Platelet rich fibrin is not a barrier membrane!Or is it?

Platelet-rich fibrin(PRF)is widely used in dentistry and other fields of medicine,and its use has become popular in dental implantology.In several published studies,PRF has been used as a barrier membrane.A barrier membrane is a sheet of a certain material that acts as a biological and mechanical barrier against the invasion of cells that are not involved in bone formation,such as epithelial cells.Among the basic requirements of a'barrier membrane,occlusivity,stiffness,and space maintenance are the criteria that PRF primarily lacks;therefore,it does not fall under the category of barrier membranes.However,there is evidence that PRF membranes are useful in significantly improving wound healing.Does the PRF membrane act as a barrier?Should we think of adding or subtracting some points from the ideal requirements of a barrier membrane,or should we coin a new term or concept for PRF that will incorporate some features of a barrier membrane and be a combination of tissue engineering and biotechnology?This review is aimed at answering the basic question of whether the PRF membrane should be considered a barrier membrane or whether it is something more beyond the boundaries of a barrier membrane.

The Role of Leukocyte and Platelet-Rich Fibrin in Enhancing the Healing of Extraction Sockets: An Overview of the Literature

Introduction: Leukocyte and platelet-rich fibrin (L-PRF) is an emerging material in dentistry, however, there are controversies surrounding its effectiveness. Despite the amount of literature available, debates regarding its effect continue. This review aims to summarize and clarify the data surrounding the use of L-PRF in promoting the healing of extraction sockets, which may offer a better outcome for future treatments. Purpose: The purpose of this review is to evaluate the current literature on the use of L-PRF in promoting the healing of extraction sockets, and to provide a comprehensive overview of the available evidence. Methods: A comprehensive computer-based search of databases such as PubMed, Medline, and Cochrane Library was conducted. Results: The results of this review suggest that L-PRF has shown promise in promoting early healing of extraction sockets, but the evidence for its effectiveness over a longer period is limited. Conclusion: Although L-PRF has shown promising results in the early healing periods, its effectiveness over a longer healing period cannot be confirmed based on the available data. More clinical trials with standardized protocols and consistent measurement methods are needed to establish the role of L-PRF in enhancing the healing of extraction sockets.

Evaluating the Benefits of Platelet Rich-Fibrin in Periodontal Regeneration: A Literature Review

Introduction: Platelet Rich-Fibrin (PRF) is a biological matrix derived from a patient’s own blood, rich in growth factors and platelets. Its use in various periodontal and non-periodontal procedures is gaining recognition due to its potential in promoting tissue regeneration. The purpose of this review was to evaluate the benefits of using PRF in intra-bony defect regeneration, guided-bone regeneration, and sinus floor elevation. Methods: The study searched PubMed for manuscripts published between 2017 and 2022 to better understand the clinical and radiological effects of PRF. The manuscripts were divided into the following sections: intra-bony defect regeneration, guided-bone regeneration, and sinus floor elevation. Results: In intra-bony defects, PRF improved clinical and radiological parameters when compared with OFD alone, with a significant difference in wound healing at 7 days. In GBR, a CBCT evaluation shows no statistical difference between the PRF-autogenous bone complex group and the bovine bone-collagen membrane complex regarding volume change of the augmented bone with a 16% rate of bone loss following a 6-month healing period. Also, a slight increase in bone thickness has been seen when liquid PRF is used. In sinus floor elevation, results revealed no differences in graft volume between PRF group and control group at any of the evaluated time points. Although higher implant stability immediately postoperatively, higher new bone formation, the lesser amount of residual graft and earlier implant placement. Conclusion: Platelet Rich-Fibrin is widely accepted for use in periodontal surgery and dentistry due to its minimally invasive nature and low risk of adverse effects, with positive results in tissue regeneration. There is evidence that PRF leads to improved and faster healing, as well as cost-effective regenerative procedures compared to other treatments.

