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Introduction: When there is significant furcation involvement, mechanical debridement without surgery can cause the disease to progressively worsen. To halt the disease process, surgery allows for odontoplasty, root debridement, osseous recontouring, and periodontal regeneration while preserving periodontal attachment. Need of the Study: In cases of furcation deficiencies, periodontal regeneration with different bone grafts is an effective method to both replace lost bone tissue and slow down the progression of the disease. In osseous abnormalities, the additive actions and features of Cissus Quadrangularis (CQ) demonstrate improved healing. Thus, the purpose of present clinical trial is to determine whether the combination of CQ, when utilised locally and systemically, is efficacious for the management of Class II furcation defects. Aim: To evaluate and compare the efficacy of CQ (Hadjod) used locally, systemically, and in combination as an adjunct to osteon II with Platelet Rich Fibrin (PRF) for the management of Class II furcation defects. Methodology: A randomised clinical trial will be conducted in the Department of Periodontics at Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, Maharashtra, India from April 2024 to March 2026. A total 60 systemically healthy individuals with Class II furcation invasions, either buccal or lingual, and moderate to severe chronic periodontitis will be selected. The study population will be categorised into three interventional groups and one control group as follows: Group A: Control group (n=15) will be treated with osteon II + PRF membrane + antibiotic coverage for Class II furcation defects, Group B: (n=15) will be treated with osteon II + PRF membrane + CQ graft (locally) for Class II furcation defects + antibiotic coverage, Group C: (n=15) will be treated with osteon II + PRF membrane + systemic dosage of CQ for Class II furcation defects + antibiotic coverage, Group D: (n=15) will be treated with osteon II + PRF membrane + CQ graft (locally) + systemic dosage of CQ for Class II furcation defects + antibiotic coverage. The data will be analysed and calculated using the Student's t-test, with a significance level of less than 0.05. [ABSTRACT FROM AUTHOR]

Introduction: When there is significant furcation involvement, mechanical debridement without surgery can cause the disease to progressively worsen. To halt the disease process, surgery allows for odontoplasty, root debridement, osseous recontouring, and periodontal regeneration while preserving periodontal attachment. Need of the Study: In cases of furcation deficiencies, periodontal regeneration with different bone grafts is an effective method to both replace lost bone tissue and slow down the progression of the disease. In osseous abnormalities, the additive actions and features of Cissus Quadrangularis (CQ) demonstrate improved healing. Thus, the purpose of present clinical trial is to determine whether the combination of CQ, when utilised locally and systemically, is efficacious for the management of Class II furcation defects. Aim: To evaluate and compare the efficacy of CQ (Hadjod) used locally, systemically, and in combination as an adjunct to osteon II with Platelet Rich Fibrin (PRF) for the management of Class II furcation defects. Methodology: A randomised clinical trial will be conducted in the Department of Periodontics at Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, Maharashtra, India from April 2024 to March 2026. A total 60 systemically healthy individuals with Class II furcation invasions, either buccal or lingual, and moderate to severe chronic periodontitis will be selected. The study population will be categorised into three interventional groups and one control group as follows: Group A: Control group (n=15) will be treated with osteon II + PRF membrane + antibiotic coverage for Class II furcation defects, Group B: (n=15) will be treated with osteon II + PRF membrane + CQ graft (locally) for Class II furcation defects + antibiotic coverage, Group C: (n=15) will be treated with osteon II + PRF membrane + systemic dosage of CQ for Class II furcation defects + antibiotic coverage, Group D: (n=15) will be treated with osteon II + PRF membrane + CQ graft (locally) + systemic dosage of CQ for Class II furcation defects + antibiotic coverage. The data will be analysed and calculated using the Student’s t-test, with a significance level of less than 0.05.

Highlights • Biodentine has undergone thorough research as a bone grafting substance due to its ability to promote bone regeneration and effectively treat root or tooth fractures. • PRF and Biodentine can stimulate osteogenesis, affecting bone repair, particularly in mandibular fractures. Abstract Background: Mandibular fracture is one of the most common fractures. The most common treatment for mandibular fractures is fixation. Therefore, xenogeneic agents such as platelet-rich fibrin (PRF) and Biodentine accelerate the reparative process. Biodentine is an interesting active ingredient that can induce bone regeneration. PRF and Biodentine can promote bone healing, but no literature discusses the differences between PRF and Biodentine osteoinduction mechanisms in treating mandibular fractures. Objective: This article aimed to compare the effect of osteoinductive PRF with Biodentine for mandibular fractures. Material and Method: The research was conducted as a scoping review by performing a thorough search of the PubMed, Scopus, Science Direct, Elsevier, and Google Scholar databases. The study was obtained based on literature studies in the form of journals and textbooks in the last ten years (2013-2023). Result: The osteoinductive effect and mechanism of Biodentine in enhancing bone repair are likely correlated with releasing biologically active ions from calcium silicate cement and stimulating gene expression Runx-2. PRF has an osteoinductive role, causing the mechanism of releasing growth factors such as PDGF, VEGF, TGF-β, and IGF that promote the osteogenic process. Conclusion: There was no significant difference in the osteoinduction effect of PRF and Biodentine because these materials have different mechanisms of action for bone repair.

Statement of the Problem: Treatment of immature necrotic teeth is a problematic situation. Conventional root canal therapy is challenging and leaves a weak, fragile and undeveloped tooth for lifetime.Purpose: This review was aimed to assess the outcome of available randomized clinical tr-ials (RCTs) on the efficacy of platelet concentrates (PC) in dentine-pulp complex regeneration.Materials and Method: An electronic search was conducted on MEDLINE, EMBASE, Cochrane, and Google scholar databases. A further manual search was performed on the list of related articles in order to ensure inclusion of potentially missed articles in earlier electronic search. Those proved RCTs matched with the standard criteria were included following an initial assessment of abstracts and the text independently by the reviewers.Results: From the total 602 harvested articles, only 13 met the criteria and were evaluated with 11 having parallel design and 2 split mouth. Only one study featured low risk of bias, while three had moderate risk and the rest were at high risk of bias. Six studies had used platelet rich plasma (PRP), 4 employed platelet rich fibrin (PRF), one utilized injectable platelet rich fibrin (I-PRF), and three used both PRF and PRP for their experimental groups while blood clot (BC) was used as the control group for all. The success rate was reported at 87.3% judged by the absence of pathologic signs and symptoms.Conclusion: Dentin wall thickening, root lengthening and apex closure were higher in PC groups, however, these differences were not statistically significant in reported studies. It can be concluded that PCs promote the pulp tissue revitalization and continuation of root development. However, a consensus on its potency for true pulp regeneration is yet to be reached.

