Intra-lesional Corticosteroids Versus Platelet-Rich Plasma Versus Platelet-Rich Fibrin for the Treatment of Oral Lichen Planus: A Systematic Review and Network Meta-Analysis.

Oral lichen planus (OLP) is a potentially malignant disorder affecting the oral mucosa. Platelet concentrates, including platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), have emerged as promising alternative treatments to corticosteroids. This study aims to comprehensively evaluate the effectiveness of PRP and PRF in the management of patients with OLP. We conducted a comprehensive search of PubMed, Scopus, Web of Science, and the Cochrane Library for randomized controlled trials (RCTs) involving patients with OLP comparing intralesional PRP or PRF with corticosteroids up to August 2024. The primary outcomes assessed were changes in lesion size, pain scores, and Thongprasom scores. Network meta-analysis (NMA) was used. Data were pooled using summary effect sizes with corresponding 95% confidence intervals (CIs) in a random-effects model based on the DerSimonian-Laird method. Eight studies comprising 157 patients and 250 lesions were included in the final analysis. Compared to corticosteroids, no significant differences were observed among PRF and PRP in terms of changes in lesion size, pain scores, clinical severity scores, and adverse events. NMA ranking showed that PRF was the best-ranking treatment in reducing lesion sizes (SUCRA values: 72.6%, 75.8%, 66.2%, 80.8%, and 77.5% at first, second, third, fourth, and eighth weeks of assessment), followed by corticosteroids, and PRP. Moreover, PRF was the best-ranking treatment in reducing pain score at the first, third, and eighth weeks of assessment (SUCRA values: 91.8%, 86%, and 85.9%), while PRP was the best intervention at the second and fourth weeks of assessment (SUCRA values: 61.3%, and 90.2%). Also, PRF was the best intervention in terms of Thongprasom scores at eight weeks of assessment (SUCRA value: 77.3%), while PRP was the best intervention at the fourth week of assessment with value of 78.1%. PRF and PRP showed comparable results with intralesional corticosteroids in all studied parameters. Considering treatments ranking, PRF was the best intervention. The optimal treatment modality for OLP varies on different clinical conditions.

The Use of Platelet-Rich Fibrin (PRF) in the Management of Dry Socket: A Systematic Review.

Dry socket or alveolar osteitis is a common postoperative complication following tooth extraction, characterized by severe pain due to the disintegration of the blood clot within the socket. Various factors contribute to its development, such as traumatic extraction, patient age and sex, smoking, and anesthetic use. To mitigate this condition, socket preservation techniques, including the use of bone substitute materials, have been employed. Platelet-rich fibrin (PRF) has emerged as a promising biomaterial, enhancing healing and reducing the incidence of dry socket. Materials and Methods: This systematic review, adhering to the PRISMA guidelines and registered with PROSPERO (ID: CRD 578018), examines the efficacy of PRF in managing dry socket by analyzing studies from PubMed, Scopus, and Web of Science published between January 2013 and May 2024. Boolean keywords have been used in the search strategy: ("Treatment") AND ("Dry Socket") AND ("Platelet Rich Fibrin" OR "PRF"). A total of 738 publications were found using the electronic database search. After the screening phase, 13 records were chosen for qualitative analysis. The results from multiple clinical trials and comparative studies indicate that PRF significantly reduces postoperative pain, expedites healing, and lowers the incidence of Alveolar Osteitis. Despite promising results, further large-scale, randomized studies are needed to validate PRF as a standard treatment for dry socket.

Role of Autologous Platelet-Rich Fibrin in Chronic Non-healing Ulcers With Various Etiologies in a Tertiary Care Rehabilitation Centre: A Case Series.

