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.

Treatment of anal fistulas with Obsidian RFT®: just another autologous compound platelet-rich fibrin foam?

BACKGROUND: Sphincter-preserving techniques like autologous compound platelet-rich fibrin foam have gained popularity, offering potential for better functional outcomes in anal fistula treatment. The present study aimed to evaluate the efficacy and safety of Obsidian RFT®. METHODS: The study conducted a retrospective analysis from January 2018 to December 2022 on patients who received anal fistula closure with Obsidian RTF® at the Department of General Surgery, Medical University of Vienna. Clinical diagnosis, complemented by radiographic imaging, was employed to confirm inconclusive cases. Demographic and fistula characteristics and postoperative data were collected from electronic records following STROCSS criteria. RESULTS: Fifteen patients received Obsidian RFT® treatment for anal fistulas. We found no intra- and postoperative complications. The median hospital stay was 3 days. After a median follow-up of 32 months, a closure rate of 53.3% was detected. Non-significant differences were observed in various variables, yet trends emerged, indicating associations between abscess presence and non-healing fistulas. A distinct age threshold (≥ 42.7 years) served as an indicator for an inability to achieve anal fistula cure. CONCLUSION: Obsidian RFT® represents a safe, minimally invasive operative procedure. Approximately half the patients experienced healing, with better outcome in a younger population. TRIAL REGISTRATION: Ethical Approval number Medical University of Vienna (#1258/2018). This study was registered retrospectively in ClinicalTrials.gov (NCT06136325).

Which of the autologous blood products administered simultaneously with arthrocentesis is more effective in terms of clinical outcomes?

This study aimed to determine which of the autologous blood products administered simultaneously with arthrocentesis is more effective on clinical outcomes in patients with temporomandibular joint disorder. The study included 116 patients who underwent arthrocentesis alone, i-PRF (injectable- Platelet Rich Fibrin) with arthrocentesis, and PRP (Platelet Rich Plasma) with arthrocentesis. A total of 35 patients underwent arthrocentesis (Group A), 47 patients underwent arthrocentesis with i-PRF (Group APRF) and 34 patients underwent arthrocentesis with PRP (Group APRP). All patients received local anaesthesia before the procedure, and then the upper joint cavity was irrigated with approximately 100 mL of saline solution. Subsequently, patients in Group APRF and Group APRP were administered 2 ml of autologous blood product. All patients' pain and maximum mouth opening values were compared statistically at each time point: before the procedure, 1 week, 1 month, 3 months, and 6 months after the procedure. The results demonstrated no significant difference among the groups in terms of pain. Nevertheless, in terms of maximum mouth opening, superior outcomes were observed in the early postoperative period in the PRP group, while superior outcomes were observed in the late postoperative period in the i-PRF group.

Platelet-rich Fibrin Membrane Transplantation for the Treatment of Highly Myopic Macular Hole Retinal Detachment.

INTRODUCTION: Highly myopic macular hole retinal detachment (MHRD) is often associated with a poor prognosis, and there is currently no optimal treatment. Platelet-rich fibrin (PRF), an autologous blood product, has been shown to promote tissue regeneration. This prospective, randomized, controlled study investigated the efficacy of conventional internal limiting membrane (ILM) peeling versus PRF membrane transplantation in highly myopic MHRD. METHODS: Eyes with highly myopic MHRD were randomly assigned to either a conventional ILM peeling group (IP group, n = 19) or a PRF membrane transplantation group (PMT group, n = 21). The study followed participants for a period of 6 months. The primary outcome measure was macular hole (MH) closure assessed using optical coherence tomography. Secondary outcomes included best-corrected visual acuity (BCVA), central retinal thickness (CRT), superficial vascular density (SVD), deep vascular density (DVD), rate of retinal reattachment, and any complications encountered. RESULTS: MH closure was achieved in a significantly greater proportion of eyes in the PMT group (21/21, 100.00%) compared to the IP group (15/19, 78.95%) (P = 0.042). Retinal reattachment was accomplished in all patients (100.00%) within both groups. Except for an insignificant difference in BCVA observed at 1 week post-surgery in the IP group, significant improvements in BCVA and CRT were documented in both groups across all other post-operative time points. Final BCVA (P = 0.040), CRT (P = 0.002), SVD (P = 0.002), and DVD (P = 0.013) were all significantly higher in the PMT group compared to the IP group. No serious complications were identified in either group. CONCLUSIONS: This study demonstrated the superiority of PRF membrane transplantation compared to conventional ILM peeling in promoting MH closure and enhancing retinal vascular density in patients with highly myopic MHRD. Additionally, PRF membrane transplantation effectively restores retinal reattachment, improves visual function, and increases retinal thickness without introducing additional complications. TRIAL REGISTRATION NUMBER: www. CLINICALTRIALS: gov , NCT06200727.