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Background: Macrophages are innate immune cells that display remarkable phenotypic heterogeneity and functional plasticity. Due to their involvement in the pathogenesis of several human conditions, macrophages are considered to be an attractive therapeutic target. In line with this, platelet derivatives have been successfully applied in many medical fields and as active participants in innate immunity, cooperation between platelets and macrophages is essential. In this context, the aim of this review is to compile the current evidence regarding the effects of platelet derivatives on the phenotype and functions of macrophages to identify the advantages and shortcomings for feasible future clinical applications. Methods: A total of 669 articles were identified during the systematic literature search performed in PubMed and Web of Science databases. Results: A total of 27 articles met the inclusion criteria. Based on published findings, platelet derivatives may play an important role in inducing a dynamic M1/M2 balance and promoting a timely M1-M2 shift. However, the differences in procedures regarding platelet derivatives and macrophages polarization and the occasional lack of information, makes reproducibility and comparison of results extremely challenging. Furthermore, understanding the differences between human macrophages and those derived from animal models, and taking into account the peculiarities of tissue resident macrophages and their ontogeny seem essential for the design of new therapeutic strategies. Conclusion: Research on the combination of macrophages and platelet derivatives provides relevant information on the function and mechanisms of the immune response. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Treatment of immature necrotic teeth is a problematic situation. Conventional root canal therapy is challenging and leaves a weak, fragile, and undeveloped tooth for lifetime. Purpose: This review was aimed to assess the outcome of available randomized clinical trials (RCTs) on the efficacy of platelet concentrates (PC) in dentine-pulp complex regeneration. Materials and Method: In this systematic review, an electronic search was conducted on MEDLINE, EMBASE, Cochrane, and Google scholar databases. A further manual search was performed on the list of related articles in order to ensure inclusion of potentially missed articles in earlier electronic search. Those proved RCTs matched with the standard criteria were included following an initial assessment of abstracts and the text independently by the reviewers. Results: From the total 602 harvested articles, only 13 met the criteria and were evaluated with 11 having parallel design and 2 split mouth. Only one study featured low risk of bias, while three had moderate risk and the rest were at high risk of bias. Six studies had used platelet rich plasma (PRP), 4 employed platelet rich fibrin (PRF), one utilized injectable platelet rich fibrin (I-PRF), and three used both PRF and PRP for their experimental groups while blood clot (BC) was used as the control group for all. The success rate was reported at 87.3% judged by the absence of pathologic signs and symptoms. Conclusion: Dentin wall thickening, root lengthening and apex closure were higher in PC groups, however, these differences were not statistically significant in reported studies. It can be concluded that PCs promote the pulp tissue revitalization and continuation of root development. However, a consensus on its potency for true pulp regeneration is yet to be reached. [ABSTRACT FROM AUTHOR]

Abstract Background This study aims to evaluate the optimal ratio of synthetic bone graft (SBG) material and platelet rich fibrin (PRF) mixed in a metal 3D-printed implant to enhance bone regeneration. Methods Specialized titanium hollow implants (5 mm in diameter and 6 mm in height for rabbit; 6 mm in diameter and 5 mm in height for pig) were designed and manufactured using 3D printing technology. The implants were divided into three groups and filled with different bone graft combinations, namely (1) SBG alone; (2) PRF to SBG in 1:1 ratio; (3) PRF to SBG in 2:1 ratio. These three groups were replicated tightly into each bone defect in distal femurs of rabbits (nine implants, n = 3) and femoral shafts of pigs (fifteen implants, n = 5). Animal tissue sections were obtained after euthanasia at the 8th postoperative week. The rabbit specimens were stained with analine blue, while the pig specimens were stained with Masson–Goldner’s trichrome stain to perform histologically examination. All titanium hollow implants were well anchored, except in fracture specimens (three in the rabbit and one fracture in the pig). Result Rabbit specimens under analine blue staining showed that collagen tissue increased by about 20% and 40% in the 1:1 ratio group and the 2:1 ratio group, respectively. Masson–Goldner's trichrome stain results showed that new bone growth increased by 32% in the 1:1 ratio PRF to SBG, while − 8% in the 2:1 ratio group. Conclusion This study demonstrated that placing a 1:1 ratio combination of PRF and SBG in a stabilized titanium 3D printed implant resulted in an optimal increase in bone growth.

Objectives The reconstruction of the lost interdental papilla remains one of the most intriguing and least predictable procedures in periodontology. Preservation of the integrity of the papillae is necessary for form, function, and aesthetics. Both surgical and non-surgical techniques are used for the reconstruction of interdental papilla. Platelet concentrates have wide application in dentistry and has shown promising results in most of its applications. Injectable PRF (i-PRF), which is a recent advancement in PRF formulations, is a liquid concentrate having advantages such as presence of higher leucocyte numbers, higher total growth factor release and expression, requirement of less time for preparation, induction of cell proliferation, migration and angiogenesis, higher fibroblast migration, etc. To date, no case or study has been reported to evaluate the efficacy of single application of i-PRF for the reconstruction of lost interdental papilla. Hence, the present case report intends to evaluate the effectiveness of single application of i-PRF for achieving interdental papillary enhancement.Materials & Methods A 36-year-old female reported to the department of periodontology with a chief complaint of spacing between teeth and gum in her upper right front gum region. A single application of i-PRF for achieving interdental papillary enhancement was evaluated.Results The patient was kept under follow-up for 3 months. After 3 months, the healing was found to be satisfactory and complete closure of the black triangle was noticed. The patient did not report of any adverse effect associated with injection of i-PRF. The patient was re-assessed after 6 months, and there was no recurrence observed.

AbstractBlood concentrates like platelet rich fibrin (PRF) have been established as a potential autologous source of cells and growth factors with regenerative properties in the field of dentistry and regenerative medicine. To further analyze the effect of PRF on bone tissue regeneration, this study investigated the influence of liquid PRF matrices on human healthy primary osteoblasts (pOB) and co-cultures composed of pOB and human dermal vascular endothelial cells (HDMEC) as in vitro model for bone tissue regeneration. Special attention was paid to the PRF mediated influence on osteoblastic differentiation and angiogenesis. Based on the low-speed centrifugation concept, cells were treated indirectly with PRF prepared with a low (44 g) and high relative centrifugal force (710 g) before the PRF mediated effect on osteoblast proliferation and differentiation was assessed via gene and protein expression analyses and immunofluorescence. The results revealed a PRF-mediated positive effect on osteogenic proliferation and differentiation accompanied by increased concentration of osteogenic growth factors and upregulated expression of osteogenic differentiation factors. Furthermore, it could be shown that PRF treatment resulted in an increased formation of angiogenic structures in a bone tissue mimic co-culture of endothelial cells and osteoblasts induced by the PRF mediated increased release of proangiogenic growth factors. The effects on osteogenic proliferation, differentiation and vascularization were more evident when low RCF PRF was applied to the cells. In conclusion, PRF possess proosteogenic, potentially osteoconductive as well as proangiogenic properties, making it a beneficial tool for bone tissue regeneration.

AbstractHorizontal platelet-rich fibrin (H-PRF) contains a variety of bioactive growth factors and cytokines that play a key role in the process of tissue healing and regeneration. The blood collection tubes used to produce Solid-PRF (plasmatrix (PM) tubes) have previously been shown to have a great impact on the morphology, strength and composition of the final H-PRF clot. Therefore, modification to PM tubes is an important step toward the future optimization of PRF. To this end, we innovatively modified the inner wall surface of the PM tubes with plasma and adjusted the gas environment inside the PM tubes to prepare super-hydrophilic anaerobic plasmatrix tubes (SHAP tubes). It was made anaerobic for the preparation of H-PRF with the aim of improving mechanical strength and bioactivity. The findings demonstrated that an anaerobic environment stimulated platelet activation within the PRF tubes. After compression, the prepared H-PRF membrane formed a fibrous cross-linked network with high fracture strength, ideal degradation characteristics, in addition to a significant increase in size. Thereafter, the H-PRF membranes prepared by the SHAP tubes significantly promoted collagen synthesis of gingival fibroblast and the mineralization of osteoblasts while maintaining excellent biocompatibility, and advantageous antibacterial properties. In conclusion, the newly modified PRF tubes had better platelet activation properties leading to better mechanical strength, a longer degradation period, and better regenerative properties in oral cell types including gingival fibroblast and alveolar osteoblasts. It also improves the success rate of H-PRF preparation in patients with coagulation dysfunction and expands the clinical application scenario.

