scholarly journals The 3 R’s for Platelet-Rich Fibrin: A “Super” Tri-Dimensional Biomaterial for Contemporary Naturally-Guided Oro-Maxillo-Facial Soft and Hard Tissue Repair, Reconstruction and Regeneration

Materials ◽  
2018 ◽  
Vol 11 (8) ◽  
pp. 1293 ◽  
Author(s):  
Consuelo Zumarán ◽  
Marcelo Parra ◽  
Sergio Olate ◽  
Eduardo Fernández ◽  
Francisco Muñoz ◽  
...  

Platelet-Rich fibrin (PRF) is a three-dimensional (3-D) autogenous biomaterial obtained via simple and rapid centrifugation from the patient’s whole blood samples, without including anti-coagulants, bovine thrombin, additives, or any gelifying agents. At the moment, it is safe to say that in oral and maxillofacial surgery, PRFs (particularly, the pure platelet-rich fibrin or P-PRF and leukocyte and platelet-rich fibrin or L-PRF sub-families) are receiving the most attention, essentially because of their simplicity, cost-effectiveness, and user-friendliness/malleability; they are a fairly new “revolutionary” step in second-generation therapies based on platelet concentration, indeed. Yet, the clinical effectiveness of such surgical adjuvants or regenerative platelet concentrate-based preparations continues to be highly debatable, primarily as a result of preparation protocol variability, limited evidence-based clinical literature, and/or poor understanding of bio-components and clinico-mechanical properties. To provide a practical update on the application of PRFs during oral surgery procedures, this critical review focuses on evidence obtained from human randomized and controlled clinical trials only. The aim is to serve the reader with current information on the clinical potential, limitations, challenges, and prospects of PRFs. Accordingly, reports often associate autologous PRFs with early bone formation and maturation; accelerated soft-tissue healing; and reduced post-surgical edema, pain, and discomfort. An advanced and original tool in regenerative dentistry, PRFs present a strong alternative and presumably cost-effective biomaterial for oro-maxillo-facial tissue (soft and hard) repair and regeneration. Yet, preparation protocols continue to be a source of confusion, thereby requiring revision and standardization. Moreover, to increase the validity, comprehension, and therapeutic potential of the reported findings or observations, a decent analysis of the mechanico-rheological properties, bio-components, and their bioactive function is eagerly needed and awaited; afterwards, the field can progress toward a brand-new era of “super” oro-dental biomaterials and bioscaffolds for use in oral and maxillofacial tissue repair and regeneration, and beyond.

2019 ◽  
Vol 36 (2) ◽  
pp. 109-123 ◽  
Author(s):  
Kristina Feigin ◽  
Bonnie Shope

Platelet concentrates, mostly represented by platelet-rich plasma and platelet-rich fibrin, have gained significant interest in various medical and oral disciplines because of their potential to stimulate and boost regeneration of hard and soft tissues. Prepared from the patient’s own blood, they have been tested and used in various different surgical fields including oral and maxillofacial surgery. The effects of these biomaterials are described to be a result of the large concentration of platelets which contain a wide range of growth factors. The aim of this article is to introduce the principle and function of these platelet concentrates, to review their preparation, and to provide a comprehensive examination of the published oral and maxillofacial literature on this subject.


Author(s):  
Sneha Ketan Gada

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junya Kusumoto ◽  
Atsushi Uda ◽  
Takeshi Kimura ◽  
Shungo Furudoi ◽  
Ryosuke Yoshii ◽  
...  

