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Purpose: To answer the following question: "Do recombinant, purified, and concentrated growth factors enhance the regenerative potential of particulate bone graft substitutes in maxillary sinus floor augmentation (MSA)" Materials and Methods: Human studies comparing histomorphometric data on new bone formation, residual graft material, and fibrous tissue ratio (outcomes of interest) following MSA procedures employing particulate bone grafts/substitutes in combination or not with growth factors were retrieved from PubMed/MEDLINE, Web of Science, Cochrane, and Scopus online databases and complemented with a hand search. Controlled studies published in English up to December 2022 and reporting on histomorphometric data expressed as volume percentage of the outcomes of interest were considered. Risk of bias was assessed, and a meta-analysis was performed to investigate the effects of supplementary growth factors on new bone formation, remaining graft particles, and fibrous tissue ratio. Results: Data were included from 613 samples in 477 patients reported in 22 publications. Meta-analysis showed that platelet-rich plasma or platelet-rich fibrin resulted in 49% more new bone formation than in control group areas (P = .004), and those areas supplemented with growth factors presented 57% less residual graft particles after healing (P < .0001). A significant (P = .03) 1.85-fold increase in connective tissue formation was noted in areas treated with recombinant human bone morphogenetic proteins (rhBMPs) after healing. Conclusions: Selective supplementary growth factors may enhance new bone formation and accelerate particulate graft turnover, while rhBMP may significantly increase connective tissue formation in MSA procedures in humans. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the impact of injectable plateletrich fibrin (iPRF) and concentrated growth factor on postoperative pain, edema, trismus, and quality of life in impacted mandibular third molar surgery. The primary aim of this study was to minimize common sequelae following third molar surgery by using iPRF and concentrated growth factor. The secondary objective was to compare the postoperative effects of these products. Method and materials: This study represents a single-center, randomized prospective clinical trial conducted at the Ordu University Faculty of Dentistry. It involved patients who underwent third molar surgery for various reasons between July and October 2022. The predictor variables were the use of concentrated growth factor and i-PRF. They were categorized as concentrated growth factor, i-PRF, and control groups. The outcome variables include pain levels and analgesic consumption measured on a visual analog scale, distances between predetermined anatomical points, maximum mouth opening capacity, and data from the postoperative symptom severity (PoSSe) scale. Some statistical tests were performed with a 95% confidence interval, which was considered significant. Results: Total analgesic use was notably lower in the concentrated growth factor group (P = .044). Concentrated growth factor and iPRF outperformed the control group in all edema measurements by postoperative day 7 (tragus–pogonion, lateral canthus–angulus, tragus–commissura; P < .05). Concentrated growth factor significantly reduced trismus on days 2 and 7. Quality of life was notably higher in the concentrated growth factor group than in the control group (P = .026), although iPRF group differences were not significant. Conclusion: The results indicate that concentrated growth factor has a limited impact on postoperative pain, but significantly reduces edema, trismus, and enhances quality of life. The iPRF group experienced positive effects on pain, edema, and trismus, although the statistically significant differences observed with concentrated growth factor highlight its potential for use instead of iPRF after third molar surgery. An increased sample size is essential for more comprehensive results [ABSTRACT FROM AUTHOR]

Gingival recession treatment is one of the major clinical challenges in periodontics, and various surgical techniques have been proposed to correct it. Most of these techniques are suitable for isolated recession sites and involve harvesting an autogenous tissue graft, which increases patient morbidity and might result in inferior esthetics due to incision design. This study assessed the benefit of adding platelet-rich fibrin (PRF) to the vestibular incision subperiosteal tunneling approach (VISTA) in treating multiple gingival recession compared to using VISTA alone. A total of 41 teeth with Miller Class I and II defects were randomized in a split-mouth design. Multiple clinical parameters were tested, including the change in gingival thickness over time, keratinized tissue width, and gingival phenotype (using the transparency of a periodontal probe). Patient-centered outcomes were also assessed via visual analog scale. Multiple Miller Class I and II recessions in the maxilla can be effectively treated with VISTA. However, when used in conjunction with PRF, no significant differences were detected in any parameter. VISTA has been shown to be associated with a low level of postsurgical pain for patients and can be used for patients with high esthetic demands. [ABSTRACT FROM AUTHOR]

Background: Platelet-rich fibrin (PRF) is used to prepare "sticky bone" by combining it with bone graft material. The present study investigated the ability of different bone grafts to absorb growth factors from the PRF and release them over time. Materials and Methods: Human blood was collected from 10 healthy volunteers for liquid PRF preparation. Bovine bone, allograft (mineralized and demineralized), and synthetic bone were each mixed with the PRF to prepare a sticky bone. All sticky bone samples were incubated for up to 4 days. The absorption and release pattern kinetics of two selective growth factors within the PRF--platelet-derived growth factor (PDGF) and bone morphogenetic protein-2 (BMP-2)--were quantified with immunofluorescence staining and enzyme-linked immunoassay (ELISA) testing. Results: All bone graft materials adsorbed the examined growth factors from the PRF. ß-TCP showed the highest adsorption levels, followed by the xenograft, and the allografts showed the lowest adsorption levels. Furthermore, PDGF showed a fast-release pattern from the grafts, whereas BMP-2 was released at a later stage. Similar to the adsorption pattern, the ß-TCP and xenograft were better able to sustain the release of the PRF growth factors from the graft than the allografts. Conclusions: The adsorption of PDGF and BMP-2 differ between graft materials, with superior results for ß-TCP, followed by xenograft, then allograft materials. [ABSTRACT FROM AUTHOR]

Objectives: Microneedling and injectable platelet-rich fibrin (i-PRF) have been proposed as relatively less invasive alternatives to surgical procedures for augmentation of thin periodontal phenotype. The present study was conducted to evaluate the effect of microneedling and i-PRF alone on gingival thickness in thin periodontal phenotype individuals. Method and materials: Systemically healthy individuals with thin periodontal phenotype in mandibular anterior teeth (n = 21) were treated with microneedling on one side and i-PRF on the contralateral side. Assessment of gingival thickness, keratinized tissue width, and periodontal parameters was done at baseline, and at 1, 3, and 6 months. Results: In intergroup comparison, a statistically significant increase in gingival thickness was observed with microneedling as compared to i-PRF at 6 months (P < .02). Intragroup comparison from baseline to 6 months showed a statistically significant increase in gingival thickness within both the groups: microneedling from 0.78 ± 0.12 mm to 1.00 ± 0.14 mm (P < .000), and i-PRF from 0.77 ± 0.10 mm to 0.93 ± 0.12 mm (P < .000). Intragroup comparison showed a statistically significant increase in keratinized tissue width in the microneedling group (P < .000). A statistically significant decrease in periodontal parameters was observed on intragroup comparison (P < .000). Conclusion: Considering the higher gain in gingival thickness and the added advantage of eliminating need for autologous blood withdrawal, microneedling is potentially better than i-PRF for phenotype modification in thin periodontal phenotype individuals. [ABSTRACT FROM AUTHOR]