Background: This study aims to evaluate the optimal ratio of synthetic bone graft (SBG) material and platelet rich fibrin (PRF) mixed in a metal 3D-printed implant to enhance bone regeneration. Methods: Specialized titanium hollow implants (5 mm in diameter and 6 mm in height for rabbit; 6 mm in diameter and 5 mm in height for pig) were designed and manufactured using 3D printing technology. The implants were divided into three groups and filled with different bone graft combinations, namely (1) SBG alone; (2) PRF to SBG in 1:1 ratio; (3) PRF to SBG in 2:1 ratio. These three groups were replicated tightly into each bone defect in distal femurs of rabbits (nine implants, n = 3) and femoral shafts of pigs (fifteen implants, n = 5). Animal tissue sections were obtained after euthanasia at the 8th postoperative week. The rabbit specimens were stained with analine blue, while the pig specimens were stained with Masson–Goldner's trichrome stain to perform histologically examination. All titanium hollow implants were well anchored, except in fracture specimens (three in the rabbit and one fracture in the pig). Result: Rabbit specimens under analine blue staining showed that collagen tissue increased by about 20% and 40% in the 1:1 ratio group and the 2:1 ratio group, respectively. Masson–Goldner's trichrome stain results showed that new bone growth increased by 32% in the 1:1 ratio PRF to SBG, while − 8% in the 2:1 ratio group. Conclusion: This study demonstrated that placing a 1:1 ratio combination of PRF and SBG in a stabilized titanium 3D printed implant resulted in an optimal increase in bone growth. [ABSTRACT FROM AUTHOR]

Aim: The present study was aimed at evaluating the variations in fibrin network patterns of the platelet-rich fibrin (PRF) procured from diabetics, non-diabetics, and smokers suffering from chronic periodontitis. Materials and Methods: Five milliliters of blood were drawn using a syringe from 60 participants (systemically healthy non-diabetics, diabetics, and smokers) who were diagnosed with chronic periodontitis. Five milliliters of blood were transferred to a dry glass tube. The clot (PRF) obtained after centrifugation from the glass tube was processed for light microscopy analysis. Results: The PRF samples have demonstrated the presence of both dense and loose fibrin networks. There is an increase in cellular content in diabetic participants compared to systemically healthy and smoker participants. Smoker participants demonstrated a higher amount of loose fibrin content, which was arranged irregularly. Conclusion: A significantly greater increase in cellular content and loose fibrin network is seen in diabetics and smokers, respectively, compared to systemically healthy individuals. As compared to the systemically healthy participants, there is a variation in the fibrin network pattern and distribution of cellular structures in diabetic and smoker participants.

BackgroundMacrophages are innate immune cells that display remarkable phenotypic heterogeneity and functional plasticity. Due to their involvement in the pathogenesis of several human conditions, macrophages are considered to be an attractive therapeutic target. In line with this, platelet derivatives have been successfully applied in many medical fields and as active participants in innate immunity, cooperation between platelets and macrophages is essential. In this context, the aim of this review is to compile the current evidence regarding the effects of platelet derivatives on the phenotype and functions of macrophages to identify the advantages and shortcomings for feasible future clinical applications.MethodsA total of 669 articles were identified during the systematic literature search performed in PubMed and Web of Science databases.ResultsA total of 27 articles met the inclusion criteria. Based on published findings, platelet derivatives may play an important role in inducing a dynamic M1/M2 balance and promoting a timely M1-M2 shift. However, the differences in procedures regarding platelet derivatives and macrophages polarization and the occasional lack of information, makes reproducibility and comparison of results extremely challenging. Furthermore, understanding the differences between human macrophages and those derived from animal models, and taking into account the peculiarities of tissue resident macrophages and their ontogeny seem essential for the design of new therapeutic strategies.ConclusionResearch on the combination of macrophages and platelet derivatives provides relevant information on the function and mechanisms of the immune response.

Aim: To evaluate “coronally advanced flap” with or without “a platelet-rich fibrin membrane for the root coverage.” Materials and Methods: All the clinical parameters were assessed at different time intervals (at baseline, 1, 3, and 6 months) in both experimental and control group. Following “clinical parameters” were recorded using “UNC-15” “Probe-Plaque Index (PI)” (Silness and Loe, 1964), “Gingival Index” (GI) (Loe and Silness, 1963), “Recession depth (RD),” “Recession width (RW),” “Clinical attachment level (CAL),” and “Width of keratinized gingiva (WKG)”. Results: At final evaluation (i.e., mean change from baseline to 6 months), “the decrease in Plaque Index was 2.5% higher in Group B (66.0%) as compared to Group A (63.5%). The decrease in Gingival Index was 6.1% higher in Group B (91.4%) as compared to Group A (85.3%), and the decrease in recession width was 4.0% higher in Group B (75.2%) as compared to Group A (71.2%). The decrease in clinical attachment level was 4.4% higher in Group B (53.2%) as compared to Group A (48.4%). The increase in width of keratinized gingiva was 1.9% higher in Group A (28.8%) as compared to Group B (26.9%).” Conclusion: The controlled, randomized, split mouth design showed that CAF surgery, either by alone or in combination with PRF, is an efficient treatment method for covering denuded roots. “This design was used to treat bilateral isolated Miller's class I and II recessions in gingival part. When compared to the CAF approach, the results from a combination of CAF and PRF after a 6-month period showed additional advantages in addition to mean root coverage in the treatment of Miller's classes I and II recessions in gingival part.”

Abstract Background This study aimed to compare the efficacy of different gap filling materials in immediate implant in anterior and premolar regions of maxilla. Materials and methods Thirty-six implants were inserted in patients seeking for replacement of non-restorable maxillary anterior and premolar teeth (esthetic zone) by immediate implant. Patients were randomly distributed into three equal groups, twelve implants in each group. Group 1 received Platelet Rich Fibrin (PRF) into the jumping distance, Group 2 received Xenograft into the jumping distance and Group 3 received Alloplastic bone grafting material into the jumping distance. Implant stability by measuring the changes in Resonance Frequency Analysis (RFA), peri-implant pocket depth, marginal bone loss and changes in buccal bone thickness were evaluated during follow up periods. All the clinical and radiographic data were subjected to statistical analysis by One Way ANOVA test and the Post Hoc Tukey test. Results This study involved 19 female patients and 17 male patients who received 36 dental implants. There was no significant difference between the study groups regarding implant stability, peri-implant pocket depth and palatal bone loss, while there was a significant difference between PRF Group (Group 1) and the other Groups regarding buccal bone loss and changes in buccal bone thickness. Conclusion PRF can be used as a gap filling material in conjunction with immediate implant placement, but other bone grafting materials give superior result regarding buccal bone loss and changes in buccal bone thickness. Trial registration The study was listed on www.clinicaltrials.gov with registration number (NCT05878392) on 26/05/2023. The Institutional Review Board (IRB) of the Faculty of Dentistry, Mansoura University, Mansoura, Egypt, approved the current study in compliance with the seventh revision of the Helsinki Declaration in 2013 (A0103023OS).