Evaluation of intra-articular injection of injectable platelet-rich fibrin, anterior repositioning splint and arthrocentesis in treatment of temporomandibular joint internal derangement.

The current research paper was designed to assess the impact of an intra-articular injection of injectable platelet-rich fibrin (I-PRF) following arthrocentesis and the use of an anterior repositioning splint (ARS) as a proposed treatment approach for addressing symptomatic internal derangement of the temporomandibular joint (TMJ). This study comprised thirty patients who presented with bilateral disc displacement without reduction. The patients were evenly distributed into two groups: Group I underwent treatment involving ARS and arthrocentesis alone, while Group II underwent treatment with ARS, arthrocentesis, and the injection of I-PRF. Clinical assessment of all patients was done postoperatively in the following intervals; first week, first month, third month, and six months for maximum mouth opening (MMO), right and left lateral excursion, and pain score. Magnetic resonance imaging (MRI) assessment for all joints was done at the sixth month postoperatively. Both groups demonstrated improvement in MMO, lateral excursion, and pain. Significant statistical differences were observed in the mean values of MMO and Visual Analogue Scale (VAS), favouring the I-PRF group. MRI postoperatively showed no significant changes in disk position or morphology at the end of the sixth month. Administering an intra-articular I-PRF injection subsequent to arthrocentesis demonstrates effectiveness as a treatment approach for alleviating the signs and symptoms associated with internal derangement of the TMJ.

Comparison Between Autologous Albumin Gel and Liquid Platelet-Rich Fibrin Mixture Versus Connective Tissue Graft to Modify the Gingival Phenotype: A Randomized Controlled Trial.

Objectives To assess changes in gingival thickness (GTH) and the width of keratinized gingival tissue (KTW) following treatment with either connective tissue graft (CTG) or an albumin gel-platelet-rich fibrin mixture (Alb-PRF). Materials and methods Twenty treatment sites were included in a split-mouth design involving 10 patients with a thin gingival phenotype in the mandibular anterior region. The sample was randomly divided into two groups, with the Alb-PRF applied to the experimental group and CTG used for the control group. GTH and KTW were measured at baseline and after one, three, and six months. Results GTH increased in both groups during all follow-up periods. However, no statistically significant differences (p > 0.05) between the groups were observed at baseline and six months. At three months, the experimental group exhibited significantly higher GTH (p < 0.001). Additionally, at three and six months, the CTG group showed a superior increase in KTW (p < 0.05). Conclusion Within the constraints of this study, Alb-PRF application for modifying thin gingival phenotypes proved to be an effective therapeutic option, potentially serving as an alternative to CTGs. Although Alb-PRF resulted in thicker gingiva, CTG demonstrated a greater enhancement in KTW.

Efficacy of photobiomodulation following L-PRF application for recovery of mental nerve neurosensory disturbances caused by genioplasty: A randomized triple-blind clinical trial.

The present study assessed the efficacy of photobiomodulation (PBM) following leukocyte-platelet rich fibrin (L-PRF) application for recovery of mental nerve neurosensory disturbances (NSDs) caused by genioplasty. This randomized triple-blind split-mouth clinical trial was conducted on 20 female patients (40 quadrants) requiring genioplasty. In each patient, one random side of the mandible served as the intervention (laser), and the other side as the control group. After genioplasty and L-PRF application, the intervention side underwent GaAIAs diode laser irradiation (880 nm, 500 mW, 15 J/cm2, 0.5 cm2 spot size, continuous-wave). Each point was laser irradiated for 15 s. Unilateral extraoral PBM was performed at 1, 3, 7, 14, 21, and 28 days, postoperatively. Laser in off mode (sham laser) was used for the control side. A visual analog scale (VAS) was used for general sensitivity, and 2-point discrimination, directional discrimination, pain discrimination, and thermal discrimination tests were used to assess the neurosensory recovery at 2 days, 2 weeks, 4 weeks, and 2 months, postoperatively. Statistical analyses were performed using two-way repeated measures ANOVA, Bonferroni test, and generalized estimating equation (alpha = 0.05). Time had a significant effect on improvement of all sensory variables (P < 0.05). Neurosensory recovery was significantly better in the intervention than the control group at all time points according to the two-point discrimination test (P = 0.0135) and brush test (P = 0.025) results. The interaction effect of time and intervention was not significant on any dependent variable (P > 0.05). Application of L-PRF + PBM resulted in significantly greater sensorineural recovery according to the two-point discrimination and brush test results.

