. Trial Registration: ClinicalTrials.gov identifier: NCT03922503.
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Affiliation(s)
- Najeeb Almoliky
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Manal Hosny
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Weam Elbattawy
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Karim Fawzy El-Sayed
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany
- Stem Cells and Tissue Engineering Research Unit, Faculty of Dentistry, Cairo University, Cairo, Egypt
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27
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Karkle A, Neimane L, Zolovs M, Dambergs M, Meistere D, Vaskevica A, Slaidina A. Impact of Advanced Platelet-Rich Fibrin on Early Bone Healing After Endodontic Microsurgery: A Randomized Controlled Trial. Diagnostics (Basel) 2025; 15:516. [PMID: 40075764 PMCID: PMC11898956 DOI: 10.3390/diagnostics15050516] [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: 01/22/2025] [Revised: 02/08/2025] [Accepted: 02/18/2025] [Indexed: 03/14/2025] Open
Abstract
Background: Apical surgery can address periapical pathologies when conventional endodontic treatments fail. Advanced platelet-rich fibrin (A-PRF) has emerged as a regenerative material with the potential to enhance healing in periapical surgery. In this study, we evaluated the effect of A-PRF on periapical lesion healing using cone beam computed tomography (CBCT). Methods: A randomized controlled trial at Rīga Stradiņš University Institute of Stomatology included 43 participants (15 males, 28 females; mean age: 44 years) with periradicular lesions. Participants were divided into experimental and control groups. Baseline and follow-up CBCT imaging assessed lesion volumes at 6 and 12 months post-surgery. Results: Mean lesion volumes significantly decreased from 431.4 mm3 at baseline to 102.8 mm3 at 6 months and 49.2 mm3 at 12 months (p < 0.001). A-PRF did not significantly reduce the lesion sizes compared to the controls (p = 0.043), but was associated with reduced inflammation and enhanced soft tissue healing. Key confounders included gender and baseline lesion volume, with males exhibiting smaller lesion sizes postoperatively. Conclusions: The results suggest that A-PRF may not offer a significant advantage in terms of reducing defect size or improving radiographic resolution.
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Affiliation(s)
- Aleksandra Karkle
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, LV-1007 Riga, Latvia
- RSU Institute of Stomatology, LV-1007 Riga, Latvia
| | - Laura Neimane
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, LV-1007 Riga, Latvia
- RSU Institute of Stomatology, LV-1007 Riga, Latvia
| | - Maksims Zolovs
- Statistics Unit, Riga Stradins University, LV-1007 Riga, Latvia
- Institute of Life Sciences and Technology, Daugavpils University, LV-5401 Daugavpils, Latvia
| | - Matiss Dambergs
- RSU Institute of Stomatology, LV-1007 Riga, Latvia
- Department of Orthodontics, Riga Stradins University, LV-1007 Riga, Latvia
| | - Dita Meistere
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, LV-1007 Riga, Latvia
- RSU Institute of Stomatology, LV-1007 Riga, Latvia
| | - Anete Vaskevica
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, LV-1007 Riga, Latvia
- RSU Institute of Stomatology, LV-1007 Riga, Latvia
| | - Anda Slaidina
- RSU Institute of Stomatology, LV-1007 Riga, Latvia
- Department of Prosthetic Dentistry, Riga Stradins University, LV-1007 Riga, Latvia
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Bukhary S. Apexification of an Endodontically Failed Permanent Tooth with an Open Apex: A Case Report with Histologic Findings. MEDICINA (KAUNAS, LITHUANIA) 2025; 61:276. [PMID: 40005393 PMCID: PMC11857209 DOI: 10.3390/medicina61020276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2025] [Revised: 01/28/2025] [Accepted: 02/04/2025] [Indexed: 02/27/2025]
Abstract
The management of an endodontic failure in a traumatized tooth with an open apex presents a major dilemma. The arrest of root growth after traumatic injury is a substantial consequence of pulpal necrosis. Conventional endodontic treatment procedures will be challenging by the resulting thin, fragile dentinal walls, which will impede the appropriate debridement and optimal apical sealing. Apexification is a well-established procedure that is designed to treat or preserve a tooth with an incomplete root apex and necrotic pulpal tissue by promoting the formation of a calcified apical barrier through the application of a bioactive substance at the root apex. The present case report demonstrates a successful apexification procedure for an endodontically failed permanent central incisor with an open apex with a two-year follow-up time. The clinical and radiographical results revealed the absence of signs and symptoms and the formation of hard tissue at the root apex. The tooth was extracted for prosthodontic reasons and processed for histologic examination. The histologic evaluation revealed dentin-like and cementum-like tissues formed at the apical barrier.
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Affiliation(s)
- Sundus Bukhary
- Division of Endodontics, Department of Restorative Dental Science, College of Dentistry, King Saud University, P.O. Box 45347, Riyadh 13313, Saudi Arabia
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29
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Gulsever S, Uckan S. Enhanced Palatal Wound Healing with Leucocyte- and Platelet-Rich Fibrin After Free Gingival Graft Harvesting: A Prospective Randomized Controlled Clinical Trial. J Clin Med 2025; 14:1029. [PMID: 39941697 PMCID: PMC11818664 DOI: 10.3390/jcm14031029] [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: 01/16/2025] [Revised: 02/01/2025] [Accepted: 02/02/2025] [Indexed: 02/16/2025] Open
Abstract
Background/Objectives: Autogenous palatal free gingival graft (FGG) harvesting presents challenges for patients due to the increased risk of postoperative morbidity related to a second intraoral surgical wound that heals with secondary intention. This parallel-group, randomized, controlled, open-label trial aimed to evaluate the efficacy of the application of leukocyte- and platelet-rich fibrin (L-PRF) membrane to the palatal donor site on wound healing, hemostasis, and pain control after FGG harvesting. Methods: Twenty-eight adult patients with insufficient attached gingiva underwent soft tissue augmentation using FGG harvested from the palate at the Department of Oral and Maxillofacial Surgery, Baskent University, Turkey. Patients were randomized to either an L-PRF group or a control group. In the L-PRF group, the L-PRF membrane was sutured to the donor sites, whereas in the control group, donor sites healed by secondary intention. Postoperative evaluations were conducted on days 1, 3, 5, and 7 and at weeks 2, 3, 4, 5, and 6. Donor sites were evaluated clinically for pain, burning sensation, bleeding, wound healing, and color match to adjacent tissues. Donor site wound areas were analyzed using digital images. Results: Two patients were excluded from the analysis due to loss of contact, leaving 26 (n = 13, n = 13) patients for analysis. Donor site pain and burning sensation were significantly lower in the L-PRF group compared to the control group during the first two postoperative weeks (p < 0.001). Bleeding was significantly lower in the L-PRF group on postoperative days 1 and 3 (p < 0.001). Clinical healing index scores were significantly higher in the L-PRF group at weeks 3 and 4 (p < 0.001). Additionally, palatal wound area reductions from baseline were significantly greater in the L-PRF group at all follow-up intervals (p < 0.001). Conclusions: The application of an L-PRF membrane to palatal donor wounds after FGG harvesting significantly reduces postoperative pain, decreases bleeding, and accelerates healing, providing a valuable autologous biomaterial for enhanced wound healing and improved patient comfort.