Aim: To evaluate "coronally advanced flap" with or without "a platelet-rich fibrin membrane for the root coverage." Materials and Methods: All the clinical parameters were assessed at different time intervals (at baseline, 1, 3, and 6 months) in both experimental and control group. Following "clinical parameters" were recorded using "UNC-15" "Probe-Plaque Index (PI)" (Silness and Loe, 1964), "Gingival Index" (GI) (Loe and Silness, 1963), "Recession depth (RD)," "Recession width (RW)," "Clinical attachment level (CAL)," and "Width of keratinized gingiva (WKG)". Results: At final evaluation (i.e., mean change from baseline to 6 months), "the decrease in Plaque Index was 2.5% higher in Group B (66.0%) as compared to Group A (63.5%). The decrease in Gingival Index was 6.1% higher in Group B (91.4%) as compared to Group A (85.3%), and the decrease in recession width was 4.0% higher in Group B (75.2%) as compared to Group A (71.2%). The decrease in clinical attachment level was 4.4% higher in Group B (53.2%) as compared to Group A (48.4%). The increase in width of keratinized gingiva was 1.9% higher in Group A (28.8%) as compared to Group B (26.9%)." Conclusion: The controlled, randomized, split mouth design showed that CAF surgery, either by alone or in combination with PRF, is an efficient treatment method for covering denuded roots. "This design was used to treat bilateral isolated Miller's class I and II recessions in gingival part. When compared to the CAF approach, the results from a combination of CAF and PRF after a 6-month period showed additional advantages in addition to mean root coverage in the treatment of Miller's classes I and II recessions in gingival part." [ABSTRACT FROM AUTHOR]

Blood concentrates like platelet rich fibrin (PRF) have been established as a potential autologous source of cells and growth factors with regenerative properties in the field of dentistry and regenerative medicine. To further analyze the effect of PRF on bone tissue regeneration, this study investigated the influence of liquid PRF matrices on human healthy primary osteoblasts (pOB) and co-cultures composed of pOB and human dermal vascular endothelial cells (HDMEC) as in vitro model for bone tissue regeneration. Special attention was paid to the PRF mediated influence on osteoblastic differentiation and angiogenesis. Based on the low-speed centrifugation concept, cells were treated indirectly with PRF prepared with a low (44 g) and high relative centrifugal force (710 g) before the PRF mediated effect on osteoblast proliferation and differentiation was assessed via gene and protein expression analyses and immunofluorescence. The results revealed a PRF-mediated positive effect on osteogenic proliferation and differentiation accompanied by increased concentration of osteogenic growth factors and upregulated expression of osteogenic differentiation factors. Furthermore, it could be shown that PRF treatment resulted in an increased formation of angiogenic structures in a bone tissue mimic co-culture of endothelial cells and osteoblasts induced by the PRF mediated increased release of proangiogenic growth factors. The effects on osteogenic proliferation, differentiation and vascularization were more evident when low RCF PRF was applied to the cells. In conclusion, PRF possess proosteogenic, potentially osteoconductive as well as proangiogenic properties, making it a beneficial tool for bone tissue regeneration. [ABSTRACT FROM AUTHOR]

Background: Non-healing ulcers are a major cause of disability and impairment, interfering with physical and mental well-being of patients chronic non-healing ulcers. They are difficult to manage having longer duration of treatment and increased financial burden. Minimizing the duration of healing can be a major step in rehabilitation of such patients. Platelet rich fibrin (PRF) is a newer modality to hasten wound healing. It is a concentration of platelets suspended in plasma extracted after centrifuging patient's own blood. Aim: To study the efficacy of platelet-rich fibrin (PRF) in management of non-healing ulcers. Methodology-Prospective Study was conducted in the Department of Dermatology, Venereology, and Leprology, Nalanda Medical College and Hospital, Patna. with Sample size of 60 patients over a period of 18 months. Results: The mean age of cases in our study was 48.41±11.52 years. The average percentage improvement in area and volume was 97.12% and 98.72% respectively. The mean duration of healing was found to be 2.41 weeks. The procedure was safe with no noted adverse events. Conclusion-PRF is an inexpensive, safe, feasible and effective procedure in the management of non-healing ulcers. [ABSTRACT FROM AUTHOR]

Extraction of third molars can cause some postoperative complications for patients, among the main ones are pain, trismus, infections and alveolitis. Currently, there are some materials that reduce such sequelae, enhancing faster healing of the region. The Platelet- and Leukocyte-Rich Fibrin (LPRF) membrane emerged more than 20 years ago and has since been associated with dental procedures, such as tooth extractions. L-FRP is defined as a material an autogenous material, capable of promoting the regeneration of hard and soft tissues. This material has the advantages of biocompatibility, low cost and easy protocol over synthetics. The objective of this study is to report a clinical case of third molar extraction in which the patient underwent a blinded study assessment, with the placement of L-PRF after tooth extraction on one side and the procedure being performed conventionally on the other. After 30 days postoperatively, better tissue healing was observed in the region where the fibrin membrane was placed. [ABSTRACT FROM AUTHOR]

Introduction:Autologous platelet concentrate (APC) are pro-angiogenic and can promote wound healing and tissue repair, also in combination with other biomaterials. However, challenging defect situations remain demanding. 3D bioprinting of an APC based bioink encapsulated in a hydrogel could overcome this limitation with enhanced physio-mechanical interface, growth factor retention/secretion and defect-personalized shape to ultimately enhance regeneration.Methods:This study used extrusion-based bioprinting to create a novel bioink of alginate/cellulose hydrogel loaded with thrombocyte concentrate. Chemico-physical testing exhibited an amorphous structure characterized by high shape fidelity. Cytotoxicity assay and incubation of human osteogenic sarcoma cells (SaOs2) exposed excellent biocompatibility. enzyme-linked immunosorbent assay analysis confirmed pro-angiogenic growth factor release of the printed constructs, and co-incubation with HUVECS displayed proper cell viability and proliferation. Chorioallantoic membrane (CAM) assay explored the pro-angiogenic potential of the prints in vivo. Detailed proteome and secretome analysis revealed a substantial amount and homologous presence of pro-angiogenic proteins in the 3D construct.Results:This study demonstrated a 3D bioprinting approach to fabricate a novel bioink of alginate/cellulose hydrogel loaded with thrombocyte concentrate with high shape fidelity, biocompatibility, and substantial pro-angiogenic properties.Conclusion:This approach may be suitable for challenging physiological and anatomical defect situations when translated into clinical use.

Aim: The present study aims to evaluate the efficacy of naturally-derived bovine hydroxyapatite (Cerabone) versus demineralized freeze-dried bone allograft both combined with platelet-rich fibrin for treatment of grade II mandibular furcation defects.

