Effectiveness of leukocyte- and platelet-rich fibrin in the management of medication-related osteonecrosis of the jaws ­ a systematic review / Efectividad de la fibrina rica en leucocitos y plaquetas en el tratamiento de osteonecrosis mandibular relacionada con medicamentos: una revisión sistemática

Background: Medication-related osteonecrosis of the jaw (MRONJ) is a rare, but significant adverse event primarily associated with the intake of antiresorptive and antiangiogenic medications. Although antiresorptive and antiangiogenic the-rapies improve life expectancy, particularly in cancer patients, MRONJ may hamper the patient's quality of life due to pain, discomfort, anxiety, depression, speech impairment, difficulty in swallowing and eating, frequent medical and dental evaluations and treatments, and the possibility of treatment discontinuation. Leukocyte­ and Platelet-rich Fibrin (L-PRF) is an autologous platelet aggregate that promotes wound healing by stimulating re-epithelialization, angiogenesis, and extracellular matrix production. Aim: The present systematic review aimed to compare the results in the published literature on whether L-PRF is an effective and predictable adjuvant to surgical debridement of necrotic bone for improving the healing efficacy in patients with MRONJ. Materials and Methods: The PubMed, Scopus, Cochrane, Science Direct, LILACS, and Web of Science databases were searched using the predetermined MeSH terms and eligibility criteria, and the search yielded a total of five articles. Two studies were retrospective, and three studies were case series. Results: Seventeen participants received a combination of surgical debridement, L-PRF membrane, and antibiotics. Complete wound healing was observed in 70% of the participants, and most of them healed without any complications. Conclusions: L-PRF as an adjuvant to surgical debridement of necrosed bone appears to have a positive association with the healing outcome in patients with MRONJ.

Introducción: La osteonecrosis mandibular relacionada con medicamentos (ONMRM) es un evento adverso raro pero significativo asociado principalmente con la ingesta de medicamentos antirresortivos y antiangiogénicos. Aunque las terapias antirresortivas y antiangiogénicas mejoran la esperanza de vida, particularmente en pacientes con cáncer, la ONMRM puede obstaculizar la calidad de vida del paciente debido a dolor, incomodidad, ansiedad, depresión, discapacidad del habla, dificultad para tragar y comer, evaluaciones y tratamientos médicos y dentales frecuentes, y la posibilidad de interrupción del tratamiento. La fibrina rica en plaquetas y leucocitos (L-PRF) es un agregado de plaquetas autólogo que promueve la curación de heridas al estimular la reepitelización, la angiogénesis y la producción de la matriz extracelular. Objetivo: La presente revisión sistemática tuvo como objetivo comparar los resultados en la literatura publicada sobre si L-PRF es un adyuvante efectivo y predecible al desbridamiento quirúrgico del hueso necrótico para mejorar la eficacia curativa en pacientes con ONMRM. Materiales y Métodos: Las bases de datos de PubMed, Scopus, Cochrane, ScienceDirect, LILACS y Web of Science se registraron utilizando los términos DeCS/MeSH predeterminados y los criterios de elegibilidad, y la búsqueda arrojó un total de cinco artículos. Dos estudios fueron retrospectivos, y tres estudios fueron series de casos. Resultado: Diecisiete participantes recibieron una combinación de desbridamiento quirúrgico, membrana L-PRF y antibióticos. Se observó curación completa de heridas en el 70% de los participantes, y la mayoría de ellos se curaron sin ninguna complicación. Conclusión: L-PRF como adyuvante para el desbridamiento quirúrgico del hueso necrótico parece tener una asociación positiva con el resultado de curación en pacientes con ONMRM.

Fibrina rica en plaquetas como parte de la regeneración tisular en procedimientos quirúrgicos odontológicos / Platelet-rich fibrin as part of tissue regeneration in dental surgical procedures

Uno de los mejores biomateriales usados en odontología es la fibrina rica en plaquetas (PRF), es un concentrado plaquetario de segunda generación que se obtiene a partir de la centrifugación de sangre autóloga y no necesita aditivos. El presente documento busca determinar la eficacia del uso del PRF como parte de la regeneración de tejidos en procedimientos quirúrgicos odontológicos, tomando como base la literatura publicada en PubMed, Elsevier y Semantic Scholar entre 2018 y 2023, la búsqueda de artículos científicos fue ejecutada empleando las palabras clave platalet rich fibrin, regeneration, dentistry, blood buffy coat. La evidencia científica muestra que el PRF puede ser usado en su forma de membrana, gel, tapón, solo o combinado con otro biomaterial para conseguir propiedades biológicas exclusivas que promueven la regeneración y cicatrización mientras reduce los efectos adversos de los procedimientos quirúrgicos. Un ensayo clínico refirió la curación de alvéolos post exodoncia atraumática, y comprobó que la cicatrización con PRF muestra un índice de curación más alto en comparación con el grupo control. El sustento biológico de su eficacia radica en su capacidad para proliferar células que promueven la angiogénesis, osteogénesis y diferenciación celular, es decir, el reparo de tejidos lesionados. Todo esto nos permite llegar a la conclusión de que el PRF representa una alternativa viable y eficaz en procesos de regeneración de tejidos en procedimientos quirúrgicos odontológicos.

One of the best biomaterials used in dentistry is platelet-rich fibrin (PRF). It is a second-generation platelet concentrate obtained by centrifugation of autologous blood and requires no additives. The aim of this article is to determine the effectiveness of using PRF for tissue regeneration in dental surgery. The methodology used consists of a descriptive search of scientific articles that employ or study PRF as a biomaterial for tissue healing in the dental field and are available on PubMed, Elsevier, and Semantic Scholar. The literature shows that PRF can be used as a membrane, gel, cap form, alone or combined with other biomaterials to achieve unique biological properties that promote regeneration and healing while reducing the adverse effects of surgical procedures. For example, a clinical trial demonstrated healing of post-traumatic alveolar exodontia, proving that healing with PRF had a higher healing rate than in the control group. The biological basis of PRF's efficacy lies in its ability to proliferate cells that promote angiogenesis, osteogenesis, and cellular differentiation, and thus repair damaged tissue. All this leads us to conclude that PRF represents a viable and effective alternative in tissue regeneration processes in dental surgery procedures.