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Affiliation(s)
- Serap Gulsever
- Department of Oral and Maxillofacial Surgery, School of Dentistry, İstanbul Medipol University, Atatürk Bulvarı No:27, Unkapanı, Fatih, 34083 İstanbul, Turkey
| | - Sina Uckan
- Department of Oral and Maxillofacial Surgery, School of Dentistry, İstanbul Medipol University, TEM Avrupa Otoyolu Göztepe Çıkışı No:1, Bağcılar, 34214 İstanbul, Turkey;
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Fouad S, Rizk A, Mosbah E, Nabeeh MM, Awadin W, Elmezayyen AS, Elmorsy E, Zaghloul A. Platelet-rich fibrin and silver nano-particles loaded chitosan treatment for post- laminectomy epidural scar adhesions: in vivo rats study model. BMC Neurosci 2025; 26:10. [PMID: 39910448 PMCID: PMC11796154 DOI: 10.1186/s12868-025-00929-9] [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: 12/15/2024] [Accepted: 01/17/2025] [Indexed: 02/07/2025] Open
Abstract
OBJECTIVE Epidural scar fibrosis commonly leads to functional disability and pain following spinal surgery and is a prevalent manifestation of Failed Back Surgery Syndrome (FBSS). This study aimed to evaluate the use of silver nano-articles (AgNPs) loaded on chitosan (Chi/Ag-NPs) with platelets-rich fibrin (PRF) gel for the reduction of post-laminectomy epidural scar adhesions. METHODS A total of 90 male Sprague Dawley rats (255 ± 55gm) were randomized in-to six groups, each group with 15 rats: control group, laminectomy group, PRF group, Chi/Ag-NPs group, combined treatment group (PRF + Chi/Ag-NPs), and a group to prepare PRF. Lumbar laminectomy procedures were performed between L3-L5 in all rats except the control group. After a 30-days follow-up, macroscopic examination, histological studies, and mRNA evaluation for TGFβ-1and IL-6, were conducted. RESULTS Data revealed that epidural scar adhesion, scaring, arachnoid involvement, dural thickness, as well as inflammation and TGFβ-1and IL-6 coding genes expression were significantly reduced in PRF group, Chi/Ag-NPs group, and combined group compared to the laminectomy group. Combined treatment showed more significant better outcomes. CONCLUSION The use of PRF with Chi/Ag-NPs as nano biomaterials could be considered a combination therapy for the reduction of EF post-laminectomy in a rat model.
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Affiliation(s)
- Samah Fouad
- Medical Experimental Research Center (MERC), Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Awad Rizk
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516, Egypt.
| | - Esam Mosbah
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Mostafa M Nabeeh
- Department of Neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Walaa Awadin
- Department of Pathology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Ayman S Elmezayyen
- Physics Department, Faculty of Science, Mansoura University, Mansoura, 35516, Egypt
- Physics Department, Faculty of Science, New Mansoura University, New Mansoura, Egypt
| | - Ekramy Elmorsy
- Center for Health Research, Northern Border University, Arar, Saudi Arabia.
| | - Adel Zaghloul
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516, Egypt
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Quirynen M, Siawasch SAM, Yu J, Miron RJ. Essential principles for blood centrifugation. Periodontol 2000 2025; 97:43-51. [PMID: 38778518 DOI: 10.1111/prd.12555] [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: 09/25/2023] [Revised: 01/09/2024] [Accepted: 02/05/2024] [Indexed: 05/25/2024]
Abstract
Currently, autologous platelet concentrates (APCs) are frequently used for soft- and hard-tissue regeneration, not only within the oral cavity, but also extra-orally including chronic wounds, burns, joints, dermatological conditions, among others. The benefits of APCs are largely influenced by the treatment strategy but also their preparation. This paper therefore discusses in detail: the physical properties of blood cells, the basic principles of blood centrifugation, the impact of the centrifugation protocol (rotations/revolutions per minute, g-force, variation between centrifuges), the importance of timing during the preparation of APCs, the impact of the inner surface of the blood tubes, the use/nonuse of anticoagulants within APC tubes, the impact of the patient's hematocrit, age, and gender, as well as the important requirements for an optimal centrifugation protocol. All these variables indeed have a significant impact on the clinical outcome of APCs.
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Affiliation(s)
- Marc Quirynen
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Sayed Ahmad Manoetjer Siawasch
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Jize Yu
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
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Resmi R, Parvathy J, Anjali S, Amrita N, Jyothi A, Harikrishnan VS, John A, Joseph R. Platelet-Rich Plasma Loaded Alginate-Based Injectable Hydrogel for Meniscal Tear Repair: In Vivo Evaluation in Lapine Model. J Biomed Mater Res B Appl Biomater 2025; 113:e35541. [PMID: 39891920 DOI: 10.1002/jbm.b.35541] [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: 09/05/2024] [Revised: 11/28/2024] [Accepted: 01/20/2025] [Indexed: 02/03/2025]
Abstract
Platelet-rich plasma (PRP) has been employed for orthopedic applications for decades due to the abundance of bioactive cues/growth factors that ameliorate the proliferation and migration of relevant cells involved in tissue repair/regeneration. In this work, PRP was incorporated into injectable compositions of alginate-based hydrogel and evaluated in vitro and in vivo. In vitro tests revealed that PRP addition promoted cell adhesion, cell proliferation, and distribution of seeded fibrochondrocytes on the hydrogel. Further, the DNA quantification and sGAG estimation confirmed the production of fibrocartilage-specific extracellular matrix, predominantly type 1 collagen and sGAG. For in vivo evaluation, tears were created surgically in the rabbit menisci and were filled with injectable hydrogel. Sham and hydrogel without PRP were used as controls. Histopathological evaluation after 3 months of implantation revealed that the healing was partial for sham control, but complete for hydrogel without PRP. The hydrogel served as the scaffold for fibrocartilage tissue regeneration. On the other hand, PRP-incorporated hydrogel showed good healing with low signs of inflammation as evidenced by histology and biochemical content. The healing was complete, and the nature of the regenerated tissues was very close to native tissue indicating that alginate-based hydrogel is a promising candidate for meniscal tissue repair.