Autologous platelet rich fibrin (PRF), is currently being widely used and investigated across the globe by clinicians and periodontal research. The technical aspect required for the procurement of PRF includes revolution per minute (RPM), relative centrifugal force (RCF) or G-force, rotor radius, rotor angle, stability or vibration in the centrifugal machine and material of test-tube, besides the systemic health of the individual may influence the final outcome. Present technical note intends to compile these aspects for better understanding and appropriate outcome while preparing PRF in varying clinical scenarios. [Display omitted] [ABSTRACT FROM AUTHOR]

This systematic review and meta-analysis aimed to assess individually the regenerative potential of PRF (Platelet-rich Fibrin), PRP (Platelet-rich Plasma), and PRGF (Plasma Rich in Growth Factors) in comparison to OFD (Open Flap Debridement) alone for treating Intrabony defects, by calculating pooled effect sizes. Relevant randomized controlled trials on humans were searched in PUBMED, COCHRANE CENTRAL, and GOOGLE SCHOLAR. Mean differences (MD) of Clinical Attachment level (CAL), Probing Pocket depth (PPD), and Defect Depth Reduction (DDR) between the Experimental and Control groups were used for calculating pooled effect sizes. Risk of bias was assessed using Cochrane's tool, and publication bias was evaluated through Funnel plots, Trim & Fill Method, and Rosenthal's Fail-Safe N Test. A total of 23 studies were identified for qualitative and quantitative analysis. These studies were categorized into PRF, PRP, and PRGF groups based on the type of APC used. PRF showed the highest CAL gain (1.60 mm, 95% CI = 0.963–2.232 mm, P < 0.001, I2 = 93.83%) and PPD reduction (1.76 mm, 95% CI = 1.056 to 2.446, P < 0.001, I2 = 96.05%). However, PRP exhibited the greatest DDR (3.42 mm, 95% CI = −13.67 to −20.50, P = 0.011, I2 = 87.27%). PRF and PRP demonstrated large effect sizes, while PRGF showed a small effect size. The use of PRF, PRP, and PRGF showed advantages in treating intrabony defects. However, caution is advised when interpreting the results due to heterogeneity and publication bias among the studies. [Display omitted] [ABSTRACT FROM AUTHOR]

Growth factors and cytokines in the platelet playa major role inthe progression of inflammation and healing processes, therefore A-PRF and L-PRF as platelet drive ingredients are widely used in periodontal treatments. The purpose of this study is to compare the effect of A-PRF and L-PRF on the number of gingival fibroblastsadhered to collagen membrane.Materials & Methods:In this In-vitro study conductedin winter of 2021 at the Iranian biological resource center, the membrane was cut into five pieces (5x5mm) and placed at the bottom of a 5 well plate. 1 milliiiter of (A-PRF) was added to two wells ineach group. And a similar amount of L-PRF was added to two wells in theother two groups.The last well was left A-PRF or L-PRF free. Gingival fibroblasts were seeded inall the wells. Cell adhesion was evaluated by means of a Field Emission Scanning Electron Microscope after 24 hours of incubation. The Data wereanalyzed by, one way and two-way ANOVA and Scheffe test (p value < 0.001).Results:based on ANOVA there was a statistically significant difference In the A-PRF+ group and L-PRF+ group (12.50 and 13.57) compared to the control group (4.67) (p value < 0.001).and Scheffe analysis showed no statistically significant difference between A-PRF+ or L-PRF+ groups (p value = 0.307).Conclusion:A-PRF and L-PRF are both effective in the adhesion of fibroblasts cells to collagen membranes, although there is no difference between A-PRF and L-PRF in the adhesion of fibroblast cells to collagen membranes

Platelet-rich plasma (PRP) is one of the most common and practicable plasma-therapy techniques. The wide therapeutic range for the use of this technique in various medical fields is due to its high content of growth factors, cytokines, and chemokines. The property of PRP to induce tissue regeneration is particularly highlighted, which is used actively for the treatment of a broad range of urological diseases. The review aimed to highlight the accumulated material on the topic of the use of autologous biomaterials based on blood in urology. This article highlights the urgent need for further study of the prospects for the use of autoplasma technologies in wide multicenter studies.

Abstract Objective To investigate the clinical observation of autologous platelet-rich fibrin (PRF) assisting the revascularization of mature permanent teeth. Methods Twenty patients with mature permanent teeth were divided into experimental group and control group. The control group was treated with classic revascularization, and the experimental group was treated with PRF-assisted mature permanent tooth revascularization. Results After treatment, the total effective rate of the experimental group (100.00%) was higher than that of the control group (50.00%); the thickness of the root canal wall of the experimental group was higher than that of the control group, and the crown root length was lower than that of the control group; The bite degree, chewing function, color, overall aesthetic score, and satisfaction rate of the patients were higher, and the difference was statistically significant (P

Background: ‘Regenerative endodontics’ using host-derived scaffolds and biomaterials (MTA) is popular in the management of teeth with open apex. Alkaline pH and bioactivity contribute to tissue healing and remineralization. We assessed the influence of PRF and Blood Clot on the pH and Ca + ion release from MTA. Methods: A total of 15 single-rooted human extracted teeth were sectioned at the level of the cementoenamel junction. Based on the type of scaffolds used, samples were divided into three groups. Group 1 (MTA+ PRF), Group 2 (MTA + Blood Clot), Group 3 (control MTA). The prepared specimens were transferred to a fresh falcon tube containing 10mL of distilled water and the collected solutions were analysed for pH and Ca + ion release at 3h, seventh day and 14 th day. Results: It was observed that the mean pH and Ca + ion release were significantly lower in the experimental groups as compared to the control group. Though there was an increase in the pH recorded in Group 1 and 2 at all time periods, the difference was not significant. Ca + ion release peaked at Day 7 (Group3 > Group2 > Group1) and reduced significantly on the 14 th day for all groups. Conclusions: Within the limitations of the study, it can be concluded that PRF and blood clot influence the pH and Ca + ion release from MTA.

Background: ‘Regenerative endodontics’ using host-derived scaffolds and biomaterials (MTA) is popular in the management of teeth with open apex. Alkaline pH and bioactivity contribute to tissue healing and remineralization. We assessed the influence of PRF and Blood Clot on the pH and Ca+ ion release from MTA. Methods: A total of 15 single-rooted human extracted teeth were sectioned at the level of the cementoenamel junction. Based on the type of scaffolds used, samples were divided into three groups. Group 1 (MTA+ PRF), Group 2 (MTA + Blood Clot), Group 3 (control MTA). The prepared specimens were transferred to a fresh falcon tube containing 10mL of distilled water and the collected solutions were analysed for pH and Ca+ ion release at 3h, seventh day and 14th day. Results: It was observed that the mean pH and Ca+ ion release were significantly lower in the experimental groups as compared to the control group. Though there was an increase in the pH recorded in Group 1 and 2 at all time periods, the difference was not significant. Ca+ ion release peaked at Day 7 (Group3 > Group2 > Group1) and reduced significantly on the 14th day for all groups. Conclusions: Within the limitations of the study, it can be concluded that PRF and blood clot influence the pH and Ca+ ion release from MTA.