Introduction Chronic non-healing ulcers are defined as a discontinuity or break in the integrity of skin that is not healing in a reasonable period of time due to an underlying systemic etiology. Despite using conventional initial treatment and many other available dressing options, such wounds are difficult to completely heal, thus affecting the progress of rehabilitation measures and compromising functional improvement and quality of life. Materials and methods In this case series, platelet-rich fibrin (PRF) was applied to eight wounds from six patients. The patients included had various etiologies (including spinal cord injury, peripheral vascular disease, Guillain-Barré syndrome, and diabetic foot ulcer) with chronic non-healing wounds over different anatomical locations on the body. Pressure ulcer scale for healing (PUSH) score, surface area, and volume of the wounds were evaluated and monitored weekly after PRF dressing. We have applied PRF every week. On average, two PRF dressings were applied, the maximum being three applications. Results The maximum healing rate in terms of PUSH score was observed to be 3.84% per day, and the minimum was 1.19% per day. The maximum healing rate in terms of surface area was observed to be 5.89% per day, and the minimum was 1.78% per day. Three of the wounds showed complete closure. The maximum follow-up period was 10 weeks. The percentage mean Functional Independence Measure (FIM) improvement was calculated to be 15.87% ± 14.04 during the course of hospitalization after PRF application. Conclusion Based on the results, we can conclude that PRF showed accelerated improvement in the healing of chronic non-healing ulcers of various etiologies at different anatomical locations. It has proven to be a safe and effective method, thereby improving their quality of life and functional independence in performing activities of daily living. To our knowledge till date, no other study in a rehabilitation setting has been done on patients having non-healing ulcers due to various etiologies and at different anatomical locations.

Periodontal regeneration using platelet-rich fibrin. Furcation defects: A systematic review with meta-analysis.

The objective of the study was to compare the treatment outcomes of periodontal furcation defects by using platelet-rich fibrin (PRF) with other commonly utilized modalities. The eligibility criteria comprised randomized controlled trials (RCTs) comparing the clinical outcomes of PRF with those of other modalities for the treatment of furcation defects. Studies were classified into 11 categories in 3 different groups as follows: Group I (addition of PRF): (1) open flap debridement (OFD) alone versus OFD/PRF, (2) OFD/bone graft (OFD/BG) versus OFD/BG/PRF; Group II (comparative studies to PRF): (3) OFD/BG versus OFD/PRF, (4) OFD/collagen membrane versus OFD/PRF, (5) OFD/PRP versus OFD/PRF, (6) OFD/rhBMP2 versus OFD/PRF; and Group III (addition of biomaterial/biomolecule to PRF): OFD/PRF versus … (7) OFD/PRF/BG, (8) OFD/PRF/amniotic membrane (AM), (9) OFD/PRF/metformin, (10) OFD/PRF/bisphosphonates, (11) OFD/PRF/statins. Weighted means and forest plots were calculated for the reduction of probing pocket depth (PPD), gain of vertical and horizontal clinical attachment levels (VCAL and HCAL), gain in vertical and horizontal bone levels (VBL, HBL), and radiographic bone fill (RBF). From 45 articles identified, 21 RCTs reporting on class II furcations were included. The use of OFD/PRF and OFD/BG/PRF statistically significantly reduced PPD and improved VCAL and HCAL when compared to OFD or OFD/BG, respectively. The comparison between OFD/PRF alone versus OFD/BG, OFD/CM, OFD/PRP, or OFD/rhBMP2 led to similar outcomes for all investigated parameters, including a reduction in PPD, VCAL/HCAL gain, and RBF. The additional incorporation of a BG to OFD/PRF only mildly improved outcomes, whereas the addition of AM improved clinical outcomes. The addition of small biomolecules such as metformin, bisphosphonates, or statins all led to significant improvements in PPD, VCAL, and HCAL when compared to OFD/PRF alone. Noteworthy, a very high heterogeneity was found in the investigated studies. The use of PRF significantly improved clinical outcomes in class II furcation defects when compared to OFD alone, with similar levels being observed between OFD/PRF and/or OFD/BG, OFD/CM, OFD/PRP, or OFD/rhBMP2. Future research geared toward better understanding potential ways to enhance the regenerative properties of PRF with various small biomolecules may prove valuable for future clinical applications. Future histological research investigating PRF in human furcation defects is largely needed. The use of PRF in conjunction with OFD statistically significantly improved PPD, VCAL, and HCAL values, yielding comparable outcomes to commonly used biomaterials. The combination of PRF to bone grafts or the addition of small biomolecules may offer additional clinical benefits, thus warranting future investigation.

