CYTOTOXICITY TESTING OF A NOVEL CROSSLINKED PRF (C-PRF) DEVELOPED FOR DENTAL PULP TISSUE ENGINEERING PURPOSE

Background- Whole pulp amputation followed by pulp space disinfection and ?lling with an arti?cial material causes loss of signi?cant amount of dentin leaving a non-vital and weakened tooth. Regenerative endodontics with its emerging ?eld of modern tissue engineering has demonstrated promising results using stem cells associated with scaffolds and responsive molecules. [1] Introduction- PRF was recognized as the “second generation” of this family of biomaterials. [6] PRF being tested in pulp tissue engineering by different research groups showed mixed results. (7,8) Research studies have shown that the interactions between the cells and their niche are closely related to physicochemical properties of the scaffolding materials [9, 10]. As PRF is a fragile gel its physical character needs to be improved by cross linking and thereby more longer period of liberation of its growth factors and delayed disintegration in physiological system. Aims and Objectives- Aim of our study was to prepare a very economical and autologous biomaterial for pulp tissue engineering by crosslinking of PRF with tannic acid. Our objective was to detect cytotoxic effect of tannic acid in PRF. Methods and Materials- We followed Choukroun et al. protocol to prepare PRF samples from whole venous blood collected from donors. PRF samples were then cross-linked in freshly prepared TA solution in dapendish for 10 minutes at room temperature. Concentrations of TA 1 wt% was used for preparing samples. After crosslinking, the gels were washed with normal saline for 5 min. to ensure that all excess TA was removed. The viability of cells cultured on the scaffolds was assessed through MTT assay (EZcountTM MTT cell Assay Kit, HiMedia, Mumbai, India). Observations- Both MTT Assay and Phalloidine staining showed favourable results of no clear cytotoxic effects of C-PRF. Conclusion- Based on the results of the cell viability analysis it can be concluded that none of the tannic acid crosslinked PRF created any clear cytotoxicity in the MC3T3 cells. So, C-PRF can safely be used as scaffold for dental pulp or similar tissue engineering purposes

Application of Platelet?Rich Fibrin and Freeze?Dried bone Allograft Following Apicoectomy: A Comparative Assessment of Radiographic Healing

Background: Apicoectomy conceptualizes surgically maintaining a tooth with an endodontic lesion that cannot be resolved by conventional endodontic (re?) treatment. To achieve this, continuous improvement in surgical techniques, materials and instruments is being done to enhance the outcome of periapical endodontic surgeries. The purpose of this study was to compare, radiographically, the healing kinetics of platelet?rich fibrin (PRF) and mineralized freeze?dried bone allograft (FDBA) in patients undergoing apicoectomy. Materials and Methods: Nineteen patients (aged 18–40 years) were included in the study and randomly assigned to groups A or B, where they received PRF or FDBA, respectively. Following apicoectomy, PRF gel and FDBA graft were prepared and placed in the osseous defect followed by placement of PRF membrane for graft stabilization and flap closure. Radiographic follow?up was done at the 1st, 3rd, 6th and 12th months for evaluation of healing using Molven’s criteria. Statistical analysis was done with Pearson’s and McNemar’s Chi?square tests. Results: A highly significant difference (P = 0.002) in radiographic healing was observed at 6 months. Complete healing was observed in 50% of cases in Group A whereas in Group B, none of the cases presented with complete radiographic healing. However, at the end of 12 months, complete radiographic healing was observed in both groups. Conclusion: Our data suggest that PRF accelerates bone healing as compared to FDBA and is both time and cost?efficient.

Uso de membranas de L-PRF para aumento da espessura de tecido mole peri-implantar: um estudo longitudinal prospectivo com acompanhamento de três anos / Use of L-PRF membranes for peri-implant soft tissue thickness augmentation: a randomized clinical trial with a three-year follow-up

After the popularization of osseointegrated implants, factors related to tissue aesthetics have gained prominence within Implantology. The search for substitutes for connective tissue grafts grew and the use of leucocyte and platelet rich fibrin (L-PRF) membranes, due to their biological potential, began to gain attention. The objective of this prospective longitudinal study with 3 years of follow-up was to evaluate whether there was an increase in the thickness of the buccal mucosa in single implants in the anterior area of the maxilla with the use of three L-PRF membranes over the ridge at the time of implant installation. A sample of 27 patients, among the individuals who participated of the study and returned for a three-year follow-up, was divided into a test group (n=15), which received three L-PRF membranes inserted over the ridge, and a control group (n=12), who only received the dental implant. The thickness of the vestibular mucosa (EMV), buccal ridge defect (DVR), and height of keratinized tissue (ATQ) were evaluated, in addition to professional (PES/WES) and patientcentered (VAS) aesthetic evaluation. The results showed that the use of L-PRF membranes was not able to increase EMV in the test group after three years post- surgery. The DVR measure showed a significant reduction in the test group after three months of follow-up and was maintained at three years. And the ATQ measure showed a statistically significant reduction after three years. There was no significant difference between the groups in the 3-year postoperative follow- up regarding clinical measurements or aesthetic analyses(AU)