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Affiliation(s)
- Rajalekshmi Resmi
- Division of Polymeric Medical Devices, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Jayasree Parvathy
- Corporate R&D Center, HLL Life Care Limited, Thiruvananthapuram, Kerala, India
| | - Sudha Anjali
- Department of Biochemistry, University of Kerala, Thiruvananthapuram, Kerala, India
| | - Natarajan Amrita
- Department of Applied Biology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Arun Jyothi
- Department of Orthopaedics, Sree Uthradom Thirunal (SUT) Hospital, Thiruvananthapuram, Kerala, India
| | - V S Harikrishnan
- Division of Laboratory Animal Science, Department of Applied Biology, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Annie John
- Department of Biochemistry, University of Kerala, Thiruvananthapuram, Kerala, India
| | - Roy Joseph
- Division of Polymeric Medical Devices, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
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Zhu Z, Sun X, Chen K, Zhang M, Wu G. Comprehensive evaluation of advanced platelet-rich fibrin in common complications following sagittal split ramus osteotomy: a double-blind, split-mouth, randomized clinical trial. Int J Oral Maxillofac Surg 2025; 54:134-142. [PMID: 38839533 DOI: 10.1016/j.ijom.2024.03.005] [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: 08/02/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 06/07/2024]
Abstract
The sagittal split ramus osteotomy (SSRO) carries potential risks and complications. A double-blind, split-mouth, randomized clinical trial was performed, involving 30 patients undergoing mandibular setback. Advanced platelet-rich fibrin (A-PRF) was applied to one side, and the other side served as a control. The volume of postoperative drainage over 24 h was recorded. At 1, 2, and 5 days, and 3 months postsurgery, nerve recovery was assessed using the two-point discrimination test (TPD), while pain was evaluated using a visual analogue scale (VAS pain). Facial swelling was evaluated by taking linear measurements from facial reference points at the same time intervals. In the treatment group, the 24-hour drainage volume was lower (P = 0.011), pain was better on day 5 (P = 0.011), and TPD was better on day 2 (P = 0.011), day 5 (P = 0.007), and 3 months postoperatively (P = 0.020) than in the control group. There was also less facial swelling in the treatment group when compared to the baseline of 3 months postoperative (day 1, P = 0.012; day 2, P = 0.001; day 5, P = 0.011). The difference in bone mineral density (HU) at 3 months between the treatment group (469.7 ± 134.2) and the control group (348.3 ± 127.2) was statistically significant (P = 0.011), in favour of the treatment group. A-PRF may reduce postoperative complications such as neurosensory disturbance of the inferior alveolar nerve, pain, swelling, and drainage while enhancing bone healing in the osteotomy gap following SSRO. TRIAL REGISTRATION: The study was registered with the Chinese Clinical Trial Register (ChiCTR2200064534).
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Affiliation(s)
- Z Zhu
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, China
| | - X Sun
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Changchun, China
| | - K Chen
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, China
| | - M Zhang
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, China
| | - G Wu
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University, Changchun, China.
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Patankar VR, Jain AK, Rao RD. Platelet-Rich Fibrin in Surgical Endodontics: A Report of Two Cases Demonstrating Its Benefits. Cureus 2025; 17:e78898. [PMID: 40091944 PMCID: PMC11908631 DOI: 10.7759/cureus.78898] [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: 01/25/2025] [Accepted: 02/12/2025] [Indexed: 03/19/2025] Open
Abstract
Surgical endodontics is the last resort to manage persistent periapical lesions, which do not respond to conventional endodontic treatment. The rationale of periapical surgery is to remove all infected tissues and provide a sealed environment that promotes the healing of periradicular tissues. In order to enhance healing, several biomaterials have been utilized, such as bone grafts, collagen membranes, and platelet concentrates. This case report presents two cases of surgical management of a periapical lesion in failed primary endodontic treatment in the maxillary first premolar and first molar by apicoectomy and the use of platelet-rich fibrin (PRF) for bone regeneration and tissue healing. Both cases were diagnosed as periapical granuloma and showed considerable radiographic bone fill at six and 12 months of follow-up, demonstrating the benefits of PRF in surgical endodontics.
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Affiliation(s)
- Vaishnavi R Patankar
- Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Ashish K Jain
- Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Rahul D Rao
- Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
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35
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Blanco J, García A, Hermida‐Nogueira L, Castro AB. How to explain the beneficial effects of leukocyte- and platelet-rich fibrin. Periodontol 2000 2025; 97:74-94. [PMID: 38923566 PMCID: PMC11808445 DOI: 10.1111/prd.12570] [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: 01/24/2024] [Revised: 03/06/2024] [Accepted: 04/15/2024] [Indexed: 06/28/2024]
Abstract
The survival of an organism relies on its ability to repair the damage caused by trauma, toxic agents, and inflammation. This process involving cell proliferation and differentiation is driven by several growth factors and is critically dependent on the organization of the extracellular matrix. Since autologous platelet concentrates (APCs) are fibrin matrices in which cells, growth factors, and cytokines are trapped and delivered over time, they are able to influence that response at different levels. The present review thoroughly describes the molecular components present in one of these APCs, leukocyte- and platelet-rich fibrin (L-PRF), and summarizes the level of evidence regarding the influence of L-PRF on anti-inflammatory reactions, analgesia, hemostasis, antimicrobial capacity, and its biological mechanisms on bone/soft tissue regeneration.
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Affiliation(s)
- Juan Blanco
- Department of Surgery (Stomatology, Unit of Periodontology)Universidade de Santiago de CompostelaSantiago de CompostelaSpain
| | - Angel García
- Platelet Proteomics Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS)Santiago de Compostela UniversitySantiago de CompostelaSpain
| | - Lidia Hermida‐Nogueira
- Platelet Proteomics Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS)Santiago de Compostela UniversitySantiago de CompostelaSpain
| | - Ana B. Castro
- Department of Oral Health Sciences, Section of Periodontology, KU Leuven & DentistryUniversity Hospitals LeuvenLeuvenBelgium
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Calciolari E, Dourou M, Akcali A, Donos N. Differences between first- and second-generation autologous platelet concentrates. Periodontol 2000 2025; 97:52-73. [PMID: 38487938 PMCID: PMC11808449 DOI: 10.1111/prd.12550] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/22/2023] [Accepted: 12/30/2023] [Indexed: 02/11/2025]
Abstract
Autologous platelet concentrates (APCs) applied alone or combined with other biomaterials are popular bioactive factors employed in regenerative medicine. The main biological rationale of using such products is to concentrate blood-derived growth factors and cells into the wound microenvironment to enhance the body's natural healing capacity. First-generation APC is represented by platelet-rich plasma (PRP). While different protocols have been documented for PRP preparation, they overall consist of two cycles of centrifugation and have important limitations related to the use of an anticoagulant first and an activator afterward, which may interfere with the natural healing process and the release of bioactive molecules. The second generation of platelet concentrates is represented by leukocyte and platelet-rich fibrin (L-PRF). L-PRF protocols involve a single centrifugation cycle and do not require the use of anticoagulants and activators, which makes the preparation more straight forward, less expensive, and eliminates potential risks associated with the use of activators. However, since no anticoagulant is employed, blood undergoes rapid clotting within the blood collection tube; hence, a timely management of L-PRF is crucial. This review provides an overview on the most documented protocols for APC preparations and critically discusses the main differences between first- and second-generation APCs in terms of cell content, protein release, and the formation of a 3D fibrin network. It appears evident that the inconsistency in reporting protocol parameters by most studies has contributed to conflicting conclusions regarding the efficacy of different APC formulations and has significantly limited the ability to interpret the results of individual clinical studies. In the future, the use of a standardized classification system, together with a detailed reporting on APC protocol parameters is warranted to make study outcomes comparable. This will also allow to clarify important aspects on the mechanism of action of APCs (like the role of leukocytes and centrifugation parameters) and to optimize the use of APCs in regenerative medicine.
