The Effects of Injectable Platelet-Rich Fibrin and Advanced-Platelet Rich Fibrin on Gingival Fibroblast Cell Vitality, Proliferation, Differentiation.

BACKGROUND: Injectable Platelet Rich Fibrin (I-PRF) and Advanced-Platelet Rich Fibrin (A-PRF) are autologous materials derived from patients' blood and employed in periodontal regenerative surgery. Although I-PRF and A-PRF have different characteristics, their biological effects on gingival tissue fibroblasts remain unclear. This research aims to compare the in vitro capacity in inducing gene expression and proliferation of human gingival fibroblasts between A-PRF and I-PRF. METHODS: Human donors undergoing dental implant surgery were sampled for normal human gingival fibroblasts (NHGFCs), followed by preparing A-PRF and I-PRF membranes. Enzyme-linked immunosorbent assay (ELISA) kit was used to assess the release of platelet-derived growth factor-AA (PDGF-AA), transforming growth factor-beta1 (TGF- ß1), and insulin growth factor-1 (IGF-1) at different periods. Cell viability and proliferation of A-PRF and I-PRF were compared using CCK-8 assay. The impacts of platelet concentration on human gingival fibroblast cells (HGFCs) were evaluated by quantifying the level or amount of phosphorylated extracellular signal-regulated protein kinase (p-ERK), and Matrix metalloproteinases (MMPs), MMP-1 and MMP-3. The effects of PRF on aged human gingival fibroblast cells were examined retrospectively. RESULTS: Overall, A-PRF demonstrated a higher release of TGF-B1 and PDGF-AA, while I-PRF reflected higher levels of IGF-1. A significantly higher level of cell proliferation was induced by higher cell proliferation by A-PRF and I-PRF. Additionally, in comparison to I-PRF, the expression of ERK phosphorylation and MMP-1 &MMP-3 in HGFCs was demonstrated by I-PRF and A-PRF. The increase in A-PRF was time-dependent (p < 0.05). CONCLUSION: Both I-PRF and A-PRF induced a stimulatory biological impact on the proliferation of human gingiva fibroblasts, with the latter demonstrating better capacity in facilitating the release of different growth factors. A-PRF also induced higher gene expression of p-ERK, MMP-1 &MMP-3, and the proliferation of fibroblasts.

Implant site development using titanium plate and platelet-rich fibrin for congenitally missed maxillary lateral incisors: A case report.

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.

Effect of Leukocyte-Platelet Rich Fibrin (L-PRF) on Tissue Regeneration and Proliferation of Human Gingival Fibroblast Cells Cultured Using a Modified Method.

BACKGROUND: An in vitro study on rapid culturing method of human gingival fibroblast cells (HGFCs) was established to investigate the potential use of the leukocyte-platelet rich fibrin (L-PRF) in tissue engineering technology, different medical fields, including periodontology and implantology. METHODS: Eight biopsies were obtained from eight different donors and a modified culturing technique was developed to obtain HGFCs. The modified 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide MTT assay was used to compare the cell viability when the modified culturing method was used in comparison to the standard method. Blood samples were collected from the same patients and L-PRF was isolated using a standard protocol. The releases of platelet-derived growth factor-AA and transforming growth factor-beta1 at various time intervals were observed using enzyme-linked immunosorbent assay (ELISA) kit. The proliferative effect of L-PRF on HGFCs was assessed by the cell counting kit-8 assay. RESULTS: A simple and rapid modified method for in vitro HGFC culture yielded a cellular monolayer within three to nine days after cell culture. L-PRF with three-dimensional polymer fibers released growth factors that peaked during the first three hours and continued to produce up to 10 days. The L-PRF presented a dose-dependent effect on HGFCs proliferation where HGFCs proliferation increased with an increase in L-PRF concentration. CONCLUSION: The modified technique for the culture of HGFCs might be useful for the development of future experimental and clinical studies, besides L-PRF has great therapeutic potential in oral surgery fields.

Soft tissue regeneration around immediate implant placement utilizing a platelet-rich fibrin membrane and without tightly flap closure: Two case reports.

RATIONALE: In this report, a combination of platelet-rich fibrin (PRF) membrane and semi-open flap technique was used to improve soft tissue regeneration in immediate implant placement in the molar region. PRF, an autologous fibrin matrix, has been widely used for soft tissue wound healing and regeneration. Semi-open flap technique is beneficial to eliminating exudates and relieving the swelling after surgery. PATIENT CONCERNS: Case 1 was a 45-year-old female with a residual crown in the posterior maxillary region that desired a dental implant operation. Case 2 was a 24-year-old male with retained deciduous tooth that requested a restoration of his congenital absent tooth. DIAGNOSES: In case 1, the tooth 16 was diagnosed with a residual crown, while in case 2, a deciduous tooth 75 was a retained deciduous tooth and 35 was congenital absent. INTERVENTIONS: In both cases, immediate implant placement was installed and PRF membranes were made to improve soft tissue augmentation with semi-open flap technique. In case 1, the mixture of an organic bovine bone and blood was filled in the gap between the implant and the socket wall. Subsequently, 2 PRF membranes covered the open wound with semi-open flap. Similarly, in case 2, another 2 PRF membranes were used to improve the soft tissue regeneration, with the same semi-open flap technique as mentioned above. OUTCOMES: In both cases, successfully soft tissue regeneration was obviously observed without postoperative infection. LESSONS: Utilizing the PRF membrane combined with semi-open flap technique can achieve excellent soft tissue augmentation around immediate implant placement in the molar regions.