Use of autologous dentin matrix in bone defects augmentation - a literature review.

A number of regenerative materials are currently used to regenerate or preserve the alveolar pro- cess. One of these is autogenous dentin matrix. With many valuable properties such as easy availability, simple preparation, low cost, low risk of disease transmission and no risk of triggering an immune response against the graft, autogenous dentin matrix appears to be a very good material of choice. The following article is intended to provide an overview of the use of autogenous dentin matrix.

Management of a Persistent Radicular Cyst in the Maxillary Right Lateral Incisor: A Case Report.

A 32-year-old male patient presented with a chief complaint of ongoing endodontic treatment and swelling in the hard palate, specifically in the rugae region. On examination, a soft, non-tender, non-fluctuant swelling was observed between teeth #11 and #12, accompanied by radiographic evidence of periapical radiolucency and perforation. Cone beam computed tomography (CBCT) scans confirmed a well-defined radiolucency in the affected region, indicative of a radicular cyst. Root canal treatment was completed with mineral trioxide aggregate (MTA) obturation during the second visit. An apicoectomy was performed to remove the cystic content, followed by the placement of bone graft material, a platelet-rich fibrin (PRF) membrane, and sutures to facilitate bone regeneration. This comprehensive approach aimed to resolve the periapical pathology and promote tissue healing around the affected tooth.

Exploring the antimicrobial potential of Leukocyte- and Platelet-Rich Fibrin - an in vitro study.

This study investigates the antimicrobial properties of leukocyte- and platelet-rich fibrin (L-PRF) against Enterococcus faecalis (ATCC 29212), Pseudomonas aeruginosa (ATCC 27853), and Candida albicans (ATCC 90028). Infections can hinder wound healing posing challenges. L-PRF's potential for regeneration and antimicrobial action has been studied. Considering the increasing concern about antibiotic resistance, assessing the antimicrobial properties of L-PRF provides valuable insights into its potential as a therapeutic agent in postoperative infections. Twenty volunteers were enrolled in the study, following ethical guidelines, and obtaining informed consent. Blood samples were collected and L-PRF was prepared. Microbial suspensions were prepared, and susceptibility testing was performed using the Kirby-Bauer agar diffusion method. The study revealed significant heterogeneity in the susceptibility to L-PRF. All L-PRF membrane samples exhibited antimicrobial activity against P. aeruginosa, with inhibition zones of 13 mm ± 3.85 SD. Enterococcus faecalis displayed inhibition diameter of 7.25 mm ± 5.15 SD. Candida albicans susceptibility to L-PRF varied among samples, with both inhibitory and non-inhibitory results. Results showed varying degrees of antimicrobial activity, particularly against P. aeruginosa, and highlight the complexity of the L-PRF-microorganism interaction. Further investigations are needed to elucidate the clinical implications and optimize the use of L-PRF.

Autologous platelet concentrates as adjuvant in the surgical management of medication-related osteonecrosis of the jaw.

Medication-related osteonecrosis of the jaw (MRONJ) is an infectious side effect associated with bisphosphonates and monoclonal antibodies (denosumab, immune modulators, and antiangiogenic medications). Adjunctive therapies for the surgical management of MRONJ include autologous platelet concentrates (APCs). These APCs serve as a source of various cells and growth factors that aid tissue healing and regeneration. This review evaluated the use of platelet-rich plasma (PRP), plasma-rich in growth factors (PRGF), and leukocyte- and platelet-rich fibrin (L-PRF) as adjuvant therapies for the surgical management of MRONJ by conducting analyses on the results of 58 articles. Compared to surgical treatment alone, the application of PRP and L-PRF after surgery appears to increase healing in the management of patients with MRONJ. No studies have reported unhealed lesions as a result of surgical treatment of MRONJ with PRGF application or compared it with surgical treatment alone. The overall results of this review have shown favorable healing rates of MRONJ lesions managed with the application of APCs after surgical treatment; however, significant methodological limitations may limit the scientific evidence supporting their use. Further randomized controlled trials with strict criteria are needed to establish the extent to which APCs can improve wound healing and quality of life in patients with MRONJ requiring surgical treatment.

