Ultrasonographic analysis of palatal donor site healing accelerated with platelet-rich fibrin following subepithelial connective tissue harvesting.

OBJECTIVE: Platelet-rich fibrin (PRF) contains a variety of growth factors and bioactive molecules that play crucial roles in wound healing and angiogenesis. We aimed to evaluate the effects of PRF on tissue thickness and vascularization of the palatal donor site by ultrasound (USG) following subepithelial connective tissue harvesting. METHODOLOGY: A subepithelial connective tissue graft was harvested from the palatal region with a single incision for root coverage in 20 systemically healthy patients. In the test group (n = 10), the PRF membrane was placed at the donor site, whereas no material was applied in the control group (n=10). Palatal tissue thickness (PTT) and pulsatility index (PI) were evaluated by USG at baseline and on the 3rd, 7th, 14th, 30th, and 90th days after surgery. The early healing index (EHI) was used to evaluate donor site healing for 30 days. RESULTS: PTT was significantly higher in the PRF group on the 3rd and 14th days after surgery when compared to the controls. In the PRF-treated group, PI levels were significantly higher than in the controls, especially on the 14th day. PTT increased significantly 90 days after surgery compared to the test group baseline, but controls showed a significant decrease. The PRF group showed statistically significant improvements in EHI scores compared to controls on days 3, 7, and 14. This study found a negative correlation between PI values and EHI scores on postoperative days three and seven in the test group. CONCLUSION: USG is a non-invasive, objective method to radiographically evaluate the regenerative effects of PRF on palatal wound healing after soft tissue harvesting. To overcome graft inadequacy in reharvesting procedures, PRF application may enhance clinical success and reduce possible complications by increasing tissue thickness and revascularization in the donor area.

Evaluation of the effect of injectable platelet-rich fibrin (i-PRF) in wound healing and growth factor release in rats: a split-mouth study.

This experimental study aimed to evaluate the effects of injectable platelet-rich fibrin (i-PRF) on mucosal healing and the release of growth factors in rats. 40 rats were used; i-PRF was administered in the right buccal area while saline was injected in the left. Cytokeratin, FGF, PDGF, TGF, and VEGF expressions were determined with immunohistochemistry. Gene expressions of EGF, TGF-ß, and VEGF were analysed. Epithelialization started on the 3rd day, and connective tissue maturation was more prominent in the i-PRF-applied group. Also, the releases of VEGF, EGF, TGF-ß, PDGF, and FGF were higher in the i-PRF group during the 14 days. Gene expression analysis showed that changes in TGF-ß at 14 days after i-PRF injection and VEGF after 21 days were statistically significant. The results of this study suggested that autologous i-PRF application enhanced the healing of oral mucosal wounds by increasing the release of growth factors for 21 days.

Ultrasonographic analysis of palatal donor site healing accelerated with platelet-rich fibrin following subepithelial connective tissue harvesting

Abstract Objective Platelet-rich fibrin (PRF) contains a variety of growth factors and bioactive molecules that play crucial roles in wound healing and angiogenesis. We aimed to evaluate the effects of PRF on tissue thickness and vascularization of the palatal donor site by ultrasound (USG) following subepithelial connective tissue harvesting. Methodology A subepithelial connective tissue graft was harvested from the palatal region with a single incision for root coverage in 20 systemically healthy patients. In the test group (n = 10), the PRF membrane was placed at the donor site, whereas no material was applied in the control group (n=10). Palatal tissue thickness (PTT) and pulsatility index (PI) were evaluated by USG at baseline and on the 3rd, 7th, 14th, 30th, and 90th days after surgery. The early healing index (EHI) was used to evaluate donor site healing for 30 days. Results PTT was significantly higher in the PRF group on the 3rd and 14th days after surgery when compared to the controls. In the PRF-treated group, PI levels were significantly higher than in the controls, especially on the 14th day. PTT increased significantly 90 days after surgery compared to the test group baseline, but controls showed a significant decrease. The PRF group showed statistically significant improvements in EHI scores compared to controls on days 3, 7, and 14. This study found a negative correlation between PI values and EHI scores on postoperative days three and seven in the test group. Conclusion USG is a non-invasive, objective method to radiographically evaluate the regenerative effects of PRF on palatal wound healing after soft tissue harvesting. To overcome graft inadequacy in reharvesting procedures, PRF application may enhance clinical success and reduce possible complications by increasing tissue thickness and revascularization in the donor area.