Observation on A-PRF promoting regeneration of osteochondral defects in rabbit knee joints / 上海交通大学学报（医学版）

Objective·To explore the role of advanced platelet-rich fibrin(A-PRF)in osteochondral regeneration.Methods·Bone-marrow mesenchymal stem cells(BMSCs)and knee joint chondrocytes were obtained from New Zealand rabbits.A-PRF was obtained by low-speed centrifugation of the heart blood of rabbits.The histological structure of A-PRF was observed by an optical microscope.The release of growth factors in A-PRF was detected by ELISA,including platelet-derived growth factor,transforming growth factor-β,insulin-like growth factor,vascular endothelial growth factor,epidermal growth factor and fibroblast growth factor.A-PRF's cytotoxicity and capability for promoting the proliferation of rabbit BMSCs were detected by live/dead double staining and MTT methods.The effect of A-PRF on the gene expression of type Ⅱ collagen,aggrecan,alkaline phosphatase(ALP)and osteocalcin(OCN)in rabbit BMSCs was detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR).Transwell chambers were used to determine the effect of A-PRF on the migration ability of rabbit BMSCs and the chondrocytes.Rabbit knee osteochondral defect models were established,and 18 rabbits were randomly divided into 3 groups.The A-PRF group(n=6)was implanted with A-PRF in the defect,the A-PRF+BMSCs group(n=6)was implanted with rabbit BMSCs on A-PRF,and the control group(n=6)did not undergo implantation.The rabbits were sacrificed 12 weeks after surgery and the knee joint specimens were stained with hematoxylin-eosin(H-E),toluidine blue and safranin O/fast green.Based on the surface morphology and histology of the knee joints,the International Cartilage Repair Society(ICRS)scoring system was used for macroscopic and histological scoring.Results·A-PRF had a loose network structure and can slowly release growth factors.No cytotoxicity to rabbit BMSCs was observed after adding A-PRF,and the the capability for promoting the proliferation of rabbit BMSCs was significantly increased at 24,48 and 72 h after adding A-PRF(all P<0.05).Chondrogenesis-related gene Ⅱ collagen and aggrecan,as well as osteogenesis-related genes ALP and OCN were significantly up-regulated(all P<0.05).After adding A-PRF,the migration abilities of rabbit BMSCs and chondrocytes were significantly enhanced(both P<0.05),and the migration ability of rabbit BMSCs was significantly higher than that of chondrocytes(P=0.025).The joint surface morphology in the rabbit knee joint defect models was observed.It can be seen that the defects in the A-PRF group and the A-PRF+BMSCs group were basically restored,while the the defects in the control group were only covered by soft tissue.In the ICRS macroscopic score,there was no statistical difference between the A-PRF group and the A-PRF+BMSCs group,but the scores of the two groups were all significantly higher than those of the control group(all P<0.05).According to the histological results,both the A-PRF group and the A-PRF+BMSCs group formed osteochondral repair,but the cartilage in the A-PRF group was more mature,while the control group formed fibrous repair.In the ICRS histological score,there was no statistical difference between the A-PRF group and the A-PRF+BMSCs group,but the scores of both the groups were significantly higher than those of the control group(both P<0.05).Conclusion·Autologous A-PRF has good biocompatibility and the capability for promoting the proliferation of BMSCs.It can promote the repair of cartilage and subchondral bone both in vitro and in vivo.

Application of autologous dentin particles combined with PRF in tooth extraction site preservation:A case report / 实用口腔医学杂志

Undicalcified autologous dentin particles(UADP)combined platelet rich fibrin(PRF)were used in a case after extraction of the left mandibular second molar for tooth extraction site preservation.CBCT images at 3,9 and 24 months after operation showed that the bone mass maintenance effect was obvious.Histological sections showed a large number of new bone formation around dentin particles.

Leukocyte-and platelet-rich fibrin with autologous hamstring tendon for traumatic patella dislocation / 中国组织工程研究

BACKGROUND:Traumatic patellar dislocation with medial patellofemoral ligament tearing at femoral attachment or body is usually performed by medial patellofemoral ligament reconstruction surgery.To promote tendon bone healing after medial patellofemoral ligament reconstruction,the researchers used a variety of biological treatment technologies including growth factors,stem cells and platelet-rich plasma. OBJECTIVE:To investigate the clinical effect of medial patellofemoral ligament reconstruction by leukocyte-and platelet-rich fibrin with autologous hamstring tendon for traumatic patellar dislocation. METHODS:Thirty-seven patients with traumatic patellar dislocation in First Hospital of Qinhuangdao from February 2019 to February 2021 were randomly divided into a trial group(n=18)and a control group(n=19).The trial group received medial patellofemoral ligament reconstruction by leukocyte-and platelet-rich fibrin with an autologous hamstring tendon.The control group received medial patellofemoral ligament reconstruction by a simple autologous hamstring tendon.Patients in the two groups were followed up for 12 months.Knee pain and functional status were evaluated by visual analog scale score,Lysholm score,Kujala patellofemoral joint score and knee range of motion.The patellar tilt angle,patellar congruence angle and patellar lateral shift rate of the patellofemoral joint were measured by MRI and CT films to evaluate the stability and improvement of the patellofemoral joint. RESULTS AND CONCLUSION:(1)The visual analog scale scores of the two groups at 6 and 12 months after operation were lower than those before operation(P<0.05).The Lysholm score and Kujala patellofemoral joint score at 6 and 12 months after operation were higher than those before operation(P<0.05).The Lysholm score and Kujala patellofemoral joint score in the trial group were higher than those in the control group 6 months after operation(P<0.05).There was no significant difference between the two groups in the visual analog scale score,Lysholm score and Kujala patellofemoral joint score 12 months after operation(P>0.05).(2)The patellar tilt angle,patellar congruence angle,patellar lateral shift rate and range of motion of the patellofemoral joint were significantly improved in both groups 12 months after operation(P<0.05).The patellar tilt angle was smaller in the trial group than that in the control group 12 months after operation(P<0.05).Patellar congruence angle,patellar lateral shift rate,range of motion and MRI score were not statistically significant between the two groups 12 months after operation(P>0.05).(3)These results confirm that medial patellofemoral ligament reconstruction by leukocyte-and platelet-rich fibrin with autologous hamstring tendon can treat traumatic dislocation effectively,improve the function of the knee joint,and restore the movement track of the patella.