Autologous Adipose-Derived Mesenchymal Stem Cells Embedded in Platelet-Rich Fibrin in Diabetic Foot Ulcers

Context and Aim: Mesenchymal stem cells (MSCs) and platelet-rich fibrin (PRF) have emerged as ideal candidates for advanced therapies of various therapeutically-challenging diseases;however, their regenerative potential in diabetic foot ulcers (DFU) has not been well determined. In this study, we reviewed our clinical experience in mitigating chronic ulcer complications of diabetic foot through a conventional treatment of autologous adipose-derived MSCs embedded in PRF with pure PRF injections. Materials and Methods: The present study was carried out in 10 patients with an open DFU wound selected over a period of 1 year starting from April 2019. Patients were either injected with PRF alone (Group A) or injected with MSCs derived from adipose tissue (ADMSC) embedded in (PRF (Group B). Results: Patients in Group B had a better healing index when compared to Group A. Conclusion: Use of ADMSC embedded in PRF showed promising results to treat DFU.

Platelet-rich fibrin-induced bone marrow mesenchymal stem cell differentiation into osteoblast-like cells and neural cells

Bone marrow mesenchymal stem cells were allowed to develop for 14 days in a platelet-rich fibrin environment.Results demonstrated that platelet-rich fibrin significantly promoted bone marrow mesenchymal stem cell proliferation.In addition,there was a dose-dependent increase in Runt-related transcription factor-2 and bone morphogenetic protein-2 mRNA expression,as well as neuron-specific enolase and glial acidic protein.Results showed that platelet-rich fibrin promoted bone marrow mesenchymal stem cell proliferation and differentiation of osteoblast-like cells and neural cells in a dose-dependent manner.

Flapless immediate implant placement into fresh molar extraction socket using platelet-rich fibrin: A case report

BACKGROUND There are some challenges concerning immediate implant placement in the molar region.Platelet-rich fibrin(PRF),an autologous biomaterial,has been used widely for periodontal intra-bony defects,sinus augmentation,socket preservation,and gingival recession.However,the literature remains scarce for reports on immediate implants with PRF,particularly in the case of fresh molar extraction socket.CASE SUMMARY The patient was a 43-year-old woman with maxillary molar vertical crown-root fracture.She underwent flapless immediate implant placement into the fresh molar socket with PRF.At the follow-up visit 15 d post procedure,the vascularization of soft tissue was visible.There was no swelling or pain after the surgery.Six months postoperatively,the regeneration of bone and soft tissues was visible.Subsequently,the definitive restoration was placed.The patient was satisfied with the aesthetic outcomes.CONCLUSION The flapless immediate implant placement into the fresh molar socket with PRF is a feasible procedure.This case report demonstrates that PRF promotes bone and soft tissue regeneration apart from having an enhanced anti-inflammatory ability.Furthermore,the procedure involves a minimally invasive technique,thus reducing the surgical complexity.

Early therapeutic effect of platelet-rich fibrin combined with allogeneic bone marrow-derived stem cells on rats’ critical-sized mandibular defects

BACKGROUND Critically sized bone defects represent a significant challenge to orthopaedic surgeons worldwide.These defects generally result from severe trauma or resection of a whole large tumour.Autologous bone grafts are the current gold standard for the reconstruction of such defects.However,due to increased patient morbidity and the need for a second operative site,other lines of treatment should be introduced.To find alternative unconventional therapies to manage such defects,bone tissue engineering using a combination of suitable bioactive factors,cells,and biocompatible scaffolds offers a promising new approach for bone regeneration.AIM To evaluate the healing capacity of platelet-rich fibrin(PRF)membranes seeded with allogeneic mesenchymal bone marrow-derived stem cells(BMSCs)on critically sized mandibular defects in a rat model.METHODS Sixty-three Sprague Dawley rats were subjected to bilateral bone defects of critical size in the mandibles created by a 5-mm diameter trephine bur.Rats were allocated to three equal groups of 21 rats each.Group I bone defects were irrigated with normal saline and designed as negative controls.Defects of group II were grafted with PRF membranes and served as positive controls,while defects of group III were grafted with PRF membranes seeded with allogeneic BMSCs.Seven rats from each group were killed at 1,2 and 4 wk.The mandibles were dissected and prepared for routine haematoxylin and eosin(HE)staining,Masson's trichrome staining and CD68 immunohistochemical staining.RESULTS Four weeks postoperatively,the percentage area of newly formed bone was significantly higher in group III(0.88±0.02)than in groups I(0.02±0.00)and II(0.60±0.02).The amount of granulation tissue formation was lower in group III(0.12±0.02)than in groups I(0.20±0.02)and II(0.40±0.02).The number of inflammatory cells was lower in group III(0.29±0.03)than in groups I(4.82±0.08)and II(3.09±0.07).CONCLUSION Bone regenerative quality of critically sized mandibular bone defects in rats was better promoted by PRF membranes seeded with BMSCs than with PRF membranes alone.