Efficacy of injectable platelet-rich fibrin on clinical and biochemical parameters in non-surgical periodontal treatment: a split-mouth randomized controlled trial.

OBJECTIVES: The purpose of this clinical trial was to evaluate the potential clinical and biochemical effects of injectable platelet-rich fibrin (i-PRF) application adjunct to scaling and root planning (ScRp) in deep periodontal pockets. MATERIALS AND METHODS: In this split-mouth-designed study, 17 patients with 34 deep periodontal pockets were randomly treated with ScRp + i-PRF (test group) and ScRp + saline (control group). Clinical periodontal measurements were recorded at baseline, 1st, 3rd, and 6th months after the treatments. The levels of vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α), and interleukin (IL)-10 in gingival crevicular fluid (GCF) samples were analyzed using the ELISA method at baseline, 7th, and 14th days. RESULTS: Clinical periodontal parameters showed significant improvements with both treatment modalities. Mean pocket reduction (PD) and clinical attachment (CAL) gain were significantly higher in the test group than in controls at follow-up visits (p < 0.05). In the test group, gingival recession (GR) values were significantly lower compared to the control group. VEGF and IL-10 levels in the test group were significantly higher than in controls at the 14th day, and TNF-α levels were found significantly lower in the test group at the 7th and 14th days. CONCLUSIONS: Especially in the test group, the significant increase in VEGF and IL-10 expressions and the decrease in TNF-α levels may have accelerated the periodontal healing observed in the clinical parameters. CLINICAL RELEVANCE: The result of the present study demonstrated the beneficial effects of adjunctive i-PRF administration during non-surgical periodontal treatment of deep periodontal pockets. CLINICAL TRIAL REGISTRATION NUMBER: NCT05753631.

The Effect of Two Different Doses of Astaxanthin on Alveolar Bone Loss in an Experimental Model of Periodontitis in Diabetic Rats.

This study evaluated the effects of astaxanthin (ASX) on alveolar bone loss, receptor activator of nuclear factor-κB ligand (RANKL), and osteoprotegerin (OPG) activity in ligature-induced periodontitis in diabetic rats. Diabetes mellitus (DM) was induced with 50 mg/kg intraperitoneal streptozotocin in 40 male Wistar rats. The Wistar rats were divided into six experimental groups: non-ligated (NL; n = 6); ligature only (L; n = 6); DM only (D; n = 6); DM + ligature (DP; n = 6); DM + ligature + 1 mg/kg/day ASX (ASX 1 group; n = 8); and DM + ligature + astaxanthin 5 mg/kg/day ASX (ASX 5 group; n = 8). Silk ligatures were placed along the gingival margin of the left mandibular first molar tooth. The study duration was 11 days, after which the animals were euthanised. Changes in alveolar bone levels were clinically measured, and RANKL and OPG activities were immunohistochemically examined. Alveolar bone loss was the most significant in the DP group (p < 0.05). Decreased alveolar bone loss was observed in the ASX 5 group (p < 0.05). Although RANKL activity was highest in the DP group, it was observed at lower levels in the groups to which ASX was administered. OPG activity did not differ between groups (p > 0.05). The results of this study suggested that 1 and 5 mg/kg ASX administration reduced RANKL activity and alveolar bone loss in rats with experimentally induced periodontitis.

Effects of taxifolin on bone formation and apoptosis in experimental periodontitis in diabetic rats.

We investigated the therapeutic potential of taxifolin for treatment of alveolar bone loss (ABL) in experimental periodontitis in diabetic rats. Diabetes mellitus (DM) was induced by streptozotocin. Rats were divided into six groups: untreated control; DM only (D) group; ligature only (P) group; DM + ligature (DP) group; DM + ligature + 5 mg/kg/day taxifolin (Taxi-5) group; DM + ligature + 10 mg/kg/day taxifolin (Taxi-10) group. Experimental periodontitis was induced by ligation of the first molar and allowed to progress for 30 days before performing cone-beam computed tomographic (CBCT), histomorphometric and immunohistochemical analyses of periodontal tissue destruction. ABL was assessed using CBCT. ABL was greatest in the P and DP groups. Decreased ABL was observed in the Taxi-5 and Taxi-10 groups. Bone morphogenic protein (BMP-2), osteocalcin (OCN), receptor activator of nuclear factor kappa-Β ligand (RANKL), alkaline phosphatase (ALP), type I collagen, B cell lymphoma-associated X (Bax), and B-cell lymphoma 2 (Bcl-2) levels were investigated using immunohistochemistry. The Taxi-5 and Taxi-10 groups exhibited decreased RANKL expression, but increased BMP-2, ALP, type I collagen and OCN levels compared to the P and DP groups. Bax activity was increased in the D, P and DP groups. Taxi-5 and Taxi-10 groups exhibited increased Bcl-2 activity. Our findings suggest that taxifolin can reduce apoptosis and improve alveolar bone formation in diabetic rats with periodontitis.