Comparative Evaluation of Immediate Implant Placement in Fresh Extraction Socket with and without the use of Platelet-Rich Fibrin.

Background: Immediate implant placement after tooth extraction has been found to be a workable and reliable treatment for tooth loss based on clinical and radiographic evaluation. Aim: This study was conducted for comparative evaluation of immediate implant placement in fresh extraction socket with and without the use of platelet-rich fibrin (PRF). Materials and Method: Forty sites in all were chosen, and they were split into two groups at random. Twenty of these were placed immediately with PRF (test category), while the remaining 20 were placed immediately without the use of any comparable adjunct (control group). Using cone beam computed tomography, radiographic characteristics were evaluated both at the time of implant implantation and a year later. Results: The crestal bone at the mesial surface was 2.74 ± 1.44 and 1.96 ± 1.41 mm at baseline and 12-month follow-up in the control group. The crestal bone at the mesial surface was 2.93 ± 1.44 and 2.57 ± 1.57 mm at baseline and 12-month follow-up in the test group. Conclusion: Immediate implant placement in fresh extraction socket showed better results with the use of PRF.

The in vitro efficacy of advanced platelet-rich fibrin plus versus injectable platelet-rich fibrin on the proliferation, migration, and differentiation of stem cells from apical papilla.

Background/purpose: Platelet-rich fibrin (PRF) is a promising host-derived scaffold for regenerative endodontic treatment. This study investigated the effects of advanced PRF plus (A-PRF+) and injectable PRF (i-PRF) on the proliferation, migration, and differentiation of stem cells from apical papilla (SCAPs). Materials and methods: A-PRF+ and i-PRF were prepared using a DUO Quattro centrifuge following a standard protocol. A-PRF+ and i-PRF extract were diluted in Dulbecco's modified Eagle's medium and Ham's F-12 medium (DMEM/F12) to produce the experimental culture medium. DMEM/F12 and DMEM/F12 supplemented with 10% foetal bovine serum (FBS) were used as the negative control (NC) and positive control (PC) media, respectively. The proliferative ability of SCAPs was assessed using a counting method (haemocytometer). The migration ability was examined using a scratch-wound assay. Alkaline phosphatase, bone sialoprotein, dentin matrix protein 1, and dentin sialophosphoprotein expression were measured to determine the differentiation ability. Results: The proliferation, migration, and differentiation of SCAPs in the A-PRF+ group were similar to those of the PC group. In the i-PRF group, the cell number was significantly (p < 0.01) lower than that of the A-PRF+ group on days 8 and 10; the percentage of the scratched area on days 1 and 2 was significantly higher than in the A-PRF+ group (p < 0.05). The mRNA expression levels of biomarkers in the i-PRF group were similar to those in the A-PRF+ group. Conclusion: Both A-PRF+ and i-PRF induce SCAPs proliferation, migration, and differentiation. However, A-PRF+ was superior in supporting the proliferation and migration of SCAPs.

In vitro studies support clinical trials showing platelet-rich fibrin-mediated local delivery of antibiotics improves outcomes in impacted mandibular third molar surgery.

Our previous clinical observations showed that platelet rich fibrin (PRF) can be used to deliver antibiotics to attenuate postoperative complications after unilaterally impacted mandibular third molar surgery (IMTMS). In order to begin understanding the mechanism involved in the beneficial in vivo effects of PRF-mediated delivery of antibiotics, in vitro studies were performed, which showed that PRF preparations containing amoxicillin/clavulanic acid or clindamycin significantly inhibited the growth of S. aureus bacteria. In our previous study, comparisons were made between control and treated groups. However, since variations among individual patients could possibly affect the results, the current study included patients with bilaterally symmetric impacted mandibular third molars, allowing us to compare control and antibiotic treatment within each patient. The effects of PRF preparations containing amoxicillin/clavulanic acid or clindamycin on IMTMS was tested in 60 clinical cases. Antibiotic-injected PRF treatment after bilaterally IMTMS resulted in significantly reduced pain, less use of analgesics, and reduced swelling and trismus compared to the control group (PRF without antibiotics) confirming our previous results after unilaterally IMTMS. The in vitro results support the hypothesis that in vivo delivery of antibiotics using PRF produces therapeutic effects after IMTMS by attenuating bacterial infection and inflammation.