Objective: The objective of the present study was to evaluate the clinical and radiographic outcomes of intrabony defects treated with decortication (intramarrow penetration) alone versus decortication combined with platelet-rich fibrin in periodontitis patients followed up for 6 months postsurgery. Method and materials: A total of 46 intrabony defects from periodontitis patients with a mean age of 36.30 ± 6.10 years were randomly assigned into two treatment groups. The control group (n = 23) intrabony sites were accessed with simplified papilla preservation flap (SPPF) followed with debridement, decortication, and closure. The test group (n = 23) sites were accessed with SPPF, followed with debridement, decortication, platelet-rich fibrin placement, and closure. The clinical parameters Plaque Index, Gingival Index, probing pocket depth, relative attachment level, gingival marginal level, along with radiographic defect depth and defect width were recorded at baseline, 3 months, and 6 months postsurgery. Gain in clinical attachment level was the primary outcome, and probing pocket depth reduction and radiographic bone fill were secondary outcomes of the study. Results: The Plaque Index and Gingival Index scores showed nonsignificant difference on intra- and intergroup comparison at baseline, 3 months, and 6 months. The probing pocket depth was 8.17 ± 1.56 mm, 6.65 ± 1.30 mm, and 5.26 ± 1.18 mm for the control group, and 8.17 ± 2.01 mm, 6.26 ± 1.42 mm, and 4.78 ± 1.28 mm for the test group, at baseline, 3 months, and 6 months, respectively. The relative attachment level was 8.83 ± 1.40 mm, 6.78 ± 1.31 mm, and 5.39 ± 1.16 mm for the control group, and 8.39 ± 1.62 mm, 6.96 ± 1.36 mm, and 5.48 ± 1.20 mm for the test group at baseline, 3 months, and 6 months, respectively. Statistically significant reductions were observed for probing pocket depth for the control (2.91 mm, P < .001) and test groups (3.39 mm, P < .001), as well as for relative attachment level for the control (3.44 mm, P < .001) and test groups (2.91 mm, P < .001). However, intergroup differences were nonsignificant for probing pocket depth and relative attachment level. The radiographic defect depth was reduced by 0.31 mm for the control and 1.57 mm for the test group. The radiographic defect width was reduced by 0.18 mm for the control and 0.83 mm for the test group. Intergroup statistically significant differences were observed at the 6-month follow-up (P < .001) for radiographic defect depth and width. Conclusion: Within the limitations of the present study, the results demonstrate statistically significant intragroup improvements in clinical outcomes with decortication alone and decortication combined with platelet-rich fibrin in the treatment of intrabony defects in periodontitis patients. The addition of platelet-rich fibrin did not improve the clinical results beyond decortication alone, and unacceptable postsurgery residual pockets were observed in both the protocols. Considering the small sample size, the addition of platelet-rich fibrin resulted in significant bone fill over and above that of decortication alone. [ABSTRACT FROM AUTHOR]

Periodontal intrabony defects (IBDs) are commonly encountered in dental practice and are usually treated by open flap debridement (OFD) with or without bone grafts and/or guided tissue regeneration (GTR), platelet-rich fibrin (PRF), or other additives. A difficulty with these approaches is maintaining the space for bone growth at the determined location. In this report, autologous sticky bone (ASB) was used and compared to a simple mixture of PRF and bone graft (PRF-BG) using the identical graft material-bioactive glass morsels-to assess its regenerative potential in IBDs, as sticky bone is known to maintain the space, according to previous research. A total of 21 IBDs were treated by OFD, PRF-BG mixture, or ASB. Regenerative assessment was clinically and radiographically performed by CBCT at 1 year. All the treatment modalities (OFD, PRF-BG, and ASB) showed statistically significant improvements clinically and radiographically at 1 year in terms of probing pocket depth reduction (PPDR), clinical attachment level gain (CALG), CBCT defect fill (CBCT-DF), and CBCT defect resolution (CBCT-DR); P < .05. The ASB group depicted the most favorable results (P < .05) in terms of the parameters at 1 year followed by the PRF-BG group and then the OFD group. Treatment of periodontal IBDs with ASB resulted in significant improvements in clinical and CBCT parameters compared to baseline at 1 year, and intrasurgical graft handling was much better in the ASB group. [ABSTRACT FROM AUTHOR]

Gingival recession is an apical shift of the gingival margin with exposure of the root surface to the oral cavity, which creates an esthetic problem. The present study was attempted to compare vestibular incision subperiosteal tunnel access (VISTA) with and without advanced platelet-rich fibrin (A-PRF) in the treatment of Miller Class I gingival recessions. A total of 24 patients were assigned randomly to either the test group (VISTA with A-PRF) or the control group (VISTA alone). Clinical parameters like recession depth, recession width, clinical attachment loss, width of keratinized gingiva, gingival thickness, and probing depth were recorded at baseline and at 3 and 6 months postoperatively. Intergroup comparison of mean root coverage (RC) in mm, %RC, change in width of keratinized gingiva and clinical attachment gain revealed no statistically significant difference (P > .05). Change in gingival thickness showed statistically significant improvement in test group. Within the limitations of this study, both treatment options (VISTA with A-PRF and VISTA alone) have resulted in predictable and comparable RC, with increased gingival thickness in the test group. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to evaluate the effect of injectable platelet-rich fibrin (i-PRF) on gingival thickness and gingival recession in individuals with thin periodontal phenotypes. Method and materials: In this prospective study, i-PRF was applied via a semisurgical method to augment 53 tooth regions with thin periodontal phenotypes. In order to ensure that sufficient blood clot formed on the side of the gingiva facing the bone and that i-PRF reached the area, a minimal incision was made with the help of a scalpel in the apical region of the relevant region, and the periosteum was elevated with a microsurgical instrument. To ensure sustained exposure to angiogenetic growth factors and enhance the histoconductive properties, i-PRF injection was applied to the relevant areas in foursessions at 10-dayintervals. Results: An increase in gingival thickness was achieved in 92.5% of the areas treated with i-PRF, and the desired gingival thickness (0.8 mm) was achieved in 44.9% of these areas. In addition, significant reductions in the amount of recession were observed in 83.3% of the 12 gingival recession areas (P= .005). Moreover, complete coverage was achieved in 60% of these regions. Conclusion: With the new i-PRF semisurgical method, it was shown that gingival thickness can be increased in tooth regions with thin gingiva, andthat areas of gingival recession can be covered. Further comprehensive studies are needed to fully understand the role of i-PRF in enhancing angiogenesis and the histoconductive properties of this fully autogenous blood concentrate. [ABSTRACT FROM AUTHOR]

This randomized controlled clinical trial evaluated the pinhole surgical technique (PST) combined with platelet-rich fibrin (PRF) for the management of multiple recession defects compared to PST alone. Ten patients with 51 Miller Class I/II or III gingival recessions were selected. Control sites were treated with PST alone, whereas test sites were treated with PST with PRF. Gingival recession depth (GRD), gingival recession width (GRW), probing depth (PD), clinical attachment level (CAL), keratinized tissue width (KTW), total soft tissue gain (TSTG), Plaque Index (PI), Gingival Index (GI), and gingival bleeding index (GBI) were measured at baseline and at 1, 3, and 6 months posttreatment. Both groups showed statistically significant root coverage. The mean recession coverage was 60.25% in the test group and 49.6% in the control group. The recession reduction from baseline was 2.50 mm for the test group and 1.88 mm for the control group. At the end of 6 months, all sites achieved adequate root coverage. PRF is a feasible alternative to connective tissue grafts as an adjunct to PST for the treatment of multiple recession defects. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the incorporation of liquid platelet-rich fibrin in different collagen matrices in vitro. Materials and Methods: Collagen matrices with liquid platelet-rich fibrin were used and divided into the following test groups (n = 5): Mucoderm (MD), Mucograft (MG), and Fibro-Gide (FG). After incubating the collagen matrices in liquid plateletrich fibrin, histologicl and fluid absorption capacity analysis were performed. Intergroup comparisons of cell count, blood plasma penetration area, and fluid absorption capacity were performed using one-way ANOVA and Tukey tests. Intragroup comparisons of fluid absorption capacity were made using the independent t test with a 5% significance level. Results: Descriptive qualitative analysis showed total incorporation of liquid platelet-rich fibrin in the FG group, while the MG and MD groups showed only partial and shallow incorporation, respectively. There was a statistically significant difference among the three groups regarding inflammatory cell infiltration (P = .000), with the FG group presenting the highest number of cells in the matrices (577.15 ± 54.88). The FG group showed an area of total blood plasma penetration into the matrix, followed by the MG group with partial penetration, and the MD group with minor penetration area (P = .000). Considering the fluid absorption capacity analysis, only groups FG and MG were statistically different when comparing the liquid platelet-rich fibrin absorption coefficient (P = .017), with higher absorption in group FG (14.30 ± 3.35). Conclusions: The FG collagen matrix showed a good capacity for liquid platelet-rich fibrin incorporation in vitro. [ABSTRACT FROM AUTHOR]

