Objective Diabetic foot ulcer(DFU)is one of the most serious complications of diabetes.Leukocyte-and platelet-rich fibrin(L-PRF)is a second-generation autologous platelet-rich plasma.This study aims to investigate the...Objective Diabetic foot ulcer(DFU)is one of the most serious complications of diabetes.Leukocyte-and platelet-rich fibrin(L-PRF)is a second-generation autologous platelet-rich plasma.This study aims to investigate the clinical effects of L-PRF in patients with diabetes in real clinical practice.Methods Patients with DFU who received L-PRF treatment and standard of care(SOC)from 2018 to 2019 in Tongji Hospital were enrolled.The clinical information including patient characteristics,wound evaluation(area,severity,infection,blood supply),SOC of DFU,and images of ulcers was retrospectively extracted and analyzed.L-PRF treatment was performed every 7±2 days until the ulcer exhibited complete epithelialization or an overall percent volume reduction(PVR)greater than 80%.Therapeutic effectiveness,including overall PVR and the overall and weekly healing rates,was evaluated.Results Totally,26 patients with DFU were enrolled,and they had an ulcer duration of 47.0(35.0,72.3)days.The severity and infection of ulcers varied,as indicated by the Site,Ischemia,Neuropathy,Bacterial Infection,and Depth(SINBAD)scores of 2–6,Wagner grades of 1–4,and the Perfusion,Extent,Depth,Infection and Sensation(PEDIS)scores of 2–4.The initial ulcer volume before L-PRF treatment was 4.94(1.50,13.83)cm3,and the final ulcer volume was 0.35(0.03,1.76)cm3.The median number of L-PRF doses was 3(2,5).A total of 11 patients achieved complete epithelialization after the fifth week of treatment,and 19 patients achieved at least an 80%volume reduction after the seventh week.The overall wound-healing rate was 1.47(0.63,3.29)cm3/week,and the healing rate was faster in the first 2 weeks than in the remaining weeks.Concurrent treatment did not change the percentage of complete epithelialization or healing rate.Conclusion Adding L-PRF to SOC significantly improved wound healing in patients with DFU independent of the ankle brachial index,SINBAD score,or Wagner grade,indicating that this method is appropriate for DFU treatment under different clinical conditions.展开更多
BACKGROUND Tooth avulsion is one of the most severe types of dental trauma.Most avulsed teeth undergo long-term ankylosis and replacement resorption after delayed reimplantation and exhibit a poor prognosis.The aim of...BACKGROUND Tooth avulsion is one of the most severe types of dental trauma.Most avulsed teeth undergo long-term ankylosis and replacement resorption after delayed reimplantation and exhibit a poor prognosis.The aim of this work was to improve the success rate of avulsed teeth after delayed reimplantation using autologous platelet-rich fibrin(PRF).CASE SUMMARY Case 1 was a 14-year-old boy who fell and knocked out his left upper central incisor 18 h prior to his arrival at the department.The diagnoses were avulsion of tooth 21,lateral luxation of tooth 11 and alveolar fracture of teeth 11 and 21.In case 2,a 17-year-old boy fell 2 h prior to his presentation to the hospital,and his left upper lateral incisor was completely knocked out of the alveolar socket.The diagnoses included avulsion of tooth 22,complicated crown fracture of tooth 11and complicated crown-root fracture of tooth 21.The avulsed teeth were reimplanted along with autologous PRF granules and splinted using a semiflexible titanium preshaped labial arch.The root canals of the avulsed teeth were filled with calcium hydroxide paste,and root canal filling was performed 4 wk after reimplantation.The reimplanted teeth showed no symptoms of inflammatory root resorption or ankylosis at the 3-,6-,and 12-mo follow-up examinations after reimplantation with autologous PRF.In addition to the avulsed teeth,the other injured teeth were treated using corresponding conventional treatment methods.CONCLUSION These cases provide examples of the successful use of PRF to reduce pathological root resorption of the avulsed teeth,and the application of PRF may provide new healing opportunities for traditionally“hopeless”avulsed teeth.展开更多
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 prol...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.展开更多