Surgical Approach to Managing an Apical Periodontal Cyst Using Titanium-Activated Platelet-Rich Fibrin (T-PRF) in a Pediatric Patient: A Case Report.

This case report discusses the surgical management of an apical periodontal cyst in a 14-year-old male patient presenting with pain in the upper anterior jaw. The patient had a history of trauma to the upper anterior teeth, leading to the development of a radicular cyst involving teeth 11 and 12. The treatment plan included initial root canal therapy followed by surgical enucleation of the cyst, apicoectomy, and retrograde filling of the affected teeth. Titanium-activated platelet-rich fibrin (T-PRF) membranes were utilized along with an osseo-bone graft to promote healing and bone regeneration. Post-operative aesthetic rehabilitation was achieved, and the patient showed complete healing upon six months of follow-up. The case highlights the efficacy of combining endodontic therapy with surgical intervention using advanced biomaterials to manage radicular cysts in pediatric patients successfully.

Comparison of the therapeutic effect of platelet-rich plasma and injectable platelet-rich fibrin on testicular torsion/detorsion injury in rats.

Testicular torsion is a common disorder in males and results in blockage of testicular circulation with subsequent damage of testicular germ cells. The current work aimed to compare the therapeutic effect of platelet-rich plasma (PRP) and injectable platelet-rich fibrin (i-PRF) on torsion/detorsion (T/D) injury in rats. Forty mature male Wister rats were arranged into 4 groups; (1) Control, (2) T/D, (3) T/D + PRP, and (4) T/D+ i-PRF. The right testis was twisting 1080° clockwise for 3 h in groups 2, 3 and 4, then 10 µl of PRP or i-PRF was injected intra-testicular 3 h after detorsion in groups 3 and 4, respectively. After 30 days postoperatively, the semen quality and hormonal assay were improved in PRP and i-PRF-treated groups with superiority of i-PRF (P < 0.001). High significance of Catalase, Glutathione Peroxidase (GPx), Superoxide Dismutase, Interleukin-1ß (IL-1ß), Caspase-3 and Tumor necrosis factor-α (TNF-α) was reported in treated rats with PRP and i-PRF (P < 0.001) with superiority to i-PRF-treated rats (P < 0.001). Testicular histoarchitectures were improved in PRP and i-PRF-treated rats with superiority of i-PRF-treated rats. It was concluded that PRP and i-PRF have regenerative efficacy on testicular damage after induced T/D injury with a superior efficacy of i-PRF.

Autolougous platelet concentrates in esthetic medicine.

This narrative review summarizes current knowledge on the use of autologous platelet concentrates (APCs) in esthetic medicine, with the goal of providing clinicians with reliable information for clinical practice. APCs contain platelets that release various growth factors with potential applications in facial and dermatologic treatments. This review examines several facial esthetic applications of APCs, including acne scarring, skin rejuvenation, melasma, vitiligo, stretchmarks, peri-orbital rejuvenation, peri-oral rejuvenation, hair regeneration and the volumizing effects of APC gels. A systematic review of literature databases (PubMed/MEDLINE) was conducted up to October 2023 to identify randomized controlled trials (RCTs) in the English language on APCs for facial rejuvenation and dermatology. A total of 96 articles were selected including those on platelet rich plasma (PRP), plasma-rich in growth factors (PRGF), and platelet-rich fibrin (PRF). Clinical recommendations gained from the reviews are provided. In summary, the use of APCs in facial esthetics is a promising yet relatively recent treatment approach. Overall, the majority of studies have focused on the use of PRP with positive outcomes. Only few studies have compared PRP versus PRF with all demonstrating superior outcomes using PRF. The existing studies have limitations including small sample sizes and lack of standardized assessment criteria. Future research should utilize well-designed RCTs, incorporating appropriate controls, such as split-face comparisons, and standardized protocols for APC usage, including optimal number of sessions, interval between sessions, and objective improvement scores. Nevertheless, the most recent formulations of platelet concentrates offer clinicians an ability to improve various clinical parameters and esthetic concerns.