Platelet-rich fibrin regulates apoptosis to promote cartilage repair in rats with knee osteoarthritis / 中国组织工程研究

BACKGROUND:Platelet-rich fibrin(PRF)is a second generation platelet concentrate with the advantages of simple operation,no anticoagulant,and high bioactivity,which has been applied in the fields of trauma repair,bone defect repair,and tendon soft tissue repair,and has been proved to have a certain tissue repair-promoting effect. OBJECTIVE:To study the repair effect of PRF on articular cartilage tissue in rats with knee osteoarthritis. METHODS:Thirty-six Sprague-Dawley rats were randomly divided into normal group,model group,and PRF group,with 12 rats in each group.Rats in the normal group did not undergo any treatment.In the model group,animal models of knee osteoarthritis were prepared and rat models were then given physiological saline into the joint cavity once a week after surgery.Rat models of knee osteoarthritis were also prepared in the PRF group,and autologous PRF was injected into the joint cavity once a week after surgery.After 5 weeks of continuous treatment,tissue samples were taken.Hematoxylin-eosin staining was used to observe the morphology of cartilage tissue.Tunel staining was used to detect chondrocyte apoptosis,ELISA was used to detect inflammatory factor levels.Western blot and RT-PCR were used to detect Bcl-2,Bax,and Caspase-3 expression in protein and mRNA levels,respectively. RESULTS AND CONCLUSION:The model group had severe cartilage tissue damage,while the PRF group had significantly improved cartilage tissue morphology compared with the model group.The model group had more apoptotic chondrocytes.Compared with the model group,the mean absorbance of Tunel positive staining in the PRF group significantly decreased(P<0.01).The levels of interleukin-1β,interleukin-6 and tumor necrosis factor-α were significantly increased in the model group and PRF group compared with the normal group(P<0.01)and were significantly decreased in the PRF group compared with the model group(P<0.01).The relative expressions of Bax and Caspase-3 at protein and mRNA levels were significantly increased in the model group and PRF group compared with the normal group(P<0.01),while the relative expressions of Bcl-2 at protein and mRNA were significantly decreased(P<0.01).Compared with the model group,the relative expression of Bax and Caspase-3 at protein and mRNA levels were significantly decreased in the PRF group(P<0.01),while the relative expressions of Bcl-2 at protein and mRNA levels were significantly increased(P<0.01).To conclude,PRF can inhibit chondrocyte apoptosis by inhibiting the expression of pro-inflammatory factors,thereby promoting cartilage tissue repair in knee osteoarthritis rats.

The applications of the plasma matrix in the treatments of dental pulp and periapical diseases / 口腔疾病防治

@#The plasma matrix is a kind of autologous blood conduct. It has been widely used in maxillofacial tissue regeneration, skin cosmetology and some other fields. Recently, to preserve the dental pulp as well as the teeth, pulp regeneration therapy and apical surgery have become increasingly important as well as the applications of bioactive materials. As a kind of autologous bioactive material, the plasma matrix has some natural advantages as it is easy to obtain and malleable. The plasma matrix can be used in the following cases: ①pulp revascularization of young permanent teeth with open apical foramina that cannot stimulate apical bleeding; ② apical barrier surgery with bone defects and large area perforation repair with bone defects or root sidewall repair surgery; ③ apical surgeries of teeth with large area of apical lesions, with or without periodontal diseases. The plasma matrix is a product derived from our blood, and there are no obvious contraindications for its use. Several systematic reviews have shown that the plasma matrix can effectively promote the regenerative repair of dental pulp in patients with periapical diseases. However, the applications of plasma matrix are different because its characteristics are affected by different preparation methods. In addition, there is still a lack of long-term clinical researches on the plasma matrix, and the histological evidences are difficult to obtain, so a large number of in vitro and in vivo experimental studies are still needed. This article will describe the applications of different kinds of plasma matrix for dental pulp regeneration and bone tissue regeneration in apical surgeries to provide references for clinicians in indication selection and prognosis evaluation.

Ultrasonographic analysis of palatal donor site healing accelerated with platelet-rich fibrin following subepithelial connective tissue harvesting

Abstract Objective Platelet-rich fibrin (PRF) contains a variety of growth factors and bioactive molecules that play crucial roles in wound healing and angiogenesis. We aimed to evaluate the effects of PRF on tissue thickness and vascularization of the palatal donor site by ultrasound (USG) following subepithelial connective tissue harvesting. Methodology A subepithelial connective tissue graft was harvested from the palatal region with a single incision for root coverage in 20 systemically healthy patients. In the test group (n = 10), the PRF membrane was placed at the donor site, whereas no material was applied in the control group (n=10). Palatal tissue thickness (PTT) and pulsatility index (PI) were evaluated by USG at baseline and on the 3rd, 7th, 14th, 30th, and 90th days after surgery. The early healing index (EHI) was used to evaluate donor site healing for 30 days. Results PTT was significantly higher in the PRF group on the 3rd and 14th days after surgery when compared to the controls. In the PRF-treated group, PI levels were significantly higher than in the controls, especially on the 14th day. PTT increased significantly 90 days after surgery compared to the test group baseline, but controls showed a significant decrease. The PRF group showed statistically significant improvements in EHI scores compared to controls on days 3, 7, and 14. This study found a negative correlation between PI values and EHI scores on postoperative days three and seven in the test group. Conclusion USG is a non-invasive, objective method to radiographically evaluate the regenerative effects of PRF on palatal wound healing after soft tissue harvesting. To overcome graft inadequacy in reharvesting procedures, PRF application may enhance clinical success and reduce possible complications by increasing tissue thickness and revascularization in the donor area.