Com a popularização dos implantes osseointegrados, fatores relacionados à estética tecidual têm ganhado destaque dentro da Implantodontia. A busca por susbstitutos ao enxerto de tecido conjuntivo cresceu e a utilização de membranas de fibrina rica em plaquetas e leucócitos, devido ao seu potencial biológico, começou a ganhar atenção. O objetivo deste estudo longitudinal prospectivo com 3 anos de acompanhamento foi avaliar se houve aumento da espessura da mucosa vestibular em implantes unitários em área anterior de maxila com a utilização de três membranas de L-PRF sobre o rebordo concomitantemente à instalação dos implantes. Uma amostra de 27 pacientes, dentre os indivíduos que participaram do estudo e retornaram para o acompanhamento de três anos foi dividida entre grupos teste (n=15), que recebeu 3 membranas de L-PRF inseridas sobre o rebordo, e grupo controle (n=12), que recebeu apenas o implante dental. Foram avaliadas a espessura da mucosa vestibular (EMV), defeito vestibular de rebordo (DVR), e altura do tecido queratinizado (ATQ), além da avaliação estética profissional (PES/WES) e por parte dos pacientes (VAS). Os resultados mostraram que o uso das membranas de L-PRF não foi capaz de aumentar a EMV no grupo teste após três anos de acompanhamento pós-operatório. A medida DVR apresentou redução significativa no grupo teste após três meses de acompanhamento e se manteve aos três anos. E a medida ATQ apresentou redução estatisticamente significativa após três anos. Não houve diferença significativa entre os grupos no acompanhamento de 3 anos pós-operatório quanto às medidas clínicas ou em relação às análises estéticas.(AU)

Does leukocyte-platelet-rich fibrin (L-PRF) cause long term acceleration in the rate of canine retraction? A split-mouth, two-arm parallel group, randomized control trial

ABSTRACT Objective: The present study was conducted to investigate the effects of leukocyte-platelet-rich fibrin (L-PRF) on the rate of maxillary canine retraction for a period of 5 months. Methods: A split-mouth study was conducted on 16 subjects (9 males and 7 females; age range 17-25 years; mean age, 21.85±2.45 years) who required therapeutic extraction of bilateral maxillary first premolars. After the initial leveling and alignment, L-PRF plugs were placed in a randomly selected extraction socket (Experimental Group), and the other side served as a control (Control Group). Canine retraction was carried out by the activation of nickel-titanium (NiTi) closed-coil springs delivering 150 g of force. The rates of canine movement, canine rotation, tipping, root resorption, and molar movement were assessed at monthly intervals for five months (T0-T5). Pain, swelling and discomfort accompanying the procedure were assessed using a Likert scale. Results: The study revealed a significant increase in the rate of canine movement on the experimental side in the first two months, and significant molar anchorage loss was observed only in the first month for control side. There were no statistically significant differences between the groups regarding canine rotation, tipping, probing depth, root resorption, and pain perception. Conclusions: The use of L-PRF plugs in extraction sockets considerably enhanced the rate of canine movement only in the first two months, and long-term efficacy was not observed in this study.

RESUMO Objetivo: O presente estudo foi realizado para investigar os efeitos da fibrina rica em leucócitos e plaquetas (L-PRF) na taxa de retração do canino superior, durante um período de cinco meses. Métodos: Um estudo de boca dividida foi realizado em 16 indivíduos (9 homens e 7 mulheres; faixa etária de 17 a 25 anos; idade média de 21,85 ± 2,45 anos) que precisavam de extração terapêutica dos primeiros pré-molares superiores de ambos os lados. Após o nivelamento e o alinhamento iniciais, os plugs de L-PRF foram colocados em um alvéolo pós-extração, selecionado aleatoriamente (Grupo Experimental), e o outro lado serviu como controle (Grupo Controle). A retração do canino foi realizada pela ativação de molas fechadas de níquel-titânio (NiTi) com 150 g de força. As taxas de movimentação do canino, rotação, inclinação e reabsorção radicular do canino e movimentação do molar foram avaliadas em intervalos mensais durante cinco meses (T0-T5). A dor, o inchaço e o desconforto após o procedimento foram avaliados por meio de uma escala de Likert. Resultados: O estudo revelou um aumento significativo na taxa de movimentação do canino no lado experimental nos dois primeiros meses, e uma perda significativa de ancoragem do molar foi observada apenas no primeiro mês no lado controle. Não houve diferenças estatisticamente significativas entre os grupos, com relação à percepção da dor e rotação, inclinação, profundidade de sondagem e reabsorção radicular do canino. Conclusões: O uso de plugs de L-PRF em alvéolos pós-extração aumentou consideravelmente a taxa de movimentação do canino apenas nos dois primeiros meses, não sendo observada uma eficácia em longo prazo.