Background and Objectives: Platelet-rich fibrin (PRF) membrane plays an important role in cell proliferation and aids in healing. This study aimed to assess the safety and efficacy of the addition of PRF to the graft in tympanoplasty. Materials and Methods: A retrospective study was conducted involving 47 patients with chronic dry eardrum perforation, who were candidates for different types of tympanoplasty (type I-IV). The study took place in the ENT department, County Emergency Clinical Hospital of Cluj-Napoca. In group 1 (27 patients) tympanoplasty was performed with a cartilage graft, while in group 2 (20 patients) a cartilage graft was used with the addition of a PRF membrane. The PRF clot was extracted and transformed into a thin membrane. Postoperative evaluation included otoendoscopy and otomicroscopy at 1, 3, 6, and 12 months after surgery, as well as pure-tone audiometry at 12 months. Results: Postoperative follow-up at 1, 3, 6, and 12 months showed a higher rate of graft survival in the PRF group than in the non-PRF group. At the 12-month mark, a successful outcome was observed in 95.0% of patients in the PRF group, while the success rate in group 1 was 70.4% (p < 0.05). The postoperative hearing threshold value was statistically significantly lower in the group with PRF, compared to the non-PRF group, being 18.4 ± 10.4 dB and 27.6 ± 16.2 dB (p < 0.001), respectively. Although the postoperative air-bone gap value did not differ significantly between groups, there was a greater improvement in the PRF group (p < 0.7). The PRF was well tolerated, and the incisions healed perfectly. Conclusions: The PRF membrane increases the rate of autograft survival and is therefore an effective material for patients with chronic perforations of the tympanic membrane. [ABSTRACT FROM AUTHOR]

The method for the production of PRF (Platelet Rich Fibrin) was developed in 2000 and belongs to the second generation of platelet concentrates. Several clinical studies have demonstrated its effectiveness in combination with various bone substitutes. The concentrate is prepared by centrifuging the patient's own blood without addition of anticoagulants, and according to the established protocol. The process yields a fibrin-rich clot of leukocytes and platelets that serves as an extracellular matrix. The growth factors from white blood cells and platelets are released slowly (2–3 weeks), and thus, have a beneficial effect on the wound healing. In this article, the authors present their review of the data available in the main literature and report on potential applications of PRF in dental, dentoalveolar, and maxillofacial surgeries (implantology, bone grafting, dentoalveolar surgery, periodontology, sinus closure, sinus elevation, osteonecrosis, endodontics).

Background: In this evolutionary era of dentistry, newer techniques have evolved for complete coverage of multiple recession defects (MRDs). Since 2012, MRDs have been treated using the vestibular incision subperiosteal tunnel access (VISTA) approach and a variety of regenerating membranes with varying degrees of success. Platelet‑rich fibrin matrix (PRFM) membrane has shown a robust release of growth factors and was known to enhance the healing process. Thus, in this study we have evaluated the effectiveness of platelet-rich fibrin matrix (PRFM) with that of platelet-rich fibrin (PRF) membrane using the vestibular incision subperiosteal tunnel access (VISTA) technique in Miller Class I and II multiple gingival recession defects. Methods: This randomized, parallel designed, controlled, clinical study was conducted in 20 subjects (10 male and 10 female) having class I/II MGR defects either buccally or labially. The test group was treated with VISTA and PRFM membrane while the control group was treated with VISTA and PRF membrane. The clinical measurements such as plaque index, papillary bleeding index, probing pocket depth, relative attachment level (RAL) and relative gingival marginal level (R-GML), width of keratinized gingiva (WKG), gingival recession (REC) and gingival thickness (GT) were measured at baseline, three and six months. A Student’s paired t-test was utilized to analyse data from the day of surgery to six months. Results: Ten patients in the test group (89.23±15.04) and 10 patients in the control group (85.06±17.71) showed marked root coverage compared to baseline. Conclusions: Both test and control groups showed statistically significant enhancement in root coverage. However, no statistically significant difference was found when a comparison was made between the two groups in terms of PD, relative RAL, R-GML and REC reduction, gain in WKG, and increase in GT. Trial registration: CTRI/2021/07/035240, registered 29 July 2021.

Background: Three-dimensional primary slice cultures (SC) of head and neck squamous cell carcinomas (HNC) are realistic preclinical models. Until now, preserving structure and viability ex vivo for several days has been difficult. The aim of this study was to optimize cultivation conditions for HNC SC and analyze the added effects of platelet rich fibrin (PRF) on these conditions. Methods: SC were prepared from the tumor biopsies of 9 HNC patients. Cultures were incubated for 1 and 7 days in three different media-Keratinocyte serumfree medium (SFM), RPMI-1640i, and 1:1 mix of both, with and without addition of PRF. After culturing, SC were fixated, embedded, and stained with Hematoxylin-Eosin (HE) and cleaved caspase-3. In addition, triple immune fluorescence staining for cytokeratin, vimentin and CD45 was performed. Outcome parameters were cell count and cell density, viability and apoptosis, SC total area and proportions of keratinocytes, mesenchymal and immune cells. The effects of culture time, medium, and addition of PRF were calculated in an SPSS generalized linear model and using the Wald Chi-Squared test. Results: Ninety-four slice cultures were analyzed. Viability remained stable for 7 days in culture. After addition of PRF, cell viability increased (p=0.05). SC total area decreased (0.44 ± 0.04 mm² on day 1 (95% CI: 0.35 to 0.56) to 0.29 ± 0.03 mm² on day 7 (95% CI: 0.22 to 0.36), but cell density and cell proportions remained stable. Differences in cultivation media had no significant impact on outcome parameters. Conclusion: HNC SC can be preserved for up to 7 days using the tested cultivation media. Cell viability was best preserved with addition of PRF. HNC SC are a versatile experimental tool to study physiology and drug actions. Autologous PRF can help simulate realistic conditions in vitro. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical observation of autologous platelet-rich fibrin (PRF) assisting the revascularization of mature permanent teeth. Methods: Twenty patients with mature permanent teeth were divided into experimental group and control group. The control group was treated with classic revascularization, and the experimental group was treated with PRF-assisted mature permanent tooth revascularization. Results: After treatment, the total effective rate of the experimental group (100.00%) was higher than that of the control group (50.00%); the thickness of the root canal wall of the experimental group was higher than that of the control group, and the crown root length was lower than that of the control group; The bite degree, chewing function, color, overall aesthetic score, and satisfaction rate of the patients were higher, and the difference was statistically significant (P < 0.05). Conclusion: Autologous PRF assists in revascularization of mature permanent teeth, which can achieve ideal results, and promote pulp regeneration. [ABSTRACT FROM AUTHOR]

Background: ‘Regenerative endodontics’ using host-derived scaffolds and biomaterials (MTA) is popular in the management of teeth with open apex. Alkaline pH and bioactivity contribute to tissue healing and remineralization. We assessed the influence of PRF and Blood Clot on the pH and Ca + ion release from MTA. Methods: A total of 15 single-rooted human extracted teeth were sectioned at the level of the cementoenamel junction. Based on the type of scaffolds used, samples were divided into three groups. Group 1 (MTA+ PRF), Group 2 (MTA + Blood Clot), Group 3 (control MTA). The prepared specimens were transferred to a fresh falcon tube containing 10mL of distilled water and the collected solutions were analysed for pH and Ca + ion release at 3h, seventh day and 14 th day. Results: It was observed that the mean pH and Ca + ion release were significantly lower in the experimental groups as compared to the control group. Though there was an increase in the pH recorded in Group 1 and 2 at all time periods, the difference was not significant. Ca + ion release peaked at Day 7 (Group3 > Group2 > Group1) and reduced significantly on the 14 th day for all groups. Conclusions: Within the limitations of the study, it can be concluded that PRF and blood clot influence the pH and Ca + ion release from MTA.