Abstract Background In Japan, oral third-generation cephalosporins with broad-spectrum activity are commonly prescribed in the practices of dentistry and oral surgery. However, there are few reports on the appropriate use of antibiotics in the field of oral surgery. This study aimed to evaluate the appropriateness of antibiotic use before and after an educational intervention in the Department of Oral and Maxillofacial Surgery, Kobe University Hospital. Methods The use of oral antibiotics was investigated among inpatients and outpatients before and after an educational intervention conducted by the antimicrobial stewardship team. Additionally, the frequency of surgical site infection after the surgical removal of an impacted third mandibular molar under general anesthesia and the prevalence of adverse effects of the prescribed antibiotics were comparatively evaluated between 2013 and 2018. Results After the educational intervention, a remarkable reduction was noted in the prescription of oral third-generation cephalosporins, but increased use of penicillins was noted among outpatients. There was reduced use of macrolides and quinolones in outpatients. Although a similar trend was seen for inpatients, the use of quinolones increased in this population. Despite the change in the pattern of antibiotic prescription, inpatients who underwent mandibular third molar extraction between 2013 and 2018 did not show a significant increase in the prevalence of surgical site infections (6.2% vs. 1.8%, p = .336) and adverse effects of drugs (2.1% vs. 0%, p = .466). Conclusions This study suggests that the judicious use of oral antibiotics is possible through conscious and habitual practice of appropriate antibiotic use. However, further investigation is required to develop measures for appropriate use of oral antibiotics.


2021 ◽  
Vol 2020 (2) ◽  
pp. 1
Author(s):  
Ciprian Roi ◽  
Emilia Ianeș ◽  
Diana Nica ◽  
Alexandra Roi ◽  
Laura Cristina Rusu ◽  
...  

(1) Background: Oronasal communication is described in the scientific literature as a common complication that occurs after a cleft palate surgery. In some cases, it can also be a consequence of oral surgery procedures; the main problem of this type of rare accident is related to the correct healing process and treatment option. (2) Case report: A patient with oronasal communication caused by an unsuccessful attempt of a superior canine odontectomy presented at the Emergency Department of the Oral and Maxillofacial Surgery Hospital, Timișoara. The case management is described from the first consult to one-year follow-up. We consider that this pathology was optimally treated surgically, and the results are more than satisfactory, taking into consideration the high rates of recurrence. (3) Conclusion: This case report can be a useful to a general dentist who is trying to decide whether to perform the canine odontectomy or refer to a specialist surgeon due to the accidents and complications of this procedure.


2020 ◽  
Vol 102 (1) ◽  
pp. 9-13
Author(s):  
H Mahmood ◽  
I Siddique ◽  
A McKechnie

Introduction An increasing number of patients are taking oral antiplatelet agents. As a result, there is an important patient safety concern in relation to the potential risk of bleeding complications following major oral and maxillofacial surgery. Surgeons are increasingly likely to be faced with a dilemma of either continuing antiplatelet therapy and risking serious haemorrhage or withholding therapy and risking fatal thromboembolic complications. While there are national recommendations for patients taking oral antiplatelet drugs undergoing invasive minor oral surgery, there are still no evidence-based guidelines for the management of these patients undergoing major oral and maxillofacial surgery. Methods MEDLINE and EMBASE databases were searched to retrieve all relevant articles published to 31 December 2017. Findings A brief outline of the commonly used antiplatelet agents including their pharmacology and therapeutic indications is discussed, together with the haemorrhagic and thromboembolic risks of continuing or altering the antiplatelet regimen in the perioperative period. Finally, a protocol for the management of oral and maxillofacial patients on antiplatelet agents is presented. Conclusions Most current evidence to guide decision making is based upon non-randomised observational studies, which attempts to provide the safest possible management of patients on antiplatelet therapy. Large randomised clinical trials are lacking.


2019 ◽  
Vol 160 (35) ◽  
pp. 1380-1386
Author(s):  
Ilona Szmirnova ◽  
Emese Gellérd ◽  
Gábor Tamás Pintér ◽  
György Szmirnov ◽  
Zsolt Németh ◽  
...  

