scholarly journals Platelet-Rich Plasma and Platelet-Rich Fibrin Can Induce Apical Closure More Frequently Than Blood-Clot Revascularization for the Regeneration of Immature Permanent Teeth: A Meta-Analysis of Clinical Efficacy

2018 ◽  
Vol 6 ◽  
Author(s):  
Peter E. Murray
Keyword(s):  
Clinical Efficacy ◽  
Platelet Rich Plasma ◽  
Blood Clot ◽  
Meta Analysis ◽  
Permanent Teeth ◽  
Platelet Rich Fibrin

Management of necrotic immature permanent maxillary incisors using a modified technique of revascularisation

2021 ◽  
Vol 14 (3) ◽  
pp. e240203
Author(s):  
Arun Mayya ◽  
Shruti Bhandary ◽  
Advith Kolakemar ◽  
Ann Mary George
Keyword(s):  
Platelet Rich Plasma ◽  
Blood Clot ◽  
Treatment Options ◽  
Permanent Teeth ◽  
Treatment Modalities ◽  
Successful Outcome ◽  
Modified Technique ◽  
Platelet Rich Fibrin ◽  
Periapical Lesions ◽  
Over Time

The management of necrotic immature permanent teeth has always been a challenge to endodontists. Various treatment modalities have been tried and tested for achieving a successful outcome. Revascularisation is one among these treatment options, which is gaining widespread attention among endodontists. The growing body of evidence demonstrating the success of revascularisation has led to different variations of this treatment option. Clinicians have over time used different scaffolds such as blood clot, collagen, platelet-rich fibrin (PRF) and platelet-rich plasma for revascularisation. This case report outlines the management of immature maxillary central incisors with pulp necrosis and large periapical lesions in a 19-year-old female patient with a modified technique of revascularisation by combining PRF and blood clot. At the end of 12 months, the patient was completely asymptomatic along with regression of the periapical lesions.

scholarly journals Platelet-Rich Fibrin Used in Regenerative Endodontics and Dentistry: Current Uses, Limitations, and Future Recommendations for Application

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Sohaib Arshad ◽  
Fatima Tehreem ◽  
Muhammad Rehab khan ◽  
Fatima Ahmed ◽  
Anand Marya ◽  
...  
Keyword(s):  
Bone Growth ◽  
Cell Attachment ◽  
Platelet Rich Plasma ◽  
Blood Clot ◽  
Permanent Teeth ◽  
Clinical Practices ◽  
Platelet Rich Fibrin ◽  
Regenerative Endodontics

Regenerative endodontics has introduced numerous procedures such as pulp implantation, revascularization, and postnatal stem cell therapy. Revascularization has been successfully implemented clinically nowadays, thus providing dentists with outrageous results. Platelet-rich fibrin (PRF) used either alone or along with bone graft promotes bone growth and vascularization. This matrix promotes migration, cell attachment, and proliferation of osteoblast that leads to bone formation. PRF consists of a packed fibrin complex consisting of leukocytes, cytokines, and glycoproteins such as thrombospondin. The usage of PRF has reported high success rates in surgical cases such as sinus lift procedures, healing of extraction sockets, and management of periapical abscesses. Compared to platelet-rich plasma, PRF is more economical, easy to prepare, and feasible to use in daily clinical practices. Revascularization compromised the induction of a blood clot into the root canal space, which emerged as a clinical triumph. This further led to platelet concentrates as an autologous scaffold on which revascularization could occur. The applications of PRF in regenerative endodontics are numerous, such as an agent for repairing iatrogenic perforation of the pulpal floor and for the revascularization of immature permanent teeth with necrotic pulps. It acts as a matrix for tissue ingrowth. Evidence of progressive thickening of dentinal walls, root lengthening, regression in the periapical lesion, and apical closure was reported. Further studies are needed to clarify the precise mechanism of action of PRF for dental pulp regeneration both in vitro and in vivo. The current review aims at the present uses of PRF in regenerative endodontics dentistry and its application with future recommendations and limitations.

scholarly journals Regenerating the Pulp–Dentine Complex Using Autologous Platelet Concentrates: A Critical Appraisal of the Current Histological Evidence

2020 ◽  
Author(s):  
Amna Riaz ◽  
Furqan A. Shah
Keyword(s):  
De Novo ◽  
Platelet Rich Plasma ◽  
Blood Clot ◽  
Permanent Teeth ◽  
Morphological Evidence ◽  
Wall Thickening ◽  
Platelet Concentrates ◽  
Pulp Tissue ◽  
True Nature ◽  
Autologous Platelet