Previous findings from a clinical trial demonstrated noninferiority of Leukocyte- and platelet-rich fibrin (L-PRF) compared to commercially available fibrin sealants in preventing postoperative cerebrospinal fluid leakage, necessitating intervention. This cost-effectiveness evaluation aims to assess the value-for-money of both techniques for dural closure in supratentorial and infratentorial surgeries. Cost-effectiveness was estimated from a health care payer's perspective alongside a randomized clinical trial comprising 328 patients. The analysis focused on clinical and health-related quality of life outcomes, as well as direct medical costs including inpatient costs, imaging and laboratory costs, and outpatient follow up costs up to twelve weeks after surgery. Clinical and health-related quality of life data showed no significant differences between L-PRF (EuroQol five dimensions questionnaire 0.75 ± 0.25, 36-item Short Form Survey 63.93% ± 20.42) and control (EuroQol five dimensions questionnaire 0.72 ± 0.22, 36-item Short Form Survey 60.93% ± 20.78) groups. Pharmaceutical expenses during initial hospitalization were significantly lower in the L-PRF group (€190.4, interquartile range 149.9) than in the control group (€394.4, interquartile range 364.3), while other cost categories did not show any significant differences, resulting in an average cost advantage of €204 per patient favoring L-PRF. This study demonstrates L-PRF as a cost-effective alternative for commercially available fibrin sealants in dural closure. Implementing L-PRF can lead to substantial cost savings, particularly considering the frequency of these procedures. [ABSTRACT FROM AUTHOR]

Background: Jaw osteoradionecrosis (ORN) is a complication in patients with previous head and neck radiotherapy. Its incidence increases with dental extractions. Hence, this review aimed to evaluate the efficacy of adjunctive treatment modalities undertaken at the time of extraction in previous head and neck radiotherapy patients in preventing ORN. Methods: A systematic review was conducted, where studies with data on ORN incidence after extraction with or without adjunctive interventions were included. Meta‐analyses were conducted to estimate the pooled prevalence of ORN per intervention and the pooled odds ratio for incidence of ORN between interventions. Results: In total, 1520 patients in 29 studies were included. Interventions identified were hyperbaric oxygen (HBO), pentoxifylline‐tocopherol (PENTO), antibiotics (ABX), platelet‐rich fibrin and photobiomodulation. The pooled prevalence of ORN for HBO (4.6%), PENTO (3.4%) and ABX (3.8%) was significantly lower than the Control (17.6%). For studies with direct comparisons between groups, HBO had lower but not significant odds of developing ORN than the Control (OR 0.27) and ABX (OR 0.57). Conclusions: HBO, PENTO and ABX may reduce the incidence of ORN compared to no intervention. Given that all three have similar incidences of ORN, ABX may be the most cost‐effective and accessible adjunctive modality. [ABSTRACT FROM AUTHOR]

Platelets are essential component of circulation that plays a major role in hemostasis and thrombosis. During activation and its demise, platelets release platelet‐derived microvesicles, with lysophosphatidylcholine (LPC) being a prominent component in their lipid composition. LPC, an oxidized low‐density lipoprotein, is involved in cellular metabolism, but its higher level is implicated in pathologies like atherosclerosis, diabetes, and inflammatory disorders. Despite this, its impact on platelet function remains relatively unexplored. To address this, we studied LPC's effects on washed human platelets. A multimode plate reader was employed to measure reactive oxygen species and intracellular calcium using H2DCF‐DA and Fluo‐4‐AM, respectively. Flow cytometry was utilized to measure phosphatidylserine expression, mitochondrial membrane potential (ΔΨm), and mitochondrial permeability transition pore (mPTP) formation using FITC‐Annexin V, JC‐1, and CoCl2/calcein‐AM, respectively. Additionally, platelet morphology and its ultrastructure were observed via phase contrast and electron microscopy. Sonoclot and light transmission aggregometry were employed to examine fibrin formation and platelet aggregation, respectively. The findings demonstrate that LPC induced oxidative stress and increased intracellular calcium in platelets, resulting in increased phosphatidylserine expression and reduced ΔΨm. LPC triggered caspase‐independent platelet death and mPTP opening via cytosolic and mitochondrial calcium, along with microvesiculation and reduced platelet counts. LPC increased the platelet's size, adopting a balloon‐shaped morphology, causing membrane fragmentation and releasing its cellular contents, while inducing a pro‐coagulant phenotype with increased fibrin formation and reduced integrin αIIbβ3 activation. Conclusively, this study reveals LPC‐induced oxidative stress and calcium‐mediated platelet death, necrotic in nature with pro‐coagulant properties, potentially impacting inflammation and repair mechanisms during vascular injury. [ABSTRACT FROM AUTHOR]

Introduction: Highly myopic macular hole retinal detachment (MHRD) is often associated with a poor prognosis, and there is currently no optimal treatment. Platelet-rich fibrin (PRF), an autologous blood product, has been shown to promote tissue regeneration. This prospective, randomized, controlled study investigated the efficacy of conventional internal limiting membrane (ILM) peeling versus PRF membrane transplantation in highly myopic MHRD. Methods: Eyes with highly myopic MHRD were randomly assigned to either a conventional ILM peeling group (IP group, n = 19) or a PRF membrane transplantation group (PMT group, n = 21). The study followed participants for a period of 6 months. The primary outcome measure was macular hole (MH) closure assessed using optical coherence tomography. Secondary outcomes included best-corrected visual acuity (BCVA), central retinal thickness (CRT), superficial vascular density (SVD), deep vascular density (DVD), rate of retinal reattachment, and any complications encountered. Results: MH closure was achieved in a significantly greater proportion of eyes in the PMT group (21/21, 100.00%) compared to the IP group (15/19, 78.95%) (P = 0.042). Retinal reattachment was accomplished in all patients (100.00%) within both groups. Except for an insignificant difference in BCVA observed at 1 week post-surgery in the IP group, significant improvements in BCVA and CRT were documented in both groups across all other post-operative time points. Final BCVA (P = 0.040), CRT (P = 0.002), SVD (P = 0.002), and DVD (P = 0.013) were all significantly higher in the PMT group compared to the IP group. No serious complications were identified in either group. Conclusions: This study demonstrated the superiority of PRF membrane transplantation compared to conventional ILM peeling in promoting MH closure and enhancing retinal vascular density in patients with highly myopic MHRD. Additionally, PRF membrane transplantation effectively restores retinal reattachment, improves visual function, and increases retinal thickness without introducing additional complications. Trial Registration Number: www.clinicaltrials.gov, NCT06200727. [ABSTRACT FROM AUTHOR]

Statement of Problem Purpose Materials and Methods Results Conclusions Osseointegration is now primarily established, but soft tissue integration is still susceptible to failure and problematic on implant surfaces. So, implant dentistry is increasingly focusing on improving peri‐implant soft tissue integration.The present study aimed to evaluate the blood fibrin clot formation and adhesion on the abutment after cleaning and decontamination and determine the suitable abutment surface associated with fibrin clot attachment.Forty‐two abutments (14 per group) were used in the present study: a brand‐new (BN), contaminated with biofilm (CO) and decontaminated with an enzymatic cleaner and autoclave sterilization (DEC). For a fibrin clot, 9 mL of whole human blood and abutments was centrifuged at 2700 rpm for 12 min. Clots were divided into two parts for histomorphometry and scanning electron microscopy (SEM) analysis. Twelve abutments disconnected from the clot and two not treated with blood were observed under SEM.Residual debris and biofilm were observed on the abutment surface in the CO group but not in other groups. Healthy and organized fibrin clots formed on all abutments. The fibrin extension areas are distributed uniformly in BN and DEC groups but irregularly in CO. The surface percentage of the fibrin clot extensions was 41.76% ± 6.73, 26.99% ± 6.40, and 37.83% ± 9.72 for the BN, CON, and DEC groups, respectively. The blood clot‐attached areas in the CO group were statistically lower than the other groups. No difference was observed between the BN and DEC groups.This study confirmed that surface contamination could influence blood clot attachment on the abutment surfaces. Cleaning and sterilization can have a favorable effect on soft tissue healing on abutment surfaces. [ABSTRACT FROM AUTHOR]