Aim: To evaluate the antimicrobial activity of PRP and PRF with and without nanosilver. Materials and Methods: The materials were tested in powdered form is nanosilver. The nanosilver particles was mixed to form with PRP and PRF so as to placed in a wells followed the groups are experimental groups; Group I: PRP + nanosilver particles, Group II: PRF + nanosilver and control group: PRP and PRF and normal saline. Silver nanoparticles was tested at concentrations of 50 μ gram per mL. The powder was prepared for each group with identical amount of the powder (milligram/mg) and then mixed with 1 milliliter liquid. The plates are then incubated at 37°C under appropriate atmospheric conditions (80% N2, 10% CO2, 10% H2) for 24 hours, 48 hours, and 72 hours under anaerobic conditions in a CO2 incubator. The diameters of the zones of bacterial and fungal growth inhibition around the wells containing the test substances are then recorded after the period of incubation. The inhibitory zone determined in millimeter by measuring scale the shortest distance between the outer margin of the well and initial microbial as well as fungal growth. The experiments were performed 20 times and the mean and standard deviations of the inhibitory zones were calculated. Result: Platelet rich fibrin is mixed with nanosilver particles showed higher antimicrobial efficacy than platelet rich plasma with nanosilver and simple platelet rich plasma and platelet rich fibrin are equivalent when it is placed against the anaerobic bacteria E.faecalis and yeast like fungi Candida albicans, respectively. Conclusion: Groups presented with antimicrobial efficacy in this order- Group IV > Group II > Group III > Group I.

Introduction: Increased incidence of localized osteonecrosis in the jaw bones caused by bisphosphanate use and reduced quality of life of the patients led researchers to diagnose the disease in the early period and to investigate the effective treatment modality. Objective: Treatment of medication-related osteonecrosis of the jaw patients is based on individual protocols from clinical experience, as there are no definitive treatment guidelines. In view of the lack of consensus on the effectiveness of medication-related osteonecrosis of the jaw treatments in the literature, the aim of this study was to evaluate the surgical technique described in the treatment of advanced stages of medication-related osteonecrosis of the jaw patients. Methods: Twenty-one patients affected by Stage 2–3 medication-related osteonecrosis of the jaw were treated with ultrasonic piezoelectric bone surgery for necrotic bone removing, leukocyte and platelet-rich fibrin concentrate obtained from the patient’s peripheral blood and Nd:YAG laser for biostimulation. Success was assessed as the maintenance of full mucosal coverage without signs of residual infection at 1-month (T1), 3-months (T2), 6-months (T3) and 1-year (T4) after surgery. Logistic regressions were used to evaluate the association between the different independent variables and treatment outcomes. Results: Two Stage 3 patients had delayed healing at 1 month after the operation. Complete mucosal healing was achieved in all patients at the third month. Multivariate analysis demonstrated that different variables were not significantly correlated with delayed healing (p > 0.05). Conclusion: The surgical protocol presented in this study shows promising results for surgical management of advanced stages of medication-related osteonecrosis of the jaw patients.

Purpose: In this study, we applied platelet rich fibrin (PRF) and pure olive oil on the incision surfaces of rats. We aimed to examine whether PRF may be used safely to prevent peritoneal adhesions. Materials and Methods: Fourty rats were divided into 4 groups (n=8). Eight rats, not included in the study groups, were used to obtain PRF material. Group 1 had no surgical procedure, Group 2 was operated without medication, Group 3 was operated and received 1cc olive oil, Group 4 was operated and received 1 cc PRF. After 21 days, cecum areas were examined histopathologically. Tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1) and platelet-derived growth factor (PDGF) levels were measured in serum by ELISA. Results: The adhesion scores and severity of fibrosis in Group 3 and 4 were significantly lower than Group 2. Plasma TNF-α value was significantly higher in Group 2 than Group 4. Plasma PDGF value was significantly higher in Group 2 than Group 3 and 4. Discussion: PRF reduced intestinal adhesion by inhibiting the proliferation of fibroblasts and inflammatory cells, and promoting the proliferation of mesothelial cells. PRF has anti-inflammatory effect and prevented postop adhesions, based mainly on growth factors and cytokines in its content.

Abstract Background The existence of mesenchymal stem cells (MSCs) in Schneiderian membrane has not been determined. The aim of this study is to investigate whether there are MSCs in Schneiderian membrane, and the effect of platelet-rich fibrin (PRF) on osteogenic differentiation of these cells and on new bone formation in maxillary sinus after maxillary sinus floor elevation. Methods Schneiderian membrane derived mesenchymal stem cells (SM-MSCs) were isolated from rabbit maxillary sinus. Cells were identified by flow cytometry and multipotential differentiation. Real-time cell analysis assay, fluorescence staining, transwell assay, and wound healing assay were used to determine the effects of PRF stimulation on cell proliferation and migration. The osteogenic differentiation ability of cells stimulated by PRF or osteoinductive medium was evaluated by alkaline phosphatase staining, alizarin red staining, PCR and Western blot. Equivalent volume Bio-oss and the mixture of Bio-oss and PRF were used as bone graft materials for maxillary sinus floor elevation. Micro-CT, bone double-staining, HE staining, Masson staining, and toluidine blue staining were used to evaluate the osteogenic effect in 8 and 12 weeks after surgery. Results The cell surface markers were positive for expression of CD90, CD105, and negative for expression of CD34, CD45. SM-MSCs had the ability of osteogenic, adipogenic and chondrogenic differentiation. PRF could stimulate proliferation, migration and osteogenic differentiation of SM-MSCs, which was achieved by up-regulating ERK 1/2 signaling pathway. PRF could accelerate the formation of new bone in maxillary sinus and increase the amount of new bone formation. Conclusions MSCs existed in Schneiderian membrane, and PRF stimulation could promote cell proliferation, migration and osteogenic differentiation. The application of PRF in maxillary sinus floor elevation could accelerate bone healing and increase the quantity and quality of new bone. PRF, as autologous graft materials, might offer a promising strategy for the clinical bone formation during MSFE procedure. Graphical abstract Video Abstract.

BackgroundThree-dimensional primary slice cultures (SC) of head and neck squamous cell carcinomas (HNC) are realistic preclinical models. Until now, preserving structure and viability ex vivo for several days has been difficult. The aim of this study was to optimize cultivation conditions for HNC SC and analyze the added effects of platelet rich fibrin (PRF) on these conditions.MethodsSC were prepared from the tumor biopsies of 9 HNC patients. Cultures were incubated for 1 and 7 days in three different media- Keratinocyte serum-free medium (SFM), RPMI-1640i, and 1:1 mix of both, with and without addition of PRF. After culturing, SC were fixated, embedded, and stained with Hematoxylin-Eosin (HE) and cleaved caspase-3. In addition, triple immune fluorescence staining for cytokeratin, vimentin and CD45 was performed. Outcome parameters were cell count and cell density, viability and apoptosis, SC total area and proportions of keratinocytes, mesenchymal and immune cells. The effects of culture time, medium, and addition of PRF were calculated in an SPSS generalized linear model and using the Wald Chi-Squared test.ResultsNinety-four slice cultures were analyzed. Viability remained stable for 7 days in culture. After addition of PRF, cell viability increased (p=0.05). SC total area decreased (0.44 ± 0.04 mm2 on day 1 (95% CI: 0.35 to 0.56) to 0.29 ± 0.03 mm2 on day 7 (95% CI: 0.22 to 0.36), but cell density and cell proportions remained stable. Differences in cultivation media had no significant impact on outcome parameters.ConclusionHNC SC can be preserved for up to 7 days using the tested cultivation media. Cell viability was best preserved with addition of PRF. HNC SC are a versatile experimental tool to study physiology and drug actions. Autologous PRF can help simulate realistic conditions in vitro.