Platelet-rich plasma,an adjuvant biological therapy to assist peripheral nerve repair

Therapies such as direct tension-free microsurgical repair or transplantation of a nerve autograft,are nowadays used to treat traumatic peripheral nerve injuries（PNI）,focused on the enhancement of the intrinsic regenerative potential of injured axons.However,these therapies fail to recreate the suitable cellular and molecular microenvironment of peripheral nerve repair and in some cases,the functional recovery of nerve injuries is incomplete.Thus,new biomedical engineering strategies based on tissue engineering approaches through molecular intervention and scaffolding offer promising outcomes on the field.In this sense,evidence is accumulating in both,preclinical and clinical settings,indicating that platelet-rich plasma products,and fibrin scaffold obtained from this technology,hold an important therapeutic potential as a neuroprotective,neurogenic and neuroinflammatory therapeutic modulator system,as well as enhancing the sensory and motor functional nerve muscle unit recovery.

Platelet-rich plasma gel in combination with Schwann cells for repair of sciatic nerve injury

Bone marrow mesenchymal stem cells were isolated from New Zealand white rabbits, culture-expanded and differentiated into Schwann cell-like cells. Autologous platelet-dch plasma and Schwann cell-like cells were mixed in suspension at a density of 1 x 106 cells/mL, prior to introduction into a poly （lactic-co-glycolic acid） conduit. Fabricated tissue-engineered nerves were implanted into rabbits to bridge 10 mm sciatic nerve defects （platelet-rich plasma group）. Controls were established using fibrin as the seeding matrix for Schwann cell-like cells at identical density to construct tissue-engineered nerves （fibrin group）. Twelve weeks after implantation, toluidine blue staining and scanning electron microscopy were used to demonstrate an increase in the number of regenerating nerve fibers and thickness of the myelin sheath in the platelet-rich plasma group compared with the fibrin group. Fluoro-gold retrograde labeling revealed that the number of Fluoro-gold-positive neurons in the dorsal root ganglion and the spinal cord anterior horn was greater in the platelet-rich plasma group than in the fibrin group. Electrophysiological examination confirmed that compound muscle action potential and nerve conduction velocity were superior in the platelet-rich plasma group compared with the fibrin group. These results indicate that autologous platelet-rich plasma gel can effectively serve as a seeding matrix for Schwann cell-like cells to construct tissue-engineered nerves to promote perJpheral nerve regeneration.

富血小板纤维蛋白对难愈合创面炎症反应的影响

目的:研究富血小板纤维蛋白(Platelet-Rich Fibrin,PRF)对难愈合创面炎症反应的影响。方法:将2020年9月至2022年12月承德医学院附属医院烧伤整形科确诊的难愈合创面患者,完全随机分为PRF组、对照组,每组各20例,入院后均进行创面清创碘伏消毒,PRF组创面外敷PRF,隔日换药;对照组无菌敷料包扎换药治疗。于治疗前、治疗后第7天和第14天留取创面组织,进行HE染色来观察创面病理学变化;抽取静脉血分别检测白细胞(White Blood Cell,WBC)、C反应蛋白(C-Reac-tive Protein,CRP)和降钙素原(Procalcitonin,PCT)水平变化;创面组织进行CD34免疫组织化学染色,观察治疗前后创面血管化情况;通过流式细胞术比较治疗前与治疗后第7天患者血液中CD4^(+)T细胞与CD8^(+)T细胞水平变化以及CD4^(+)T/CD8^(+)T比值。结果:两组患者在性别、年龄和入院前病程的比较,差异均无统计学意义(P>0.05)。HE染色显示,在治疗前,两组患者创面均可见大量炎症细胞浸润,可见少量血管;治疗后第7天,PRF组的炎性细胞浸润减少,血管新生,治疗后第14天,PRF组炎性细胞明显减少,上皮增生,出现新生的皮肤附属器。WBC、CRP、PCT水平,治疗前差异无统计学意义(P>0.05),在治疗后的第7天和第14天时,炎症指标均下降,并且两组差异有统计学意义(P<0.05)。在治疗后第7、14天,PRF组CD34阳性表达细胞多于对照组,新生血管较多,创面上皮化出现也早于对照组。治疗前两组患者CD4^(+)T细胞、CD8^(+)T细胞和CD4^(+)/CD8^(+)比值无统计学意义(P>0.05);在治疗后第7天,两组患者的CD4^(+)T和CD4^(+)/CD8^(+)比值细胞均有上升,CD8^(+)T细胞均有下降,两组患者CD4^(+)T细胞、CD8^(+)T细胞及CD4^(+)/CD8^(+)比值比较具有统计学差异(P<0.05)。结论:PRF应用于难愈合创面,能减轻创面炎症反应,改善创面血液循环和免疫功能。