BACKGROUND In the clinical scenario,adult patients with periodontal diseases and dental malformation,characterized by dental crowding in lower anterior teeth with the thin biotype,often require orthodontic treatment.T...BACKGROUND In the clinical scenario,adult patients with periodontal diseases and dental malformation,characterized by dental crowding in lower anterior teeth with the thin biotype,often require orthodontic treatment.This case report aimed to evaluate the clinical and radiographic outcomes of periodontally accelerated osteogenic orthodontics(PAOO)combined with autologous platelet-rich fibrin(PRF)in an adult patient with class I malocclusion along with dental crowding,a thin periodontal biotype,and buccal plate deficiency.CASE SUMMARY A 32-year-old female complaining of dental crowding and gingival bleeding was referred to the orthodontic clinic.The patient underwent periodontal risk assessment prior to orthodontic treatment.She was diagnosed with a high risk of gingival recession due to dental crowding,root prominence,loss of buccal plates,and a thin gingival tissue biotype.The treatment regimen included PAOO combined with autologous PRF for alveolar augmentation and interproximal enamel reduction for moderate dental crowding.Clinically,PAOO-assisted orthodontic tooth movement in this case showed enhanced periodontium remodeling.Radiographic outcomes also showed statistically significant improvements(P<0.01)in the mandibular buccal alveolar bone.CONCLUSION This case report suggests the combination of autologous PRF with PAOO to enhance bone augmentation and long-term tissue support in adult orthodontic patients with periodontal disease.展开更多
BACKGROUND Keratinized gingival insufficiency is a disease attributed to long-term tooth loss,can severely jeopardizes the long-term health of implants.A simple and effective augmentation surgery method should be urge...BACKGROUND Keratinized gingival insufficiency is a disease attributed to long-term tooth loss,can severely jeopardizes the long-term health of implants.A simple and effective augmentation surgery method should be urgently developed.CASE SUMMARY A healthy female patient,45-year-old,requested implant restoration of the her left mandibular first molar and second molar.Before considering a stage II,as suggested from the probing depth measurements,the widths of the mesial,medial,and distal buccal keratinized gingiva of second molar(tooth#37)were measured and found to be 0.5 mm,0.5 mm,and 0 mm,respectively.This suggested that the gingiva was insufficient to resist damage from bacterial and mechanical stimulation.Accordingly,modified apically repositioned flap(ARF)surgery combined with xenogeneic collagen matrix(XCM)and platelet-rich fibrin(PRF)was employed to increase the width of gingival tissue.After 1 mo of healing,the widths of mesial,medial,and distal buccal keratinized gingiva reached 4 mm,4 mm,and 3 mm,respectively,and the thickness of the augmented mucosa was 4.5 mm.Subsequently,through the second-stage operation,the patient obtained an ideal soft tissue shape around the implant.CONCLUSION For cases with keratinized gingiva widths around implants less than 2mmthe soft tissue width and thickness could be increased by modified ARF surgery combined with XCM and PRF.Moreover,this surgery significantly alleviated patients’pain and ameliorated oral functional comfort.展开更多
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 augment...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.展开更多
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 graft...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.展开更多
BACKGROUND Bone deficiency and soft tissue atrophy in the absence of maxillary lateral incisors are among the most challenging problems for implant clinicians.Autologous bone grafting is the gold standard for bone aug...BACKGROUND Bone deficiency and soft tissue atrophy in the absence of maxillary lateral incisors are among the most challenging problems for implant clinicians.Autologous bone grafting is the gold standard for bone augmentation,but not without limitations.Platelet-rich fibrin(PRF),a biodegradable autologous biomaterial,has been widely used for bone and soft tissue management.Moreover,titanium plate is an advantageous barrier due to its good space-maintaining ability.However,there