The effects of taxifolin on alveolar bone in experimental periodontitis in rats.

OBJECTIVE: This study aimed to evaluate the effect of taxifolin, a powerful antioxidant, on the progression of periodontitis by immunohistochemical and cone-beam computed tomography (CBCT) examination. DESIGN: This study was performed with 32 rats in four experimental groups: a non-ligated group (Control, n = 8), periodontitis group (Perio, n = 8), periodontitis with 1 mg/kg/day taxifolin group (Taxi-1, n = 8), and periodontitis with 10 mg/kg/day taxifolin group (Taxi-10, n = 8). A ligature-induced experimental periodontitis design was used. All rats were sacrificed at 30 days. Alveolar bone loss was determined by CBCT. Hematoxylin-eosin stained slides were examined. The expression levels of bone morphogenetic protein 2 (BMP-2), osteocalcin (OCN), alkaline phosphatase (ALP), collagen type I (Col 1), Bcl-2, Bax, and receptor activator of NF-κB ligand (RANKL) were determined immunohistochemically. RESULTS: Both doses of taxifolin showed a decrease in alveolar bone loss. The inflammatory reaction was higher in the Perio group and lower in the taxifolin groups. BMP-2, OCN, ALP, and Col 1 expression were dose-dependently elevated in the taxifolin groups. RANKL immunoexpression decreased with both doses of taxifolin. Bcl-2 expression increased and Bax expression decreased in the taxifolin groups. CONCLUSION: Taxifolin successfully reduced apoptosis and improved bone formation in alveolar bone in this experimental periodontitis model.

Effects of a Glycogen Synthase Kinase 3 Inhibitor Tideglusib on Bone Regeneration With Calvarial Defects.

Tideglusib is a glycogen synthase kinase 3 (GSK-3) inhibitor which has shown the effects of bone regeneration, used for the treatment of Alzheimer disease. The aim of the study was to determine the effects of Tideglusib in the apoptosis and the bone regeneration in rats with calvarial defects. Twenty male Wistar rats (aged 11-13 weeks) were used for the study. Full-thickness flap elevated to exposure calvarial bone. Two 5 mm critical size calvarial defects were created on each rat calvarium. The defects were divided into 4 study groups: 1-Control (n = 10); 2- Gelatin sponge+Tideglusib (Gs+TDG; n = 10); 3- Autogenous bone (AB; n = 10); 4-Autogenous bone+Tideglusib (AB+TDG; n = 10). Then, the rats were sacrificed at fourth week. Three-dimensional imaging, histopathologic and immunohistochemical examinations were performed to evaluate the samples. The most increased bone formation and interaction between graft and new bone were observed in AB+TDG group. Bone morphogenic protein-2 (BMP-2), alkaline phosphatase (ALP), collagen type 1 (Col 1) and osteocalcin (OCN) was determined significantly higher in Tideglusib received groups compared with those of Control and AB groups (P < 0.05). Osteoclast numbers found to be higher in Gs+TDG and AB+TDG groups as well as RANKL expression dis not affected in Gs+TDG group but decreased in AB+TDG group comparing those of Control and AB groups. In addition, Tideglusib increased the Bcl-2 levels (P < 0.05) and decreased Bax levels (P > 0.05) in Tideglusib received groups compared with their controls. The administration of Tideglusib in calvarial bone defects increased bone mineral density, new bone area and total bone area by decreasing apoptosis and increasing osteoblastogenesis.

PRF improves wound healing and postoperative discomfort after harvesting subepithelial connective tissue graft from palate: a randomized controlled trial.