Evaluation and Comparison of Mechanical Properties of Platelet-Rich Fibrin Membrane, Fish Collagen Membrane, Bovine Collagen Membrane and Chorionic Membrane – An SEM Study

Objectives: This study aimed to evaluate and compare the mechanical properties of platelet?rich fibrin (PRF) membrane with that of commercially available collagen membranes and chorionic membranes. Materials and Methods: The modulus of elasticity and hardness of PRF membrane, bovine collagen membrane, fish collagen membrane, and chorionic membrane were assessed using a universal testing machine. The in vitro degradation rate was assessed by placing these membranes on a temperature?controlled shaker set for one week. The degradation profiles were expressed as the accumulated weight loss of the membrane. A scanning electron microscope (SEM) evaluation of these membranes was done under both low and high magnification. One?way analysis of variance (ANOVA) and Tukey’s post hoc tests were performed for statistical analysis. Results: A statistically significant difference in the tensile strength and hardness of membranes was observed. Bovine collagen membrane had the highest strength (84.11 MPa and 16.46 MPa) followed by fish collagen membrane, chorionic membrane, and least for PRF membranes observed. The degradation rate at one week was highest for the PRF membrane (55.6%), followed by the fish collagen membrane (32.5%). SEM evaluation showed that the bovine collagen membrane had significantly higher numbers of collagen fibres compared to the fish collagen membrane and chorionic membrane. Conclusion: Bovine collagen membrane had the highest mechanical properties with the maximum amount of collagen fibre meshwork. Only the PRF membrane had cellular distribution in its composition, while the commercially available membrane had significantly higher numbers of collagen fibres with the total absence of cellular components

Biomateriales utilizados en cirugía bucal

Los biomateriales son todos aquellos materiales aceptados por el organismo y pueden ser obtenidos de manera autóloga o sintética lo que dependería del tipo de utilidad que proporcionará el profesional odontólogo. La utilización de estos materiales se ha ido incrementando en la medida en que se ven favorecidos los pacientes en el proceso de reparación de los tejidos. El plasma rico en plaquetas (PRP) es el contenido de plaquetas en forma de sobrenadante tras la centrifugación de sangre anti coagulada; constituye la principal fuente de actividad mitógena en el plasma sanguíneo y actúa como vehículo portador de factores de crecimiento y proteínas importantes en la biología ósea. Los factores de crecimiento son un conjunto de sustancias de naturaleza peptídica cuya función es la comunicación intercelular a nivel molecular. Regulan la migración, la proliferación, la diferenciación, el metabolismo y la apoptosis celular, y estimulan el aumento del tamaño celular al incrementar la síntesis proteica de las células sobre las que actúan. Este trabajo tiene por objetivo revisar los biomateriales utilizados en cirugía bucal en la literatura actualizada en los sitios web como Mendeley, Cicco, Science Direct, Wiley, Springer Open, Scielo, BVS, Google Académico, PubMed.

Biomaterials are all those materials accepted by the organism and can be obtained autologously or synthetically, which would depend on the type of use provided by the professional dentist. The use of these materials has increased as patients are favored in the process of repairing tissues. Platelet rich plasma (PRP) is the content of platelets in the form of a supernatant after centrifugation of anti-coagulated blood; it constitutes the main source of mitogenic activity in blood plasma and acts as a carrier of growth factors and important proteins in bone biology. Growth factors are a set of substances of a peptide nature whose function is intercellular communication at the molecular level. They regulate cell migration, proliferation, differentiation, metabolism and apoptosis, stimulate an increase of cell size by increasing the protein synthesis of the cells on which they act. This work aims to review the biomaterials used in oral surgery in updated literature on websites such as Mendeley, Cicco, Science Direct, wiley, springer open, Scielo, BVS, Google Academico, PubMed.

Tratamiento de heridas complejas mediante fibrina rica en plaquetas y leucocitos (L-PRF), experiencia inicial de un centro / Treatment of complex wounds using platelet rich fibrin and leukocytes (L-PRF), initial experience of a center

Resumen Introducción El uso de concentrados plaquetarios para el tratamiento de heridas complejas y regeneración tisular está siendo ampliamente utilizado a nivel mundial. Durante el último tiempo, la segunda generación de concentrados plaquetarios, particularmente el L-PRF, ha permitido tratar de manera efectiva a pacientes con esta patología. Debido a su bajo costo y versatilidad, ha sido posible aplicar esta técnica en variadas situaciones clínicas con buenos resultados. El objetivo de este trabajo es presentar nuestra experiencia utilizando L-PRF para la curación de heridas complejas (CHC) como una alternativa al uso de injertos de distinto grado de complejidad. Materiales y Método: Se realizó un análisis prospectivo de una serie de casos de pacientes que fueron sometidos a tratamiento quirúrgico de heridas complejas mediante el uso de L-PRF en el Hospital Santiago Oriente - Luis Tisné Brousse, entre los meses de enero de 2017 y diciembre de 2018. Mediante examen clínico y parámetros de inclusión, de éxito y de fracaso definidos previamente, se evaluó un total de 11 pacientes con heridas complejas a los cuales se les realizó un tratamiento local con injerto de L-PRF. Resultados: _La etiología de las heridas fue variada. 8 (72%) de los casos lograron una epitelización del 100% y 3 (28%) fracasaron. Se identificaron factores predisponentes para el fracaso de la técnica, y también fue posible establecer una relación de predicción de éxito en donde se relaciona una probabilidad alta de epitelización cuando la granulación de la herida ocurre durante los primeros 10 días sobre el injerto de L-PRF. Conclusión: El tratamiento de heridas complejas mediante L-PRF es una alternativa factible, de bajo costo y requerimientos (comparada con el uso de injertos, colgajos y sustitutos dérmicos), es segura en la resolución de heridas complejas, permitiendo disminuir la morbilidad, los costos asociados al tratamiento y estadía hospitalaria.