is a lack of literature on implant site development using titanium plate and PRF for congenitally missing maxillary lateral incisors.CASE SUMMARY The patient was a 19-year-old girl with a congenitally missing tooth(#12).She underwent implant placement and simultaneous autologous bone grafting with titanium plate and 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,bone regeneration was evident.Subsequently,the definitive restoration was placed,and the patient was satisfied with the esthetic outcomes.CONCLUSION Implant site development using titanium plate and PRF for congenitally missing maxillary lateral incisors is a feasible procedure.In this case,the labial bone plate was displaced but remained connected to the base bone,ensuring blood supply.The titanium plate fixed the labial bone plate and maintained the osteogenic space,while the PRF provided growth factors and leukocytes for bone and soft tissue regeneration.Furthermore,the procedure reduced the surgical complexity and adverse reactions,displaying outstanding esthetic outcomes.展开更多
BACKGROUND A key requirement for biomimetic regeneration of tissues is a 3D scaffold.The gold standard scaffold for revascularization is the blood clot,however,an adequate blood clot cannot always be achieved in narro...BACKGROUND A key requirement for biomimetic regeneration of tissues is a 3D scaffold.The gold standard scaffold for revascularization is the blood clot,however,an adequate blood clot cannot always be achieved in narrow canals or mature roots.Hereby,we document the effects of platelet-rich fibrin(PRF)for the regenerative endodontic treatment(RET)of two immature permanent teeth with necrotic pulps for up to 48 mo.CASES SUMMARY The first patient was a 22-year-old female with history of trauma in tooth#9 with a sinus tract and a large periapical lesion.The second was a 9-year-old male presenting with a badly decayed tooth#14.Both cases were treated with RET and PRF prepared from the patients’blood.PRF and its extract were used as a scaffold for RET.Patients were followed-up to 9 and 48 mo(4 years),respectively.Both patients,were asymptomatic after treatment.At the 9-mo-follow-up of case#1,there was radiographic evidence of periapical bone healing,however,the root apex was still open.In case#2,the roots exhibited apical closure and normal periapical bone architecture at 12-mo follow-up,while no root lengthening was observed.After 48 mo,case#2 showed extensive intracanal calcification in all root canals that complicated conventional root canal treatment.CONCLUSION RET with PRF and its extract could be used in revascularization of immature permanent teeth.However,proper case selection to comply with long-term follow-up is necessary and adverse events such as calcification and canal obliteration should be planned for.展开更多
BACKGROUND Collagen membrane and platelet-rich fibrin(PRF)have emerged as vital biomaterials in the field of periodontal regeneration.Minimally invasive techniques are being preferred by most periodontists,as it is pa...BACKGROUND Collagen membrane and platelet-rich fibrin(PRF)have emerged as vital biomaterials in the field of periodontal regeneration.Minimally invasive techniques are being preferred by most periodontists,as it is patient compliant with fewer post-surgical complications as compared to conventional surgical techniques.Thus,in this study we have evaluated the effect of injectable PRF(i-PRF)with collagen membrane compared with collagen membrane alone using vestibular incision subperiosteal tunnel access(VISTA)technique for gingival recession coverage.AIM To compare the efficacy of VISTA using collagen membrane with collagen membrane soaked in injectable PRF for gingival recession coverage.METHODS A split mouth randomized controlled clinical trial was designed;13 subjects having at least 2 teeth indicated for recession coverage were enrolled in this study.The sites were randomly assigned to control group(VISTA using collagen membrane alone)and the test group(VISTA using collagen membrane with i-PRF).The clinical parameters assessed were pocket depth,recession depth(RD),recession width(RW),relative attachment level,keratinised tissue width(KTW),keratinised tissue thickness(KTT),and percentage root coverage.RESULTS RD showed a statistically significant difference