Platelet-rich fibrin (PRF) in implants dentistry in combination with new bone regenerative flapless technique: evolution of the technique and final results

AbstractMost common techniques for alveolar bone augmentation are guided bone regeneration (GBR) and autologous bone grafting. GBR studies demonstrated long-term reabsorption using heterologous bone graft. A general consensus has been achieved in implant surgery for a minimal amount of 2 mm of healthy bone around the implant.A current height loss of about 3-4 mm will result in proper deeper implant insertion when alveolar bone expansion is not planned because of the dome shape of the alveolar crest. To manage this situation a split crest technique has been proposed for alveolar bone expansion and the implants’ insertion in one stage surgery. Platelet-rich fibrin (PRF) is a healing biomaterial with a great potential for bone and soft tissue regeneration without inflammatory reactions, and may be used alone or in combination with bone grafts, promoting hemostasis, bone growth, and maturation.AimThe aim of this study was to demonstrate the clinical effectiveness of PRF combined with a new split crest flapless modified technique in 5 patients vs. 5 control patients.Materials and methodsTen patients with horizontal alveolar crests deficiency were treated in this study, divided into 2 groups: Group 1 (test) of 5 patients treated by the flapless split crest new procedure; Group 2 (control) of 5 patients treated by traditional technique with deeper insertion of smaller implants without split crest. The follow-up was performed with x-ray orthopantomography and intraoral radiographs at T0 (before surgery), T1 (operation time), T2 (3 months) and T3 (6 months) post-operation.ResultsAll cases were successful; there were no problems at surgery and post-operative times. All implants succeeded osteointegration and all patients underwent uneventful prosthetic rehabilitation. Mean height bone loss was 1 mm, measured as bone-implant most coronal contact (Δ-BIC), and occurred at immediate T2 post-operative time (3 months). No alveolar bone height loss was detected at implant insertion time, which was instead identified in the control group because of deeper implant insertion.ConclusionThis modified split crest technique combined with PRF appears to be reliable, safe, and to improve the clinical outcome of patients with horizontal alveolar crests deficiency compared to traditional implanting techniques by avoiding alveolar height-loss related to deeper insertion of smaller implants.

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A Comparative Study of the Effects of Platelet-Rich Fibrin, Concentrated Growth Factor and Platelet-Poor Plasma on the Healing of Tooth Extraction Sockets in Rabbits

10.21203/rs.3.rs-1225393/v1 ◽

2022 ◽

Author(s):

Siying Li ◽

Hongyi Yang ◽

Qinyu Duan ◽

Hongyu Bao ◽

Aodi Li ◽

...

Keyword(s):

New Zealand ◽

Growth Factor ◽

Tooth Extraction ◽

Alveolar Bone ◽

Control Group ◽

Platelet Concentrates ◽

Platelet Rich Fibrin ◽

Bone Absorption ◽

Autologous Platelet ◽

Over Time

Abstract Background：Autologous platelet concentrate has been widely used to encourage the regeneration of hard and soft tissues. Up to now, there are three generations of autologous platelet concentrates. Many studies have shown that different autologous platelet concentrates have different healing effects. However, these differences still need to be further verified and discussed. The purpose of this study was to explore and compare the effects of platelet-rich fibrin, concentrated growth factor and platelet-poor plasma on the healing of tooth extraction sockets in New Zealand rabbits. Methods：A total of 24 healthy male New Zealand white rabbits aged 8-12 weeks were selected. The experimental animals were randomly divided into four groups: three experimental groups were respectively implanted with PPP, CGF and PRF gel after bilateral mandibular anterior teeth were extracted, and the control group did not implant any material. The alveolar bone of the mandibular anterior region was taken at 2, 4 and 8 weeks after operation. The height and width of the extraction wound were detected by CBCT, the growth of the new bone was observed by HE and Masson staining, and the expression of osteogenic genes was detected by real-time PCR. Data were analyzed using IBM SPSS statistical package 22.0.Results: The radiological results showed that alveolar bone absorption in all groups gradually increased over time. However, the experimental groups showed lower amounts of bone absorption. The histological results showed that new bone formation was observed in all groups. Over time, the new bone trabeculae of the CGF group became closely aligned while those in the PPP and PRF groups remained scattered. PCR results showed that the expression of BMP-2 and ALP was higher in the experimental groups than the control group.Conclusion: In conclusion, the application of PRF, CGF and PPP in tooth extraction sockets effectively promoted bone regeneration. CGF showed more effective bone induction and tissue regeneration ability in the long term.