Novel approach to soft tissue regeneration: in vitro study of compound hyaluronic acid and horizontal platelet-rich fibrin combination

Abstract Objective This study aims to develop a compound biomaterial to achieve effective soft tissue regeneration. Methodology Compound hyaluronic acid (CHA) and liquid horizontal-platelet-rich fibrin (H-PRF) were mixed at a ratio of 1:1 to form a CHA-PRF gel. Human gingival fibroblasts (HGFs) were used in this study. The effect of CHA, H-PRF, and the CHA-PRF gel on cell viability was evaluated by CCK-8 assays. Then, the effect of CHA, H-PRF, and the CHA-PRF gel on collagen formation and deposition was evaluated by qRT‒PCR and immunofluorescence analysis. Finally, qRT‒PCR, immunofluorescence analysis, Transwell assays, and scratch wound-healing assays were performed to determine how CHA, H-PRF, and the CHA-PRF gel affect the migration of HGFs. Results The combination of CHA and H-PRF shortened the coagulation time of liquid H-PRF. Compared to the pure CHA and H-PRF group, the CHA-PRF group exhibited the highest cell proliferation at all time points, as shown by the CCK-8 assay. Col1a and FAK were expressed at the highest levels in the CHA-PRF group, as shown by qRT‒PCR. CHA and PRF could stimulate collagen formation and HGF migration, as observed by fluorescence microscopy analysis of COL1 and F-actin and Transwell and scratch healing assays. Conclusion The CHA-PRF group exhibited greater potential to promote soft tissue regeneration by inducing cell proliferation, collagen synthesis, and migration in HGFs than the pure CHA or H-PRF group. CHA-PRF can serve as a great candidate for use alone or in combination with autografts in periodontal or peri-implant soft tissue regeneration.

The effect of injectable platelet-rich fibrin and platelet-rich fibrin in regenerative endodontics: a comparative in vitro study

Abstract Objective To explore the feasibility of injectable platelet-rich fibrin (i-PRF) in regenerative endodontics by comparing the effect of i-PRF and platelet-rich fibrin (PRF) on the biological behavior and angiogenesis of human stem cells from the apical papilla (SCAPs). Methodology i-PRF and PRF were obtained from venous blood by two different centrifugation methods, followed by hematoxylin-eosin (HE) staining and scanning electron microscopy (SEM). Enzyme-linked immunosorbent assay (ELISA) was conducted to quantify the growth factors. SCAPs were cultured with different concentrations of i-PRF extract (i-PRFe) and PRF extract (PRFe), and the optimal concentrations were selected using the Cell Counting Kit-8 (CCK-8) assay. The cell proliferation and migration potentials of SCAPs were then observed using the CCK-8 and Transwell assays. Mineralization ability was detected by alizarin red staining (ARS), and angiogenesis ability was detected by tube formation assay. Real-time quantitative polymerase chain reaction (RT-qPCR) was performed to evaluate the expression of genes related to mineralization and angiogenesis. The data were subjected to statistical analysis. Results i-PRF and PRF showed a similar three-dimensional fibrin structure, while i-PRF released a higher concentration of growth factors than PRF ( P <.05). 1/4× i-PRFe and 1/4× PRFe were selected as the optimal concentrations. The cell proliferation rate of the i-PRFe group was higher than that of the PRFe group ( P <.05), while no statistical difference was observed between them in terms of cell mitigation ( P >.05). More importantly, our results showed that i-PRFe had a stronger effect on SCAPs than PRFe in facilitating mineralization and angiogenesis, with the consistent result of RT-qPCR ( P <.05). Conclusion This study revealed that i-PRF released a higher concentration of growth factors and was superior to PRF in promoting proliferation, mineralization and angiogenesis of SCAPs, which indicates that i-PRF could be a promising biological scaffold for application in pulp regeneration.

Demineralized freeze-dried bone allograft with/without i-Platelet-rich fibrin in 3 wall intrabony defects

Demineralized freeze-dried bone allograft (DFDBA) contains bone morphogenetic proteins (BMPs), hence is osteoinductive. Autologous platelet concentrates exhibit a higher quantity of growth factors. Both these biomaterials aid in bone regeneration when placed in three-wall intrabony defects. However, their efficacy when used alone and in conjugation is not clear. Aim: To assess clinical and radiographic efficacy of injectable platelet-rich fibrin (i-PRF) with microsurgical access flap in the treatment of three-wall intrabony defects in chronic periodontitis patients. Methods: Thirty sites with three-wall intrabony defects were randomly assigned to control and test group by computer generated method. The test group obtained i-PRF mixed with DFDBA while the control group received only DFDBA. Clinical parameters such as site-specific Plaque index (PI), Radiographic intrabony defect depth (IBDD), modified- Sulcular bleeding index (mSBI), Clinical attachment level (CAL), and Probing pocket depth (PPD) were measured at baseline, three and six months. Results: Intragroup comparison within the control group and test group exhibited statistically highly significant variation of mean PI, mSBI, PPD, CAL, and IBDD score from baseline to 3 months and from 3-6 months (p<0.001). However, intergroup comparison demonstrated no statistically significant variation of mean IBDD at all 3 intervals (p>0.05). Conclusion: i-PRF combined with DFDBA enhanced the radiographic and clinical parameters as opposed to DFDBA alone. The role of i-PRF is promising in its capacity for easy obtainability and increased potential to aid in regeneration