Background: Medication-related osteonecrosis of the Jaw (MRONJ) is a rare but severe side effect in patients treated with medications such as Bisphosphonates (BPs). Its pathophysiological mechanism needs to be more precise. Establishing preventive measures and treatment standards is necessary. This study aimed to develop a composite hydrogel scaffold constituted by methacrylated gelatin (GelMA), methacrylated heparin (HepMA) and PRF, and investigate its potential application value in the prevention of MRONJ. Methods: GelMA, HepMA, and PRF were prepared using specific ratios for hydrogel scaffolds. Through mechanical properties and biocompatibility analysis, the release rate of growth factors and the ability to promote bone differentiation in vitro were evaluated. To explore the healing-enhancing effects of hydrogels in vivo, the composite hydrogel scaffold was implanted to the MRONJ rat model. Micro-computed tomography (Micro-CT) and histological examination were conducted to evaluate the bone morphology and tissue regeneration. Results: The Hep/GelMA-PRF hydrogel improved the degradation rate and swelling rate. It was also used to control the release rate of growth factors effectively. In vitro, the Hep/GelMA-PRF hydrogel was biocompatible and capable of reversing the inhibitory effect of zoledronic acid (ZOL) on the osteogenic differentiation of MC3T3-E1s. In vivo, the micro-CT analysis and histological evaluation demonstrated that the Hep/GelMA-PRF group exhibited the best tissue reconstruction. Moreover, compared to the ZOL group, the expression of osteogenesis proteins, including osteocalcin (OCN), type collagen I (Col I), and bone morphogenetic protein-2 (BMP-2) in the Hep/GelMA-PRF group were all significantly upregulated (P < 0.05). Conclusions: The Hep/GelMA-PRF hydrogel scaffold could effectively control the release rate of growth factors, induce osteogenic differentiation, reduce inflammation, and keep a stable microenvironment for tissue repair. It has potential application value in the prevention of MRONJ. [ABSTRACT FROM AUTHOR]

AbstractOur previous clinical observations showed that platelet rich fibrin (PRF) can be used to deliver antibiotics to attenuate postoperative complications after unilaterally impacted mandibular third molar surgery (IMTMS). In order to begin understanding the mechanism involved in the beneficial in vivo effects of PRF-mediated delivery of antibiotics, in vitro studies were performed, which showed that PRF preparations containing amoxicillin/clavulanic acid or clindamycin significantly inhibited the growth of S. aureus bacteria. In our previous study, comparisons were made between control and treated groups. However, since variations among individual patients could possibly affect the results, the current study included patients with bilaterally symmetric impacted mandibular third molars, allowing us to compare control and antibiotic treatment within each patient. The effects of PRF preparations containing amoxicillin/clavulanic acid or clindamycin on IMTMS was tested in 60 clinical cases. Antibiotic-injected PRF treatment after bilaterally IMTMS resulted in significantly reduced pain, less use of analgesics, and reduced swelling and trismus compared to the control group (PRF without antibiotics) confirming our previous results after unilaterally IMTMS. The in vitro results support the hypothesis that in vivo delivery of antibiotics using PRF produces therapeutic effects after IMTMS by attenuating bacterial infection and inflammation. [ABSTRACT FROM AUTHOR]

For more than 40 years, autologous platelet concentrates have been used in clinical medicine. Since the first formula used, namely platelet-rich plasma (PRP), other platelet concentrates have been experimented with, including platelet-rich fibrin and concentrated growth factor. Platelet concentrates have three standard characteristics: they act as scaffolds, they serve as a source of growth factors and cytokines, and they contain live cells. PRP has become extensively used in regenerative medicine for the successful treatment of a variety of clinical (non-)dermatological conditions like alopecies, acne scars, skin burns, skin ulcers, muscle, cartilage, and bone repair, and as an adjuvant in post-surgery wound healing, with obvious benefits in terms of functionality and aesthetic recovery of affected tissues/organs. These indications were well documented, and a large amount of evidence has already been published supporting the efficacy of this method. The primordial principle behind minimally invasive PRP treatments is the usage of the patient's own platelets. The benefits of the autologous transplantation of thrombocytes are significant, representing a fast and economic method that requires only basic equipment and training, and it is biocompatible, thus being a low risk for the patient (infection and immunological reactions can be virtually disregarded). Usually, the structural benefits of applying PRP are attributed to fibroblasts only, as they are considered the most numerous cell population within the interstitium. However, this apparent simplistic explanation is still eluding those different types of interstitial cells (distinct from fibroblasts) that are residing within stromal tissue, e.g., telocytes (TCs). Moreover, dermal TCs have an already documented potential in angiogenesis (extra-cutaneous, but also within skin), and their implication in skin recovery in a few dermatological conditions was attested and described ultrastructurally and immunophenotypically. Interestingly, PRP biochemically consists of a series of growth factors, cytokines, and other molecules, to which TCs have also proven to have a positive expression. Thus, it is attractive to hypothesize and to document any tissular collaboration between cutaneous administered PRP and local dermal TCs in skin recovery/repair/regeneration. Therefore, TCs could be perceived as the missing link necessary to provide a solid explanation of the good results achieved by administering PRP in skin-repairing processes. [ABSTRACT FROM AUTHOR]

Background: Among pediatric surgical procedures, hypospadias surgery is one of the most difficult. The most prevalent complication following hypospadias repair is urethrocutaneous fistula. Numerous procedures have been developed to prevent and resolve this issue. One such method is platelet-rich fibrin (PRF) membrane preparation, which is a straightforward process requiring only the patient's serum. It has already been utilized successfully in plastic and reconstructive surgeries, where it significantly enhances the healing capacity and decreases the risk of infections. The purpose of this study is to assess the efficacy of an autologous PRF membrane in promoting healing and reducing fistula occurrence in cases of de novo distal hypospadias. Methods: Forty patients with primary distal hypospadias underwent TIP repair, as a part of a prospective controlled randomized study from April 2017 to February 2018. The cases were randomly allocated into two categories. TIP repair done in all cases by the same surgeon. Twenty cases comprised group A, which utilized a preputial or local dartos flap as an additional protective layer over the urethroplasty. In contrast, group B comprised 20 cases in which the urethroplasty was covered with a PRF membrane. The initial follow-up duration was 6 months. Each group's fistula incidence and other associated complications were documented. Results: Two groups were compared during the initial 6-month follow-up period. There were seven cases of urethrocutaneous fistula in group A, representing a 35% incidence rate. In group B, there were two cases that had fistula with an incidence of 10% in the early postoperative period. Two patients (10%) in group A developed meatal stenosis and only one patient in group B (5%) developed meatal stenosis. Glandular dehiscence occurred in one patient (5%) in group B. There was no skin wound infection in both groups. Conclusion: The PRF membrane may be a promising method as a coverage layer over the urethroplasty aiming to reduce the fistula rate after the repair. A larger comparative study is needed to evaluate the efficacy of PRF membranes in promoting wound healing. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess the effectiveness of advanced platelet-rich fibrin (A-PRF) combined with the pinhole surgical technique (PST) for enhancing root coverage (RC) in individuals with Miller class I or II gingival recessions (GR). Additionally, it compared the clinical effect of A-PRF and resorbable collagen membrane (RCM). Materials and methods: A total of 18 patients, encompassing 36 treatment sides of 18 Miller class I or II, were randomly assigned to the PST + A-PRF side (18 sides) and the PST + RCM side (18 sides). Clinical assessments of various parameters, including plaque index (PI), clinical attachment level (CAL), keratinized tissue width (KTW), recession depth (RD), recession width (RW), and gingival thickness (GT) were conducted at baseline and three months after the surgical procedure. A numeric rating scale (NRS) was also evaluated during the 1st, 2nd, 3rd and 4th days. This study was formally recorded under the TCTR identification number TCTR20230613005 in the Thai Clinical Trials Register-Medical Research Foundation of Thailand (MRF) on 13/06/2023. Furthermore, it was ethically approved by Sana'a University's Ethical Committee for Medical Research. Results: When comparing the values of 3 months follow-up with the baseline values, intra-side comparison of the PST + A-PRF group showed significant improvements in PI (P = 0.02), CAL (P = 0.01), and RD (P = 0.04), and GT values (P < 0.01). The improvements in the PST + A-PRF group were through the reduction of baseline values of PI, CAL, and RD; the mean reductions in PI, CAL, and RD were 0.44 ± 0.71, 0.33 ± 0.45, and 0.22 ± 0.43 respectively, and a significant increase in GT value (0.44 ± 0.24). While there was an insignificant increase in KTW value with no change in RW values (4.50 ± 0.71, P = 1). In contrast, intra- side comparison of PST + RCM side showed only a significant reduction in PI value (0.44 ± 0.71, P = 0.02) and a significant increase in GT value (0.42 ± 0.26, P = < 0.01). Meanwhile, there were insignificant improvements in CAL (2.89 ± 0.95), KTW (3.97 ± 0.74), and RD (1.94 ± 0.87) values. Regarding inter-side comparison, there were no statistically significant among all variables (p > 0.05). The pain scores of the numeric rating scale were significantly lower on the PST + A-PRF sides compared with the PST + RCM sides, especially on the 1st, 2nd, and 3rd days (P < 0.001). Conclusion: Both A-PRF and RCM showed not wholly satisfactory outcomes in gingival recession treatment. Interestingly, the combination of PST with A-PRF has proven more effective than combining PST with RCM. Additionally, the localized application of A-PRF has been shown to reduce post-operative pain following the pinhole surgical technique. [ABSTRACT FROM AUTHOR]