Socket Preservation Using Platelet-Rich Fibrin and Free Gingival Grafts.

OBJECTIVE: The present randomised controlled trial is based on the null hypothesis that there is no difference in crestal bone levels (CBLs) following socket preservation (SP) using platelet-rich fibrin (PRF) and free gingival graft (FGG). The aim was to evaluate CBLs following SP using PRF and FGG. METHODS: This study is a parallel-arm randomised controlled trial. Patients in the test and control groups underwent SP using PRF and FGG, respectively. Intraoral visual examination was performed to clinically assess signs of swelling, pus/abscess, and stability of sutures and graft. Self-rated postoperative pain was assessed after 1 week and 6 months using the visual analogue scale (VAS). At the 6-month follow-up, cone-beam computed tomography was performed to evaluate CBL in mesiodistal and buccolingual dimensions. The preoperative cone-beam computed tomographic images were superimposed with those taken at the 6-month follow-up to compare CBLs. Statistical comparisons were performed and level of significance was set at P < .05. RESULTS: The test and control groups each comprised 13 individuals with comparable ages. All teeth included in the test and control groups were located in the maxillary aesthetic zone. At the 1-week follow-up, VAS scores were higher in the control than in the test group (P < .01). At the 6-month follow-up, none of the participants reported self-rated pain. The change in buccolingual dimension was greater in the control group than in the test group (P < .05). CONCLUSIONS: Both FGG and PRF are effective techniques for SP; however, the latter technique is more effcacious in maintaining buccolingual dimensions of the extraction socket.

Eggshell membrane as a regenerative material in alveolar bone grafting in combination with advanced platelet rich fibrin.

Abstract: The eggshell and the eggshell membrane (ESM) are significant by-products of the poultry industry and are being utilized for various valuable purposes in health care, like soft tissue healing and pain alleviation. The aim and objective of our study are to assess the effect of the eggshell membrane on alveolar bone regeneration after tooth extraction. A total of 40 extraction sockets (bilateral) among 20 patients were assessed clinically for healing, and radiographic parameters of bone density and socket volume were assessed on CBCT at baseline, 3 months, and 6 months. Advanced platelet-rich fibrin was created from 5 ml of autologous blood from the patient and centrifuged for 15 minutes at 1500 RPM/168 RCF. The commercially available powdered form of egg shell membrane was used in the study. Based on the randomized allotment (coin-flip), A-PRF alone or A-PRF mixed with eggshell membrane was placed inside the extraction socket and was stabilized using 3-0 silk sutures. It was ob-served that wound healing was uneventful in all 20 patients. No evidence of dry sockets or allergic reactions was noted in any patient. Statistical analysis was done using the un-paired t-test and Mann-Whitney U test with SPSS version 20.0. P<0.05 was considered significant. On comparison of the mean bone density at baseline, 3 months, and 6 months, the socket density in the eggshell with the PRF group was higher compared to the control group. To conclude, eggshell membrane has good regenerative properties and excellent osteogenic capacity; therefore, it could be a useful graft due to its low cost, abundant availability, and simple application.

Diagnostic performance of 3.0 Tesla diffusion tensor imaging in the assessment of brain stem glioma grading.

