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1.
Compend Contin Educ Dent ; 42(5): 212-217; quiz 218, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33980018

RESUMO

During healing after injury, platelets are natural reservoirs of growth factors and cytokines that play a critical role in the formation, maturation, and repair of soft and hard tissues. Platelet concentrates (PCs) have long been used to improve such healing in multiple applications throughout medicine and dentistry. Platelet-rich plasma and platelet-rich fibrin are autologous PCs derived from patients' blood. Because of the readily available source of blood after a simple venipuncture and the high level of patient acceptance of autologous materials, the use of autologous PCs for dental and oral surgical procedures is increasing in practice. Many indications for their use in dental procedures have been described, including hard- and soft-tissue regeneration. This article reviews the properties of currently available autologous platelet concentrates used in dentistry and identifies clinical applications for their adjunctive use to improve regeneration of oral tissues.


Assuntos
Procedimentos Cirúrgicos Bucais , Fibrina Rica em Plaquetas , Plasma Rico em Plaquetas , Plaquetas , Humanos , Cicatrização
2.
Artigo em Inglês | MEDLINE | ID: mdl-33802261

RESUMO

We present the preliminary results of the treatment of teeth with a deep, non-contained periodontal residual defect, vestibular bone dehiscence, and soft tissue recession, by combining an apical non-incised papilla surgical approach (NIPSA) to the defect and leukocyte platelet-rich fibrin (L-PRF) in the vestibular aspect. Four patients (upper left first premolar, upper left central incisor, upper right central incisor and upper right lateral incisor) have been treated. At one year of follow up, all cases showed a considerable reduction in the periodontal pocket depth, a gain in clinical attachment and no bleeding on probing, as well as an improvement in the marginal soft tissue minimizing soft tissue contraction (recession and/or loss of papilla) and improving soft tissue architecture. NIPSA plus L-PRF seem to improve clinical outcomes in deep non-contained intrabony defects associated with soft tissue recession.


Assuntos
Perda do Osso Alveolar , Fibrina Rica em Plaquetas , Perda do Osso Alveolar/cirurgia , Regeneração Tecidual Guiada Periodontal , Humanos , Leucócitos , Perda da Inserção Periodontal/cirurgia , Resultado do Tratamento
3.
Int J Mol Sci ; 22(8)2021 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-33919677

RESUMO

Platelet-rich fibrin (PRF) is a natural fibrin meshwork material with multiple functions that are suitable for tissue engineering applications. PRF provides a suitable scaffold for critical-size bone defect treatment due to its platelet cytokines and rich growth factors. However, the structure of PRF not only promotes cell attachment but also, due to its density, provides a pool for cell migration into the PRF to facilitate regeneration. In our study, we used repeated freeze drying to enlarge the pores of PRF to engineer large-pore PRF (LPPRF), a type of PRF that has expanded pores for cell migration. Moreover, a biodegradable Mg ring was used to provide stability to bone defects and the release of Mg ions during degradation may enhance osteoconduction and osteoinduction. Our results revealed that cell migration was more extensive when LPPRF was used rather than when PRF was used and that LPPRF retained the growth factors present in PRF. Moreover, the Mg ions released from the Mg ring during degradation significantly enhanced the calcium deposition of MC3T3-E1 preosteoblasts. In the present study, a bone substitute comprising LPPRF combined with a Mg ring was demonstrated to have much potential for critical-size bone defect repair.


Assuntos
Osso e Ossos/patologia , Movimento Celular/efeitos dos fármacos , Magnésio/farmacologia , Osteoblastos/citologia , Osteogênese/efeitos dos fármacos , Fibrina Rica em Plaquetas/metabolismo , Cicatrização , Animais , Osso e Ossos/efeitos dos fármacos , Cálcio/metabolismo , Diferenciação Celular/efeitos dos fármacos , Linhagem Celular , Proliferação de Células/efeitos dos fármacos , Forma Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Peptídeos e Proteínas de Sinalização Intercelular/farmacologia , Camundongos , Osteoblastos/efeitos dos fármacos , Osteoblastos/ultraestrutura , Coelhos , Tecidos Suporte/química , Titânio/farmacologia , Cicatrização/efeitos dos fármacos
4.
Int J Oral Maxillofac Implants ; 36(2): 341-345, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33909725