Sub-bundle based analysis reveals the role of human optic radiation in visual working memory.

White matter (WM) functional activity has been reliably detected through functional magnetic resonance imaging (fMRI). Previous studies have primarily examined WM bundles as unified entities, thereby obscuring the functional heterogeneity inherent within these bundles. Here, for the first time, we investigate the function of sub-bundles of a prototypical visual WM tract-the optic radiation (OR). We use the 7T retinotopy dataset from the Human Connectome Project (HCP) to reconstruct OR and further subdivide the OR into sub-bundles based on the fiber's termination in the primary visual cortex (V1). The population receptive field (pRF) model is then applied to evaluate the retinotopic properties of these sub-bundles, and the consistency of the pRF properties of sub-bundles with those of V1 subfields is evaluated. Furthermore, we utilize the HCP working memory dataset to evaluate the activations of the foveal and peripheral OR sub-bundles, along with LGN and V1 subfields, during 0-back and 2-back tasks. We then evaluate differences in 2bk-0bk contrast between foveal and peripheral sub-bundles (or subfields), and further examine potential relationships between 2bk-0bk contrast and 2-back task d-prime. The results show that the pRF properties of OR sub-bundles exhibit standard retinotopic properties and are typically similar to the properties of V1 subfields. Notably, activations during the 2-back task consistently surpass those under the 0-back task across foveal and peripheral OR sub-bundles, as well as LGN and V1 subfields. The foveal V1 displays significantly higher 2bk-0bk contrast than peripheral V1. The 2-back task d-prime shows strong correlations with 2bk-0bk contrast for foveal and peripheral OR fibers. These findings demonstrate that the blood oxygen level-dependent (BOLD) signals of OR sub-bundles encode high-fidelity visual information, underscoring the feasibility of assessing WM functional activity at the sub-bundle level. Additionally, the study highlights the role of OR in the top-down processes of visual working memory beyond the bottom-up processes for visual information transmission. Conclusively, this study innovatively proposes a novel paradigm for analyzing WM fiber tracts at the individual sub-bundle level and expands understanding of OR function.

Platelet-Rich Fibrin: A Self-Derived Biomaterial for Surgical Treatment of a Periapical Lesion.

This case report explores the application of platelet-rich fibrin (PRF) as an autologous biomaterial in the surgical management of a periapical cyst in an 18-year-old female patient. The patient presented with pain, discoloration, and swelling in the maxillary left central incisor region, indicative of an asymptomatic periapical lesion associated with a history of trauma. Despite initial endodontic treatment with calcium hydroxide, the lesion persisted, necessitating surgical intervention. PRF, prepared from the patient's blood, was utilized during periapical surgery to promote healing and tissue regeneration. The surgical procedure included enucleation of the cyst, apicoectomy, and retrograde filling with Biodentine. Clinical and radiographic assessments at follow-up visits (three, six, and nine months post-surgery) revealed successful healing with no signs of inflammation or discomfort. The use of PRF demonstrated favorable outcomes in enhancing wound healing and maintaining a favorable environment for tissue remodeling. This case underscores the potential of PRF as an effective biomaterial in periapical surgery, advocating for its integration into dental therapeutic strategies for its regenerative properties and cost-effectiveness.

Advancement in Tympanic Membrane Repair: Exploring the Potential of Platelet Rich Fibrin.

To assess the effectiveness of the autologous plasma-rich fibrin plug technique for repairing small tympanic membrane perforations. Platelet rich fibrin (PRF) is also called second generation platelet rich plasma due to its high amount of growth factors which could be used in tympanic perforation closure. Being autologous, it is readily available with no immunogenic reactions. PRF membrane has a strong elastin fibrin structure containing growth factors and hence can be considered as an ideal sealing material or an adjuvant to the graft in repairing tympanic membrane perforations. Ours is a prospective study. A total of 52 patients with dry small tympanic membrane perforation were included in the study. In this technique, 10 ml of blood is withdrawn from the patient, processed in a centrifuge machine, and platelet-rich fibrin (PRF) is separated from the mixture for use in the repair of small tympanic membrane defects. Out of the 52 patients, 42 experienced successful repair (full closure) of the tympanic membrane. The mean time of closure of the perforation was around 2 weeks. However, five of them encountered failure. Although the size of the perforation decreased compared to the preoperative size. Additionally, two patients developed granulations on the tympanic membrane. No major side effects were noted. Autologous PRF is a product derived from whole blood through the process of centrifugation. It is safe and effective in promoting the natural process of wound healing by incorporating a high concentration of platelet-derived growth factors as well as fibrin into the graft mixture. This facilitates the rapid healing of tympanic membrane perforation.