Purpose: This study aimed to investigate the role of 3 Tesla Dif-fusion tensor imaging (DTI) in the assessment of brainstem glioma (BSG) grading. Materials and methods: The study comprised 22 patients, including pathology-proven 6 brainstem low-grade gliomas (BS-LGG) and 16 brainstem high-grade gliomas (BS-HGG). Characteristics including age, gender, fractional anisotropy (FA), mean diffusivity (MD) of the tumor, peritumoral region, and the ratio of tumor FA to parenchymal FA, as well as tumor MD to parenchymal MD (rFA and rMD), were compared using Mann-Whitney U test, Shapiro-Wilk test, and Chi-square test. Receiver operating characteristic (ROC) curve analysis was used in the study to determine cut-off values and diagnostic values for grading brainstem gliomas (BSG) using diffusion tensor imaging (DTI). Results: Our study revealed no significant difference in age and gender between the BS-LGG and BS-HGG groups (p>0.05). Fractional anisotropy (FA) indices on DTI MRI were found to be highly valuable in grading BSG, with an area under the curve (AUC) of 0.958 - 0.979 when using cut-off values of tFA, pFA, rtFA, and rpFA at 0.318, 0.378, 0.424, and 0.517, respectively. Particularly, rtFA demonstrated the hi-ghest diagnostic value with a sensitivity (Se) of 100%, specificity (Sp) of 93.8%, and AUC of 0.079. Conversely, the indices of tumor mean diffusivity (tMD), peritumoral edema region mean diffusivity (pMD), rtMD, and rpMD showed no diagnostic value in grading BSG. Conclusion: The fractional anisotropy (FA) value on DTI between the tumor region and normal brain parenchyma holds significant value in diagnosing brainstem gliomas (BSG) grading, thereby playing a crucial role in treatment planning and predicting outcomes for patients with brainstem gliomas.

Effect of Platelet-Rich Fibrin Combined With Hyaluronic Acid on Bone Formation in Dental Implant Sockets: An In Vivo Study in Sheep.

OBJECTIVES: The goal was to evaluate the effect of the combined growth factor of hyaluronic acid (HA) and advanced platelet-rich fibrin (A-PRF) on acceleration and maturation of bone formation around titanium dental implants in the bone-free space (jumping distance) of an over-preparation socket. MATERIALS AND METHODS:  Thirty-two titanium dental implants were placed in four sheep and distributed into one control group (A) and three experimental groups (B, C, and D) in two different time periods. Each sheep received eight implants. The eight implants in each sheep were distributed into four groups. The first period was one month after the initial placement, 16 implants were used in two sheep. The second period was three months after the initial placement; another 16 implants were used in the other two sheep. All implants were placed in over-prepared implant sockets, resulting in minimal primary stability. In Group A: the space between the dental implant and the bone of the inner wall of the socket was left without a growth substrate material. In Group B: we added HA between the dental implant and the bone of the inner wall of the socket. In Group C: we added A-PRF between the dental implant and the bone of the inner wall of the socket. In Group D: we added a combination of HA and A-PRF between the dental implant and the bone of the inner wall of the socket. Data was collected for each group at one month and three months at the same time. A high-resolution, desktop micro-CT system (Bruker Skyscan 1275, Kontich, Belgium) was used to scan the specimens. The NRecon software (ver. 1.6.10.4, SkyScan) and CTAn (SkyScan) were used for the visualization and quantitative measurement of the samples. One-way analysis of variance (ANOVA) was used to compare the means of the four study groups in the same period. A post hoc test was used after ANOVA to compare the means of two samples at the same time. A p-value of ≤ 0.05 was considered statistically significant. RESULTS: After one month and three months of using combined HA and A-PRF on Group D, significant acceleration was observed in bone formation in all tests around dental implants compared with other groups, while no significant acceleration was observed when they were used separately; all three study groups showed significant results when compared with the control group. CONCLUSION: Our data showed that using a combination of HA and A-PRF had a significant effect on the acceleration of the bone formation and ossification process when added to bone-free space (jumping distance) around implants while leaving space without any growth substrates might delay the bone ossification process.

Platelet-Rich Fibrin impact on the Diced Cartilage viability in Rhinoplasty.