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Modified Approach to Central Giant Cell Lesion

Journal of Clinical Pediatric Dentistry ◽

10.17796/1053-4628-42.4.9 ◽

2018 ◽

Vol 42 (4) ◽

pp. 292-294 ◽

Cited By ~ 1

Author(s):

Lucas Borin Moura ◽

Sandra Beatriz Chaves Tarquinio ◽

Ana Paula Neutzling Gomes ◽

André Ribeiro Schinestsck ◽

Marcos Antonio Torriani

Keyword(s):

Giant Cell ◽

Bone Growth ◽

Invasive Technique ◽

Early Age ◽

Conservative Approach ◽

Modified Technique ◽

Giant Cell Lesion ◽

Central Giant Cell Lesion ◽

Bone Expansion

This case report discusses a modified technique for treatment of a central giant cell lesion (CGCL) in children, where a recontouring procedure is performed prior to the treatment with intra lesional corticosteroid. We discuss the advantages of this less invasive technique, specially considering the early age of the patient and its bone growth, as well as the conservative approach for lesions in those cases. The treatment of an 8-year-old female patient exhibiting CGCL in anterior region of mandible with bone expansion is described. The procedure was performed using blade #15 and rongeur forceps, in order to obtain an adequate jaw contour. Two weeks later, drug treatment started with triamcinolone 10mg/ml diluted in 0.5% bupivacaine without vasoconstrictor agent, 1:1 ratio, for eight sessions. There were no complications in surgery and postoperative period. In 3-year follow-up, anatomical preservation is present with no signs of recurrence.

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Functional Evaluation of a Novel Multi-Axial Alveolar Distractor—Preliminary In Vivo Animal Study

Applied Sciences ◽

10.3390/app11041898 ◽

2021 ◽

Vol 11 (4) ◽

pp. 1898

Author(s):

Cheng-Hsien Wu ◽

Kun-Chun Chen ◽

Yang-Sung Lin ◽

Yuan-Chih Liu ◽

Chun-Li Lin

Keyword(s):

Mechanical Strength ◽

Animal Study ◽

Bone Growth ◽

Alveolar Bone ◽

Control Group ◽

Functional Evaluation ◽

Intact Bone ◽

Living Bone ◽

The Right

This study evaluates the biomechanical performance of a new multi-axial alveolar distractor using an animal study. The multi-axial alveolar distractor is designed with a ball and socket joint mechanism that can rotate up to 60° toward the buccal/lingual and mesial/distal sides intra-operatively to achieve vector control. The transport segment can be moved through activating the transport screw with 0.25 pitch, allowing 13 mm in distraction height. This distractor was fixed at the right angulus mandibular of experimental rabbits and adjusted 15° toward the mesial side and 25° toward the buccal side as Group TMB (toward mesial-buccal) (n = 3), and 15° toward the mesial side as Group TM (toward mesial) (n = 3). Group TC (control) was the control group. The distractors were activated 1 mm/day for 13 days. Living bone growth was observed at various periods. The total bone growth length at the angulus region and buccal side distraction thickness after distraction were calculated. The variations in bone growth geometric shape at the mandible angulus were also recorded. Fracture testing was performed to understand the variations in the mechanical strength between the distracted and intact bone specimens. The digital radiography results showed that the osteotomy areas at the mandible angulus were healed and the bone growth completed after surgery. The average bone growth length of Group TMB was 17.68 mm. This was greater than that of Group TM at 14.79 mm. The corresponding buccal side distractor thicknesses for Group TMB and TM after distraction were 5.12 ± 0.52 mm and 3.32 ± 0.37 mm, respectively. The tensile strengths of the bone specimens after distraction of Groups TMB, TM and TC were 172.13 N, 119.27 N and 304.24 N, respectively, and the percentage of distraction bone tensile strength to normal bone was 57% and 39% for Groups TMB and TM, respectively. This study concluded that this new multi-axial alveolar bone distractor can drive bones to grow in accordance with the direction/angle of the distraction plan. The bone growth healed gradually and presented insufficient mechanical strength.