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Affiliation(s)
- Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and DentistryQueen Mary University of LondonLondonUK
- Dental School, Department of Medicine and SurgeryUniversity of ParmaParmaItaly
| | - Marina Dourou
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and DentistryQueen Mary University of LondonLondonUK
| | - Aliye Akcali
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and DentistryQueen Mary University of LondonLondonUK
- Department of Periodontology, Faculty of DentistryDokuz Eylul UniversityIzmirTurkey
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and DentistryQueen Mary University of LondonLondonUK
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Maree M, Nabriski O, Yoshpe M, Lin S, Kaufman AY. Time-Dependent Morphological Changes in Traumatic Immature Teeth With Necrotic Pulps Following Regenerative Endodontic Treatment: A Retrospective Study. Dent Traumatol 2025; 41:47-58. [PMID: 39440805 DOI: 10.1111/edt.12986] [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: 12/06/2023] [Revised: 07/11/2024] [Accepted: 07/21/2024] [Indexed: 10/25/2024]
Abstract
BACKGROUND/AIM Regenerative endodontic treatment is a promising approach for healing periapical lesions and continuous root maturation. Although previous studies have reported its outcomes, the dynamics of morphological changes over time remain unclear. Therefore, this study aimed to evaluate changes in the periapical status and root dimensions over a 60-month follow-up period. MATERIALS AND METHODS The follow-up duration, periapical status changes, calcific barrier formation, degree of apical closure and radiographic root area changes were compared with those of the last follow-up in this retrospective study. Radiographic root area changes were calculated as the difference between the total root and total canal areas. RESULTS Fifty-eight patients (81 teeth) underwent regenerative endodontic treatment during the study period, of whom 32 patients (36 teeth, 62%) were included. The survival and success rates of the treated teeth were 100% and 94.4%, respectively. All teeth developed a calcific bridge in the cervical third of the root canal, indicating the presence of vital tissue. Apical narrowing (partial or total) was observed in 75% of the cases. The root maturation stage affected the percentage increase in the radiographic root area. Teeth in Cvek stages II-III showed a higher radiographic root area increase than more mature teeth. All tooth radiographic root areas increased significantly in the initial 20 months of the treatment and moderately thereafter. CONCLUSIONS Regenerative endodontic treatment is a safe approach for traumatised immature teeth. The presence of a radiographic calcified bridge may be an early indication of treatment success. The main complete tooth morphological changes occur after approximately 20 months posttreatment. These findings may help clinicians better understand the time-dependent changes in the root morphology after treatment, improve the follow-up schedule and predict the progress of healing during follow-up visits.
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Affiliation(s)
- Manal Maree
- Endodontics Department, School of Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Omri Nabriski
- Endodontics Department, School of Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Margarita Yoshpe
- Department of Endodontics, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Shaul Lin
- Endodontics Department, School of Dentistry, Rambam Health Care Campus, Haifa, Israel
- The Israeli National Center for Trauma & Emergency Medicine Research, the Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Arieh Y Kaufman
- Department of Endodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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Abdelhaleem M, Saleh W, Elmeadawy S. Treatment of gingival recession with vestibular incision subperiosteal tunnel access and advanced platelet-rich fibrin. BMC Oral Health 2025; 25:63. [PMID: 39806320 PMCID: PMC11731150 DOI: 10.1186/s12903-024-05398-w] [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: 08/24/2024] [Accepted: 12/26/2024] [Indexed: 01/16/2025] Open
Abstract
OBJECTIVES The current literature about the effect of advanced platelet rich fibrin(A-PRF) with vestibular incision subperiosteal tunnel access (VISTA) technique in treating gingival recession is scarce. Therefore, the aim of the current randomized clinical trial is to evaluate the effect of A-PRF with VISTA technique in the treatment of Cairo class 1 gingival recession (RT1). METHODS Twenty-four patients who met the eligibility criteria were randomly allocated into two groups. VISTA + A-PRF was the treatment of the study group, while VISTA + collagen matrix was performed for the control group. The clinical outcomes were assessed by a single-blind assessor at baseline, three months, and six months. They were divided into primary and secondary outcomes. The primary outcomes included recession depth (RD), recession width (RW), gingival thickness (GT), mean of root coverage % (MRC%), and width of attached gingiva (WAG) while the secondary outcome included clinical attachment level (CAL). RESULTS The primary outcomes analysis demonstrated statistically significant improvements in RD, RW, MRC%, GT, and WAG after 3 and 6 months in both groups (p < 0.001). However, the study group demonstrated a significantly greater improvement than the control group in RD, RW, and MRC%. No significant differences were observed between the two groups regarding GT and WAG. CONCLUSIONS Both treatment approaches were effective in the treating of RT1 adjacent gingival recessions. A-PRF showed promising results compared to collagen matrix. TRIAL REGISTRATION The current randomized clinical trial was registered at ClinicalTrials.gov (Registration number: NCT06357351) and it was released on 10/04/2024.
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Affiliation(s)
- Marwa Abdelhaleem
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Horus University, New Damietta, Egypt
| | - Wafaa Saleh
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, 33516, Egypt.
| | - Samah Elmeadawy
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, 33516, Egypt.
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Darwish OB, Aziz SMA, Sadek HS. Healing potentiality of blood clot, S-PRF and A-PRF as scaffold in treatment of non-vital mature single rooted teeth with chronic peri-apical periodontitis following regenerative endodontic therapy: randomized clinical trial. BMC Oral Health 2025; 25:50. [PMID: 39789544 PMCID: PMC11715601 DOI: 10.1186/s12903-024-05378-0] [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: 09/11/2024] [Accepted: 12/23/2024] [Indexed: 01/12/2025] Open
Abstract
OBJECTIVES This randomized prospective controlled trial investigated the effectiveness of different strategies of regenerative endodontic therapy on necrotic mature anterior teeth with chronic periapical periodontitis with 18 months follow up. METHODS A total analyzed 51 adult participant with mature single rooted teeth having necrotic pulp with chronic periapical periodontitis (PAI ≥ 3) were selected. Patients had been randomly categorized into three distinct groups (n = 17 each group). All groups received the same treatment on the first visit. After 2 weeks, regenerative treatment was performed using either blood clot technique, Standard-PRF and Advanced-PRF approach. A standardized radiograph was taken, and the patients instructed for 6, 12 and 18 months follow up periods. Fisher's exact test was applied to compare the frequency of PAI scores at different follow-up intervals between the three groups. RESULTS The results showed radiographic success at 18 months (58.8% in blood group, 94.1% in S-PRF group and 76.5% in A-PRF group). There was no statistically significant difference between the three groups according to incidence of healing at 6, 12 and 18 months. Clinical success was 82.4% in blood group and 88.2% in both S-PRF and A-PRF groups. There was no significant difference between the three groups (p = 1). The overall success (clinical and radigraphic) was 76.5%. Incidence of the gaining sensitivity after 12 and 18 months was 29.4% with A-PRF group and 41.2% within the S-PRF group, 17.6% with BC group. CONCLUSION PRF based regenerative technique may outperform the blood clot technique in treatment of non-vital mature teeth with chronic periapical periodontitis. There is a need for future randomized clinical studies to consolidate procedures in this field with more prolonged evaluation periods. CLINICAL TRIAL REGISTRATION The study was retrospectively registered with ClinicalTrials.gov (ID: NCT04606719 ) in 28/10/2020.