Introduction: Diced cartilage grafts are well-liked, dependable, and simple-to-use techniques for dorsum camouflage in rhinoplasty. Recent research results demonstrate how effectively PRF increases the survivability of diced cartilage in the nasal dorsum and decreases its absorption. In this study, we intend to investigate the effect of fibrin-rich platelets (PRF) on diced cartilage survival in rhinoplasty surgery. Materials and Methods: This clinical trial included people referred to Rasoul Akram Hospital for rhinoplasty between 2020 and 2021. Patients were divided into two groups: Diced Cartilage alone (DC) and Diced Cartilage + PRF (DC+PRF). Cartilage survival was assessed by ultrasound, photography, and nasal examination, and the two groups were compared six months after rhinoplasty. Patients' satisfaction with surgery was also evaluated using the Utrecht questionnaire. Results: The mean age of the two groups of 20 patients was 29.05 ± 7.02 and 26.65 ± 8.16 years in the DC and DC + PRF groups, respectively (P>0.05). After treatment, the frequency of irregularity on examination and dissatisfaction score was slightly but insignificantly higher in the DC group compared to the DC + PRF group (25% vs. 15% and 12.25 ± 6.45 vs. 10.45 ± 6.74, respectively, and P values>0.05). The total volume decrease, regardless of the injection site, was significant in both groups (P < 0.05), but the magnitude of volume reduction was significantly higher in the DC group compared to the DC + PRF group (-0.060 ± 0.087 vs. - 0.033±0.017, respectively, P<0.05). Conclusion: PRF may slow down the absorption process of diced cartilage.

Effectiveness of Injectable Platelet-Rich Fibrin Therapy in Alopecia and Facial Rejuvenation: A Systematic Review.

Platelet-rich fibrin (PRF) has gained attention in regenerative medicine for its potential to enhance tissue repair and regeneration. Its application in dermatology, particularly for treating alopecia and facilitating facial rejuvenation, is of significant interest but requires systematic evaluation. This review aims to systematically assess the effectiveness of injectable PRF therapy in treating alopecia and facial rejuvenation procedures. We searched PubMed, Scopus, and Web of Science for studies published up to 2023 that involved injectable PRF for alopecia and facial rejuvenation. Eligible studies included prospective cohorts, original studies, case series, and retrospective studies that reported clinical outcomes. Key outcomes were improved hair growth for alopecia and skin texture, elasticity, and appearance for facial rejuvenation. Seven studies met the inclusion criteria, encompassing 130 patients. For alopecia, three studies reported a noticeable improvement in hair density and growth. For facial rejuvenation, four studies demonstrated moderate to significant improvements in skin texture and elasticity and a reduction in facial wrinkles and lines, confirmed by both subjective assessments and objective measurements such as VISIA® skin analysis. Injectable PRF therapy shows promise in treating androgenetic alopecia and enhancing facial esthetics, indicating its potential as an effective treatment option in regenerative dermatology. However, further research involving larger sample sizes, control groups, and longer follow-ups is required to validate these findings and establish standardized treatment protocols.

Tooth Autotransplantation, Autogenous Dentin Graft, and Growth Factors Application: A Method for Preserving the Alveolar Ridge in Cases of Severe Infraocclusion-A Case Report and Literature Review.

Background: Tooth infraocclusion is a process in which a completely or partially erupted tooth gradually moves away from the occlusal plane. Submerged teeth can lead to serious complications. Treating teeth with infraocclusion is very challenging. One of the procedures allowing for the replacement of a missing tooth is autotransplantation. The aim of this paper is to review the literature on teeth autotransplantation, supported by a case report involving the autotransplantation of a third mandibular molar into the site of an extracted infraoccluded first mandibular molar, as well as the utilization of advanced platelet-rich fibrin (A-PRF) alongside autogenous dentin grafts for bone tissue regeneration. Methods: A severely infraoccluded first permanent right mandibular molar was extracted and then ground to obtain the dentin graft. A-PRF clots (collected from the patient's peripheral blood) were added to the autogenous dentin graft, to create the A-PRF membrane. An atraumatic extraction of the lower left third molar was performed and then it was transplanted into the socket of tooth no. 46. Immediately after transplantation, tooth no. 38 was stabilized with orthodontic bracket splints for 3 months. The patient attended regular follow-up visits within 12 months. Results: After one year, the patient did not report any pain. In the clinical examination, the tooth and surrounding tissues did not show any signs of infection. However, radiographically, cervical inflammatory resorption, unchanged pulp canal dimensions, absent root growth, periapical radiolucency, and lack of apical and marginal healing were observed. Reconstruction of the bone defect was obtained and the alveolar ridge of the mandible was preserved. Due to poor stability of the tooth and severe resorption, the tooth needed to be extracted. Conclusions: This study is designed to critically evaluate the efficacy of autotransplantation, the application of growth factors, and the integration of autogenous dentin grafts in remedying dental deficiencies resulting from reinclusion. We aim to point out the possible causes of treatment failure.