Introduction: The use of platelet concentrates for the treatment of complex wounds and tissue regenera-tion is being widely used worldwide. During the last time, the second generation of platelet concentrates, particularly L-PRF, has made it possible to effectively treat patients with this pathology. Due to its low cost and versatility, it has been possible to apply this technique in various clinical situations with good results. The objective of this work is to present our experience using L-PRF for the healing of complex wounds (HCC) as an alternative to the use of grafts of different degrees of complexity. Materials and Method: A prospective analysis was carried out with a series of cases who underwent surgical treatment of complex wounds using L-PRF at Santiago Oriente - Luis Tisné Brousse Hospital, between the months of January 2017 and December 2018. Through clinical examination and previously defined inclusion, success, and failure parameters, a total of 11 patients with complex wounds were evaluated who underwent local treatment with an L-PRF graft. Results: The etiology of the wounds was varied. 8 (72%) of the cases achieved 100% epithelialization and 3 (28%) failed. Predisposing factors for the failure of the technique were identified, and it was also possible to establish a predictive relationship of success where a high probability of epithelialization is related when the granulation of the wound occurs during the first 10 days on the L-PRF graft. Conclusion: The treatment of complex wounds using L-PRF is a feasible alternative, with low cost and requirements (compared to the use of grafts, flaps and dermal substitutes) and safe in the resolution of complex wounds, allowing to reduce morbidity, the costs associated with treatment and hospital stay.

Identification and characterization of profilin gene family in rice

BACKGROUND Profilin proteins (PRFs) are small (12­15 kD) actin-binding protein, which play a significant role in cytoskeleton dynamics and plant development via regulating actin polymerization. Profilins have been well documented in Arabidopsis, Zea mays L. as well as Phaseolus vulgaris, however no such fully characterization of rice (Oryza sativa L.) profilin gene family has been reported thus far. RESULTS In the present study, a comprehensive genome-wide analysis of rice PRF genes was completed and three members were identified. OsPRF1 and OsPRF2 shared 98.5% similarity (6 nucleotide divergence), but the deduced amino acid sequences of OsPRF1 and OsPRF2 are fully identical. In contrast, the OsPRF3 presents relatively lower similarity with OsPRF1 and OsPRF2. Phylogenetic analysis also support that OsPRF1 has a closer relationship with OsPRF2. Expression pattern analysis revealed the differential expression of OsPRFs in tissues of mature plant, which suggested the potential spatial functional specificity for rice profilin genes. Subcellular localization analysis revealed the OsPRFs were localized in cytoplasm and nucleus and all of them could bind actin monomers. Furthermore, abiotic stresses and hormones treatments assay indicated that the three OsPRF genes could be differentially regulated, suggesting that OsPRF genes might participate in different stress processes in rice. CONCLUSIONS Taken together, our study provides a comprehensive analysis of the OsPRF gene family and will provide a basis for further studies on their roles in rice development and in response to abiotic stresses

Efecto de la Fibrina Rica en Plaquetas en la Curación de los Tejidos Blandos de Alveolos Post Exodoncia Atraumática. Un Ensayo Clínico Controlado Aleatorizado Cruzado a Ciego Simple

RESUMEN: El objetivo de este estudio fue determinarel efecto de la fibrina rica en plaquetas (FRP) en la curación de los tejidos blandos de alveolos post exodoncia atraumática. El presente es un ensayo clínico controlado aleatorizado a ciego simple y de diseño cruzado. Se llevó a cabo en el Servicio de Odontología del Hospital Distrital Santa Isabel del Porvenir - Perú, durante los años 2016 y 2017. La muestra estuvo conformada por 51 pacientes cuyos alveolos post exodoncia fueron divididos de forma aleatoria en 2 grupos, cada paciente firmó un consentimiento informado. Al grupo A (control) se le dejó con un coágulo de sangre para su curación normal y al grupo B (experimental) se le administró FRP (como tapón y membrana), obtenido según el protocolo de Choukroun. Para determinar el efecto del FRP en la curación de los tejidos blandos de los alveolos post exodoncia atraumática se utilizó el índice de Landry. Las medidas se realizaron a los 7 y 14días después de la cirugía.Para la comparación de cada una de las variables del estudio se utilizó el Test de Mc Nemar y el Test exacto de Fisher. La significación estadística fue del 5 %. Al comparar ambos grupos en la curación de los tejidos blandos de alveolos post exodoncia atraumática se encontró que existe una diferencia estadísticamente significativa a los 7 y 14 días después de la cirugía (p0.05). La FRP presenta un efecto positivo en la curación de los tejidos blandos de alveolos post exodoncia atraumática de forma independiente del sexo y la edad.

ABSTRACT: The objective of the study was to determine the effect of platelet-rich fibrin (PRF) on the healing of soft tissues of socket after atraumatic exodontia. The present is a single-blind, cross-sectional randomized controlled trial. It was carried out in the Dental Service of the Santa Isabel District Hospital of Porvenir - Peru, during the years 2016 and 2017. The sample consisted of 51 patients whose alveoli post exodontia were randomly divided into 2 groups, each patient signed an informed consent. Group A (control) was left with a blood clot for normal healing and group B (experi- mental) was given PRF (as a plug and membrane), obtained according to the Choukroun protocol. The effect of PRF on the healing of the soft tissues of the alveoli after atraumatic exodontia was used the Landry index. The measurements were made at 7 and 14 days after surgery. For the comparison of each one of the variables of the study, the Mc Nemar test and the Fisher exact test were used. The statistical significance was 5 %. When comparing both groups in the healing of the soft tissues of alveoli after atraumatic exodontia, a statistically significant difference was found at 7 and 14 days after surgery (p 0.05). The PRF has a positive effect on the healing of the soft tissues of the alveoli after atraumatic exodontia independently of sex and age.