RESUMO

PURPOSE: To evaluate and compare human chorionic amniotic membrane and platelet-rich fibrin on new bone formation and soft tissue healing in extraction sockets indicated for rehabilitation with dental implants. MATERIALS AND METHODS: A prospective, triple blind clinical study was conducted. The inclusion criteria were as follows: patient with two extraction sites each in the same arch, intact buccal bone and soft tissue around the socket, and recommended rehabilitation with dental implants. Postextraction, the sockets were randomly placed with human chorionic amniotic membrane in one site and platelet-rich fibrin in the other site. After 3 months, a trephine drill was used to take a biopsy of the respective sites for soft and hard tissue samples. The outcome parameters that were assessed histologically were percentage of new bone formation and lymphocyte density. RESULTS: After screening 80 patients, eight participants were recruited for the study. The mean percentage of new bone formation in the human chorionic amniotic membrane group was 45.71% ± 4.82%, and for the plasma-rich fibrin group, it was 41.39% ± 6.29%, showing no statistically significant difference (z = 0.99, P = .31). In the human chorionic amniotic membrane group, six out of eight sites had mild lymphocyte density, while the plasmarich fibrin group had equal numbers of mild and moderate lymphocyte density. No statistically significant difference between the groups (Fischer test value = 0.60, P = .25) was noted. CONCLUSION: Within the limitations of the study, the results showed that there is no difference in the efficiency of human chorionic amniotic membrane compared with platelet-rich fibrin in achieving new bone formation and soft tissue healing in the extraction socket.


Assuntos
Implantes Dentários , Fibrina Rica em Plaquetas , Âmnio , Humanos , Osteogênese , Estudos Prospectivos , Extração Dentária , Alvéolo Dental/cirurgia
5.
Int J Oral Maxillofac Implants ; 36(2): 362-370, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33909729

RESUMO

PURPOSE: There is little knowledge about healing patterns for the socket with an intentionally retained root fragment: a socket shield. The clinical observation is soft tissue ingrowth next to the socket shield. The aim of this study was to evaluate the effectiveness of autologous grafting matrices in preventing soft tissue ingrowth. MATERIALS AND METHODS: Patient data from a private clinic were searched for sockets with a socket shield left to heal with blood clot or grafted with autologous materials: autologous platelet-rich fibrin (PRF), scraped particulate bone, cortical tuberosity bone plate, or particulate dentin and covered with PRF membranes. The included sites were exposed by the flap 4 months after the first surgery, and soft tissue ingrowth depth and width next to the root fragment were measured by a scaled probe and documented. RESULTS: Evaluation of 34 sites showed the greatest depth of soft tissue ingrowth in the nongrafted sockets (6.0 ± 0.0 mm). Grafting with PRF plugs (depth of 2.3 ± 0.2 mm) or particulate bone (depth of 2.7 ± 0.6 mm) decreased soft tissue ingrowth. Grafting with particulate dentin or cortical tuberosity bone plate resulted in a soft tissue ingrowth depth of only 1 mm, yielding the best clinical outcome. Radiography confirmed those findings. CONCLUSION: Autologous dentin particulate or tuberosity cortical bone plate is most effective for preventing soft tissue ingrowth.


Assuntos
Fibrina Rica em Plaquetas , Alvéolo Dental , Tecido Conjuntivo , Humanos , Estudos Retrospectivos , Extração Dentária , Alvéolo Dental/diagnóstico por imagem , Alvéolo Dental/cirurgia
6.
BMC Oral Health ; 21(1): 92, 2021 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-33653326

RESUMO

BACKGROUND: The role of injectable platelet rich fibrin (i-PRF) in orthodontic treatment has not been investigated with focus on its effect on dental and bony periodontal elements. OBJECTIVE: To evaluate the efficacy of i-PRF in bone preservation and prevention of root resorption. METHODS: A randomized split-mouth controlled trial included 21 patients aged 16-28 years (20.85 ± 3.85), who were treated for Class II malocclusion with the extraction of the maxillary first premolars. Right and left sides were randomly allocated to either experimental treated with i-PRF or control sides. After the leveling and alignment phase, the canines were retracted with 150gm forces. The i-PRF was prepared from the blood of each patient following a precise protocol, then injected immediately before canine retraction on the buccal and palatal aspects of the extraction sites. Localized maxillary cone beam computed tomography scans were taken before and after canine retraction to measure alveolar bone height and thickness and canine root length (indicative of root resorption), and the presence of dehiscence and fenestration. Paired sample t-tests and Wilcoxon signed rank tests were used to compare the changes between groups. RESULTS: No statistically significant differences in bone height, bone thickness were found between sides and between pre- and post-retraction period. However, root length was reduced post retraction but did not differ between sides. In both groups, postoperative dehiscence was observed buccally and palatally and fenestrations were recorded on only the buccal aspect. CONCLUSIONS: I-PRF did not affect bone quality during canine retraction or prevent canine root resorption. I-PRF did not reduce the prevalence of dehiscence and fenestration. Trial registration ClinicalTrials.gov (identifier number: NCT03399760. 16/01/2018).