Clot formation is the first step of the healing process, and clinical procedures always find ways to stabilize this clot better. Platelets play a significant role in clot formation, and Platelet Concentrates (Pc) are an abundant reservoir of platelets. This article aims to review the in vitro research and systematic reviews on PCs that are currently available. Broadly, PCs mainly include Platelet-rich plasma and platelet-rich fibrin. PCs are an excellent source for growth factors such as PDGF-AA, TGF β1, VEGF, EGF, and IGF. Numerous systematic reviews and meta-analyses have analyzed the clinical application of PCs in various periodontal procedures. In alveolar ridge preservation, PCs are known to reduce postoperative pain, edema, trismus, and inflammation. PRF had shown significant improvement in achieving root coverage and recession depth reduction. PCs exhibited a positive influence on CAL gain when used as an adjunct to OFD in treating infra-bony defects. Pcs have a positive effect on bone maturation in the short term. Besides, PCs can be used in regenerative endodontics, treatment of medication-related osteoradionecrosis of Jaw (MRONJ), and accelerating tooth movement. In conclusion, PCs positively affect soft tissue healing, while their role in hard tissue healing is still unclear. [ABSTRACT FROM AUTHOR]

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Introduction: Due to the high prevalence of periodontal diseases that increase the possibility of tooth loss, platelet-rich fibrin (PRF) as a regenerative treatment has been proposed. PRF is a potential second-generation platelet concentrate and autologous healing biomaterial which contain growth factors that accelerate wound healing mechanisms. This study aimed to evaluate the efficacy of platelet-rich fibrin application to improve gingival connective tissue collagen density in periodontitis-induced rabbits. Methods: An experimental study with a post-test only control group design approach was conducted on 20 samples calculated using the Federer formula. Periodontitis was induced in ten rabbits with silk ligatures tied around the cervical region of central incisors teeth bilaterally for 14 days. After periodontitis occurred, phase I treatment was performed and followed by curettage. PRF was placed in the lower region as a treatment group using a split-mouth design, whereas a control group without PRF was in the upper jaw region. Subjects were euthanised after the 7th and 14th days of healing. Histopathological analysis was performed, and collagen density was quantified using ImageJ software. Statistical analysis was carried out using paired-T and two-way ANOVA tests. Results: There was a significant difference (p=0.001; p

Introduction: Earlier, treatment of immature necrotic tooth focussed only on surgical endodontic management and apexification procedures. Regenerative endodontic therapies have called for a paradigm shift in management of such cases. Prognosis becomes challenging though at times due to chronicity of infection, inadequate disinfection of canal space and cytotoxic nature of irrigants used hindering the survival of the apical stem cells.

Background: Several bone grafting formulations have been given clinically acceptable outcomes in treating intrabony defects. Platelet rich fibrin (PRF), an autologous platelet concentrate holds potential to be used for regenerative treatment. The purpose of this study was to evaluate clinical and radiographic outcomes in periodontal intrabony defects treated with advanced-PRF block (A PRF + i PRF + nanohydroxyapatite [nHA]) compared to nHA alone. Methods: Twenty-eight sites in chronic periodontitis patients having probing pocket depth (PPD) ≥6 mm and 3 walled intrabony defects (depth of ≥3 mm) were selected, randomly allotted into two groups: Group A was treated with A-PRF block and Group B with nHA (Sybograf™). Clinical parameters including plaque index (PI), gingival index (GI), PPD, relative attachment level (RAL) and radiographically linear and volumetric defect fill were assessed using cone beam computed tomography at baseline and 6 months postoperatively. Results: Intragroup comparison using paired t-test and intergroup comparison using unpaired t-test was done. Group A demonstrated significantly higher reduction in PPD and gain in RAL when compared to Group B (P ≤ 0.05) at the end of 6 months. Similarly gain in bone volume was greater in Group A (0.1 ± 0.05) as compared to Group B (0.04 ± 0.02) (P ≤ 0.05). Conclusion: Advanced-PRF block showed significant clinical and radiographic improvement as compared to nHA alone which depicts that, it may be an ideal graft to be used for the treatment of periodontal intrabony defects.

Gingival recession which is described as the loss of gingival attachment due to apical migration of the gingival margin from the cementoenamel junction leading to the exposure of the root surface, is one of the most prevalent diseases in the world. The treatment of gingival recession is therefore essential to achieve good aesthetics, relieve root hypersensitivity, prevent root caries and cervical abrasions. Till date, many root coverage techniques have been implicated for the coverage of recession defect. This case report focuses on the Vestibular Incision Subperiosteal Tunnel Access (VISTA™) technique for the root coverage procedure and simultaneous application of the microsurgical principles helps in executing the procedure in the most minimally invasive manner. Here, this technique has been accomplished in a 24-year-old female, with the chief complaint of poor aesthetics in the region of maxillary central incisors due to recession defects. Furthermore with the use of microsurgical instruments and magnifying loupes; complete coverage of the recession defects was achieved in a single stage surgery along with superior aesthetics, causing minimal trauma to the patient that was followed by an uneventful inflammatory phase.

Refractory wounds are a major global health problem that not only affects the quality of life, but also causes significant physical, psychological and economic burdens. How to promote wound healing has become the main goal of clinicians. To evaluate the safety and efficacy of local autologous platelet rich plasma (PRP) injection combined with platelet rich fibrin (PRF) filling as the main treatment for refractory wounds. In the study, autologous PRP and PRF were prepared from whole blood. Twelve patients, each having a refractory wound, were included. The wounds were debrided first to remove necrotic and infected tissues, and then were given once or twice local PRP injection combined with PRF filling treatment. The total healing time (the time from admission to wound healing) and the healing time after PRP/PRF combined treatment (the time from PRP treatment to wound healing), as well as the adverse events were recorded. The results showed that the wound duration before the combination treatment was 10.48 ± 3.66 weeks, and the mean area/volume (for sinus or fistula) of the wounds was 8.23 ± 2.67 cm2/9.54 ± 2.13 cm3 (for sinus or fistula). All wounds healed after once or twice PRP/PRF combined treatment. The total healing time was 26.91 ± 8.01 days, and the healing time after the combined treatment was 16.36 ± 7.47 days. No adverse events were reported during the treatment and follow-up period. Our case series demonstrate the safety and synergistic effectiveness of local autologous PRP injection combined with PRF filling as the main treatment for refractory wounds. Platelet concentrates is not only an adjuvant treatment for chronic wounds, but a potential substitute for chronic wounds, especially in sinuses and fistulas.