Human venous blood derivatives as fetal bovine serum substitute for fibroblast culture cells in a fibrin construct

Aim: Venous blood derivatives (VBDs) have been suggested as substitutes for Fetal Bovine Serum (FBS) to improve the clinical transition of cell-based therapies. The literature is not clear about which is the best VBDs substitute. The present study aimed to evaluate the influence of VBDs on cell viability and describe a new method to seed these cells in a 3D Platelet-Rich Fibrin (PRF). Methods: Blood was processed to obtain Platelet-Poor Plasma from PRF (P-PRF), Human Serum (HS), Platelet-Poor Plasma from PRP (P-PRP), activated-PRP (a-PRP), and Platelet lysate (PL). Cells were supplemented with each VBD at 10% and FBS at 10% was the control. Cell viability (fibroblast 3T3/NIH) test was evaluated with MTT assay in two ways: i) cell-seeded and expanded with VBD; ii) cell-seed with FBS and expanded with VBD. To seed the Fibrin construct, cells were suspended in PBS and dropped into the blood sample before performing Choukroun's protocol for PRF. Constructs were cultured for 7 days in VBD supplements and FBS. Histological and Immunohistochemical analysis with vimentin was performed. Cell viability was analyzed by one-way ANOVA. Results: VBD's production time was very heterogeneous. Cells expanded in HS and a-PRP has grown faster. VBD-supplemented culture media provided cell culture highly sensible to trypsin/EDTA 0.25%. Cells seeded and expanded with VBD presented viability comparable to FBS in HS, a-PRP, and P-PRP (p>0.05) and lower in P-PRF and PL groups (p<0.05). The viability of cell seed with FBS and expanded with VBD was similar between P-PRF, a-PRP, PL, and FBS (p>0.05) and lower in HS and P-PRP (p<0.005). PRF-seeded cells showed a positive expression of vimentin and were able to maintain all cells supplemented with VBD. Conclusion: VBD supplements were able to maintain fibroblast cells in 2D and 3D cultures. The new method of the fibrin-cell construct was efficient to insert the cells into the fibrin network

Treatment of osteoradionecrosis of the jaw with injectable platelet-rich fibrin (i-PRF): case series / Tratamento de osteorradionecrose dos maxilares com fibrina rica em plaquetas injetável (i-PRF): série de casos

Objective: This study evaluated the use of autogenous blood concentrate (injectable platelet-rich fibrin) [i-PRF] for promoting soft tissue healing in osteoradionecrosis (ORN) lesions in patients who underwent head and neck radiotherapy. Material and Methods: This study included five ORN lesions in four patients who were treated with i-PRF (applied weekly for 4 weeks to the lesions). Soft tissue features were evaluated through clinical analysis at baseline and at 7, 15, 30, 60, and 90 days after the first session of i-PRF. Extension of the bone lesions was evaluated radiographically. Patient-centered related outcomes were evaluated using quality-of-life questionnaires at baseline and 90 days after the first treatment session. Quality of life data were analyzed using descriptive and frequency statistics and the Wilcoxon test. Results: Of the 5 treated lesions, 1 was completely closed and 3 remained open. The open lesions showed increased necrotic tissue exposure. No changes were observed in the radiographic appearance of the lesions. There was also no impact on the patient's quality of life. Conclusion: The results suggest that the majority of ORN lesions remained stable after the application of i-PRF, with a slight improvement in the quality of the mucosa around the lesions. Furthermore, it was observed that i-PRF did not compromise the quality of life of patients during treatment.(AU)

Objetivo: Este estudo avaliou o uso de concentrado de sangue autógeno (fibrina rica em plaquetas injetável) [i-PRF] para promover a cicatrização de tecidos moles em lesões de osteorradionecrose (ORN) em pacientes submetidos a radioterapia de cabeça e pescoço. Material e Métodos: Este estudo incluiu cinco lesões de ORN em quatro pacientes tratados com i-PRF (aplicado semanalmente por 4 semanas nas lesões). As características do tecido mole foram avaliadas por meio de análises clínicas no início e aos 7, 15, 30, 60 e 90 dias após a primeira sessão de i-PRF. A extensão das lesões ósseas foi avaliada radiograficamente. Os resultados centrados no paciente foram avaliados usando questionários de qualidade de vida no início e 90 dias após a primeira sessão de tratamento. Os dados de qualidade de vida foram analisados usando estatísticas descritivas e de frequência, além do teste de Wilcoxon. Resultados: Das 5 lesões tratadas, 1 foi completamente fechada e 3 permaneceram abertas. As lesões abertas mostraram aumento na exposição de tecido necrótico. Não foram observadas mudanças na aparência radiográfica das lesões. Também não houve impacto na qualidade de vida do paciente. Conclusão: Os resultados sugerem que a maioria das lesões de ORN permaneceu estável após a aplicação de i-PRF, com uma discreta melhora na qualidade da mucosa ao redor das lesões. Além disso, observou-se que a i-PRF não comprometeu a qualidade de vida dos pacientes durante o tratamento.(AU)

Exodoncia de premolar inferior supernumerario con posterior colocación de Fibrina Rica en Plaquetas y Leucocitos (L-PRF)

Los dientes supernumerarios son una anomalía odontogénica, consiste en aumento del número dentario con respecto a la cantidad normal. La Fibrina rica en Plaquetas y Leucocitos (L-PRF) es una matriz rica en plaquetas y glóbulos blancos, que promueve la curación y regeneración de los tejidos. La exodoncia de un tercer premolar inferior supernumerario con posterior colocación de membrana de L-PRF. Paciente de sexo masculino de 27 años de edad con un probable premolar supernumerario por lingual. Se programó la cirugía incluyendo L-PRF. Se realizó extracción de sangre para preparar la membrana de L-PRF, anestesia, incisión lineal, despegamiento mucoperióstico, osteotomía, exodoncia, tratamiento del lecho quirúrgico colocando la membrana de L-PRF y sutura interdental. Se prescribió medicación antibiótica, antiinflamatoria y analgésica. La técnica con L-PRF es sencilla y económica. Los resultados postoperatorios fueron favorables, observándose una buena cicatrización, ausencia de dolor, edema o infección.