自体富白细胞-血小板纤维蛋白凝胶与腘绳肌腱修复创伤性髌骨脱位

背景:临床上创伤性髌骨脱位合并内侧髌股韧带股骨止点或体部撕裂多采用内侧髌股韧带重建手术,为促进内侧髌股韧带重建术后的腱骨愈合,研究者采用了包括生长因子、干细胞、富血小板血浆在内的多种生物治疗技术。目的:探讨自体富白细胞-血小板纤维蛋白凝胶联合腘绳肌腱重建内侧髌股韧带修复创伤性髌骨脱位的临床疗效。方法:选择2019年2月至2021年2月秦皇岛市第一医院诊治的创伤性髌骨脱位患者37例,采用随机数字表法分为试验组(n=18)与对照组(n=19),试验组接受自体富白细胞-血小板纤维蛋白凝胶联合自体腘绳肌腱重建内侧髌股韧带手术,对照组接受单纯自体绳肌腱重建内侧髌股韧带手术。两组患者术后随访12个月,通过目测类比评分、Lysholm评分、Kujala髌股关节评分及膝关节活动度评估患者膝关节疼痛及功能状态,通过MRI及CT片测量髌股关节髌骨倾斜角、髌骨适合角及髌骨外移率,评估髌股关节的稳定性及改善情况。结果与结论:①两组术后6,12个月的目测类比评分均低于术前(P<0.05),术后6,12个月的Lysholm评分、Kujala髌股关节评分均高于术前(P<0.05);试验组术后6个月的Lysholm评分、Kujala髌股关节评分高于对照组(P<0.05),两组间术后12个月的目测类比评分、Lysholm评分、Kujala髌股关节评分比较差异无显著性意义(P>0.05);②两组术后12个月的髌股关节髌骨倾斜角、髌骨适合角、髌骨外移率及关节活动度测量值均较术前明显改善(P<0.05);试验组术后12个月的髌骨倾斜角小于对照组(P<0.05),两组间术后12个月的髌骨适合角、髌骨外移率及关节活动度及MRI评分比较差异无显著性意义(P>0.05);③结果表明,自体富白细胞-血小板纤维蛋白凝胶联合腘绳肌腱重建内侧髌股韧带能有效治疗创伤性髌骨脱位,改善膝关节功能,恢复髌骨的运动轨迹。