Platelet rich fibrin augmented tympanoplasty versus cartilage tympanoplasty: a randomized clinical trial.

OBJECTIVES: The aim of the current study was to evaluate the efficacy of PRF-augmented fascia tympanoplasty versus cartilage tympanoplasty in repair of large TM perforations. METHODS: This randomized clinical trial included 156 patients with dry large tympanic membrane perforations. Patients were randomly allocated into 2 groups, cartilage tympanoplasty group (n = 77) and platelet rich fibrin (PRF) augmented tympanoplasty group (n = 79). Graft take rates, hearing outcomes, operative time, and postoperative complications were documented and compared. RESULTS: Graft take rate was 96.1% in the cartilage group and 93.7% PRF group with no statistically significant difference. Operative time was significantly longer in the cartilage group. No differences in the hearing outcomes and postoperative complications were reported. CONCLUSION: Application of PRF on the fascia in tympanoplasty promotes healing of the tympanic membrane. PRF is safe, cheap, readily available, and easily prepared and applied. It increases the success rates of large tympanic membrane perforations without the need for cartilage grafts.

Salvaging the second molar with platelet-rich fibrin and photobiomodulation (970 nm diode laser) following third molar extraction.

Second molars are more susceptible to periodontitis when present adjacent to periodontally hopeless third molars. It is crucial to restore the health of the second molar and to prevent a dry socket after third molar extraction. To ensure complete eradication of infection along with regeneration, mere nonsurgical periodontal therapy might be inadequate. Thus, in this case report, high-level laser therapy (HLLT), advanced-platelet-rich fibrin (A-PRF), and low-level laser therapy (photobiomodulation [PBM]) were adapted to obtain a synergistic effect. HLLT was accomplished for decontamination and clot stabilization following the third molar extraction. Further, A-PRF was placed and irradiated with PBM on 3rd, 7th, 15th, and 21st days, postoperatively. There was reduced clinical probing depth and gain in clinical attachment level with a significant radiographic bone fill distal to second molar at 3 months follow-up. This combined use of HLLT, and PBM along with PRF could be a reliable treatment approach for regeneration, particularly in acute infections.

Effect of platelet-rich fibrin on the recovery after third molar surgery: A systematic review and meta-analysis.

This meta-analysis aimed to elucidate the effects of platelet-rich fibrin (PRF) on the recovery of alveolar bone after surgical removal of the mandibular third molars. PubMed, Cochrane Library, Web of Science, and Embase databases were searched from the inception to February 2023 for relevant studies on the application of PRF after the extraction of impacted mandibular third molars, with the language limited to English. Literature screening was conducted by two independent researchers. The Cochrane risk-of-bias tool was adopted for quality evaluation, and Stata 15.0 was used for statistical analysis. A total of 33 randomized controlled trials were included in the present study. Following surgical removal of the mandibular third molars, 1139 tooth sockets were filled with PRF, while 1138 sockets were sutured after conventional saline irrigation. The meta-analyses showed that PRF can relieve pain [(RR 0.454; 95% CI 0.23, 0.891); (SMD -0.74; 95% CI -0.97, 0.52)], improve swelling (SMD -1.48; 95% CI -1.90, -1.06), alleviate trismus (SMD -0.35; 95% CI -0.51, -0.19), reduce dry socket (SMD -0.18; 95% CI -030, -0.05), and promote bone tissue healing (SMD 2.34; 95% CI 0.18, 4.51). The current study confirms that PRF can reduce some postoperative complications. Local application of PRF after lower third molar extraction is a viable method for relieving pain and swelling, reducing the incidence of dry socket and trismus, and increasing bone density. However, whether it can promote soft tissue healing remains unclear. For patients undergoing complicated surgical extraction, local application of PRF into the sockets might be a good option.

Evaluation of platelet-rich fibrin matrix combined with PGE-1 injection on erectile function in patients with refractory response to PDE5-I: a randomized placebo-controlled study.