Supernumerary teeth are an odontogenic anomaly, involving an increase in the number of teeth compared to the normal amount. Platelet-Rich Fibrin (L-PRF) is a matrix rich in platelets and white blood cells that promotes tissue healing and regeneration. The Extraction of a supernumerary lower third premolar followed by placement of L-PRF membrane. A 27-year-old male patient with a probable lingual supernumerary premolar. Surgery was scheduled, including L-PRF. Blood was extracted to prepare the L-PRF membrane, followed by anesthesia, linear incision, mucoperiosteal detachment, osteotomy, extraction, treatment of the surgical site with L-PRF membrane placement, and interdental suturing. Antibiotic, anti-inflammatory, and analgesic medication was prescribed. The L-PRF technique is simple and cost-effective. Postoperative results were favorable, with good healing, absence of pain, swelling, or infection was observed.

Membrana de fibrina rica en plaquetas asociada al colgajo de reposición coronal tres años después

Fundamento la asociación de la membrana de fibrina rica en plaquetas con el colgajo de reposición coronal constituye una modalidad de la ingeniería de tejidos que aporta elementos regenerativos al proceso de reparación tisular. Objetivo evaluar la efectividad de la membrana de fibrina rica en plaquetas asociada al colgajo de reposición coronal en el tratamiento de la recesión periodontal tres años después. Métodos se realizó un cuasiexperimento en la facultad de Estomatología de Villa Clara, en el periodo marzo de 2017-julio de 2020, y con una población de estudio conformada por 46 pacientes portadores de recesión periodontal, quienes requerían recubrimiento radicular mediante el colgajo de reposición coronal. Se utilizó un muestreo no probabilístico intencional por criterios, y la muestra quedó conformada por 26 pacientes. Se establecieron sitios de estudio y sitios de control. Las variables estudiadas fueron: edad, sexo, largo de la recesión, clasificación de Miller, cobertura radicular, ancho y ganancia de la encía insertada, categorías de evaluación y efectividad del tratamiento. Resultados en el 88,68 % de los dientes ubicados en los sitios de estudio predominó la categoría de evaluación favorable. El porcentaje de efectividad a los tres años de la terapéutica fue superior en los sitios de estudio (54,71 %). Conclusiones se consideró más efectivo el tratamiento de la recesión periodontal con membrana de fibrina rica en plaquetas asociada al colgajo de reposición coronal a los tres años del proceder.

Foundation the association of the platelet-rich fibrin membrane with the coronal replacement flap constitutes a modality of tissue engineering that provides regenerative elements to the tissue repair process. Objective to evaluate the effectiveness of the platelet-rich fibrin membrane associated with the coronal repositioning flap in the treatment of periodontal recession three years later. Methods a quasi-experiment was carried out at the Villa Clara Dentistry Faculty, from March 2017 to July 2020, a study population of 46 patients with periodontal recession, who required root coverage using the replacement flap coronal. Intentional non-probabilistic sampling by criteria was used, and the sample of 26 patients. Study sites and control sites were established. The studied variables were: age, sex, recession length, Miller classification, root coverage, width and gain of the attached gingiva, evaluation categories and treatment effectiveness. Results in 88.68% of the teeth located in the study sites, the favorable evaluation category predominated. The effectiveness percentage three years after treatment was higher in the study sites (54.71%). Conclusions the treatment of periodontal recession with platelet-rich fibrin membrane associated with the coronal replacement flap was considered more effective three years after the procedure.

Uso de L-PRF en defectos infraóseos de pacientes con estadios avanzados de periodontitis / Use of L-PRF in intrabone defects in patients with advanced stages of periodontitis

Objetivo: El propósito de este estudio fue observar el efecto del uso de L-PRF en defectos infraoseos de pacientes con periodontitis en estadios avanzados. Métodos: Se incluyeron 32 defectos infraoseos de 12 pacientes con diagnóstico de Periodontitis estadio III y IV (Workshop 2018). Se realizó raspaje a campo abierto con colocación de membrana de L-PRF. Se incluyeron defectos infraóseos de 1-2-3 paredes y cráter óseo. Se registró la profundidad de sondaje (PS), nivel de inserción clínica (NIC), índice de placa (IP) e índice de sangrado (IS). Se realizaron radiografías periapicale digitales antes de la cirugía y al cuarto mes para observar el llenado óseo. Resultados: De los 32 defectos el 75 % mostró disminución de la profundidad de sondaje (PS) y el 66 % mejoro el nivel de inserción clínica (NIC). Se realizó un análisis de correlación pre y posquirúrgico en PS: MV (p = 0,02), MP/L (p = 0,00), DP/L (p = 0,00) y V (p =0,00). El porcentaje de llenado óseo fue de 62,96 % (DS± 3,88). Conclusiones: La mayoría de los defectos infraóseos mostraron radiográficamente llenado óseo parcial o total con el uso de membranas L-PRF. Además, se mejoraron los parámetros clínicos de profundidad de sondaje y nivel de inserción clínica.