WHBE兔膝骨关节炎模型的建立与PRFr的干预研究

目的采用内侧副韧带和部分髌韧带切除术建立WHBE兔KOA模型并用富血小板纤维蛋白释放液(PRFr)干预,探讨WHBE兔KOA模型软骨损伤和炎症的机制以及PRFr干预疗效。方法取WHBE兔24只,随机分成3组,即对照(NC)组(n=6)、模型(KOA)组(n=12)和治疗(PRFr)组(n=6);其中KOA组和PRFr组分别于术后第7天和第14天时向两侧关节腔内注射生理盐水和PRFr 0.5 mL。造模4、8周时,各组动物进行行为学评分、X线影像学观察,并取血清进行ELISA检测IL-1β、TNF-α、MMP-13水平,4周时KOA组处理6只,8周时处理各组剩余动物,取兔双侧膝关节,进行大体评分,脱钙后行病理切片制作,然后进行HE染色、甲苯胺蓝染色和番红O固绿染色以及TGF-β、BMP3和NF-κB免疫组化表达检测。结果与NC组比,造模后WHBE兔Lequesne MG行为学评分,Mankin’s评分,Pelletier评分均显著升高(P<0.01),可见膝关节肿胀明显、关节疼痛刺激和活动受限明显,且X光显示软组织呈高密度阴影,关节积液较多,解剖观察显示关节面粗糙,病理观察显示软骨表面缺损,软骨细胞丢失或部分丢失,表明WHBE兔KOA模型成立。与KOA组比较,PRFr干预治疗后血清炎症水平(IL-1β、TNF-α、MMP-13)均显著降低(P<0.05,P<0.01),软骨表面粗糙程度低,大部分软骨细胞分布整齐;同时TGF-β、BMP3和NF-κB表达水平亦显著降低(P<0.01)。结论本研究成功建立了WHBE兔KOA模型,且PRFr可通过TGF-β/BMP和NF-κB途径改善WHBE兔KOA模型软骨损伤和炎症。

自体脂肪颗粒联合PRF移植填充矫治面部凹陷的效果及PRF对移植脂肪成活率的影响

目的:研究自体脂肪颗粒联合富血小板纤维蛋白(Platelet-rich fibrin,PRF)移植填充矫治面部凹陷的效果及PRF对移植脂肪成活率的影响。方法:选取2019年3月-2021年12月在笔者医院择期行脂肪颗粒移植填充手术的120例面部凹陷女性就医者,按照随机分组原则分为观察组和对照组,每组60例。两组均采取脂肪颗粒移植手术,观察组在移植自体脂肪颗手术基础上联合富血小板纤维蛋白治疗。术后6个月,比较两组移植脂肪的成活率及治疗效果。结果:观察组移植成活率显著高于对照组(P<0.05),且观察组治疗效果显著优于对照组(P<0.05);两组血肿情况、局部感染情况、坏死、脂肪液化、破溃、纤维囊肿发生情况比较,差异无统计学意义(P>0.05)。结论:自体脂肪颗粒移植联合PRF在面部凹陷填充中疗效确切,不仅提升了脂肪移植成活率,而且改善了面部凹陷情况,值得临床推广应用。

血浆基质在牙髓根尖周病治疗中的应用

血浆基质作为一种自体血液离心产物,具有再生修复的功能,已被广泛应用于口腔颌面部软硬组织再生修复、皮肤美容等领域,并取得了较好的效果。目前,牙髓再生治疗和根尖手术已成为保存牙髓以及保存患牙的主要方法,生物活性材料的应用至关重要,血浆基质作为一种自体生物活性材料,较易获取,可塑性强,具有天然优势。血浆基质可应用于以下情况:①无法刺激根尖出血的根尖孔未闭合年轻恒牙的牙髓血运重建术;②存在骨缺损的根尖屏障术及大面积穿孔髓室底或根侧壁修补术;③大面积根尖病变,伴或不伴随牙周疾病患牙的根尖手术。因血浆基质为自身血液来源制品,使用方面无明显禁忌。虽然已有系统综述表明,相比传统血凝块,血浆基质作为天然再生支架,可有效促进牙髓根尖周病的再生性修复。然而,由于血浆基质的特性受不同制备方式的影响,其适用范围有所差异。此外,目前尚缺乏血浆基质长期的临床研究结果,且组织学证据较难获取,仍然需要大量的体内外研究进一步探索。本文将对不同血浆基质在牙髓再生、根尖手术中的骨组织再生等方面的应用进行阐述,以期为临床医生在适应证选择及预后评估时提供参考。

“改良”上颌窦底提升

上颌后牙缺失时,由于缺乏牙的功能性刺激以及上颌窦气化作用导致种植所需的剩余骨高度不足,剩余骨量无法保证种植体的初始稳定性时,需要采取上颌窦底提升增加上颌后牙区骨量。“改良”上颌窦底内提升是通过使用富血小板纤维蛋白(platelet-rich fibrin,PRF),在内镜(endoscope)辅助下实现同期植入种植体(simultaneous implants placement)的一种改良的、微创的牙槽嵴入路上颌窦底提升(sinus floor elevation),简称“PESS”。“PESS”在一定程度上优化了上颌窦底提升,减小了手术创伤。本文阐述了“PESS”的原理、适应证、临床操作流程及注意事项,以期为“PESS”在临床中的应用提供技术支持。