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Affiliation(s)
- Omnia Badawy Darwish
- Endodontics Department, Faculty of Dentistry, Cairo University, 11 El-Saraya Street, Manial, Cairo, Egypt.
- Endodontics Department, Faculty of Dentistry, Menofia University, Shibin Al kawm, Menofia, Egypt.
| | | | - Hany Samy Sadek
- Endodontics Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Bhattacharjee K, Venkatraman V, Soni D, Gaikwad S. Autologous Platelet-rich Fibrin as a Three-dimensional Structural Scaffold in the Healing of Contracted Orbital Sockets. Ophthalmic Plast Reconstr Surg 2025; 41:52-60. [PMID: 38776162 DOI: 10.1097/iop.0000000000002714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
PURPOSE Evaluation of platelet-rich fibrin as an adjuvant in surface healing of contracted orbital sockets. METHODS Prospective, interventional, and comparative study of 25 patients with moderate to severe contracted sockets conducted over 2 years (February 2020-February 2022). Group 1 underwent a dermis-fat graft with fornix forming sutures supplemented by a platelet-rich fibrin membrane, while group 2 received a dermis-fat graft with fornix forming sutures only. Patients over 18 years were evaluated as per prefixed inclusion and exclusion criteria. Assessments were conducted at 1, 3, and 12 months postsurgery, focusing on wound evaluation, socket epithelialization, postoperative pain, prosthesis rehabilitation, and complications, if any. Wound evaluation and pain intensity were assessed utilizing the wound evaluation score and visual analog scale, respectively. Socket epithelization was documented clinically at every visit. RESULTS The study showed a mean age of 38.8 ± 8.8 years, with a 2:1 male-to-female ratio. Group 1 consistently scored higher on wound evaluation score than group 2 at all follow-up points. In group 1, 81.8% achieved a maximum wound evaluation score at 4 weeks and 100% at 3 and 12 months, compared to group 2's 42.8%, 50%, and 57.1%, respectively ( p < 0.05). Postoperative contracture occurred in 3 group 2 patients at the final follow-up, with 6 showing unsatisfactory appearance. Group 1 demonstrated significantly lower pain intensity on postoperative day 1 ( p = 0.03), and greater epithelization at 4 weeks. CONCLUSION platelet-rich fibrin appears to be an effective solution for enhancing wound healing during socket reconstruction, attributed to its sustained release of growth factors and mesenchymal stem cells.
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Affiliation(s)
- Kasturi Bhattacharjee
- Department of Ophthalmic Plastic and Reconstructive Surgery, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
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Elnashar AM, Albishbishy M, Sheir H, Elayyouti M, Elsherbiny M, Elzohiri M, Ghazaly Waly ME, Elsaied A. Comparative Study Between Autologous Platelet-rich Fibrin Membrane and Local Flaps as Intervening Layer in Management of Distal Hypospadias. J Pediatr Surg 2025; 60:161994. [PMID: 39461004 DOI: 10.1016/j.jpedsurg.2024.161994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 09/26/2024] [Accepted: 10/02/2024] [Indexed: 10/28/2024]
Abstract
BACKGROUND/PURPOSE The most frequent complication following hypospadias correction is fistula formation. Recently, fibrin glue has been employed as a 2nd layer covering the urethroplasty resulting in a reduction in the incidence of fistulas. Platelet-rich fibrin (PRF) is an autologous growth factor-rich source. Although the authors recommend the use of additional layers in hypospadias correction, there remains a controversy. In a trial to address this issue, our research was conducted to compare the accessibility of urethroplasty coverage using PRF to traditional local flaps, aiming to prevent fistula formation in hypospadias repair. PATIENTS AND METHODS This is a prospective single-blinded randomized controlled study that involved 60 hypospadias cases admitted to Mansoura University Children Hospital's Pediatric Surgery department between March 2021 and March 2023. These 60 cases were randomly divided into 2 equal groups: (group A platelet-rich fibrin coverage membrane & group B local dartos flap as an additional layer). Both groups were compared regarding the rate of complications. All cases were evaluated regarding age at repair, type of hypospadias, urethral plate width, length of urethroplasty, and size of the 2nd layer. The blood loss and operative time were documented and post-operatively; the cases were assessed for the repair intactness, shape, and size of the neo-meatus, existence of any post-operative problems such as urethral fistula, urethral stricture, meatal stenosis, failure of the repair, or diverticulum. Statistical analysis was carried out following data collection. RESULTS The median length of the 2nd layer in group A was 20 mm (range 15-23 mm) and in group B was 22.5 mm (range 19.5-25 mm) and the difference between the two groups was statistically significant (p = 0.012∗), while its median width in group A was 10 mm (range 10-11 mm) and in group B was 15 mm (range 10-18 mm) and also there was statistically significant difference (p = 0.001∗). The mean operative time in group A was 95.73 ± 11.9 min and in group B was 102.33 ± 10.32 min and there was a statistically significant difference (P < 0.001). The length of hospital stay in group A was 5.47 ± 1.11 days and in group B was 5.47 ± 0.89 days. The urethral fistula was detected in 4 cases of group A (13.3%) and 3 cases of group B (10%). The failure of repair was similar, one case of each group (3.3%). The meatal stenosis was reported in only one case of group A (3.4%) and 7 cases of group B (24.1%) (P = 0.02∗) and the difference was statistically significant. There were no reports of urethral strictures among the cases in either group over the follow-up period (mean 9 months, range 5-17 months). CONCLUSION PRF patch may be employed as a coverage layer over the urethroplasty in repair of the distal hypospadias, especially in cases without accessible vascular flap with comparable outcome to traditional local flaps. TYPE OF STUDY A prospective single blinded randomized controlled trial (computer-generated numbers method). LEVEL OF EVIDENCE Level 2.