In-Vitro Quantitative Comparison of Platelet Rich Fibrin, and Plasma Rich in Growth Factor, with Age, Gender, Blood Parameters

Periodontal therapy and its recent advances has modernised leaps and bounds with newer regenerative modalities in an attempt to regenerate bone, gingiva, periodontal ligament and cementum. One of the newly accepted trends in regenerative therapy is the use of platelet concentrates such as platelet rich fibrin, plasma rich in growth factor which act as biological scaffold, fillers as well a vehicle along with bone grafts. Platelet concentrates have been found to be rich in growth factors and are used in the field of periodontology as an additive to bone grafting in sites of bony defects as a potential filler material. We wanted to evaluate the relation between the volume of blood extracted and weight of corresponding platelet rich fibrin and plasma rich in growth factor, and correlation of weight of platelet rich fibrin and plasma rich in growth factor with age, gender and blood parameters. MethodsA sample of 36 systemically healthy patients was randomly selected from the outpatient department of a dental college in Chennai. They were matched for age, gender and distributed into two broad groups: one for PRF and the other for PRGF comprising 9 females and 9 males in each group. A routine complete blood count including red blood cell count, white blood cell count and platelet count and haemoglobin were determined. ResultsThere was no relation between the weight of platelet rich fibrin and plasma rich in growth factor and the gender or age of the patient. There was also no apparent correlation between the platelet count and the platelet weight obtained. In some patients despite high platelet concentration, substantial PRF or PRGF weight was not obtained. ConclusionsWithin the limits of this study, it was found that the quantity of PRF and PRGF obtained is independent of age, and gender with no direct relation between the RBC count, WBC count, and haemoglobin.

Uso de la Fibrina Rica en Plaquetas Inyectable (i-PRF) en Defectos Infra Óseos en Terapia Periodontal no Quirúrgica. Reporte de Dos Casos / Use of Injectable Platelet-Rich Fibrin (i-PRF) in Infra Osseous Defects in Non-Surgical Periodontal Therapy. Report of Two Cases

RESUMEN: Entre los concentrados plaquetarios de segunda generación, ha suscitado creciente interés, el uso de fibrina rica en plaquetas y leucocitos inyectable (i-PRF); que se obtiene a partir de la centrifugación inmediata de sangre venosa del propio individuo, y que aporta concentraciones elevadas de factor de crecimiento vascular endotelial, factor de crecimiento transformante beta, y factor de crecimiento derivado de plaquetas, entre otras proteínas que inician y coordinan el proceso reparativo. Su nula citotoxicidad y consistencia líquida abren un nuevo campo de estudio y experimentación en el ámbito de la Cirugía Oral y de la Periodoncia, como sustancia para irrigar. El objetivo de este manuscrito fue reportar el uso del i-PRF como irrigador subgingival en el tratamiento periodontal convencional de defectos infra óseos con 6 meses de seguimiento. En ambos casos, se verificó un efecto positivo de irrigación, lo que abre el debate al uso de productos farmacéuticos tradicionales como la clorhexidina versus preparados autólogos sin efectos adversos reportados a la fecha.

ABSTRACT: Second generation platelet concentrates include the use of injectable platelet-rich fibrin (i-PRF), which has generated increasing interest because it is derived from immediate centrifugation of venous blood from the patients themselves. It provides high concentrations of vascular endothelial growth factor, transforming growth factor beta, and platelet-derived growth factor, among other proteins that initiate and coordinate the healing process. Its null cytotoxicity and liquid consistency has opened new research lines in the field of oral surgery and periodontics, as an irrigation substance. The aim of this manuscript was to report the use of i-PRF, as a subgingival irrigator in conventional periodontal treatment of infra osseous defects, with six months follow-up. In both cases, a positive effect of irrigation was confirmed. These findings, open the debate as regards the use of traditional pharmaceutical products (such as chlorhexidine), versus autonomous preparations without adverse effects reported to date.

Uso do hormônio do crescimento associado à fibrina rica em plaquetas e leucócitos injetável (I-PRF) / Use of the growth hormone associated with injectable platelet-rich fibrin (I-PRF)

Objetivo: demonstrar, por meio de uma revisão de literatura, a utilização do hormônio do crescimento (GH) e concentrados plaquetários e sugerir técnica de associação de uso para odontologia em processos de preservação de osso alveolar. Revisão de literatura: enxertos ósseos são uma necessidade na área da saúde, por diversas razões. A utilização de osso autógeno apresenta grande desvantagem em ter um segundo sítio cirúrgico, entretanto, os substitutos ósseos não possuem as características ideais. Assim, existe a busca por alternativas que otimizem a cicatrização e a incorporação dos substitutos ósseos, dentre elas os concentrados sanguíneos, ricos em fatores de crescimento derivados das plaquetas e o hormônio do crescimento. É possível encontrar uma vasta literatura utilizando os concentrados sanguíneos, inclusive utilizando esses como veículos para outras substâncias. Os concentrados sanguíneos são ricos em fatores de crescimento derivados das plaquetas, como fator de crescimento semelhante à insulina (IGF), Fator de crescimento derivado de plaquetas (PDGF) e outros. Além disso, também é possível encontrar, na literatura, o uso tópico de hormônio do crescimento em enxertos ósseos, fraturas e implantes dentários. Entretanto, o GH possui uma meia-vida de 20 minutos, assim, quando utilizado em conjunto com a I-PRF, espera-se um aumento no tempo de ação local. Considerações finais: é possível otimizar os enxertos ósseos utilizando-se L-PRF/I-PRF e hormônio do crescimento. Porém, são necessárias mais pesquisas.(AU)