Effect of L-PRF and autogenous bone grafts for immediate implant placement in post tooth extract socket.

The clinical outcomes of bone augmentation substances in immediate dental implant (IDI) placement are of interest to dentists. Hence, we evaluated and compared the effectiveness of L-PRF and autogenous bone grafts in immediate implant placement in tooth extract socket. Hence, assessment of periimplantis pocket depth, assessment of tissue biotype, implant stability and marginal bone loss at one month, three months, and six months follow up was completed. The tissue biotype values at one month, 3 month and 6 month follow up revealed that tissue biotype increased in each category as the time increased in all categories. We found that all three techniques were found to have good clinical outcomes regarding immediate implant placement in fresh tooth extraction socket, however the outcomes were better in the case L-PRF.

Peri-implant bone changes after using platelet-rich fibrin scaffold among Indians.

Bone transplant with osteopromotive elements - such as herbal extracts - that promote the creation of new boneis of interest to dentists. Hence, we compared the bone loss around dental implants while placing platelet rich fibrin (PRF) scaffold alone and PRF scaffold with simvastatin (SIM) and PRF scaffold with Moringaoleifera (MO). There were thirty six patients total. A total of 36 implants, or twelve implants in all three categories, were the estimated sample size. Category 1: PRF scaffolds alone. Category 2: PRF scaffolds with SIM. Category 3: PRF scaffolds with MO. Alteration in the bones were measured with CBCT. It was observed that there was decreased loss of crestal bone in PRF+ SIM and PRF+MO as compared to PRF alone. The use of herbal osteopromotive agents like simvastitin and Moringaoleifera along with PRF scaffolds can be effective in reducing bone loss around dental implants.

RNAseq of Gingival Fibroblasts Exposed to PRF Membrane Lysates and PRF Serum.

Platelet-rich fibrin (PRF) is prepared by spontaneous coagulation of fractionated blood. When squeezed between two plates, PRF is separated into solid PRF membranes and a liquid exudate, the PRF serum. The question arises regarding how much the overall activity remains in the PRF membranes and what is discarded into the PRF serum. To this end, we have exposed gingival fibroblasts to lysates prepared from PRF membranes and PRF serum, followed by bulk RNA sequencing. A total of 268 up- and 136 down-regulated genes in gingival fibroblasts exposed to PRF membrane lysates were significantly regulated under the premise of a minimum log2 with 2.5-fold change and a minus log10 significance level of two, respectively. PRF serum only caused 62 up- and 32 down-regulated genes under these conditions. Among the 46 commonly up-regulated genes were CXCL1, CXCL5, CXCL6, CXCL8, IL33, IL6, and PTGS2/COX2, stanniocalcin-1-all linked to an inflammatory response. PRF membrane lysates further increased chemokines CCL2, CCL7, CXCL2, CXCL3, and IL1R1, IL1RL1, and IL1RN, as well as the paracrine factors IL11, LIF, IGF1, BMP2, BMP6, FGF2, and CCN2/CTGF, and all hyaluronan synthases. On the other hand, PRF serum increased DKK1. The genes commonly down-regulated by PRF membrane lysates and PRF serum included interferon-induced protein with tetratricopeptide repeats (IFIT1, IFIT2, IFIT3) and odd-skipped-related transcription factors (OSR1 and OSR2), as well as FGF18 and GDF15, respectively. Taken together, PRF membrane lysates, compared to PRF serum, cause a more complex response in gingival fibroblasts, but each increased chemokine expression in gingival fibroblasts.