PURPOSE: We studied the effect of a platelet-rich fibrin matrix (PRFM) combined with prostaglandin E-1 (PGE-1) injection on erectile function in patients refractory to response for phosphodiesterase type 5 inhibitors (PDE5-Is). METHODS: This randomized, double-blind, placebo-controlled study included 80 patients. The patients were randomly assigned to four groups and blinded together with the administrating physicians to the nature of the intracorporeal injection (ICI) therapies. Group (1) received saline, group (2) received platelet-rich fibrin matrix (PRFM), group (3) received prostaglandin E-1 (PGE-1), and group (4) received a combination of PRFM + PGE-1. The patients received ICI therapy weekly for 8 consecutive weeks. Clinical information and follow-up data were obtained at 1, 2, 3, and 6 months. RESULTS: A significant increase occurred in the validated Arabic version of the International Index of Erectile Function (ArIIEF-5) score in group (4) compared to the other three groups (p value = 0.037). There was a significant difference in erection hardness scale (EHS) scores among all groups after receiving the different treatments (p = 0.004). A significant increase was seen in the ArIIEF-5 score in groups 4 and 3 compared to that in groups 1 and 2 (p < 0.001). There was also a significant increase in the arterial dilatation % in groups 4 and 3 compared to that in groups 1 and 2 (p = 0.019). CONCLUSION: The combination of PRFM plus PGE-1 had shown significant improvement in the ArIIEF-5 score, yet the patients still had mild to moderate ED.

Immunoregulatory role of platelet derivatives in the macrophage-mediated immune response.

Background: Macrophages are innate immune cells that display remarkable phenotypic heterogeneity and functional plasticity. Due to their involvement in the pathogenesis of several human conditions, macrophages are considered to be an attractive therapeutic target. In line with this, platelet derivatives have been successfully applied in many medical fields and as active participants in innate immunity, cooperation between platelets and macrophages is essential. In this context, the aim of this review is to compile the current evidence regarding the effects of platelet derivatives on the phenotype and functions of macrophages to identify the advantages and shortcomings for feasible future clinical applications. Methods: A total of 669 articles were identified during the systematic literature search performed in PubMed and Web of Science databases. Results: A total of 27 articles met the inclusion criteria. Based on published findings, platelet derivatives may play an important role in inducing a dynamic M1/M2 balance and promoting a timely M1-M2 shift. However, the differences in procedures regarding platelet derivatives and macrophages polarization and the occasional lack of information, makes reproducibility and comparison of results extremely challenging. Furthermore, understanding the differences between human macrophages and those derived from animal models, and taking into account the peculiarities of tissue resident macrophages and their ontogeny seem essential for the design of new therapeutic strategies. Conclusion: Research on the combination of macrophages and platelet derivatives provides relevant information on the function and mechanisms of the immune response.

The efficacy of Platelet and Leukocyte Rich Fibrin (L-PRF) in the healing process and bone repair in oral and maxillofacial surgeries: a systematic review.

INTRODUCTION: The search to optimize the healing and bone repair processes in oral and maxillofacial surgeries reflects the constant evolution in clinical practice, driven by the demand for increasingly satisfactory results and the need to minimize postoperative complications. OBJECTIVE: To evaluate the efficacy of Platelet and Leukocyte Rich Fibrin (L-PRF) in the healing and bone repair process in oral and maxillofacial surgeries. MATERIALS AND METHODS: The systematic review protocol for this study included the definition of the research question, the domain of the study, the databases searched, the search strategy, the inclusion and exclusion criteria, the types of studies to be included, the measures of effect, the methods for screening, data extraction and analysis, and the approach to data synthesis. Systematic literature searches were carried out on Cochrane databases, Web of Science, PubMed, ScienceDirect, Embase and Google Scholar. RESULTS: The strategic search in the databases identified 1,159 studies. After removing the duplicates with the Rayyan© software, 946 articles remained. Of these, 30 met the inclusion criteria. After careful evaluation based on the inclusion and exclusion criteria, 8 studies were considered highly relevant and included in the systematic review. CONCLUSION: Platelet and Leukocyte Rich Fibrin (L-PRF) has a positive effect on the healing process and bone repair in oral and maxillofacial surgeries.