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Comparison of one versus two maxillary molars distalization with iPanda: a finite element analysis

Progress in Orthodontics ◽

10.1186/s40510-021-00356-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Kamontip Sujaritwanid ◽

Boonsiva Suzuki ◽

Eduardo Yugo Suzuki

Keyword(s):

Finite Element ◽

Stress Distribution ◽

Alveolar Bone ◽

Vertical Direction ◽

Minimal Amount ◽

Element Analysis ◽

Molar Distalization ◽

Second Molar ◽

Maxillary Molars ◽

Displacement Patterns

Abstract Background The purpose of this study was to compare the stress distribution and displacement patterns of the one versus two maxillary molars distalization with iPanda and to evaluate the biomechanical effect of distalization on the iPanda using the finite element method. Methods The finite element models of a maxillary arch with complete dentition, periodontal ligament, palatal and alveolar bone, and an iPanda connected to a pair of midpalatal miniscrews were created. Two models were created to simulate maxillary molar distalization. In the first model, the iPanda was connected to the second molar to simulate a single molar distalization. In the second model, the iPanda was connected to the first molar to simulate “en-masse” first and second molar distalization. A varying force from 50 to 200 g was applied. The stress distribution and displacement patterns were analyzed. Results For one molar, the stress was concentrated at the furcation and along the distal surface in all roots with a large amount of distalization and distobuccal crown tipping. For two molars, the stress in the first molar was 10 times higher than in the second molar with a great tendency for buccal tipping and a minimal amount of distalization. Moreover, the stress concentration on the distal miniscrew was six times higher than in the mesial miniscrew with an extrusive and intrusive vector, respectively. Conclusions Individual molar distalization provides the most effective stress distribution and displacement patterns with reduced force levels. In contrast, the en-masse distalization of two molars results in increased force levels with undesirable effects in the transverse and vertical direction.

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Clinical Efficacy and Safety of Silicone Elastomer Sheet during Decompressive Craniectomy: Anti-Adhesive Role in Cranioplasty

Brain Sciences ◽

10.3390/brainsci11010124 ◽

2021 ◽

Vol 11 (1) ◽

pp. 124

Author(s):

Young Ha Kim ◽

Chi Hyung Lee ◽

Chang Hyeun Kim ◽

Dong Wuk Son ◽

Sang Weon Lee ◽

...

Keyword(s):

Decompressive Craniectomy ◽

Fluid Collection ◽

Multivariate Logistic Regression Analysis ◽

Operation Time ◽

Silicone Elastomer ◽

Control Group ◽

Estimated Blood Loss ◽

Adhesion Tissue ◽

Skull Bone Defect ◽

Epidural Adhesion

(1) Background: Cranioplasty is a surgery to repair a skull bone defect after decompressive craniectomy (DC). If the process of dissection of the epidural adhesion tissue is not performed properly, it can cause many complications. We reviewed the effect of a silicone elastomer sheet designed to prevent adhesion. (2) Methods: We retrospectively reviewed 81 consecutive patients who underwent DC and subsequent cranioplasty at our institution between January 2015 and December 2019. We then divided the patients into two groups, one not using the silicone elastomer sheet (n = 50) and the other using the silicone elastomer sheet (n = 31), and compared the surgical outcomes. (3) Results: We found that the use of the sheet shortened the operation time by 24% and reduced the estimated blood loss (EBL) by 43% compared to the control group. Moreover, the complication rate of epidural fluid collection (EFC) in the group using the sheet was 16.7%, which was lower than that in the control group (41.7%, p < 0.023). Multivariate logistic regression analysis showed the sheet (OR 0.294, 95% CI 0.093–0.934, p = 0.039) to be significantly related to EFC. (4) Conclusions: The technique using the silicone elastomer sheet allows surgeons to easily dissect the surgical plane during cranioplasty, which shortens the operation time, reduces EBL, and minimizes complications of EFC.

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The Bone Buttress Theory: The Effect of the Mechanical Loading of Bone on the Osseointegration of Dental Implants

Biology ◽

10.3390/biology10010012 ◽

2020 ◽

Vol 10 (1) ◽

pp. 12

Author(s):

David Chavarri-Prado ◽

Aritza Brizuela-Velasco ◽

Ángel Álvarez-Arenal ◽

Markel Dieguez-Pereira ◽

Esteban Pérez-Pevida ◽

...