Mesh-augmented hernia repair is the gold standard in abdominal wall and hiatal/diaphragmatic hernia management and ranks among the most common procedures performed by general surgeons. However, it is associated with a series of drawbacks, including recurrence, mesh infection, and adhesion formation. To address these weaknesses, numerous biomaterials have been investigated for mesh coating. Platelet-rich plasma (PRP) is an autologous agent that promotes tissue healing through numerous cytokines and growth factors. In addition, many reports highlight its contribution to better integration of different types of coated meshes, compared to conventional uncoated meshes. The use of PRP-coated meshes for hernia repair has been reported in the literature, but a review of technical aspects and outcomes is missing. The aim of this comprehensive review is to report the experimental studies investigating the synergistic use of PRP and mesh implants in hernia animal models. A comprehensive literature search was conducted across PubMed/Medline, Web of Science, and Scopus without chronological constraints. In total, fourteen experimental and three clinical studies have been included. Among experimental trials, synthetic, biologic, and composite meshes were used in four, nine, and one study, respectively. In synthetic meshes, PRP-coating leads to increased antioxidant levels and collaged deposition, reduced oxidative stress, and improved inflammatory response, while studies on biological meshes revealed increased neovascularization and tissue integration, reduced inflammation, adhesion severity, and mechanical failure rates. Finally, PRP-coating of composite meshes results in reduced adhesions and improved mechanical strength. Despite the abundance of preclinical data, there is a scarcity of clinical studies, mainly due to the absence of an established protocol regarding PRP preparation and application. To this point in time, PRP has been used as a coating agent for the repair of abdominal and diaphragmatic hernias, as well as for mesh fixation. Clinical application of conclusions drawn from experimental studies may lead to improved results in hernia repair. [ABSTRACT FROM AUTHOR]

Background: Schatzker type II fractures usually need to be grafted. Autograft bone from the iliac crest represents the gold standard, but it comes with high rates of morbidity on the donor side. Sticky bone is one of the regenerative therapies that aims to find new solutions to treat bone defects and to overcome the limitation of conventional options regarding bone grafts, due to their content in growth factors, which offer osteo-induction and osteo-conduction properties. Notably, regenerative dentistry has been at the forefront of applying these products in bone regeneration, demonstrating that PRF produces a highly promising "sticky bone" when combined with bone chips. To the best of our knowledge, this grafting technique has not been used in the orthopedic field to date. Methods: The subject was a 53-year-old woman with a Schatzker type II tibial plateau fracture, for which a new autologous bone grafting technique, i.e., sticky bone, was used for the treatment of the fracture. Results: This case reports the effectiveness of sticky bone as autologous bone graft used in Shatzker type II tibial plateau fracture. As an indispensable component of regenerative medicine, it seems to be an ideal biologic graft with a fibrin-rich structure that provides effective treatment in impressed tibial plateau fractures. Conclusion: Sticky bone showed promising results and should be considered in the future as an appropriate bone implant. [ABSTRACT FROM AUTHOR]

Autologous Platelet-rich fibrin (PRF) is an amalgam of fibrin mesh, platelets and growth factors that favour wound healing. It can be easily used as a graft material in myringoplasty, making it a promising, easy to harvest and cost effective alternative compared to cartilage or fascia graft used in conventional myringoplasty. 50 patients of small to medium, dry central perforation underwent myringoplasty using PRF graft (Group 1). Results were compared to 50 patients with similar small to medium perforations who underwent conventional transcanal myringoplasty using temporalis fascia graft (Group 2): Outcome of surgery was measured by closure of perforation and improvement in hearing at 3 months. In group 1, overall closure rate was 70% while in group 2 it was 96%. For both small and medium perforations healing was significantly higher in group 2 compared to group 1, (100% vs 87.5%) for small perforations and (95.45% vs 66.67%) for medium perforations. Hearing gain was comparable in both groups in patients in whom healing of perforation occurred. PRF stands as a suitable graft material for closure of small perforations, but, lack of rigidity and early disintegration of the graft makes it less suitable for larger perforations compared to other conventional grafts such as temporalis fascia. [ABSTRACT FROM AUTHOR]

To assess the effectiveness of the autologous plasma-rich fibrin plug technique for repairing small tympanic membrane perforations. Platelet rich fibrin (PRF) is also called second generation platelet rich plasma due to its high amount of growth factors which could be used in tympanic perforation closure. Being autologous, it is readily available with no immunogenic reactions. PRF membrane has a strong elastin fibrin structure containing growth factors and hence can be considered as an ideal sealing material or an adjuvant to the graft in repairing tympanic membrane perforations. Ours is a prospective study. A total of 52 patients with dry small tympanic membrane perforation were included in the study. In this technique, 10 ml of blood is withdrawn from the patient, processed in a centrifuge machine, and platelet-rich fibrin (PRF) is separated from the mixture for use in the repair of small tympanic membrane defects. Out of the 52 patients, 42 experienced successful repair (full closure) of the tympanic membrane. The mean time of closure of the perforation was around 2 weeks. However, five of them encountered failure. Although the size of the perforation decreased compared to the preoperative size. Additionally, two patients developed granulations on the tympanic membrane. No major side effects were noted. Autologous PRF is a product derived from whole blood through the process of centrifugation. It is safe and effective in promoting the natural process of wound healing by incorporating a high concentration of platelet-derived growth factors as well as fibrin into the graft mixture. This facilitates the rapid healing of tympanic membrane perforation. [ABSTRACT FROM AUTHOR]

Platelet-rich fibrin (PRF), originally used to support soft tissue healing, is also considered a therapeutic option for treating oral lichen planus and leukoplakia. The progression from the two premalignant lesions to the aggressive malignant oral squamous cell carcinoma involves an inflammatory process linked to chemokine expression. Thus, there is a rationale for studying how PRF modulates the expression of chemokines in oral squamous carcinoma cells. To this aim, we expose the oral squamous carcinoma cell line HSC2 to IL1β and TNFα either alone or in the presence of lysates obtained from solid PRF membranes. We report here that in HSC2 cells, PRF lysates significantly reduce the forced transcription of chemokines, e.g., CXCL1, CXCL2, CXCL8, CXCL10, and CCL5. Moreover, PRF lysates attenuate the nuclear translocation of p65 in HSC2 oral epithelial cells when exposed to IL1β and TNFα. PRF lysates further reduce chemokine expression provoked by poly:IC HMW. Even though less pronounced, PRF lysates reduce IL1β- and TNFα-induced chemokine expression in TR146 cells. In primary oral epithelial cells, however, PRF lysates increase the basal expression of CXCL1, CXCL2 and CXCL8. Thus, PRF can exert a biphasic effect on chemokine expression in oral squamous cell carcinoma cell lines and primary oral epithelial cells. These findings suggest that PRF may reduce inflammation in a malignant environment while provoking an immunological response in healthy oral epithelium. [ABSTRACT FROM AUTHOR]