Objective: The purpose of this study was to observe the effect of L-PRF (Leuko- cyte-Platelet Rich Fibrin) usage in intraosseous defects in patients with advanced-stages of periodontitis. Methods: Thirty-two intraosseous defects in 12 patients diagnosed with stage III and IV periodontitis (Workshop 2018) were included in the study. Open flap debridement was performed with the placement of L-PRF membranes. Included defects consisted of 1-2-3 wall defects and osseous craters. Parameters such as probing depth (PD), clinical attachment level (CAL), plaque index (PI), and bleeding index (BI) were recorded. Digital periapical radiographs were taken before surgery and at the fourth month to assess bone fill. Results: Out of the 32 defects, 75% showed a reduction in probing depth (PD), and 66% showed improvement in clinical attachment level (CAL). Pre- and post-surgical correlation analysis was performed for PD: MV (p = 0.02), PI/L (p = 0.00), BI/L (p = 0.00), and CAL (p = 0.00). The percentage of bone fill was 62.96% (±3.88 SD). Conclusion: The majority of intraosseous defects exhibited partial or complete radiographic bone fill with the use of L-PRF membranes. Furthermore, clinical parameters such as probing depth and clinical attachment level improved.

Barrera de reparación de la base craneal en los abordajes endonasales endoscópicos / Skull base reconstruction barrier in endoscopic endonasal approaches

Introducción: Los abordajes endonasales endoscópicos son los procedimientos de elección para tumores mediales en la base craneal por su seguridad y efectividad. La reparación de la base craneal constituye un elevado desafío. Objetivo: Evaluar la efectividad de la construcción de una barrera de reconstrucción de la base craneal en pacientes con tumores de la base craneal operados por procedimientos endonasales endoscópicos. Método: Se realizó un estudio descriptivo, que incluyó a 70 pacientes del Hospital Hermanos Ameijeiras operados de tumores de la base craneal por procedimientos endonasales endoscópicos. Se construyó una barrera de reparación de la base craneal para aislar el compartimiento nasosinusal del intracraneal. Se determinó la eficiencia de la barrera de reparación mediante aspectos clínicos y endoscópicos. Se definieron aspectos a evaluar en relación con la vitalidad de la barrera de reparación con el empleo de la fibrina rica en plaquetas y leucocitos. Resultados: Se evidenció una barrera de reparación eficiente en el 98,6 por ciento. En relación con estado de vitalidad de la barrera se apreció una adherencia, granulación en el 98,6 por ciento de pacientes, mientras una angiogénesis de 97,1 por ciento. La incidencia de fístula de líquido cefalorraquídeo posoperatoria fue de solo 1,4 por ciento. Conclusiones: El presente estudio evidencia el efecto positivo de la construcción de una barrera de reparación eficiente de la base craneal por vía endonasal endoscópica con disminución significativa de fístula de líquido cefalorraquídeo y sus complicaciones(AU)

Introduction: Endoscopic endonasal approaches are the procedures of choice for medial tumors in the cranial base given their safety and effectiveness. Repair of the cranial base constitutes a high challenge. Objective: To evaluate the effectiveness of constructing a cranial base reconstruction barrier in patients with cranial base tumors operated on by endoscopic endonasal approaches. Method: A descriptive study was carried out, which included 70 patients from the Hermanos Ameijeiras Hospital operated on for cranial base tumors using endoscopic endonasal approaches. A cranial base repair barrier was constructed to isolate the sinonasal and intracranial compartments. The efficiency of the repair barrier was determined through clinical and endoscopic aspects. Aspects were defined to be evaluated in relation to the vitality of the repair barrier with the use of fibrin rich in platelets and leukocytes. Results: An efficient repair barrier was evident in 98.6 percent. In relation to the state of vitality of the barrier, adhesion and granulation were observed in 98.6 percent of patients, while angiogenesis was observed in 97.1 percent. The incidence of postoperative cerebrospinal fluid leak was only 1.4 percent. Conclusions: The present study shows the positive effect of the construction of an efficient repair barrier of the cranial base in endoscopic endonasal approaches with a significant reduction in cerebrospinal fluid leak and its complications(AU)

A tecnologia da Fibrina Rica em Plaquetas (PRF) pode ser aplicada em diversas áreas da Odontologia e Medicina? / Can Platelet Rich Fibrin (PRF) technology be applied in different areas of Dentistry and Medicine? / Se puede aplicar la tecnología de Fibrina Rica en Plaquetas (PRF) en diferentes áreas de la Odontología y la Medicina?

A Fibrina Rica em Plaquetas (PRF) é um material biológico feito do próprio sangue do paciente. É um material natural e não sintético. A PRF é rica em fatores de crescimento necessários para a cicatrização e o reparo tecidual. Também é rica em leucócitos, que são células do sistema imunológico que ajudam a proteger o paciente contra infecções. A PRF pode ser usada para acelerar o processo de cicatrização, redução da dor, do sangramento e melhora a estética do resultado final. Também pode ser usada para melhorar a eficácia de outros tratamentos médicos e odontológicos que vão desde Exodontia à aplicação na harmonização orofacial. Essa tecnologia pode ser usada na cirurgia oral e maxilofacial, implantodontia, periodontia, harmonização orofacial, cirurgia plástica, queimaduras, feridas crônicas, doenças degenerativas e doenças autoimunes. A PRF é uma tecnologia segura e eficaz que tem o potencial de melhorar a qualidade de vida de muitos pacientes.

Platelet Rich Fibrin (PRF) is a biological material made from the patient's own blood. It is a natural material and not synthetic. PRF is rich in growth factors necessary for tissue healing and repair. It is also rich in leukocytes, which are immune system cells that help protect the patient against infections. PRF can be used to accelerate the healing process, reduce pain and bleeding and improve the aesthetics of the final result. It can also be used to improve the effectiveness of other medical and dental treatments, ranging from extractions to orofacial harmonization. This technology can be used in oral and maxillofacial surgery, implant dentistry, periodontics, orofacial harmonization, plastic surgery, burns, chronic wounds, degenerative diseases and autoimmune diseases. PRF is a safe and effective technology that has the potential to improve the quality of life for many patients.