Keyword(s):

Dental Implants ◽

Mechanical Loading ◽

Bone Growth ◽

Bone Matrix ◽

Test Group ◽

Control Group ◽

Group A ◽

Bone To Implant Contact ◽

The Stability ◽

Group B

Objectives: To determine the effect of mechanical loading of bone on the stability and histomorphometric variables of the osseointegration of dental implants using an experimental test in an animal model. Materials and Methods: A total of 4 human implants were placed in both tibiae of 10 New Zealand rabbits (n = 40). A 6-week osseointegration was considered, and the rabbits were randomly assigned to two groups: Group A (Test group) included 5 rabbits that ran on a treadmill for 20 min daily during the osseointegration period; Group B (Controls) included the other 5 that were housed conventionally. The monitored variables were related to the primary and secondary stability of the dental implants (implant stability quotient—ISQ), vertical bone growth, bone to implant contact (BIC), area of regenerated bone and the percentage of immature matrix. Results: The results of the study show a greater vertical bone growth (Group A 1.26 ± 0.48 mm, Group B 0.32 ± 0.47 mm, p < 0.001), higher ISQ values (Group A 11.25 ± 6.10 ISQ, 15.73%; Group B 5.80 ± 5.97 ISQ, 7.99%, p = 0.006) and a higher BIC (Group A 19.37%, Group B 23.60%, p = 0.0058) for implants in the test group, with statistically significant differences. A higher percentage of immature bone matrix was observed for implants in the control group (20.68 ± 9.53) than those in the test group (15.38 ± 8.84) (p = 0.108). A larger area of regenerated bone was also observed for the test implants (Group A 280.50 ± 125.40 mm2, Group B 228.00 ± 141.40 mm2), but it was not statistically significant (p = 0.121). Conclusions: The mechanical loading of bone improves the stability and the histomorphometric variables of the osseointegration of dental implants.

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A Clinical Study of Platelet-Rich Fibrin Combined With Autologous High-Density Fat Transplantation in Augmentation Rhinoplasty

Ear Nose & Throat Journal ◽

10.1177/01455613211016902 ◽

2021 ◽

pp. 014556132110169

Author(s):

Dan Yan ◽

Shuai-Hua Li ◽

An-Li Zhang ◽

Yao Xiao ◽

Ze-Chun Huang

Keyword(s):

Retention Rate ◽

Statistical Significance ◽

High Density ◽

Control Group ◽

Long Term Effects ◽

Fat Transplantation ◽

Augmentation Rhinoplasty ◽

Platelet Rich Fibrin ◽

Autologous Fat

Objective: This study was designed to analyze the clinical effect of autologous fat-granule transplantation in augmentation rhinoplasty and explore methods to improve the fat retention rate. Methods: A total of 70 enrolled patients were randomly divided into 2 groups: the platelet-rich fibrin (PRF) combined with high-density fat transplantation group (combined group) and the conventional fat-granule transplantation group (control group; n = 35 in each group). In the combined group, an appropriate amount of autologous fat was extracted and centrifuged, and the lower layer of high-density fat was taken and mixed with PRF isolated from whole blood for autotransplantation. In the control group, only fat was extracted and centrifuged for transplantation. The patients were followed up with for more than one year to observe the short- and long-term effects, complications, safety, and patient satisfaction. Results: Six months after the operation, the nasal shape was stable, the contour was higher and more stereoscopic than before, the average increase of nasal height was 3.0 mm in the combined group and 2.0 mm in the control group. No complications, such as fat embolism, infection, or necrosis occurred during the 1-year follow-up. The satisfaction rate between the 2 groups has statistical significance ( P < .05). Conclusion: Overall, PRF combined with autologous high-density fat transplantation is simple to perform, has a significantly increased fat-retention rate than the control group, and has stable long-term effects without obvious adverse reactions. A sufficient amount of fat and PRF transplantation can achieve a good orthopedic effect. Thus, this method can be widely used in clinical augmentation rhinoplasty.

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Effect of Platelet-Rich Fibrin Application on Non-Infectious Complications after Surgical Extraction of Impacted Mandibular Third Molars

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168249 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8249

Author(s):

Grzegorz Trybek ◽

Justyna Rydlińska ◽

Magda Aniko-Włodarczyk ◽

Aleksandra Jaroń

Keyword(s):

Treatment Process ◽

Infectious Complications ◽

Control Group ◽

Surgical Removal ◽

Study Group ◽

Impacted Tooth ◽

Platelet Rich Fibrin ◽

Surgical Extraction ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

Due to the frequent development of non-infectious complications after surgical removal of the third lower impacted tooth, many techniques are used to reduce their severity. Among them is the technique of applying platelet-rich fibrin to the post-extraction alveolus. The study included 90 consecutively enrolled patients. Eligible patients were randomly assigned to two groups: patients with and without platelet-rich fibrin introduced into the postoperative alveolus. Pain, swelling, trismus, and temperature were evaluated after the procedure. Pain intensity was significantly higher in the control group than in the study group at 6 h, 1, and 3 days after surgery. PRF application did not significantly affect the intensity of swelling. Body temperature was significantly higher in the control group than the study group on day two after surgery. The trismus was significantly higher in the control group than in the study group at one, two, and seven days after surgery. Application of the PRF allows for a faster and less traumatic treatment process. It will enable for speedier recovery and return to active life and professional duties.