between the test group at 3 mo(0.5±0.513)and 6 mo(0.9±0.641)and the control group at 3 mo(0.95±0.51)and 6 mo(1.5±0.571),with P values of 0.008 and 0.04,respectively.RW also showed a statistically significant difference between the test group at 3 mo(1±1.026)and 6 mo(1.65±1.04)and the control group at 3 mo(1.85±0.875)and 6 mo(2.25±0.759),with P values of 0.008 and 0.001,respectively.Results for KTW showed statistically significant results between the test group at 1 mo(2.85±0.489),3 mo(3.5±0.513),and 6 mo(3.4±0.598)and the control group at 1 mo(2.45±0.605),3 mo(2.9±0.447),and 6 mo(2.75±0.444),with P values of 0.04,0.004,and 0.003,respectively.Results for KTT also showed statistically significant results between test group at 1 mo(2.69±0.233),3 mo(2.53±0.212),and 6 mo(2.46±0.252)and the control group at 1 mo(2.12±0.193),3 mo(2.02±0.18),and 6 mo(1.91±0.166),with P values of 0.001,0.001,and 0.001,respectively.The test group showed 91.6%,81.6%,and 67%root coverage at 1 mo,3 mo,and 6 mo,while the control group showed 82.3%,66.4%,and 53.95%of root coverage at 1 mo,3 mo,and 6 mo,respectively.CONCLUSION The use of minimally invasive VISTA technique along with collagen membrane and injectable form of platelet-rich fibrin can be successfully used as a treatment method for multiple or isolated gingival recessions of Miller’s class-I and class-II defects.展开更多
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 recog...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.展开更多
目的:将富血小板纤维蛋白(Pl at el et-ri ch fi bri n,PRF)应用于牙槽嵴裂植骨手术,验证其是否能够减少植骨术后的骨吸收。方法:8～12月龄犬8只,以外科手术的方法制备双侧牙槽嵴裂模型,随机于两侧同期植入自体髂骨(对照组)及自体髂骨混...目的:将富血小板纤维蛋白(Pl at el et-ri ch fi bri n,PRF)应用于牙槽嵴裂植骨手术,验证其是否能够减少植骨术后的骨吸收。方法:8～12月龄犬8只,以外科手术的方法制备双侧牙槽嵴裂模型,随机于两侧同期植入自体髂骨(对照组)及自体髂骨混合PRF(实验组)。于术后当日、2个月、4个月时拍摄上颌骨CT,利用三维重建软件测量植骨区体积,计算骨吸收率。结果:术后2个月、4个月时实验组的骨吸收率明显小于对照组,行配对样本的t检验,P<0.01。结论:将PRF加入自体髂骨进行骨移植修复犬的牙槽嵴裂,在术后4个月的时间范围内,可以减少术后的骨吸收。展开更多
基金supported by grants from the National Natural Science Foundation of China(No.81100581)the Bethune Merck Diabetes Research Fund(No.2018)+1 种基金the Fund of the Sichuan Provincial Western Psychiatric Association's CSPC LEADING Scientific Research Project(No.WL2021104)the China International Medical Foundation-Senmei China Diabetes Research Fund(No.Z-2017-26-1902-5).
文摘Objective Diabetic foot ulcer(DFU)is one of the most serious complications of diabetes.Leukocyte-and platelet-rich fibrin(L-PRF)is a second-generation autologous platelet-rich plasma.This study aims to investigate the clinical effects of L-PRF in patients with diabetes in real clinical practice.Methods Patients with DFU who received L-PRF treatment and standard of care(SOC)from 2018 to 2019 in Tongji Hospital were enrolled.The clinical information including patient characteristics,wound evaluation(area,severity,infection,blood supply),SOC of DFU,and images of ulcers was retrospectively extracted and analyzed.L-PRF treatment was performed every 7±2 days until the ulcer exhibited complete epithelialization or an overall percent volume reduction(PVR)greater than 80%.Therapeutic effectiveness,including overall PVR and the overall and weekly healing rates,was evaluated.Results Totally,26 patients with DFU were enrolled,and they had an ulcer duration of 47.0(35.0,72.3)days.The severity and infection of ulcers varied,as indicated by the Site,Ischemia,Neuropathy,Bacterial Infection,and Depth(SINBAD)scores of 2–6,Wagner grades of 1–4,and the Perfusion,Extent,Depth,Infection and Sensation(PEDIS)scores of 2–4.The initial ulcer volume before L-PRF treatment was 4.94(1.50,13.83)cm3,and the final ulcer volume was 0.35(0.03,1.76)cm3.The median number of L-PRF doses was 3(2,5).A total of 11 patients achieved complete epithelialization after the fifth week of treatment,and 19 patients achieved at least an 80%volume reduction after the seventh week.The overall wound-healing rate was 1.47(0.63,3.29)cm3/week,and the healing rate was faster in the first 2 weeks than in the remaining weeks.Concurrent treatment did not change the percentage of complete epithelialization or healing rate.Conclusion Adding L-PRF to SOC significantly improved wound healing in patients with DFU independent of the ankle brachial index,SINBAD score,or Wagner grade,indicating that this method is appropriate for DFU treatment under different clinical conditions.