La fibrina rica en plaquetas (PRF) es un material biológico elaborado a partir de la propia sangre del paciente. Es un material natural y no sintético. PRF es rico en factores de crecimiento necesarios para la curación y reparación de tejidos. También es rico en leucocitos, que son células del sistema inmunológico que ayudan a proteger al paciente frente a infecciones. PRF se puede utilizar para acelerar el proceso de curación, reducir el dolor y el sangrado y mejorar la estética del resultado final. También se puede utilizar para mejorar la eficacia de otros tratamientos médicos y dentales, desde extracciones hasta armonización orofacial. Esta tecnología puede ser utilizada en cirugía oral y maxilofacial, implantología, periodoncia, armonización orofacial, cirugía plástica, quemaduras, heridas crónicas, enfermedades degenerativas y enfermedades autoinmunes. PRF es una tecnología segura y eficaz que tiene el potencial de mejorar la calidad de vida de muchos pacientes.

Regeneração óssea guiada para aumento horizontal de rebordo utilizando fibrina rica em plaquetas associada a enxertos ósseos: revisão de literatura / Guided bone regenerationfor horizontal bone augmentation using platelet- rich fibrin associated with bone grafts: literature review

Objetivo: revisar a literatura sobre os diferentes tipos de derivados de plaquetas autólogas e o desempenho clínico do uso do sticky bone para aumento ósseo horizontal de rebordo. Materiais e métodos: Para realização dessa revisão foram realizadas buscas nas bases de dados PubMed, Google Scholar e Web of Science, utilizando os seguintes descritores: "platelet-rich fibrin" AND "sticky bone" OR "alveolar bone grafting" AND "sticky bone" OR "guided bone regeneration" AND "sticky bone" AND "alveolar ridge augmentation" OR "Alveolar ridge augmentation" AND "sticky bone". Foram incluídos artigos publicados em inglês, que abordavam conceitos relacionados aos agregados plaquetários e a regeneração óssea guiada para aumento ósseo horizontal de rebordo utilizando fibrina rica em plaquetas associada à enxertos ósseos (sticky bone). Resultados: Após avaliação dos estudos encontrados foram selecionados 11 artigos sobre o uso do sticky bone para aumento horizontal de rebordo. Para compor este trabalho foram selecionados também 14 estudos de revisão e artigos associados ao tema. Por ser de fácil aplicação e obtenção, muitos autores têm estudado as aplicações cirúrgicas do sticky bone e os resultados demonstram que o aumento horizontal do rebordo utilizando essa técnica pode ser realizado de forma previsível. Conclusão: apesar de haver estudos promissores sobre o uso do sticky bone, falta evidência na literatura sobre seu sucesso clínico. Assim, para compreender o potencial regenerativo desta técnica são necessários um maior número de estudos randomizados, com diferentes materiais de enxerto e protocolos padronizados de obtenção do sticky bone.(AU)

Objective: to review the literature on the different types of autologous platelet derivatives and the clinical performance of using sticky bone for horizontal bone ridge augmentation. Materials and methods: In order to conduct this review, it was conducted searches in the PubMed, Google Scholar, and Web of Science databases using the following descriptors: "platelet-rich fibrin" AND "sticky bone" OR "alveolar bone grafting" AND "sticky bone" OR "guided bone regeneration" AND "sticky bone" AND "alveolar ridge augmentation" OR "Alveolar ridge augmentation" AND "sticky bone". It included articles published in English that addressed concepts related to platelet aggregates and guided bone regeneration for horizontal bone augmentation using platelet-rich fibrin associated with bone grafts (sticky bone). Results: After evaluating the studies found, were selected 11 articles on the use of sticky bone for horizontal ridge augmentation. To compose this work, 14 review studies and articles associated with the topic were also selected. Due to its ease of application and availability, many authors have explored the surgical applications of sticky bone, and the results indicate that horizontal ridge augmentation using this technique can be predictably performed. Conclusion: while there are promising studies on the use of sticky bone, the literature lacks evidence regarding its clinical success. Therefore, to fully understand the regenerative potential of this technique, further randomized studies are needed, involving different graft materials and standardized protocols for obtaining sticky bone.(AU)

Regeneration of a large bony lesion with advanced-platelet rich fibrin: case report / Regeneración de una lesión ósea de gran tamaño con fibrina rica en plaquetas: reporte de caso

Introduction: This case report analyzes the regeneration potential of advanced-platelet rich fibrin (A-PRF) in large bony lesions. Advanced-platelet rich fibrin provides various growth factors which aids in faster healing. Materials and Methods: Patient presented with peri-apical radiolucency. CBCT showed bony radiolucency in teeth 31, 32, 41, 42. A full mouth mucoperiosteal flap was raised and a cyst lining was enucleated. Apicoectomy was done with respect to 31, 32, 41, 42 along with and retrograde with a preparation of APRF clots were placed in the bony cavity. Results: Post-op CBCT at 6 months showed a significant difference in size and bone density of the lesion. Conclusions: Advanced-platelet rich fibrin has shown promising results in reducing the size of bony defect and periapical lesion in this case.

Introducción: Este caso clínico demuestra el potencial de regeneración de la fibrina rica en plaquetas avanzada (A-PRF) en lesiones óseas de gran tamaño. La fibrina rica en plaquetas avanzada proporciona varios factores de crecimiento que ayudan a una curación más rápida. Materiales y Métodos: El paciente se presentó con radiolucencia periapical. Tomografía computarizada de haz cónico mostró radiolucencia ósea en los dientes 31, 32, 41, 42. Se levantó un colgajo mucoperióstico de boca completa y se enucleó el revestimiento del quiste. Se realizó apicectomía con respecto a 31, 32, 41, 42, y se colocó una preparación de APRF se colocaron coágulos en la cavidad ósea. Resultados: La tomografía computarizada de haz cónico postoperatorio a los 6 meses mostró una diferencia significativa en el tamaño y la densidad ósea de la lesión. Conclusión: La fibrina rica en plaquetas avanzada ha mostrado resultados prometedores en la reducción del tamaño del defecto óseo y la lesión periapical en este caso.