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Affiliation(s)
- Ahmed M Elnashar
- Mansoura University Children Hospital, Pediatric Surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Mohammed Albishbishy
- Mansoura University Children Hospital, Pediatric Surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Hesham Sheir
- Mansoura University Children Hospital, Pediatric Surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Moustafa Elayyouti
- Mansoura University Children Hospital, Pediatric Surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed Elsherbiny
- Mansoura University Children Hospital, Pediatric Surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed Elzohiri
- Mansoura University Children Hospital, Pediatric Surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - M El Ghazaly Waly
- Mansoura University Children Hospital, Pediatric Surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Adham Elsaied
- Mansoura University Children Hospital, Pediatric Surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Wei Z, Zhang M, Chen M, Song Y, Wang Y. Effects of Cell-Free Fat Extract and Platelet-Rich Fibrin on Scar Maturation in an Experimental Rabbit Ear Wound Model. Clin Cosmet Investig Dermatol 2024; 17:2901-2909. [PMID: 39712941 PMCID: PMC11662919 DOI: 10.2147/ccid.s489625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2024] [Accepted: 12/12/2024] [Indexed: 12/24/2024]
Abstract
Background Multiple methods have been used to treat hypertrophic scarring; however, an optimal treatment method remains to be established. We aimed to research and compare the effects of cell-free fat extract (CEFFE) and platelet-rich fibrin (PRF) on hypertrophic scar formation based on histomorphological analysis in this study. Methods Twelve rabbits were divided into four groups randomly. (CEFFE+PRF group, n=3; CEFFE group, n=3, PRF group, n=3 and Control group, n=3). After the ear hypertrophic scar model were established, the two ears of each rabbit in the four groups were injected with CEFFE 0.05 mL/cm2 + PRF 0.05 mL/cm2, CEFFE 0.1 mL/cm2, PRF 0.1 mL/cm2, and saline 0.1 mL/cm2, respectively. The scar elevation index and histological analysis using hematoxylin-eosin and Masson staining were evaluated after injection on day 40. Results The CEFFE+PRF group was significantly more effective in the prevention of pathological scar formation than the CEFFE-only, PRF-only, and control groups in terms of capillary count, collagen organization, fibroblast count, and scar elevation index (p<0.05). Discussion CEFFE combined with PRF was the most effective treatment for the prevention of hypertrophic scar formation in our study.
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Affiliation(s)
- Zhenni Wei
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
- Fujian Obstetrics and Gynecology Hospital, Fuzhou, Fujian, People’s Republic of China
| | - Mingliang Zhang
- Fuzhou First General Hospital Affiliated with Fujian Medical University, Fuzhou, People’s Republic of China
| | - Minjian Chen
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
| | - Yong Song
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
| | - Yi Wang
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
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Chmielewski M, Pilloni A, Adamska P. Application of Advanced Platelet-Rich Fibrin in Oral and Maxillo-Facial Surgery: A Systematic Review. J Funct Biomater 2024; 15:377. [PMID: 39728177 DOI: 10.3390/jfb15120377] [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: 11/11/2024] [Revised: 12/04/2024] [Accepted: 12/12/2024] [Indexed: 12/28/2024] Open
Abstract
Background: Advanced platelet-rich fibrin (A-PRF) is produced by centrifuging the patient's blood in vacuum tubes for 14 min at 1500 rpm. The most important component of A-PRF is the platelets, which release growth factors from their ⍺-granules during the clotting process. This process is believed to be the main source of growth factors. The aim of this paper was to systematically review the literature and to summarize the role of A-PRF in oral and maxillo-facial surgery. Materials and Methods: A systematic review was carried out, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO: CRD42024584161). Results: Thirty-eight articles published before 11 November 2024 were included in the systematic review. The largest study group consisted of 102 patients, and the smallest study group consisted of 10 patients. A-PRF was most often analyzed compared to leukocyte-PRF (L-PRF) or blood cloth. A-PRF was correlated with lower postoperative pain. Also, A-PRF was highlighted to have a positive effect on grafting material integration. A-PRF protected areas after free gingival graft very well, promoted more efficient epithelialization of donor sites and enhanced wound healing. Conclusions: Due to its biological properties, A-PRF could be considered a reliable addition to the surgical protocols, both alone and as an additive to bio-materials, with the advantages of healing improvement, pain relief, soft tissue management and bone preservation, as well as graft integration. However, to determine the long-term clinical implications and recommendations for clinical practice, more well-designed randomized clinical trials are needed in each application, especially those with larger patient cohorts, as well as additional blinding of personnel and long follow-up periods.
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Affiliation(s)
| | - Andrea Pilloni
- Section of Periodontics, Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00-185 Rome, Italy
| | - Paulina Adamska
- Division of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland
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Fakih-Gomez N, Manay R, Nazari S, Martins L, Muñoz-Gonzalez C. Regenerative Nanofat Membrane Development Process. Aesthetic Plast Surg 2024:10.1007/s00266-024-04562-5. [PMID: 39663222 DOI: 10.1007/s00266-024-04562-5] [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: 07/19/2024] [Accepted: 11/11/2024] [Indexed: 12/13/2024]
Abstract
INTRODUCTION Chronic wounds present a significant challenge in clinical practice due to complications like infections and prolonged healing times. Conventional treatments often fall short, necessitating advancements in wound healing strategies. This article introduces a novel approach using a combination of adipose-derived stem cells (ADSCs) from fat and growth factors from platelet-rich fibrin (PRF) to enhance wound healing outcomes. METHODS The Fakih-Manay fat membrane device was utilized to prepare fat membranes. Microfat was harvested and emulsified to produce nanofat, which was then combined with PRF to create a Nanofat-PRF membrane. The resulting membrane was uniform, versatile, and suture-friendly, making it ideal for various medical and surgical applications. RESULTS Between April 2019 and April 2024, 172 patients received treatment using a nanofat membrane. The membrane showed significant improvement in wound healing in various cases including diabetic foot ulcers, cleft palate surgeries, facial dermabrasion, skin necrosis, revision rhinoplasties, and post-cosmetic surgery complications. Postoperative follow-up after healing ranged from 1 to 16 months, showing high patient satisfaction and significant improvements in wound healing and no reported complications. CONCLUSION The nanofat membrane presents a versatile and innovative approach to enhancing healing across a broad range of medical and surgical applications. This study provides the first evidence on the method for creating these membranes, demonstrating their clinical efficacy and safety, with no reported complications over a 5-year period. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Nabil Fakih-Gomez
- Department of Facial Plastic & Cranio-Maxillo-Facial Surgery, Fakih Hospital, Khaizaran, Lebanon.
- Department of Surgery, University of Salamanca, Salamanca, Spain.
| | - Roshini Manay
- Department of Facial Plastic & Cranio-Maxillo-Facial Surgery, Fakih Hospital, Khaizaran, Lebanon
| | - Shahriar Nazari
- Department of Otorhinolaryngology and Head and Neck Surgery, BMI Hospital, Tehran, Iran
| | - Lessandro Martins
- Private Practice, 2653 Orion Business Health and Center, Goiania, Brazil
| | - Cristina Muñoz-Gonzalez
- Department of Facial Plastic & Cranio-Maxillo-Facial Surgery, Fakih Hospital, Khaizaran, Lebanon
- Department of Surgery, University of Salamanca, Salamanca, Spain
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Inchingolo F, Inchingolo AM, Latini G, de Ruvo E, Campanelli M, Palermo A, Fabbro MD, Blasio MD, Inchingolo AD, Dipalma G. Guided Bone Regeneration: CGF and PRF Combined With Various Types of Scaffolds-A Systematic Review. Int J Dent 2024; 2024:4990295. [PMID: 39669891 PMCID: PMC11637628 DOI: 10.1155/ijod/4990295] [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: 05/31/2024] [Accepted: 11/08/2024] [Indexed: 12/14/2024] Open
Abstract
Objective: Bone regeneration plays a pivotal role in modern oral surgery, particularly in facilitating successful implant-prosthetic rehabilitation. This systematic review explores the regenerative potential of growth factors, such as platelet-rich fibrin (PRF) and concentrated growth factors (CGFs), when combined with various types of scaffolds in bone augmentation procedures, including guided bone regeneration, split crest, sinus lift (SL), and alveolar ridge preservation. Method: A comprehensive search strategy yielded 18 relevant studies, which were analyzed for bone formation and stabilization outcomes. Results: Results indicate that PRF enhances bone regeneration and stabilization in SL and ridge augmentation procedures, while CGFs facilitate surgical techniques and augment bone. However, some studies did not report significant differences. Growth factors also demonstrate benefits in wound healing, reducing bone resorption, and enhancing socket preservation. Conclusion: Despite valuable insights, further research is needed to comprehensively understand the characteristics of growth factors in various surgical interventions, ensuring informed decision-making in bone regeneration surgery.