Abstract: Introduction: Dental care for mentally disabled people poses a growing challenge for healthcare. In Hungary, the number of mentally disabled people needing special dental care is ca. 100 000. Aim: The aim of our retrospective analysis is to provide a summary of the demographic data and the treatment outcomes of patients with mental disorders treated at the Department of the Oral and Maxillofacial Surgery of the Semmelweis University in the past five years. Method: Dental care for patients with a severe level of mental disability can be carried out in general anaesthesia only. At Semmelweis University, in the Oral and Maxillofacial Department, 1717 mentally disabled adults received dental care during the past five years. (Patients included people with a mild, medium or severe level of mental disability, patients with Down’s syndrome, autism, epilepsy or panic disorder.) Results: The single biggest achievement seems to be the fact that the issue of acute dental care and oral surgery has basically been settled. A workable relationship has been forged with foundations and organizations dealing with the problems of these patients. It has been realized, however, that in the case of mentally disabled patients there is an enormous need for prevention and ongoing care. Conclusions: Up to now no survey has been carried out in Hungary with the aim of objectively revealing the dental care needs of these patients. Internationally, however, several surveys have been published. It can be stated on the basis of these that both caries frequency and the presence of parodontal diseases increase in correlation with age and the level of disability. Oral hygiene is insufficient, patients or their caretakers do not get proper information, only a few of them receive adequate training and they are not motivated to keep up oral health. Dental care, except for tending acute cases, is not satisfactory. For the sake of prevention, cooperation is needed with non-governmental organizations, foundations, special education teachers and psychiatrists specialized in this field. Orv Hetil. 2019; 160(35): 1380–1386.


2019 ◽  
Vol 24 (2) ◽  
pp. 569-584 ◽  
Author(s):  
Franz-Josef Strauss ◽  
Jila Nasirzade ◽  
Zahra Kargarpoor ◽  
Alexandra Stähli ◽  
Reinhard Gruber

Abstract Objective To systematically assess the effects of platelet-rich fibrin (PRF) on in vitro cellular behavior. Methods A systematic electronic search using MEDLINE database was performed. In vitro studies using PRF were considered and articles published up to June 31, 2018 were screened. Eligible studies were selected based on the use of human PRF. Results In total, 1746 titles were identified with the search terms, from these 37 met the inclusion criteria and were chosen for data extraction. In addition, 16 new studies, mainly published in 2019, were also included in the analysis resulting in 53 studies. No meta-analysis could be performed due to the heterogeneity of study designs. Included studies show that PRF enhances proliferation, migration, adhesion, and osteogenic differentiation on a variety of cell types along with cell signaling activation. Furthermore, PRF reduces inflammation, suppresses osteoclastogenesis, and increases the expression of various growth factors in mesenchymal cells. Summary and conclusions Despite some notable differences of the studies, the overall findings suggest a positive effect of PRF on cell proliferation, migration, adhesion, differentiation, and inflammation pointing towards a therapeutic potential in regenerative dentistry. Clinical relevance PRF serves as a reservoir of bioactive molecules to support wound healing and bone regeneration. Although the cellular mechanisms by which PRF supports the clinical outcomes remain unclear, in vitro research provides possible explanations. This systematic review aims to provide an update of the existing research on how PRF affects basic physiological processes in vitro. The overall findings suggest that PRF induces cell proliferation, migration, adhesion, and differentiation along with possessing anti-inflammatory properties further supporting its therapeutic potential in wound healing and bone regeneration.


2013 ◽  
Vol 4 (3) ◽  
pp. 110-111 ◽  
Author(s):  
Bernie Speculand

The April issue of the FDJ was devoted to a series of articles about the specialty of oral surgery (OS), relating to both work and workforce. A twin track response by UK oral and maxillofacial surgeons may be summarised as a feeling that the debate so far has been rather one-sided and has not included any contribution from oral and maxillofacial surgeons, and a feeling that the Faculty of Dental Surgery (FDS) is less interested in and supportive of the specialty of oral and maxillofacial surgery (OMFS) than it used to be (regardless of whether this is true).


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