Background: Autologous platelet concentrates such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have gained overwhelming popularity in regenerative endodontics. Clinical evidence reveals the lack of a particular advantage of using PRP or PRF over an evoked blood clot in promoting canal wall thickening and/or continued root development in immature necrotic teeth. Moreover, despite stimulating tissue repair and repopulating the root canals of immature and mature permanent teeth, the new vital tissue may not possess the functional activity of the native pulp tissue. Methods: To better understand the origin, nature, and long-term fate of the tissue types found within the pulp space, we critically examine all available histo-/morphological evidence for pulp–dentine complex regeneration using PRP and/or PRF, alone or together with an evoked blood clot, specialised or unspecialised primary cells, and other biomaterials. Results: Histological data from clinical studies is scant. Reportedly, the inner dentinal surface supports cementum-like tissue formation, but this interface likely deviates in structure and function from the native cementodentinal junction. Presence of bone-like tissue within the pulp space is intriguing since de novo osteogenesis requires closely coordinated recruitment and differentiation of osteoprogenitor cells. Compared to untreated necrotic teeth, an evoked blood clot (with/without PRF) improves fracture resistance. Tooth regeneration using PRF and dental bud cells is unreliable and the constituent neoformed tissues are poorly organised. Conclusion: PRP/PRF fail to demonstrate a significant advantage over an induced blood clot, alone. The true nature of neoformed tissues remains poorly characterised while their response to subsequent insult/injury is unexplored.

scholarly journals Role of platelet-rich plasma in the treatment of osteoarthritis: a meta-analysis

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096466
Author(s):  
Haijiang Ren ◽  
Shouwei Zhang ◽  
Xuejie Wang ◽  
Zehui Li ◽  
Wenlai Guo
Keyword(s):  
Patient Satisfaction ◽  
Clinical Efficacy ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Womac Score ◽  
Cochrane Library ◽  
Control Group ◽  
Absolute Value ◽  
Vas Score ◽  
The Absolute

Objective The clinical efficacy of platelet-rich plasma (PRP) in the treatment of osteoarthritis remains controversial. In this paper, we evaluated the clinical efficacy of PRP in the treatment of osteoarthritis using meta-analysis, providing evidence for the selection of clinical treatment options. Methods We performed a computer-based search of PubMed, Embase, and the Cochrane Library databases to retrieve articles using the search terms “platelet-rich plasma”, “osteoarthrosis”, and “knee joint”. Quality evaluation and data extraction were performed. The combined effect was assessed using RevMan 5.3 software. Results Five randomized controlled trials, involving 320 patients, were included in this study. No significant differences were observed in the International Knee Documentation Committee score, visual analog scale (VAS) score, or the absolute value of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score between the experimental and control groups. The absolute value of the VAS score and change in the WOMAC score were significantly decreased and patient satisfaction was increased in the experimental group, as compared with the control group. Conclusion The findings of this meta-analysis suggest that intra-articular injection of PRP is an effective treatment for osteoarthritis that can reduce post-operative pain, improve locomotor function, and increase patient satisfaction.

Platelet-Rich Plasma Versus Corticosteroid Injections in the Management of Elbow Epicondylitis and Plantar Fasciitis: An Updated Systematic Review and Meta-analysis

2019 ◽  
Vol 48 (10) ◽  
pp. 2572-2585 ◽  
Author(s):  
Kai Huang ◽  
Grey Giddins ◽  
Li-dong Wu
Keyword(s):  
Systematic Review ◽  
Clinical Efficacy ◽  
Effect Size ◽  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Medium Effect ◽  
Large Effect Size ◽  
Short Term

Background: Platelet-rich plasma (PRP), as a promising alternative to traditional corticosteroid (CS), is now increasingly used in the treatment of elbow epicondylitis (EE) and plantar fasciitis (PF). To date, however, the synthesis of information on the clinical efficacy of PRP versus CS is limited with divergent conclusions. Purpose: To compare the clinical efficacy of PRP and CS injections in reducing pain and improving function in EE and PF. Study Design: Systematic review and meta-analysis. Methods: Online databases were searched from inception to October 2018 for prospective studies evaluating PRP versus CS injections for EE or PF. Independent reviewers undertook searches, screening, and risk-of-bias appraisals. The primary outcomes of interest were pain and function in both the short term (1-3 months) and the long term (≥6 months). Results: Twenty trials with 1268 participants were included. For EE, PRP provides a statistically and clinically meaningful long-term improvement in pain, with a very large effect size of −1.3 (95% CI, −1.9 to −0.7) when compared with CS, but the evidence level was low. For EE, there was moderate evidence that CS provides a statistically meaningful improvement in pain in the short term, with a medium effect size of 0.56 (95% CI, 0.08-1.03) as compared with PRP; this improvement might not be clinically significant. For PF, there was low evidence that PRP provides a statistically and clinically meaningful long-term improvement in function (American Orthopedic Foot & Ankle Society score), with a very large effect size of 1.94 (95% CI, 0.61-3.28). There were no significant differences between the groups in improvement in function in EE and pain and short-term function in PF, but the quality of the evidence was low. Conclusion: The use of PRP yields statistically and clinically better improvement in long-term pain than does CS in the treatment of EE. The use of PRP yields statistically and clinically better long-term functional improvement than that of CS in the treatment of PF.