Objective: this study aims to show through a literature review the use of the growth hormone and platelet concentrates and to suggest an association technique for dentistry use in alveolar bone preservation processes. Literature review: bone grafts are a health requirement for a number of reasons. The use of autogenous bone has the main disadvantage of a second surgical site, while bone substitutes do not present optimal characteristics. Thus, there is a search for alternatives that optimize the healing and incorporation of bone substitutes, which include blood concentrates that are rich in platelet-derived growth factors and the growth hormone. A vast literature can be found on blood concentrates, including their use as vehicles to other substances. Blood concentrates are rich in platelet-derived growth factors such as IGF, PDGF, and others. Moreover, the literature also shows the topical use of the growth hormone in bone grafts, fractures, and dental implants. However, the growth hormone presents a half-life of 20 minutes; therefore, when combined with I-PRF, an increased time in local action is expected. Final considerations: it is possible to optimize bone grafts by using L-PRF/I-PRF and the growth hormone. However, further research is required.(AU)

L-PRF Membrane (Fibrin Rich in Platelets and Leukocytes) and Its Derivatives (A-PRF, i-PRF) are Helpful as a Basis of Stem Cells in Regenerative Injury Treatment: Trial Work on the Horse

Developing a multidisciplinary field of tissue engineering aims to recover, improve or supplant typically damaged or missing tissues for a collection of conditions brought about by trauma, malady and old age. To guarantee that tissue engineering techniques are generally relevant in the clinical setting, it is important to adjust them so that they are promptly accessible and moderately simple to use in the everyday clinical schedule. Consequently, the steps between preparation and application must be limited and improved to make them practical in application. The general objective of creating platelet concentrates of natural origin can be delivered near the patient to quicken the implantation procedure, being monetarily practical for the patient and the health framework. Fibrin rich in platelets and leukocytes (PRF) and its derivatives (L-PRF, A-PRF, i-PRF) has been utilized in a wide collection of medical fields for delicate tissue restoration. Practically all platelets (> 97%) are missing within test-tubes in groups tested after PRF membrane extraction. Growth Factors liberated by platelets contained in derivatives of L-PRF induce and control the proliferation and migration of other cell types, associated with tissue repair, similar to smooth cell muscles (SMCs) and mesenchymal stem cells (MSCs). Conclusively, the outcomes of this work feature the positive effects of PRF on wound healing after regenerative treatment for the administration of different delicate tissue defects found in wound care.

Possibilidades com o PRF no tratamento das recessões gengivais: uma revisão de literatura / Possibilities with PRF on treatment of gingival recession: a literature review

Os problemas periodontais possuem uma grande prevalência na população em geral. Estes se caracterizam pela alteração e/ou destruição dos tecidos de suporte dentário. A regeneração periodontal, que consiste na reconstrução de alguma parte perdida do periodonto, ainda enfrenta alguns desafios no que tange ao tratamento de recessões gengivais. Atualmente, o considerado padrão ouro para estes tratamentos é o retalho avançado coronalmente adjunto ao enxerto de tecido conjuntivo subeptelial. Contudo, novas técnicas têm surgido, buscando aumentar a eficácia e diminuir o desconforto dos pacientes submetidos a estes procedimentos. A fibrina rica em plaqueta (PRF) é uma nova geração de agregados plaquetários, com um processamento simples e rápido, que se mostra capaz de dar um novo rumo à regeneração tecidual. Esta já vem sido estudada e aplicada como um acelerador de cicatrização, tanto em tecidos moles quanto duros, devido à liberação de citocinas e fatores de crescimento por um longo tempo. O objetivo deste trabalho foi realizar uma breve revisão de literatura, buscando artigos científicos através da plataforma CAFe, PubMed e Scielo, afim de descobrirmos em que ponto a ciência está em relação ao uso do PRF nos tratamentos de recessão gengival e quais são as suas possíveis aplicações clínicas. Pode-se concluir que, apesar de ter uma técnica simples de uso, eficácia na cicatrização e diversas aplicabilidades, ainda precisamos de mais estudos com acompanhamento a médios e longos prazo para definirmos as limitações deste biomaterial. (AU)

Periodontal problems have a high prevalence in the general population. These are characterized by the alteration and/or destruction of dental's support tissues. Periodontal regeneration, which consists in the reconstruction of some lost part of the periodontium, still faces some challenges regarding the treatment of gingival recessions. Currently, the gold standard for these treatments is the coronally advanced flap attached to the subeptelial connective tissue graft. However, new techniques have emerged, seeking to increase efficacy and decrease the discomfort of patients undergoing these procedures. Platelet-rich fibrin (PRF) is a new generation of platelet aggregates, with a simple and fast processing, showing itself capable of giving a new direction to tissue regeneration. This has been studied and applied as a healing accelerator, both in soft and hard tissues, due to the release of cytokines and growth factors for a long time. The objective of this work was to carry out a brief review of the literature, searching for scientific articles through the CAFe platform, PubMed and Scielo, in order to find out where the science spot is due to the use of PRF in gingival recession treatments and what their possible clinical applications are. It can be concluded that, despite having a simple technique of use, healing efficacy and several applicability, we still need more follow-up studies in the medium and long term to define the limitations of this biomaterial. (AU)