基金Supported by Natural Science Foundation of China,No.31971248National Clinical Research Center for Oral Diseases Project of Military Stomatology,No.LCA202007。
文摘BACKGROUND Tooth avulsion is one of the most severe types of dental trauma.Most avulsed teeth undergo long-term ankylosis and replacement resorption after delayed reimplantation and exhibit a poor prognosis.The aim of this work was to improve the success rate of avulsed teeth after delayed reimplantation using autologous platelet-rich fibrin(PRF).CASE SUMMARY Case 1 was a 14-year-old boy who fell and knocked out his left upper central incisor 18 h prior to his arrival at the department.The diagnoses were avulsion of tooth 21,lateral luxation of tooth 11 and alveolar fracture of teeth 11 and 21.In case 2,a 17-year-old boy fell 2 h prior to his presentation to the hospital,and his left upper lateral incisor was completely knocked out of the alveolar socket.The diagnoses included avulsion of tooth 22,complicated crown fracture of tooth 11and complicated crown-root fracture of tooth 21.The avulsed teeth were reimplanted along with autologous PRF granules and splinted using a semiflexible titanium preshaped labial arch.The root canals of the avulsed teeth were filled with calcium hydroxide paste,and root canal filling was performed 4 wk after reimplantation.The reimplanted teeth showed no symptoms of inflammatory root resorption or ankylosis at the 3-,6-,and 12-mo follow-up examinations after reimplantation with autologous PRF.In addition to the avulsed teeth,the other injured teeth were treated using corresponding conventional treatment methods.CONCLUSION These cases provide examples of the successful use of PRF to reduce pathological root resorption of the avulsed teeth,and the application of PRF may provide new healing opportunities for traditionally“hopeless”avulsed teeth.
文摘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.
基金Supported by Natured Science Foundation of Anhui Province,No.1908085MH255.
文摘BACKGROUND In the clinical scenario,adult patients with periodontal diseases and dental malformation,characterized by dental crowding in lower anterior teeth with the thin biotype,often require orthodontic treatment.This case report aimed to evaluate the clinical and radiographic outcomes of periodontally accelerated osteogenic orthodontics(PAOO)combined with autologous platelet-rich fibrin(PRF)in an adult patient with class I malocclusion along with dental crowding,a thin periodontal biotype,and buccal plate deficiency.CASE SUMMARY A 32-year-old female complaining of dental crowding and gingival bleeding was referred to the orthodontic clinic.The patient underwent periodontal risk assessment prior to orthodontic treatment.She was diagnosed with a high risk of gingival recession due to dental crowding,root prominence,loss of buccal plates,and a thin gingival tissue biotype.The treatment regimen included PAOO combined with autologous PRF for alveolar augmentation and interproximal enamel reduction for moderate dental crowding.Clinically,PAOO-assisted orthodontic tooth movement in this case showed enhanced periodontium remodeling.Radiographic outcomes also showed statistically significant improvements(P<0.01)in the mandibular buccal alveolar bone.CONCLUSION This case report suggests the combination of autologous PRF with PAOO to enhance bone augmentation and long-term tissue support in adult orthodontic patients with periodontal disease.