A-PRF促进兔膝关节骨软骨损伤愈合的观察

目的·探讨改良型富血小板纤维蛋白(advanced platelet-rich fibrin,A-PRF)在骨软骨再生中的作用。方法·获取新西兰兔骨髓间充质干细胞(bone-marrow mesenchymal stem cells,BMSCs)和膝关节软骨细胞;通过低速离心兔心脏血液获得A-PRF。采用光学显微镜观察A-PRF的组织学结构;ELISA法检测A-PRF中生长因子,包括血小板衍生生长因子、转化生长因子-β、胰岛素样生长因子、血管内皮生长因子、表皮生长因子和成纤维细胞生长因子的释放;采用活/死细胞双染法及MTT法检测A-PRF对兔BMSCs细胞毒性及增殖情况的影响;采用实时荧光定量聚合酶链反应(qRT-PCR)检测A-PRF对兔BMSCsⅡ型胶原蛋白、聚集蛋白聚糖、碱性磷酸酶(ALP)和骨钙素(OCN)基因表达的影响;使用transwell小室测定A-PRF对于兔BMSCs以及软骨细胞迁移能力的影响。建立兔膝关节骨软骨缺损模型,将18只兔随机分为3组:A-PRF组(n=6)在缺损处植入A-PRF;A-PRF+BMSCs组(n=6)植入接种兔BMSCs的A-PRF;对照组(n=6)不进行植入操作。术后12周处死兔,采用苏木精-伊红(H-E)、甲苯胺蓝和番红O-固绿染色进行膝关节标本的组织学观察,并根据膝关节的表面形态学与组织学情况,采用国际软骨修复协会(International Cartilage Repair Society,ICRS)评分系统进行宏观与组织学评分。结果·A-PRF具有松散的网络结构,可以缓慢释放生长因子。加入A-PRF后,未观察到其对兔BMSCs具有细胞毒性;在加入A-PRF后24、48和72 h,BMSCs的增殖能力均明显升高(均P<0.05),成软骨相关基因Ⅱ型胶原蛋白、聚集蛋白聚糖,以及成骨相关基因ALP和OCN均显著上调(均P<0.05)。加入A-PRF后,兔BMSCs与软骨细胞的迁移能力均显著增强(均P<0.05),且兔BMSCs的迁移能力显著高于软骨细胞(P=0.025)。在兔膝关节缺损模型中,观察关节表面形态,可见A-PRF组和A-PRF+BMSCs组缺损均基本恢复,而对照组仅有软组织覆盖。在ICRS宏观评分方面,A-PRF组与A-PRF+BMSCs组的差异无统计学意义,但2组评分均显著高于对照组(均P<0.05)。组织学观察显示,A-PRF组和A-PRF+BMSCs组均产生骨软骨修复,但A-PRF组软骨更加成熟,对照组则形成纤维修复。在ICRS组织学评分方面,A-PRF组与A-PRF+BMSCs组的差异无统计学意义,但2组评分均显著高于对照组(均P<0.05)。结论·自体A-PRF具有良好的生物相容性和促进BMSCs增殖的能力,在体外和体内均可促进软骨和软骨下骨的修复。