Evaluation of platelet-rich plasma and fibrin matrix to assist in healing and repair of rotator cuff injuries: a systematic review and meta-analysis

2016 ◽  
Vol 31 (2) ◽  
pp. 158-172 ◽  
Author(s):  
Chun-Jiang Fu ◽  
Jia-Bing Sun ◽  
Zheng-Gang Bi ◽  
Xu-Ming Wang ◽  
Cheng-Lin Yang
Keyword(s):  
Rotator Cuff ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Post Treatment ◽  
Score Change ◽  
Platelet Rich Fibrin ◽  
Fibrin Matrix ◽  
Rotator Cuff Injuries ◽  
Functional Scores ◽  
Standard Difference

Objective: To perform a meta-analysis examining the effectiveness of platelet-rich plasma and platelet-rich fibrin matrix for improving healing of rotator cuff injuries. Data sources/design: A meta-analysis of eligible studies was performed after searching Medline, Cochrane, and EMBASE on 14 December 2015. Setting: University hospital. Participants: Patients with rotator cuff injuries. Review methods/intervention: Databases were searched using the keywords “PRP or platelet-rich plasma,” “PRFM or platelet-rich fibrin matrix,” “rotator cuff,” and “platelet-rich” for studies comparing outcomes of patients with rotator cuff injuries that did and did not receive a platelet-rich product. Main measures: The primary outcome was a functional score change from pre- to post-treatment (Scorepost–Scorepre). The secondary outcome was a visual analogue scale (VAS) pain score change from pre- to post-treatment (VASpost–VASpre). Results: A total of 11 studies were included in the meta-analysis. The total number of patients that received platelet-rich plasma or platelet-rich fibrin matrix was 320 and the number of control patients was 318. The standard difference in means of the functional scores was similar between patients administered platelet-rich plasma/fibrin matrix and patients in the control group (standard difference in means for functional scores = 0.029; 95% confidence interval (CI): –0.132 to 0.190; p = 0.725). The standard difference in means was similar between patients administered platelet-rich plasma and the controls (standard difference in means = 0.142; 95% CI: –0.080 to 0.364; p = 0.209). Conclusion: The results of this meta-analysis do not support the use of platelet-rich plasma/platelet-rich fibrin matrix in patients with rotator cuff injuries.

scholarly journals The Clinical Application Of Platelet Concentrates: A Systematic Meta-analysis

2015 ◽  
Vol 5 (1) ◽  
pp. 21-26
Author(s):  
Sneha Ketan Gada
Keyword(s):  
Clinical Application ◽  
Oral Surgery ◽  
Therapeutic Potential ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Pediatric Dentistry ◽  
Platelet Concentrates ◽  
Bone Contact ◽  
Platelet Rich Fibrin ◽  
Regenerative Dentistry

ABSTRACT Background Autologous plasma rich in platelets is derived blood product whose uses in dentistry dates back to the 1990s and it has been gaining popularity ever since. Aim A systematic review of the available literature to determine the efficacy, safety and success of platelet concentrates in physiological systems as well as describing its vigilant use. Study design and methods A Medline search with keywords ‘platelet rich plasma dental’ further filtered using Boolean opera- tors (AND, OR, NOT) and combination of specific keywords as follows: ‘platelet rich fibrin’, ‘platelet rich plasma regenerative’, ‘platelet rich plasma periodontal’, ‘platelet rich plasma extraction’ with a custom range of 10 years was performed, which yielded 88 results out of which 32 were selected based on the inclusion criteria. Results Significantly, successful outcomes have been wit- nessed in the field of osteoregeneration though it has been evidenced that adequate platelet rich plasma (PrP) additives are essential to bear a therapeutic potential. Favoring blood cell adhesion on the root surface optimizing periodontal healing, PrP has also shown positive effect on gingival repair; though controversial facts have also been reported. In the scope of implant dentistry, PrP has also reported greater implant-bone contact when used in both gel or liquid form. Emerging as a possible pulp capping agent along with properties of decreased chances root growth, PrP has successfully completed apexo- genesis in cases of pulpotomy.   Research has shown that although clinical results from the comparison of PrP alone vs PrP and resorbable membrane or various graft materials has shown a varied results, additional research in the field is needed. Conclusion Platelet rich plasma has shown promising results in the field of regenerative dentistry, with high success rate in implantology, periodontology and oral surgery. Because of conflicting success rates reported in literature further research is warrented. Clinical implication Platelet rich fibrin has displayed various features of rapid clinical healing, excellent bone density, less surgical time, less resorption during healing and decreased postoperative pain, as compared to guided bone regeneration procedures. Platelet rich plasma has also shown a myriad of applications ranging from hard tissue regeneration to soft tissue management, stretching across to the field of pediatric dentistry and endodontics. How to cite this article Gada SK, Gupta P. the Clinical Application of Platelet Concentrates: A Systematic Meta- analysis. Int J Prosthodont restor Dent 2015;5(1):21-26.

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