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Autologous Platelet-Rich Fibrin (PRF) as an Adjunct in the Management of Osteoradionecrosis and Medication-Related Osteonecrosis of Jaws. Case Series in A Single Centre

Applied Sciences ◽

10.3390/app11083365 ◽

2021 ◽

Vol 11 (8) ◽

pp. 3365

Author(s):

Benjie Law ◽

Hui Yuh Soh ◽

Syed Nabil ◽

Rama Krsna Rajandram ◽

Abd Jabar Nazimi ◽

...

Keyword(s):

Case Series ◽

Cost Effective ◽

Control Group ◽

Platelet Rich Fibrin ◽

Tissue Healing ◽

Number Of Patients ◽

Short Period ◽

Oral And Maxillofacial Region ◽

Surgical Adjunct ◽

Autologous Platelet

Osteoradionecrosis (ORN) of the jaws and medication-related osteonecrosis of the jaws (MRONJ) are uncommon but serious diseases affecting the oral and maxillofacial region with clinically similar appearance but distinct pathophysiology. Management of ORN and MRONJ is inherently challenging and the treatment outcomes are unpredictable. The use of autologous platelet concentrates (APCs) to promote hard and soft tissue healing is well described in the literature, and the efficacy of leucocyte and platelet-rich fibrin (L-PRF) has been well documented in a number of clinical studies. The aim of this study was to present our treatment strategy and the outcomes of incorporating L-PRF as a surgical adjunct in management of ORN and MRONJ in our centre. Methods: eight cases of ORN and MRONJ were treated with a combination of sequestrectomy and L-PRF as a surgical adjunct. Results: the overall success was 87.5%. Using L-PRF as an adjunct, we were able to predictably manage ORN and MRONJ without causing significant morbidity. Conclusion: our experience shows that L-PRF may be used as a valuable and cost-effective adjunct to surgical management of ORN and MRONJ. However, due to a limited number of patients, and a short period of review, the true effectiveness of the method is yet to be demonstrated in a longer follow-up study including a greater number of patients, besides the inclusion of a control group.

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Lactobacillus plantarum ATG-K2 and ATG-K6 Ameliorates High-Fat with High-Fructose Induced Intestinal Inflammation

International Journal of Molecular Sciences ◽

10.3390/ijms22094444 ◽

2021 ◽

Vol 22 (9) ◽

pp. 4444

Author(s):

Miey Park ◽

Eun-Jung Park ◽

So-Hyeun Kim ◽

Hae-Jeung Lee

Keyword(s):

Small Intestine ◽

Cell Injury ◽

Intestinal Inflammation ◽

Liver Weight ◽

Diet Group ◽

Normal Diet ◽

Control Group ◽

High Fat ◽

Inflammatory Reactions ◽

High Fructose

Obesity has become a worldwide health problem, and many significant inflammatory markers have been associated with the risk of side effects of obesity and obesity-related diseases. After a normal diet or high-fat diet with high-fructose water (HFHF) for 8 weeks, male Wistar rats were divided randomly into four experimental groups according to body weight. Next, for 8 weeks, a normal diet, HFHF diet, and HFHF diet with L. plantarum strains ATG-K2 or ATG-K6 were administered orally. Compared to the control group, the HFHF diet group showed significantly increased visceral fat, epididymal fat, and liver weight. The mRNA and protein expression levels of FAS and SREBP-1c were higher in the HFHF diet group than in the HFHF diet with L. plantarum strains ATG-K2 and ATG-K6. The HFHF diet with L. plantarum strain ATG-K2 showed significantly decreased inflammatory cytokine expression in the serum and small intestine compared to the HFHF diet group. Furthermore, histological morphology showed minor cell injury, less severe infiltration, and longer villi height in the small intestine ileum of the HFHF diet with L. plantarum strains groups than in the HFHF diet group. These results suggest that L. plantarum strains K2 and K6 may help reduce intestinal inflammation and could be used as treatment alternatives for intestinal inflammatory reactions and obesity.

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