Whereas rhinoplasty with a reduction of the dorsum and modification of the tip is a common procedure among Caucasians, augmentation of the dorsum remains a challenge in Asians. Choice of the ideal grafting material for dorsal augmentation is a matter of preference and remains under discussion. Autologous and alloplastic materials have their advantages and disadvantages. We report our experiences of the extrusion of alloplastic materials and their management. We report of 18 patients, who had rhinoplasty in the past for dorsal augmentation with alloplastic material. Augmentation rhinoplasty was performed in Asia (n = 15) and Germany (n = 3). All cases showed recurrent signs of foreign body infection and/or partial extrusion and therefore underwent revision surgery in our centers. Once all patients had been successfully treated with antibiotics, we performed a one-stage revision rhinoplasty with explantation of the alloplastic material and subsequent reconstruction with autologous rib cartilage. The nasal dorsum was augmented with either solid rib cartilage grafts, diced cartilage in fascia, or free diced cartilage in platelet-rich fibrin. All patients received pre-, peri-, and postoperative antibiotics. The outcome was screened via clinical examination, ultrasound examination pre- and postoperatively, two-dimensional/three-dimensional (3D) imaging, and magnetic resonance imaging scans. Alloplastic augmentation of the nasal dorsum runs the risk of foreign body reaction, recurrent infections, uncontrolled scarring, and unsatisfying long-term results. We have obtained a series of aesthetically and functionally satisfying results after single-stage revision surgery with autologous cartilage and demonstrate a variety of novel postoperative screening tools including 3D imaging and high-frequency ultrasound. Level of Evidence N/A [ABSTRACT FROM AUTHOR]

Platelet-rich fibrin (PRF) is prepared by spontaneous coagulation of fractionated blood. When squeezed between two plates, PRF is separated into solid PRF membranes and a liquid exudate, the PRF serum. The question arises regarding how much the overall activity remains in the PRF membranes and what is discarded into the PRF serum. To this end, we have exposed gingival fibroblasts to lysates prepared from PRF membranes and PRF serum, followed by bulk RNA sequencing. A total of 268 up- and 136 down-regulated genes in gingival fibroblasts exposed to PRF membrane lysates were significantly regulated under the premise of a minimum log2 with 2.5-fold change and a minus log10 significance level of two, respectively. PRF serum only caused 62 up- and 32 down-regulated genes under these conditions. Among the 46 commonly up-regulated genes were CXCL1, CXCL5, CXCL6, CXCL8, IL33, IL6, and PTGS2/COX2, stanniocalcin-1—all linked to an inflammatory response. PRF membrane lysates further increased chemokines CCL2, CCL7, CXCL2, CXCL3, and IL1R1, IL1RL1, and IL1RN, as well as the paracrine factors IL11, LIF, IGF1, BMP2, BMP6, FGF2, and CCN2/CTGF, and all hyaluronan synthases. On the other hand, PRF serum increased DKK1. The genes commonly down-regulated by PRF membrane lysates and PRF serum included interferon-induced protein with tetratricopeptide repeats (IFIT1, IFIT2, IFIT3) and odd-skipped-related transcription factors (OSR1 and OSR2), as well as FGF18 and GDF15, respectively. Taken together, PRF membrane lysates, compared to PRF serum, cause a more complex response in gingival fibroblasts, but each increased chemokine expression in gingival fibroblasts. [ABSTRACT FROM AUTHOR]

Accelerated orthodontic tooth movement (OTM) has been widely desired because of its potential advantages, which include reduced treatment duration, enhanced posttreatment stability and reduction of adverse effects commonly associated with extended treatment periods. Recently, platelet-rich fibrin (PRF) and advanced platelet-rich fibrin (A-PRF) had potential functions in accelerating OTM and shortening treatment duration. This study was designed to examine the potency of intrasulcular injection of PRF and A-PRF in inducing transforming growth factor-β1 (TGF-β1) during OTM in rabbits. The study examined 45 rabbits (Oryctolagus cuniculus) that were randomly divided into 3 groups, each consisting of 15 animals: The untreated group (control), intrasulcular PRF injection group and A-PRF injection group. Each group was randomly divided into 5 subgroups according to the day of observation (days 0, 3, 7, 14 and 21). TGF-β1 levels during OTM were determined by enzyme-linked immunosorbent assay (ELISA). Data gathered were analyzed using the 2-way analysis of variance and post hoc Tukey's honest significant difference (p < 0.05). The TGF-β1 levels were significantly different (p < 0.05) on the compression side. The TGF-β1 level in the A-PRF group was significantly lower than those in the PRF and control groups on days 7, 14 and 21 (p < 0.05). Decreasing TGF-β1 levels can affect the balance of osteoclastogenesis, thereby altering osteoclast production and function. PRF and A-PRF can help create a favorable environment for bone regrowth, which can help preserve bone health and accelerate OTM. [ABSTRACT FROM AUTHOR]

Background: Sphincter-preserving techniques like autologous compound platelet-rich fibrin foam have gained popularity, offering potential for better functional outcomes in anal fistula treatment. The present study aimed to evaluate the efficacy and safety of Obsidian RFT®. Methods: The study conducted a retrospective analysis from January 2018 to December 2022 on patients who received anal fistula closure with Obsidian RTF® at the Department of General Surgery, Medical University of Vienna. Clinical diagnosis, complemented by radiographic imaging, was employed to confirm inconclusive cases. Demographic and fistula characteristics and postoperative data were collected from electronic records following STROCSS criteria. Results: Fifteen patients received Obsidian RFT® treatment for anal fistulas. We found no intra- and postoperative complications. The median hospital stay was 3 days. After a median follow-up of 32 months, a closure rate of 53.3% was detected. Non-significant differences were observed in various variables, yet trends emerged, indicating associations between abscess presence and non-healing fistulas. A distinct age threshold (≥ 42.7 years) served as an indicator for an inability to achieve anal fistula cure. Conclusion: Obsidian RFT® represents a safe, minimally invasive operative procedure. Approximately half the patients experienced healing, with better outcome in a younger population. Trial Registration: Ethical Approval number Medical University of Vienna (#1258/2018). This study was registered retrospectively in ClinicalTrials.gov (NCT06136325). [ABSTRACT FROM AUTHOR]

Background: Androgenetic alopecia (AGA) is a major cause of hair loss resulting from a complex interplay between various genes and hormones with the result being follicular miniaturization and altered hair cycle dynamics. Platelet‐rich plasma (PRP) has a well‐established role as adjunctive therapy in AGA but there are many limitations of it. In an attempt to overcome the shortcomings of PRP, liquid platelet‐rich fibrin (PRF) was developed. Aim: This article critically reviews the protocol for the preparation and clinical outcomes of PRF. Patients/Methods: The articles published so far in the English language regarding the preparation and clinical outcomes of PRF were reviewed. Results: Among five studies analyzing various centrifugation speeds and centrifugation times, three of the studies favored low‐speed centrifugation, whereas two studies did not support this methodology. A horizontal centrifuge may be preferred over a fixed‐angle centrifuge for PRF. Five clinical studies on the use of PRF showed a significant effect on AGA. Conclusion: At present, there is no consensus regarding the preparation of PRF. Most studies used fixed‐angle centrifugation favored low centrifuge speed and less centrifugation time. Larger studies are needed to determine the optimal centrifugation force and time. A horizontal centrifuge may be preferred over a fixed‐angle centrifuge due to the higher yield of platelets, and lesser shear trauma to the cells. In addition, larger, well‐designed studies are needed to confirm the benefits of PRF over PRP. [ABSTRACT FROM AUTHOR]

Background: The purpose of this randomized clinical study was to clinically evaluate and compare the efficiencies of platelet‐rich fibrin (PRF), concentrated growth factor (CGF) and autogenous bone graft (ABG) in the treatment of intrabony pockets and to assess the alveolar bone gain (AB gain) radiographically (panoramic and CBCT images). Methods: Eighty intrabony pockets were divided into four groups: ojnly open flap debridement (OFD), OFD+PRF, OFD+CGF and OFD+ABG; each group consisted of 20 defects. Plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and tooth mobility (TM) by using Periotest M device were evaluated. Radiographic images were also taken to evaluate the AB gain. PRF was produced using a protocol of 2,700 RPM for 12 min and the relative centrifugal force (RCF) was evaluated. CGF was prepared as follows: 2 min 2700 rpm, 4 min 2400 rpm, 4 min 2700 rpm, 3 min 3000 rpm. Results: The study results revealed a similar improvement in PI and GI values in all groups (p > 0.05). There was a statistically significant decrease in PD and CAL in favor of ABG group at day 180 in comparison with other groups (p = 0.001). There was also a statistically significant decrease in TM and alveolar bone height loss (ABHL), whereby the AB gain gradually increased among the groups with the best group being ABG, followed by CGF, PRF, and control groups, respectively (p = 0.001). Conclusions: The study results support the treatment of periodontal intrabony pockets using OFD in combination with ABG, CGF, and PRF, as ABG showed the best results followed by CGF and PRF. [ABSTRACT FROM AUTHOR]