Physiological and biochemical characteristics of four dominant microbes and content of yellow pigment in fermentation process of Pinelliae Rhizoma Fermentata / 中草药

Objective: To study the physiological and biochemical characteristics of four dominant microorganisms and the yellow pigment content of Pinelliae Rhizoma Fermentata (PRF), and provide basis for exploring the mechanism of PRF processing. Methods: The optimum growth temperature and pH value of the four dominant microorganisms Bacillus subtilis, Paecilomyces variotii, Byssochlamys spectabilis, and Aspergillus niger were studied. The ability of producing acidase, amylase, protease, and yellow pigment were determined. The yellow pigment content of each sample at different fermentation time points in process of PRF was determined. Results: The most suitable growth temperatures for B. subtilis, P. variotii, B. spectabilis, and A. niger were 35 ℃, 29 ℃, 29-31 ℃, and 39 ℃; And the optimum pH were 7.0, 7.0, 7.5, and 7.0, respectively. Four kinds of microorganisms had the ability to produce amylase and protease. P. variotii and B. spectabilis had the ability to produce yellow pigment. The content of yellow pigment were 69.875, 69.875, 71.750, 119.500, and 137.875 μg/g in the samples at different time points. Conclusion: Four kinds of dominant microorganisms may play an important role in fermentation process of PRF.

Osteonecrose mandibular associada ao uso de bisfosfonatos tratada com plasma rico em fibrina leucocitária: relato de caso

Bisfosfonatos são antiabsortivos que agem especificamentesobre a atividade dos osteoclastos. Uma complicaçãograve do seu uso é a osteonecrose dos maxilares,definida como uma área de exposição óssea na regiãomaxilofacial sem resolução espontânea por um períodode no mínimo oito semanas em pacientes com históricode uso de compostos bisfosfonatos, mas que não foramsubmetidos à radioterapia na região de cabeça e pescoço.Tratamentos conservadores são recomendados, masos resultados da literatura são controversos e nem sempreefetivos. Por isso, novas abordagens, como o usodos concentrados plaquetários, têm sido sugeridas. Sãoprodutos autólogos que contém altas concentrações defatores de crescimento e que atuam como moléculasde adesão celular, acelerando o reparo ósseo. Objetivo:descrever, por meio de relato de caso, o uso do plasmarico em fibrina e leucocitária (L-PRF) como forma detratamento da osteonecrose mandibular. Relato do caso:paciente do gênero feminino, 79 anos, diagnosticadacom osteonecrose mandibular associada ao uso de bisfosfonatos,tratada por meio de cirurgia convencionalassociando curetagem óssea e rotação de retalho, massem sucesso. Então, foi submetida à modificação detécnica cirúrgica, associando o uso de plasma rico emfibrina leucocitária (L-PRF), a fim de acelerar o processode reparo ósseo e garantir a cicatrização dos tecidosmoles. Considerações finais: o uso de L-PRF como tratamentoda osteonecrose mandibular estimula o reparoósseo e acelera a cicatrização dos tecidos moles, sendouma alternativa eficaz de tratamento.

Expressions and clinical significance of GAS1, IL-1RAP and PRF1 in patients with ALK positive anaplastic large cell lymphoma / 中华血液学杂志

Objective: To investigate the expressions of growth arrest-specific protein (GAS1), IL-1 receptor accessory protein (IL-1RAP) and perforin (PRF1) in patients with anaplastic lymphoma kinase positive, anaplastic large cell lymphoma (ALK+ ALCL) and their relationships with clinical significances and the prognoses of ALK+ ALCL. Methods: Twenty-six formalin-fixed paraffin-embedded (FFPE) samples of ALK+ ALCL patients who were diagnosed from January 2011 to September 2016 were collected. Twelve FFPE samples of patients with ALK+ALCL, 13 FFPE samples of patients with peripheral T cell lymphoma (not otherwise specified) (PTCL-NOS) and 8 FFPE samples of patients with angioimmunoblastic T-cell lymphoma (AITL) were used as control groups. RQ-PCR and immunohisto-chemical staining were used to detect the mRNA and protein expressions of GAS1, IL-1RAP and PRF1. The clinical data were analyzed. Results: ①The expression levels of GAS1, IL-1RAP and PRF1 gene and protein in ALK+ ALCL group were higher than those of the control groups (P<0.05), but the expression levels had no statistically significant differences between the control groups (P>0.05). ②Patients with elevated lactate dehydrogenase (LDH) (0.77 vs 1.38, z=-3.292, P=0.001) or International prognostic index (IPI)≥3(0.62 vs 1.29, z=-2.495, P=0.013) had lower expression level of GAS1. Patients with stage Ⅲ/Ⅳ disease (0.89 vs 1.18, z=-2.212, P=0.027) or IPI≥3 (0.48 vs 1.13, z=-2.008, P=0.045) had lower expression level of PRF1. IL-1RAP expression level was not associated with clinical features. ③ALK+ ALCL patients in complete remission (CR) group had higher expression levels of GAS1 and PRF1 than patients in non-remission (NR) group (P values were 0.016 and 0.009). ④Kaplan-Meier survival analysis showed that patients with high expression levels of GAS1 and PRF1 had longer median overall survival and progression-free survival than patients with low expression levels of GAS1 and PRF1. Conclusion: GAS1, IL-1RAP and PRF1 could be molecular markers for ALK+ ALCL patients. They have potential diagnostic value and can be used for differential diagnosis in some difficult cases. ALK+ ALCL patients with high expression levels of GAS1 or PRF1 have better curative effects and prognoses.