OBJECTIVES: The aim of this study is to determine the use of platelet-rich fibrin (PRF) in the management of soft tissue donor site healing after harvesting connective tissue graft (CTG) from the palate and evaluate the postoperative discomfort (pain, bleeding, analgesic consumption, tissue color match) of patients. MATERIALS AND METHODS: Forty patients were randomly assigned to PRF or control group. In the PRF group, PRF membrane was placed into CTG donor site. After surgery, delayed bleeding, early healing index (EHI), tissue color match, and analgesic consumption were recorded. The visual analog scale (VAS) was used to observe the postoperative pain and tissue color match. Data were analyzed using the independent sample t test and the repeated measure ANOVA test. RESULTS: The patients in the PRF group reported significantly lower pain scores at all-time points. Postoperative 3rd and 7th day, EHI scores were lower in the favor of the PRF group. VAS score values of tissue color match were lower in the control group at 7th and 14th day, compared with the PRF group. Analgesic intake was significantly lower in the PRF group postoperatively at 1st and 3rd day that of control group. CONCLUSION: PRF application at the palatal donor site demonstrates promising results in terms of better wound healing and reduced postoperative discomfort in the patients after harvesting CTG. CLINICAL RELEVANCE: Patients may avoid surgical operations because of the discomfort or pain feeling. Reducing postoperative pain and discomfort and accelerating recovery meet the wishes of every patient and physician. PRF can provide these requirements as an easy method to obtain and implement.

Humic Acid Enhances Wound Healing in the Rat Palate.

INTRODUCTION: Humic acid was previously shown to enhance cutaneous wound healing and show antibacterial properties; however, it has not been used for wound healing in the oral cavity. Thus, the goal of this study was the evaluation of the effect of the humic acid on the healing of excisional wounds in an experimental rat study. MATERIALS AND METHODS: A circular wound on mid-palatal surfaces was made on a total of 77 Wistar rats by using a 3-mm biopsy punch under anesthesia. The animals were divided into 4 groups as baseline, saline control (0.09%), chlorhexidine gluconate (0.05%), and humic acid (80 mg/kg) and were treated with these materials for 7 days. RESULTS: The rats were observed for 3 weeks in order to track the wound closure rates. Both humic acid treatment and chlorhexidine gluconate treatment resulted in statistically significant enhanced rate of wound closure compared to the saline control on both the 1st and 2nd weeks of treatment. Humic acid treatment for the wounds in the palate resulted in enhanced recovery compared to not only saline control but also chlorhexidine gluconate treatment. CONCLUSION: In this study, humic acid was shown to enhance healing of oral wounds for the first time in the literature. These findings indicate that humic acid can be used as an alternative to current treatment methods for oral wounds.

Effects of Curcumin on Alveolar Bone Loss in Experimental Periodontitis in Rats: A Morphometric and Histopathologic Study.

Background: Curcumin is found in the rhizomes of the turmeric plant that has been showed antioxidant and anti-inflammatory effect. The aim of this study was to evaluate the effects of systemic curcumin therapy on alveolar bone loss in an experimental periodontitis model in rats. Material and Methods: Thirty-two male Wistar rats were randomly divided to 4 groups: 75 mg/kg/daily curcumin (C75; n =8), 150 mg/kg/daily curcumin (C150; n =8), Control (n =8), and Ligated (n =8). Curcumin was administrated using gastric gavage. After 12 days, the rats were sacrificed. Right mandibles samples were histopathologically examined. Alveolar bone loss was measured. Interleukin 1ß (IL-1ß) and interleukin 10 (IL-10) were evaluated in the serum samples and gingival homogenates. Results: The measurements of alveolar bone loss in the mandibular molars revealed significantly higher bone-loss values in the Ligated group than the Control, C75 and C150 groups. The IL-1ß levels in the gingival homogenates were significantly increased in the Ligated group compared to those of the Control, C75 and C150 groups. The serum IL-1ß levels in the Ligated group were significantly higher than the Control group. The mean osteoblast numbers in the Ligated group were lower than those of the Control, C75 and C150 groups. The C150 groups showed significantly more osteoblasts than the Control group. The osteoclast numbers in the Ligated group increased significantly compared to the C75, C150 and control groups. Conclusion: This study demonstrates that systemic administration of curcumin at the 75 and 150mg/kg doses reduced alveolar bone loss in the periodontal disease in rats. Keywords: Alveolar bone loss, Antioxidant, Curcumin, Ligature-induced, Histomorphometric, Micronutrition.