文摘BACKGROUND Keratinized gingival insufficiency is a disease attributed to long-term tooth loss,can severely jeopardizes the long-term health of implants.A simple and effective augmentation surgery method should be urgently developed.CASE SUMMARY A healthy female patient,45-year-old,requested implant restoration of the her left mandibular first molar and second molar.Before considering a stage II,as suggested from the probing depth measurements,the widths of the mesial,medial,and distal buccal keratinized gingiva of second molar(tooth#37)were measured and found to be 0.5 mm,0.5 mm,and 0 mm,respectively.This suggested that the gingiva was insufficient to resist damage from bacterial and mechanical stimulation.Accordingly,modified apically repositioned flap(ARF)surgery combined with xenogeneic collagen matrix(XCM)and platelet-rich fibrin(PRF)was employed to increase the width of gingival tissue.After 1 mo of healing,the widths of mesial,medial,and distal buccal keratinized gingiva reached 4 mm,4 mm,and 3 mm,respectively,and the thickness of the augmented mucosa was 4.5 mm.Subsequently,through the second-stage operation,the patient obtained an ideal soft tissue shape around the implant.CONCLUSION For cases with keratinized gingiva widths around implants less than 2mmthe soft tissue width and thickness could be increased by modified ARF surgery combined with XCM and PRF.Moreover,this surgery significantly alleviated patients’pain and ameliorated oral functional comfort.
基金Supported by Interdisciplinary Project for Ph.D. students of Jilin University,No.10183201846 X.S
文摘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.
文摘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.
基金Supported by Developmental Plan Project of Science and Technology at Jilin Province,No.20200201302JC.
文摘BACKGROUND Bone deficiency and soft tissue atrophy in the absence of maxillary lateral incisors are among the most challenging problems for implant clinicians.Autologous bone grafting is the gold standard for bone augmentation,but not without limitations.Platelet-rich fibrin(PRF),a biodegradable autologous biomaterial,has been widely used for bone and soft tissue management.Moreover,titanium plate is an advantageous barrier due to its good space-maintaining ability.However,there is a lack of literature on implant site development using titanium plate and PRF for congenitally missing maxillary lateral incisors.CASE SUMMARY The patient was a 19-year-old girl with a congenitally missing tooth(#12).She underwent implant placement and simultaneous autologous bone grafting with titanium plate and 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,bone regeneration was evident.Subsequently,the definitive restoration was placed,and the patient was satisfied with the esthetic outcomes.CONCLUSION Implant site development using titanium plate and PRF for congenitally missing maxillary lateral incisors is a feasible procedure.In this case,the labial bone plate was displaced but remained connected to the base bone,ensuring blood supply.The titanium plate fixed the labial bone plate and maintained the osteogenic space,while the PRF provided growth factors and leukocytes for bone and soft tissue regeneration.Furthermore,the procedure reduced the surgical complexity and adverse reactions,displaying outstanding esthetic outcomes.
文摘BACKGROUND A key requirement for biomimetic regeneration of tissues is a 3D scaffold.The gold standard scaffold for revascularization is the blood clot,however,an adequate blood clot cannot always be achieved in narrow canals or mature roots.Hereby,we document the effects of platelet-rich fibrin(PRF)for the regenerative endodontic treatment(RET)of two immature permanent teeth with necrotic pulps for up to 48 mo.CASES SUMMARY The first patient was a 22-year-old female with history of trauma in tooth#9 with a sinus tract and a large periapical lesion.The second was a 9-year-old male presenting with a badly decayed tooth#14.Both cases were treated with RET and PRF prepared from the patients’blood.PRF and its extract were used as a scaffold for RET.Patients were followed-up to 9 and 48 mo(4 years),respectively.Both patients,were asymptomatic after treatment.At the 9-mo-follow-up of case#1,there was radiographic evidence of periapical bone healing,however,the root apex was still open.In case#2,the roots exhibited apical closure and normal periapical bone architecture at 12-mo follow-up,while no root lengthening was observed.After 48 mo,case#2 showed extensive intracanal calcification in all root canals that complicated conventional root canal treatment.CONCLUSION RET with PRF and its extract could be used in revascularization of immature permanent teeth.However,proper case selection to comply with long-term follow-up is necessary and adverse events such as calcification and canal obliteration should be planned for.