Background: The present study aims to evaluate and compare the effects of 1% melatonin gel plus platelet‐rich fibrin (PRF) and PRF alone in treatment of furcation defects, clinically and radiographically using cone‐beam computed tomography. Methods: This split‐mouth clinical trial included 23 patients with 46 bilateral Grade II furcation defects in first or second maxillary or mandibular molars. Control group was treated with PRF alone while the test group was treated with 1% melatonin gel and PRF. Clinical attachment level (CAL) and horizontal probing depth (HPD) were primary outcome parameters while secondary outcome parameters were pocket probing depth (PPD) and defect volume (DV) assessed at 3 and 6 months postoperatively. Results: Significantly greater mean reduction of PPD, HPD, and CAL gain was observed in test group (2.23 ± 0.41, 2.36 ± 0.68, and 2.97 ± 0.62 mm, respectively) in comparison with control group (2.83 ± 0.78, 2.85 ± 0.67, and 3.21 ± 0.86 mm, respectively) at 6 months. A significant reduction in the mean DV was exhibited radiographically in test group (1.06 ± 0.5 mm3) as compared with control group (3.94 ± 1.32 mm3) at the end of 6 months. Both the groups showed improvements in assessed parameters. Conclusions: In Grade II furcation defects the combination therapy of 1% melatonin + PRF shows a statistically significant degree of bone fill within the periodontal tissues and also better results in terms of decrease in PPD, HPD, and a greater CAL gain. [ABSTRACT FROM AUTHOR]

Wound dehiscence is a common complication after secondary alveolar bone grafting (SABG), leading to unfavourable surgical outcomes. Studies have shown that autologous platelet concentrates (APC) may enhance wound healing and improve outcomes. Therefore, this review aimed to evaluate in patients with alveolar clefts, whether using APC and iliac crest bone graft can mitigate the likelihood of wound dehiscence formation compared with those who underwent iliac bone grafting only following SABG. A comprehensive literature search was conducted using various electronic databases, including PubMed, Embase, Scopus, Web of Science, EBSCOhost, Ovid MEDLINE, LILACS, Cochrane Library, and grey literature, to include studies until July 31, 2023, without any restriction to language and time of publication. Only randomized (RCT) and controlled (CCT) clinical trials were included. Two independent reviewers screened the studies based on the predefined criteria, after which a qualitative and quantitative analysis was conducted. The search yielded 821 studies, of which seven were deemed eligible for systematic review. The risk of bias assessment done using "The Cochrane collaboration tool for risk of bias assessment" for six RCTs and the "Risk of Bias in Non-randomized Studies - of Interventions" for one CCT revealed a moderate to high risk of bias. The meta-analysis of five studies showed that the overall risk of developing wound dehiscence was lower in the APC group (RR = 0.33; 95% CI: 0.16, 0.71; p = 0.005; χ2 = 0.82; I2 = 0%). Subgroup analyses based on study design further supported these findings. Although the adjuvant use of APC for alveolar cleft reconstruction reduces the risk of wound dehiscence, more studies with increased scientific rigour and fewer confounding variables are warranted. [ABSTRACT FROM AUTHOR]

Background: Anticoagulant drugs are a valuable tool for minimizing thrombotic risks in at-risk patients. The purpose of this study is to conduct a literature review highlighting the management of these drugs during daily clinical dental practice. Materials and Methods: We limited our search to English-language papers published between 1 January 1989, and 7 March 2024, in PubMed, Scopus and Web of Science that were relevant to our topic. In the search approach, the Boolean keywords "anticoagulant AND dentistry" were used. Results: Twenty-five clinical trials were included for final review from 623 articles obtained from the databases Web of Science (83), PubMed (382), and Scopus (158), eliminating duplicates and 79 off-topic items, resulting in 419 articles after removing 315 entries and confirming eligibility. Overall, these studies support the use of local hemostatic measures to manage the risk of bleeding in patients on anticoagulant therapy undergoing dental procedures and highlight the importance of greater education and collaboration among healthcare professionals. Conclusions: Research and clinical investigation have improved understanding and management of dental procedures in patients undergoing anticoagulant or antiplatelet therapy. Hemostatic agents, clinical protocols, risk factors, and continuous education are essential for navigating the complexities of anticoagulant therapy, ensuring optimal outcomes and enhancing patient well-being. [ABSTRACT FROM AUTHOR]

Several techniques have been described for maxillary sinus graft augmentation, including the lateral window technique and crestal approach with osteotomes or osseodensification. Platelet-rich fibrin has been used in maxillary sinus lift procedures due to its ability to accelerate soft and hard tissue healing. The aim of this study was to evaluate the potential of PRF in combination with the synthetic hydroxyapatite NanoBone® to enhance bone regeneration in sinus floor elevation with the lateral window technique. Out of the 50 individuals screened in a preoperative assessment visit from the CESPU—Famalicão clinical unit and intervened upon between January 2023 and December 2023, only 6 patients who met the study's inclusion criteria consented to participate. In a split-mouth study, twelve sinus graft surgeries were carried out. Our observations reveal that for the test group (NanoBone®/PRF), there is a 27.5 ± 4.9% increase new vital bone, 23.0 ± 3.7% increase in inert bone particles, and 49.4 ± 2.8% increase in connective tissue. Meanwhile, for the control group (NanoBone®), there is a 19.5 ± 3.0% increase in new vital bone, 23.4 ± 5.7% increase in inert bone particles, and 57.0 ± 3.5% increase in connective tissue. The results strongly indicate that mixing liquid PRF with NanoBone® does not have a negative influence on the amount of viable bone formation, and it seems to slightly increase the amount of new bone formation and revascularization in sinus bone graft procedures with the lateral window technique compared to the single use of NanoBone®. [ABSTRACT FROM AUTHOR]

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Objective To explore the effect of leukocyte-and platelet-rich fibrin (L-PRF) as a capping agent in the modulation of inflammation in rat dental pulp. Methods The rat model of pulpitis was established by lipopolysaccharide (LPS) . A total of 30 Sprague-Dawley rats were randomly divided into five groups: Normal control group, Model group, iRoot BP PLUS group, L-PRF group, iRoot BP PLUS+ L-PRF group. Samples were collected on the 14th day after pulp capping. Micro-CT scans, HE and Masson staining, qRT-PCR assays were performed to observe pulp tissue inflammatory and hard tissue formation. Results Micro-CT results: no hard tissue formation was seen in the LPS group, plaque calculus was seen in the L-PRF group, and a more complete calcified bridge was seen at the perforation of the pulp in the BP and combined groups, HE and Masson staining results: the LPS group had the most severe inflammation and no hard tissue formation, the combined group had the least inflammation and the most complete and continuous hard tissue formation, and there was a statistical difference between the two groups(P < 0.01), There was no statistical difference in the degree of inflammatory reaction and hard tissue formation between the BP group and the combined group (P > 0.05), qRT-PCR results: the relative expression levels of TNF-α, IL-1β, and IL-6 mRNA in the pulp tissues of all experimental groups were reduced compared with those of the LPS group, but the differences between the L-PRF and LPS groups were not statistically significant (P > 0.05) . Conclusion The combination of L-PRF and iRoot BP PLUS as a composite pulp capping material can be used for the repair of dental pulp tissue and the regulation of inflammation in dental pulpitis in rats. [ABSTRACT FROM AUTHOR]