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Affiliation(s)
- Francesco Inchingolo
- Interdisciplinary Department of Medicine, Università degli Studi di Bari Aldo Moro, Bari 70124, Italy
| | - Angelo Michele Inchingolo
- Interdisciplinary Department of Medicine, Università degli Studi di Bari Aldo Moro, Bari 70124, Italy
| | - Giulia Latini
- Interdisciplinary Department of Medicine, Università degli Studi di Bari Aldo Moro, Bari 70124, Italy
| | - Elisabetta de Ruvo
- Interdisciplinary Department of Medicine, Università degli Studi di Bari Aldo Moro, Bari 70124, Italy
| | - Merigrazia Campanelli
- Interdisciplinary Department of Medicine, Università degli Studi di Bari Aldo Moro, Bari 70124, Italy
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK
| | - Massimo Del Fabbro
- Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Marco Di Blasio
- Department of Biomedical Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Alessio Danilo Inchingolo
- Interdisciplinary Department of Medicine, Università degli Studi di Bari Aldo Moro, Bari 70124, Italy
| | - Gianna Dipalma
- Interdisciplinary Department of Medicine, Università degli Studi di Bari Aldo Moro, Bari 70124, Italy
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Bhandare RS, Mattigatti S. Management of an Open Apex Using a Platelet-Rich Fibrin Membrane as an Internal Matrix and Mineral Trioxide Aggregate as an Apical Barrier: A Case Report. Cureus 2024; 16:e75316. [PMID: 39776744 PMCID: PMC11706102 DOI: 10.7759/cureus.75316] [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: 06/14/2024] [Accepted: 12/08/2024] [Indexed: 01/11/2025] Open
Abstract
Apexification is a crucial procedure for achieving apical healing in non-vital teeth with open apices. Traditionally, calcium hydroxide has been used for this purpose, but it has significant drawbacks, including prolonged treatment duration, increased risk of root fracture, and the potential for porous barrier formation. Mineral trioxide aggregate (MTA) has emerged as a superior alternative due to its biocompatibility, faster setting time, and better sealing properties. However, MTA extrusion into periradicular tissues can cause persistent discomfort. The use of an internal matrix such as platelet-rich fibrin (PRF) can help contain MTA within the root canal, enhancing treatment outcomes. A 35-year-old female presented with dull, aching pain in tooth 21, a history of trauma 10 years prior, and incomplete root canal therapy 2 years ago. Diagnosis revealed an open apex with chronic apical periodontitis and pulpal necrosis. Initial management involved canal disinfection with sodium hypochlorite (NaOCl) and calcium hydroxide as intracanal medication. One week later, the patient returned asymptomatic. PRF was prepared from the patient's blood and used as an internal matrix. Mineral trioxide aggregate was then placed against the PRF membrane to form an apical stop. The canal was subsequently obturated with thermoplasticized gutta-percha and restored with composite resin. The use of PRF and MTA provided effective apical sealing, preventing material extrusion and promoting tissue healing. The PRF matrix facilitated the controlled placement of MTA, minimizing complications and enhancing periapical healing. The combination of PRF as an internal matrix and MTA for apical barrier formation represents a promising approach for managing non-vital teeth with open apices. This technique ensures better control over material placement, reduces treatment time, and improves the overall success of endodontic therapy. The aim of this case report is to describe the endodontic management of a non-vital permanent tooth with an open apex and chronic apical periodontitis using a single-step apical barrier technique with MTA and PRF as an internal matrix.
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Affiliation(s)
- Ruchali S Bhandare
- Department of Conservative Dentistry and Endodontics, School of Dental Science, Krishna Vishwa Vidyapeeth (Deemed To Be University), Karad, IND
| | - Sudha Mattigatti
- Department of Conservative Dentistry and Endodontics, School of Dental Science, Krishna Vishwa Vidyapeeth (Deemed To Be University), Karad, IND
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Yadav R, Chaudhary AK, Gupta DK, Saroj SK, Singh V, Kumar R. Use of Autologous Leukocyte-Platelet Rich Fibrin (L-PRF) in Endoscopic Anterior Skull Base Defect Repair-A Newer Graft Material: Name of Authors. Indian J Otolaryngol Head Neck Surg 2024; 76:5618-5622. [PMID: 39559155 PMCID: PMC11569114 DOI: 10.1007/s12070-024-05046-3] [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: 02/07/2024] [Accepted: 08/04/2024] [Indexed: 11/20/2024] Open
Abstract
CSF rhinorrhea secondary to anterior skull base defect may be spontaneous or traumatic (accidental or iatrogenic), spontaneous being common in middle aged, obese females. Nowadays endoscopic technique is gold standard for anterior skull base defect repair. The graft materials available may be autologous (fat, temporalis fascia, fascia lata, septal mucosa, cartilage, middle turbinate), homologous e.g., cadaveric pericardium or allograft e.g. dural substitute. Leukocyte-platelet rich fibrin (L-PRF) is a newer graft material that contain concentrated platelets and doesn't require any exogenous material or chemical in blood. A prospective study including 31 patients was carried out at tertiary care centre in eastern India, over the period of 2 years. All the surgeries targeted for closure of the anterior skull base defect were performed endoscopically under general anaesthesia. 30 out of 31 (96.77%) patients successfully improved after repair and one patient required revision surgery due to recurrence of disease and was cured after revision surgery. Autologous Leokocyte-plasma rich fibrin (L-PRF) is a newer and cost-effective graft material for the CSF leak repair with good healing property and with a success rate of more than 95%.