文摘BACKGROUND Collagen membrane and platelet-rich fibrin(PRF)have emerged as vital biomaterials in the field of periodontal regeneration.Minimally invasive techniques are being preferred by most periodontists,as it is patient compliant with fewer post-surgical complications as compared to conventional surgical techniques.Thus,in this study we have evaluated the effect of injectable PRF(i-PRF)with collagen membrane compared with collagen membrane alone using vestibular incision subperiosteal tunnel access(VISTA)technique for gingival recession coverage.AIM To compare the efficacy of VISTA using collagen membrane with collagen membrane soaked in injectable PRF for gingival recession coverage.METHODS A split mouth randomized controlled clinical trial was designed;13 subjects having at least 2 teeth indicated for recession coverage were enrolled in this study.The sites were randomly assigned to control group(VISTA using collagen membrane alone)and the test group(VISTA using collagen membrane with i-PRF).The clinical parameters assessed were pocket depth,recession depth(RD),recession width(RW),relative attachment level,keratinised tissue width(KTW),keratinised tissue thickness(KTT),and percentage root coverage.RESULTS RD showed a statistically significant difference between the test group at 3 mo(0.5±0.513)and 6 mo(0.9±0.641)and the control group at 3 mo(0.95±0.51)and 6 mo(1.5±0.571),with P values of 0.008 and 0.04,respectively.RW also showed a statistically significant difference between the test group at 3 mo(1±1.026)and 6 mo(1.65±1.04)and the control group at 3 mo(1.85±0.875)and 6 mo(2.25±0.759),with P values of 0.008 and 0.001,respectively.Results for KTW showed statistically significant results between the test group at 1 mo(2.85±0.489),3 mo(3.5±0.513),and 6 mo(3.4±0.598)and the control group at 1 mo(2.45±0.605),3 mo(2.9±0.447),and 6 mo(2.75±0.444),with P values of 0.04,0.004,and 0.003,respectively.Results for KTT also showed statistically significant results between test group at 1 mo(2.69±0.233),3 mo(2.53±0.212),and 6 mo(2.46±0.252)and the control group at 1 mo(2.12±0.193),3 mo(2.02±0.18),and 6 mo(1.91±0.166),with P values of 0.001,0.001,and 0.001,respectively.The test group showed 91.6%,81.6%,and 67%root coverage at 1 mo,3 mo,and 6 mo,while the control group showed 82.3%,66.4%,and 53.95%of root coverage at 1 mo,3 mo,and 6 mo,respectively.CONCLUSION The use of minimally invasive VISTA technique along with collagen membrane and injectable form of platelet-rich fibrin can be successfully used as a treatment method for multiple or isolated gingival recessions of Miller’s class-I and class-II defects.
文摘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.
文摘目的:将富血小板纤维蛋白(Pl at el et-ri ch fi bri n,PRF)应用于牙槽嵴裂植骨手术,验证其是否能够减少植骨术后的骨吸收。方法:8～12月龄犬8只,以外科手术的方法制备双侧牙槽嵴裂模型,随机于两侧同期植入自体髂骨(对照组)及自体髂骨混合PRF(实验组)。于术后当日、2个月、4个月时拍摄上颌骨CT,利用三维重建软件测量植骨区体积,计算骨吸收率。结果:术后2个月、4个月时实验组的骨吸收率明显小于对照组,行配对样本的t检验,P<0.01。结论:将PRF加入自体髂骨进行骨移植修复犬的牙槽嵴裂,在术后4个月的时间范围内,可以减少术后的骨吸收。