The Effects of Leukocyte-Platelet Rich Fibrin (L-PRF) on Suppression of the Expressions of the Pro-Inflammatory Cytokines, and Proliferation of Schwann Cell, and Neurotrophic Factors.

This study evaluates the use of L-PRF as an autologous scaffold in nerve regeneration, and Schwann cells (SCs) proliferation and secretion of neurotrophic factors and its anti-inflammatory effect on SC Porphyromonas Gingivalis-Lipopolysaccharide (PG-LPS)-induced inflammatory responses in vitro. SEM was done to investigate various features of L-PRF. L-PRF-extracts was used to investigate the release of growth factors and treatment of SCs line. ELISA was applied to examine the release of IGF-1. The proliferative effect of L-PRF on SCs was assessed with CCK-8 assay. The effect of L-PRF on the mRNA and protein expression of SC neurotrophic factors were analyzed by RT-qPCR and ELISA. CCK-8 assay and RT-qPCR were used to determine the required concentration and the action time of PG-LPS before the anti-inflammatory effect of L-PRF was determined by measuring the changes in IL-1ß, IL-6, and TNF-a with RT-qPCR and ELISA. There are different features in L-PRF. Fourteen days was sufficient to release adequate GF. The mRNA expressions of the pro-inflammatory cytokines were notably raised by PG-LPS in 3-hours treatment. L-PRF can increase SC proliferation, neurotrophic factors secretion, and suppress SC PG-LPS-induced inflammatory responses in vitro. L-PRF has the potential as an autologous biological additive for peripheral nerve regeneration in the event of nerve inflammation and injuries.

The evaluation of leukocyte-platelet rich fibrin as an anti-inflammatory autologous biological additive. A novel in vitro study.

OBJECTIVES: To investigate the use of leukocyte-platelet rich fibrin on suppressing the porphyromonas gingivalis (PG-LPS)-induced secretion of proinflammatory cytokines. Methods:This quantitative experimental study was conducted at the School and Hospital of Stomatology, Jilin University, Changchun, China, between September 2017 and January 2019. A modified technique was used to obtain human gingival fibroblast cells (HGFCs). 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and Cell Counting Kit-8 tests were established to determine the proliferation rate. Human gingival fibroblast cells were treated by PG-LPS at different periods and the isolated mRNA was subjected to reverse transcription polymerase chain reaction and real time quantitative polymerase chain reaction. The release of platelet-derived growth factor and transforming-growth factor-ß1 at various time intervals was observed. Results: We successfully established a modified technique for the production of HGFCs culture. One µg/mL PG-LPS was the recommended concentration to inhibit fibroblast proliferation. The expression of the pro-inflammatory cytokines messenger ribnucleic acid was notably raised at 3 and 6 hours post-PG-LPS treatment. The cumulative release of growth factors peaked during the first 24 hours and the production continued for 10 days. However, the fibroblast expression of cytokines was significantly suppressed after treatment with leucocyte- and platelet-rich fibrin (L-PRF). Conclusion: This study provided a novel way of obtaining HGFCs and greater understanding of the clinical impacts through the assessment of the anti-inflammatory properties of L-PRF in vitro.

Minimally invasive endoscopic maxillary sinus lifting and immediate implant placement: A case report.

BACKGROUND: This case report discusses a modified approach for maxillary sinus augmentation, in which platelet-rich fibrin, endoscope, simultaneous implant placement, and sinus floor elevation (PESS) were applied for a maxillary sinus floor lift in a 40-year-old patient. CASE SUMMARY: A 40-year-old woman suffered missing upper right first molar. Implant stability quotient and cone-beam computed tomography (CBCT) were used to evaluate the diagnosis. CBCT showed insufficient posterior maxillary bone with a mean residual alveolar bone height of only 3.5 mm. The patient underwent a minimally invasive sinus floor elevation endoscopically. The sinus membrane was elevated in two stages, and a 12-mm implant was placed immediately. At 3 mo postoperatively, the final impressions were accomplished, and a full-ceramic crown was fit-placed. A 6-mo follow-up demonstrated satisfactory aesthetic and functional results. CONCLUSION: This is the first report to use an endoscope for maxillary sinus floor lifting in cases with severe and insufficient bone height. This case report demonstrates the advantages of the PESS technique, which include minimal invasiveness with high precision, being applicable in cases with a residual alveolar bone height < 4 mm with a promising result, and a shortened treatment period from 12 to 3 mo.

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.