Application of platelet rich-fibrin in immediate implantation for antirior dentition / 实用口腔医学杂志

There are different degrees of bone defect in immediate implantation for anterior dentition. During conventional guided bone regeneration, the wound was difficultly closed in operation,and there was more inflammatory response and infection risk. In this paper,a case of immediate implantation for anterior dentition combined with platelet rich-fibrin(PRF) was reported,the clinical effects of guiding bone regeneration and alleviating the inflammatory response.

Expressions and clinical significance of GAS1, IL-1RAP and PRF1 in patients with ALK positive anaplastic large cell lymphoma / 中华血液学杂志

Objective@#To investigate the expressions of growth arrest-specific protein (GAS1), IL-1 receptor accessory protein (IL-1RAP) and perforin (PRF1) in patients with anaplastic lymphoma kinase positive, anaplastic large cell lymphoma (ALK+ ALCL) and their relationships with clinical significances and the prognoses of ALK+ ALCL.@*Methods@#Twenty-six formalin-fixed paraffin-embedded (FFPE) samples of ALK+ ALCL patients who were diagnosed from January 2011 to September 2016 were collected. Twelve FFPE samples of patients with ALK+ALCL, 13 FFPE samples of patients with peripheral T cell lymphoma (not otherwise specified) (PTCL-NOS) and 8 FFPE samples of patients with angioimmunoblastic T-cell lymphoma (AITL) were used as control groups. RQ-PCR and immunohisto-chemical staining were used to detect the mRNA and protein expressions of GAS1, IL-1RAP and PRF1. The clinical data were analyzed.@*Results@#①The expression levels of GAS1, IL-1RAP and PRF1 gene and protein in ALK+ ALCL group were higher than those of the control groups (P<0.05), but the expression levels had no statistically significant differences between the control groups (P>0.05). ②Patients with elevated lactate dehydrogenase (LDH) (0.77 vs 1.38, z=-3.292, P=0.001) or International prognostic index (IPI)≥3(0.62 vs 1.29, z=-2.495, P=0.013) had lower expression level of GAS1. Patients with stage Ⅲ/Ⅳ disease (0.89 vs 1.18, z=-2.212, P=0.027) or IPI≥3 (0.48 vs 1.13, z=-2.008, P=0.045) had lower expression level of PRF1. IL-1RAP expression level was not associated with clinical features. ③ALK+ ALCL patients in complete remission (CR) group had higher expression levels of GAS1 and PRF1 than patients in non-remission (NR) group (P values were 0.016 and 0.009). ④Kaplan-Meier survival analysis showed that patients with high expression levels of GAS1 and PRF1 had longer median overall survival and progression-free survival than patients with low expression levels of GAS1 and PRF1.@*Conclusion@#GAS1, IL-1RAP and PRF1 could be molecular markers for ALK+ ALCL patients. They have potential diagnostic value and can be used for differential diagnosis in some difficult cases. ALK+ ALCL patients with high expression levels of GAS1 or PRF1 have better curative effects and prognoses.

Effects of salmon DNA fraction in vitro and in a monosodium iodoacetate-induced osteoarthritis rat model

PRF001 is a fragmented DNA polymer extracted from the testes of salmon. The purpose of this study was to assess the anti-inflammatory effect of PRF001 in vitro as well as the protective effect of PRF001 intake against arthritis in a rat model. In vitro, cell survival and inflammatory markers after H₂O₂ treatment to induce cell damage were investigated in CHON-001 cells treated with different concentrations of PRF001. In vivo, osteoarthritis was induced by intra-articular injection of monosodium iodoacetate (MIA) into the knee joints of rats. After consumption of PRF001 (10, 50, or 100 mg/kg) for 4 weeks, inflammatory mediators and cytokines in articular cartilage were investigated. In vitro, the levels of inflammatory markers, IL-1β, TNF-α, COX-2, iNOS, and PGE2, were significantly suppressed by PRF001 treatment. In vivo, the inflammatory mediators and cytokines, IL-1β, p-Erk1/2, NF-κB, TNF-α, COX-2, and PGE2, as well as MMP3 and MMP7, which have catabolic activity in chondrocytes, were decreased in the MIA-induced osteoarthritic rats following intake of PRF001. Histological analysis revealed that PRF001 had a protective effect on the articular cartilage. Altogether, these results demonstrated that the anti-inflammatory property of PRF001 contributes to its protective effects in osteoarthritis through deregulating IL-1β, TNF-α, and subsequent signals, such as p-Erk1/2, NF-κB, COX-2, PGE2, and MMPs.