富血小板纤维蛋白膜填塞联合硅油填充治疗高度近视黄斑裂孔伴视网膜脱离的效果评价

目的探讨富血小板纤维蛋白(PRF)膜填塞联合硅油填充在高度近视黄斑裂孔(HMMH)伴视网膜脱离(RD)治疗中的作用。方法采用随机对照研究方法,纳入2021年9月至2023年4月于武汉大学人民医院眼科中心检查确诊的HMMH伴RD患者52例52眼,采用随机数字表法随机分为3个组,均行23G标准三通道平坦部玻璃体切割术。其中内界膜(ILM)剥除组18例18眼,术中剥除ILM;ILM填塞组16例16眼,术中将翻转的ILM填塞裂孔;PRF填塞组18例18眼,使用PRF填塞裂孔。于术前和术后1周、1个月、3个月、6个月行眼压、最佳矫正视力(BCVA)测量,采用光学相干断层扫描测量黄斑中心凹视网膜厚度(CMT);于术前和术后6个月采用光学相干断层扫描血管成像测量浅层视网膜血流密度(SVD)和深层视网膜血流密度(DVD);以术后6个月为疗效判定点,对比3个组裂孔闭合率、视网膜复位率。结果术后6个月,ILM剥除组、ILM填塞组、PRF填塞组的裂孔闭合率分别为83.3%(15/18)、87.5%(14/16)和94.4%(17/18),各组间裂孔闭合率比较,差异无统计学意义(拟合χ^(2)=1.180,P>0.05);各组视网膜全部复位。ILM剥除组、ILM填塞组、PRF填塞组术后BCVA均较术前提升,差异均有统计学意义(均P<0.05)。术后6个月,PRF填塞组CMT较ILM剥除组和ILM填塞组厚,各组术后各时间点CMT较术前均明显下降,差异均有统计学意义(均P<0.05)。各组术后6个月SVD和DVD均高于术前,差异均有统计学意义(均P<0.05)。治疗和随访期间各组均未见眼内炎、玻璃体积血等严重并发症。ILM填塞组观察到4眼Müller细胞过度增殖,ILM剥除组和ILM填塞组未见Müller细胞过度增殖。结论PRF填塞联合硅油填充可促进HMMH伴RD患者的裂孔愈合和视网膜复位,改善视力和血流密度,是一种安全、有效的手术方式。

改良型富血小板纤维蛋白促进脂肪移植存活的最适混合比例实验研究

目的探索改良型富血小板纤维蛋白(A-PRF)促进脂肪移植存活的最适混合比例。方法酶消化法分离脂肪干细胞并培养,传代至第三代,抽取健康患者静脉血一次性制备A-PRF,以1:6、1:8、1:10、1:12、1:14五种混合比例分别与脂肪干细胞混合。取6周龄SPF级雌性裸鼠60只,随机分为5组,每组12只,分别将A-PRF以体积比1:6、1:8、1:10、1:12、1:14五种混合比例分别与人脂肪颗粒混合后注射至5组裸鼠背部,分别记为1:6、1:8、1:10、1:12、1:14组。于移植后4、8、12周以断颈法处死裸鼠,比较脂肪标本体积及质量变化;HE染色观察脂肪标本的血管密度及分布;分析囊腔/空泡占比、炎症反应程度、间质化纤维程度;免疫组化测定CD31蛋白含量。结果第24小时,5组迁移变化均不明显,在第48小时及72小时1:12组的细胞迁移程度明显高于其他组,差异具有统计学意义(P<0.05)。在第4、8及12周,1:12组的脂肪质量组织体积及质量的保留率最高,差异具有统计学意义(P<0.05)。HE染色结果显示,1:12组的囊腔/空泡占比、间质化纤维程度均为最低并伴有大量新生毛细血管,5组在第4周时炎性反应程度均较严重,在第8及第12周的炎性反应程度均较轻且差异不明显。CD31染色结果显示,1:12组的CD31蛋白含量较其他组明显升高,差异具有统计学意义(P<0.05)。结论改良型富血小板纤维蛋白促进脂肪移植存活的最适混合比例是1:12。

自体牙本质颗粒联合PRF在拔牙位点保存术中的应用1例

报告1例利用未脱矿的自体牙本质颗粒(UADP)联合自体血液浓缩物富血小板纤维蛋白(PRF),为左下颌第二磨牙进行拔牙位点保存术,术后3、 9、 24个月的CBCT显示骨量维持效果明显。组织学切片可见牙本质颗粒周围有大量新生骨形成。

富血小板纤维蛋白在口腔种植软组织处理中的应用

富血小板纤维蛋白(PRF)是一种从自体血液中提取的血小板浓缩制品,具有三维立体结构且富含血小板及高浓度的生长因子,因此被视为是一种结构稳定的、具有良好弹性且可促进组织愈合及再生的生物材料,具有可促进软硬组织愈合、抗炎及抗感染作用。近年PRF已广泛用于口腔软组织处理且获得良好的临床疗效。因此,深入了解PRF在口腔软组织中的基础研究及临床应用,可促进口腔颌面部软组织再生,为疾病的治疗提供参考依据。