This rapid review summarizes the latest primary research in temporomandibular joint (TMJ) injection treatment. The final literature searches were conducted on 4 January 2024. Selection was performed systematically following predefined eligibility criteria. Randomized control trials concerning the treatment of TMJ disorders with intra-articular injections were included. Studies on more invasive interventions were excluded. Quality of life, joint pain and range of mandibular mobility were assessed. Ultimately, 12 studies covering a total of 603 patients qualified. They concerned: (1) arthrocentesis (AC) and the administration of, (2) injectable platelet-rich fibrin (I-PRF), (3) platelet-rich plasma (PRP), (4) hyaluronic acid (HA), (5) non-steroidal anti-inflammatory drugs (NSAIDs), and (6) hypertonic dextrose (HD) with a local anesthetic. The dominant approach was to perform arthrocentesis before administering the appropriate injection substance (I-PRF, PRP, HA, or NSAID). Two current studies on the intra-articular administration of NSAIDs, specifically tenoxicam and piroxicam, are noteworthy. A mixture of PRP and HA was injected in another two trials. These two innovative approaches may prove to be significant directions for further research on injection treatment of TMJs. [ABSTRACT FROM AUTHOR]

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]

Platelet‑rich fibrin (PRF) has been widely applied for periodontal regeneration due to its simplicity, autologous nature and economics. This study aims to evaluate the variations in the fibrin network patterns of the PRF clot, which was isolated from chronic periodontitis patients with and without diabetes mellitus(DM). Materials and Methods: This study included 90 participants undergoing periodontal treatment therapy. The patients were divided into three groups: Group A (n = 30), chronic periodontitis patients without Type 2 DM; Group B (n = 30), chronic periodontitis patients with Type 2 DM (haemoglobin A1c [HbA1c], 6.5%-6.9%) and Group C (n = 30), chronic periodontitis patients with Type 2 DM (HbA1c ≥ 7%). The clinical parameters and blood samples were collected, and PRF preparation was done. Histological slide analysis was done in the stained section of the PRF clot and examined for the presence of dense and loose fibrin network patterns with the entrapments of platelets. Results: There was a significant difference in the dense and loose fibrin framework between chronic periodontitis patients without type 2 DM, chronic periodontitis patients with type 2 DM of 6.5-6.9 HbA1c and chronic periodontitis patients with type 2 DM of >7 HbA1c. Conclusion: Within the limitations of this study, future studies are needed to find the clinical outcomes of various PRF preparations in diabetic patients and other systemic factors that influence the fibrin network pattern, so that better regenerative outcomes can be achieved in patients with systemic diseases. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to assess the efficacy of adipose-derived mesenchymal stem cell exosomes (ASCs exosome) and platelet-rich fibrin (PRF) in treating critical long bone defects in Sprague-Dawley rats. Critical long bone defects, defined as exceeding 2 cm or 50% of the bone diameter, often pose a healing challenge. While autologous bone grafts have been considered, they have shown unreliable results and donor-site complications, necessitating alternative treatments. Methods: The research followed a quasi-experimental post-test only control group design involving 30 male Sprague-Dawley rats. The rats were divided into five groups and subjected to femur bone defect creation, internally fixed with a 1.4 mm K-wire, and treated with various combinations of hydroxyapatite (HA), bone graft (BG), ASCs exosome, and PRF. Histomorphometry and BMP-2 gene expression analysis were performed to evaluate bone healing. Results and Discussion: The results indicated that the group treated with HA + BG + ASCs exosome (group IV) exhibited the highest BMP-2 gene expression, while group III (HA + BG + ASCs exosome + PRF) had the highest chordin level. Overall, groups receiving ASCs exosome or PRF intervention showed elevated BMP-2 expression compared to the control group. The use of ASCs exosome and PRF showed comparable outcomes compared to bone graft administration in terms of histomorphometry analysis. Conclusion: The administration of adipose tissue derived mesenchymal stem cells and PRF has a comparable outcome with the use of bone graft in terms of osseus area and expression of BMP-2 in critical bone defect. [ABSTRACT FROM AUTHOR]

Introduction: The search to optimize the healing and bone repair processes in oral and maxillofacial surgeries reflects the constant evolution in clinical practice, driven by the demand for increasingly satisfactory results and the need to minimize postoperative complications. Objective: To evaluate the efficacy of Platelet and Leukocyte Rich Fibrin (L-PRF) in the healing and bone repair process in oral and maxillofacial surgeries. Materials and methods: The systematic review protocol for this study included the definition of the research question, the domain of the study, the databases searched, the search strategy, the inclusion and exclusion criteria, the types of studies to be included, the measures of effect, the methods for screening, data extraction and analysis, and the approach to data synthesis. Systematic literature searches were carried out on Cochrane databases, Web of Science, PubMed, ScienceDirect, Embase and Google Scholar. Results: The strategic search in the databases identified 1,159 studies. After removing the duplicates with the Rayyan© software, 946 articles remained. Of these, 30 met the inclusion criteria. After careful evaluation based on the inclusion and exclusion criteria, 8 studies were considered highly relevant and included in the systematic review. Conclusion: Platelet and Leukocyte Rich Fibrin (L-PRF) has a positive effect on the healing process and bone repair in oral and maxillofacial surgeries. [ABSTRACT FROM AUTHOR]

Purpose: To compare TGF- β and type 1 collagen expression between Platelet rich fibrin (PRF) membrane and conjunctival autograft treatment after conjunctival excision. Study Design: Experimental animal study. Place and Duration of study: Faculty of Veterinary Medicine, Airlangga University, Surabaya, Indonesia from October 24, 2022 to November, 19, 2022. Methods: Twenty New Zealand white rabbits were randomly assigned to either the PRF group or the conjunctival autograft group. A 5x5 mm excision was made in the temporal quadrant of the right eye of each rabbit. In the first group, the conjunctival defect was closed using a PRF membrane, while in the second group, closure was done with a conjunctival autograft from the superior quadrant of the same eye. After 14 days, all rabbits were terminated and enucleated. An immunohistochemical study of conjunctival tissue was conducted to assess TGF-β and type 1 collagen expression, and results were statistically analyzed. Results: An independent T-Test revealed that PRF membrane group exhibited higher TGF-β expression compared to the conjunctival autograft group (p = 0.000), with a mean TGF-β expression of 9.02 in the PRF membrane group and 5.76 in the conjunctival autograft group. Conversely, type 1 collagen expression was found to be higher in the conjunctival autograft group compared to the PRF membrane group (p = 0.032), with a mean type 1 collagen expression of 9.22 in the conjunctival autograft group and 6.92 in the PRF membrane group. Conclusion: TGF-β expression was higher in the PRF group and type 1 collagen expression was higher in the conjunctival autograft group [ABSTRACT FROM AUTHOR]

Introduction: Diced cartilage grafts are well-liked, dependable, and simple-to-use techniques for dorsum camouflage in rhinoplasty. Recent research results demonstrate how effectively PRF increases the survivability of diced cartilage in the nasal dorsum and decreases its absorption. In this study, we intend to investigate the effect of fibrin-rich platelets (PRF) on diced cartilage survival in rhinoplasty surgery. Materials and Methods: This clinical trial included people referred to Rasoul Akram Hospital for rhinoplasty between 2020 and 2021. Patients were divided into two groups: Diced Cartilage alone (DC) and Diced Cartilage + PRF (DC+PRF). Cartilage survival was assessed by ultrasound, photography, and nasal examination, and the two groups were compared six months after rhinoplasty. Patients' satisfaction with surgery was also evaluated using the Utrecht questionnaire. Results: The mean age of the two groups of 20 patients was 29.05 ± 7.02 and 26.65 ± 8.16 years in the DC and DC + PRF groups, respectively (P>0.05). After treatment, the frequency of irregularity on examination and dissatisfaction score was slightly but insignificantly higher in the DC group compared to the DC + PRF group (25% vs. 15% and 12.25 ± 6.45 vs. 10.45 ± 6.74, respectively, and P values>0.05). The total volume decrease, regardless of the injection site, was significant in both groups (P < 0.05), but the magnitude of volume reduction was significantly higher in the DC group compared to the DC + PRF group (-0.060 ± 0.087 vs. - 0.033±0.017, respectively, P<0.05). Conclusion: PRF may slow down the absorption process of diced cartilage. [ABSTRACT FROM AUTHOR]