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Affiliation(s)
- Ramraj Yadav
- Department of Otorhinolaryngology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh India
| | - Ashvanee Kumar Chaudhary
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, Patna, Bihar India
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, Gorakhpur, India
| | - Deepak Kumar Gupta
- Department of Otorhinolaryngology, Maharshi Vishwamitra Autonomous State Medical College, Ghazipur, Uttar Pradesh India
- Department of Otorhinolaryngology, Baba Kinaram Autononomous State Medical College, Chandauli, India
| | - Sanjay Kumar Saroj
- Department of Otorhinolaryngology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh India
- Department of Otorhinolaryngology, Maa Vindhyawasani Autonomous State Medical College, Mirzapur, India
| | - Vishwambhar Singh
- Department of Otorhinolaryngology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh India
| | - Rajesh Kumar
- Department of Otorhinolaryngology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh India
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Dohle E, Schmeinck L, Parkhoo K, Sader R, Ghanaati S. Platelet rich fibrin as a bioactive matrix with proosteogenic and proangiogenic properties on human healthy primary cells in vitro. Platelets 2024; 35:2316744. [PMID: 38390838 DOI: 10.1080/09537104.2024.2316744] [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: 12/06/2023] [Accepted: 01/04/2024] [Indexed: 02/24/2024]
Abstract
Blood concentrates like platelet rich fibrin (PRF) have been established as a potential autologous source of cells and growth factors with regenerative properties in the field of dentistry and regenerative medicine. To further analyze the effect of PRF on bone tissue regeneration, this study investigated the influence of liquid PRF matrices on human healthy primary osteoblasts (pOB) and co-cultures composed of pOB and human dermal vascular endothelial cells (HDMEC) as in vitro model for bone tissue regeneration. Special attention was paid to the PRF mediated influence on osteoblastic differentiation and angiogenesis. Based on the low-speed centrifugation concept, cells were treated indirectly with PRF prepared with a low (44 g) and high relative centrifugal force (710 g) before the PRF mediated effect on osteoblast proliferation and differentiation was assessed via gene and protein expression analyses and immunofluorescence. The results revealed a PRF-mediated positive effect on osteogenic proliferation and differentiation accompanied by increased concentration of osteogenic growth factors and upregulated expression of osteogenic differentiation factors. Furthermore, it could be shown that PRF treatment resulted in an increased formation of angiogenic structures in a bone tissue mimic co-culture of endothelial cells and osteoblasts induced by the PRF mediated increased release of proangiogenic growth factors. The effects on osteogenic proliferation, differentiation and vascularization were more evident when low RCF PRF was applied to the cells. In conclusion, PRF possess proosteogenic, potentially osteoconductive as well as proangiogenic properties, making it a beneficial tool for bone tissue regeneration.
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Affiliation(s)
- Eva Dohle
- FORM, Frankfurt Orofacial Regenerative Medicine, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Lena Schmeinck
- FORM, Frankfurt Orofacial Regenerative Medicine, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Kamelia Parkhoo
- FORM, Frankfurt Orofacial Regenerative Medicine, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Robert Sader
- FORM, Frankfurt Orofacial Regenerative Medicine, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Shahram Ghanaati
- FORM, Frankfurt Orofacial Regenerative Medicine, Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Johann Wolfgang Goethe University, Frankfurt, Germany
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Jiang X, Cao H, He X, Zou X, Mao H, Tang L, Lu J. Skin necrosis after autologous fat grafting for augmentation rhinoplasty: a case report and review of the literature. J COSMET LASER THER 2024; 26:138-142. [PMID: 39740095 PMCID: PMC11750145 DOI: 10.1080/14764172.2024.2421013] [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: 10/17/2022] [Revised: 07/23/2023] [Accepted: 10/21/2024] [Indexed: 01/02/2025]
Abstract
BACKGROUND Autologous fat transplantation has gained increasing attention in the field of cosmetic surgery. However, a series of complications can occur after fat transplantation. CASE PRESENTATION A 24-year-old woman presented at our Hospital with nasal skin necrosis and ulceration. She had undergone autologous fat transplantation on the nose six days ago. Physical examination showed an abnormal skin range of approximately 5 × 2 cm on the left side of the nose. The initial diagnosis was "skin necrosis after autologous fat grafting for augmentation rhinoplasty." In addition to the conventional treatment, topical oxygen therapy (TOT) and platelet-rich fibrin (PRF) injection were applied to the nasal wounds area. After 16 days, the pale and dark areas of necrosis on nose were scabby, and the local skin conditions were significantly improved. CONCLUSION We treated a case of ischemic necrosis of the skin after autologous fat grafting for augmentation rhinoplasty. For this kind of local vascular embolism, we first proposed a comprehensive therapy of "biological + physical + drug." The therapeutic method achieved satisfactory results, providing a new strategy for the clinical treatment of vascular embolism.
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Affiliation(s)
- Xiao Jiang
- Department of Plastic Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, P.R. China
- Innovative Technology Research Institute of Tissue Repair and Regeneration, Key Laboratory of Regenerative Medicine, Ministry of Education, Guangzhou, Guangdong Province, P.R. China
| | - Hanchen Cao
- Department of Plastic Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, P.R. China
- Innovative Technology Research Institute of Tissue Repair and Regeneration, Key Laboratory of Regenerative Medicine, Ministry of Education, Guangzhou, Guangdong Province, P.R. China
| | - Xingfeng He
- Department of Plastic Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, P.R. China
- Innovative Technology Research Institute of Tissue Repair and Regeneration, Key Laboratory of Regenerative Medicine, Ministry of Education, Guangzhou, Guangdong Province, P.R. China
| | - Xinhui Zou
- Department of Plastic Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, P.R. China
- Innovative Technology Research Institute of Tissue Repair and Regeneration, Key Laboratory of Regenerative Medicine, Ministry of Education, Guangzhou, Guangdong Province, P.R. China
| | - Haoran Mao
- Department of Plastic Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, P.R. China
- Innovative Technology Research Institute of Tissue Repair and Regeneration, Key Laboratory of Regenerative Medicine, Ministry of Education, Guangzhou, Guangdong Province, P.R. China
| | - Lingzhi Tang
- Department of Plastic Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, P.R. China
- Innovative Technology Research Institute of Tissue Repair and Regeneration, Key Laboratory of Regenerative Medicine, Ministry of Education, Guangzhou, Guangdong Province, P.R. China
| | - Jinqiang Lu
- Department of Plastic Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, P.R. China
- Innovative Technology Research Institute of Tissue Repair and Regeneration, Key Laboratory of Regenerative Medicine, Ministry of Education, Guangzhou, Guangdong Province, P.R. China
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de Oliveira FH, de Oliveira LS, Pereira LX, Belo VS, Rabelo FEF, Couto GS, Lacerda-Filho A. Results of the use of human platelet-rich fibrin membrane applied on colorrhaphy in nourished and malnourished rats. Acta Cir Bras 2024; 39:e397824. [PMID: 39536184 PMCID: PMC11548133 DOI: 10.1590/acb397824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Accepted: 09/20/2024] [Indexed: 11/16/2024] Open
Abstract
PURPOSE To evaluate the effects of platelet-rich fibrin (PRF) on the healing of intestinal sutures in rats. METHODS Forty rats were distributed into four groups. Two groups were treated with a standard diet and considered nourished (I and II). Two other groups were treated with cornmeal and considered malnourished (III and IV). All animals underwent cecotomy and cecorrhaphy. Groups II and IV had sutures overlapped with human PRF membrane. The following parameters were evaluated: animal weight, death, rupture site, rupture pressure, collagen, and reticulin dosage in the suture line. RESULTS The use of PRF did not influence deaths, rupture pressure or rupture location. For malnourished animals, a significant difference was observed in relation to the rupture site, corresponding to the suture line (p = 0.038) and reticulin dosage (p = 0.040), when PRF was used. There was no difference in relation to burst pressures. CONCLUSIONS The use of PRF did not influence intestinal healing in nourished rats. In the group of malnourished animals, its use favored healing.
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