Assuntos
Fibrina Rica em Plaquetas , Reabsorção da Raiz , Adolescente , Adulto , Dente Pré-Molar , Humanos , Maxila/diagnóstico por imagem , Boca , Reabsorção da Raiz/diagnóstico por imagem , Reabsorção da Raiz/prevenção & controle , Adulto Jovem
7.
BMC Oral Health ; 21(1): 135, 2021 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-33740959

RESUMO

BACKGROUND: Platelet-rich fibrin (PRF) has been widely utilized in modern medicine and dentistry owing to its ability to rapidly stimulate neoangiogenesis, leading to faster tissue regeneration. While improvements over traditional platelet rich plasma therapies (which use chemical additives such as bovine thrombin and calcium chloride) have been observed, most clinicians are unaware that many tubes utilized for the production of 'natural' and '100% autologous' PRF may in fact contain chemical additives without appropriate or transparent knowledge provided to the treating clinician. The aim of this overview article is therefore to provide a technical note on recent discoveries related to PRF tubes and describe recent trends related to research on the topic from the authors laboratories. METHODS: Recommendations are provided to clinicians with the aim of further optimizing PRF clots/membranes by appropriate understanding of PRF tubes. The most common additives to PRF tubes reported in the literature are silica and/or silicone. A variety of studies have been performed on their topic described in this narrative review article. RESULTS: Typically, PRF production is best achieved with plain, chemical-free glass tubes. Unfortunately, a variety of other centrifugation tubes commonly used for lab testing/diagnostics and not necessarily manufactured for human use have been utilized in clinical practice for the production of PRF with unpredictable clinical outcomes. Many clinicians have noted an increased variability in PRF clot sizes, a decreased rate of clot formation (PRF remains liquid even after an adequate protocol is followed), or even an increased rate in the clinical signs of inflammation following the use of PRF. CONCLUSION: This technical note addresses these issues in detail and provides scientific background of recent research articles on the topic. Furthermore, the need to adequately select appropriate centrifugation tubes for the production of PRF is highlighted with quantitative data provided from in vitro and animal investigations emphasizing the negative impact of the addition of silica/silicone on clot formation, cell behavior and in vivo inflammation.


Assuntos
Fibrina Rica em Plaquetas , Plasma Rico em Plaquetas , Animais , Bovinos , Centrifugação , Humanos , Dióxido de Silício , Silicones
8.
Medicina (Kaunas) ; 57(2)2021 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-33672534

RESUMO

The management of critical-size bone defects is still demanding. Recently, autologous platelet concentrates in combination with bone substitute have been applied and reported in a few studies. Our aim is to report the healing of a critical-size alveolar bone defect treated with a new bone regeneration technique by means of L-PRF and L-PRF blocks. A 45-year-old woman presented a large cystic lesion; the extraction of three teeth, a cyst removal procedure, and bone regeneration procedures with L-PRF and L-PRF blocks were planned. The L-PRF block was prepared by mixing a bone substitute with a piece of L-PRF membrane and liquid fibrinogen. Additionally, after bone healing an implant-based rehabilitation was optimally performed. On the basis of the positive results, in terms of bone healing and tissue regeneration in a large bone defect, the application of L-PRF and L-PRF blocks, in agreement with the scarce literature, is suggested as a feasible procedure in selected cases.


Assuntos
Substitutos Ósseos , Cistos , Fibrina Rica em Plaquetas , Regeneração Óssea , Feminino , Humanos , Leucócitos , Pessoa de Meia-Idade
9.
BMJ Case Rep ; 14(3)2021 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-33731387

RESUMO

The management of necrotic immature permanent teeth has always been a challenge to endodontists. Various treatment modalities have been tried and tested for achieving a successful outcome. Revascularisation is one among these treatment options, which is gaining widespread attention among endodontists. The growing body of evidence demonstrating the success of revascularisation has led to different variations of this treatment option. Clinicians have over time used different scaffolds such as blood clot, collagen, platelet-rich fibrin (PRF) and platelet-rich plasma for revascularisation. This case report outlines the management of immature maxillary central incisors with pulp necrosis and large periapical lesions in a 19-year-old female patient with a modified technique of revascularisation by combining PRF and blood clot. At the end of 12 months, the patient was completely asymptomatic along with regression of the periapical lesions.


Assuntos
Fibrina Rica em Plaquetas , Plasma Rico em Plaquetas , Adulto , Necrose da Polpa Dentária/terapia , Dentição Permanente , Feminino , Humanos , Incisivo , Necrose , Adulto Jovem
10.
Medicine (Baltimore) ; 100(10): e25068, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725897

RESUMO

RATIONALE: To describe the clinical effects of human umbilical cord mesenchymal stem cells (UCMSCs) combined with allogenic platelet-rich fibrin (PRF) for the treatment of lower limb ischemia in an elderly patient. PATIENT CONCERNS: The patient was a 93-year-old Chinese woman with bilateral foot gangrene and ulcers lasting for 6 months. She had a prior history of Behcet's disease. DIAGNOSES: The admitting diagnosis for this episode was atherosclerosis bilateral limb ischemia. INTERVENTIONS: First, treatment consisting of immunosuppressants, anticoagulation, antiplatelets, and anti-microbials were instituted. A UCMSC suspension was administered intravenously and injected into the lower limbs twice. An allogenic PRF membrane was externally applied 15 times over the lower limbs. OUTCOMES: The patient's pain improved and the 6 ulcers healed. LESSONS: The combination of UCMSCs with a PRF membrane for the treatment of lower limb ischemia in an elderly patient is effective and safe. More and larger trials are needed before incorporating this therapy into mainstream treatment.


Assuntos
Isquemia/terapia , Transplante de Células-Tronco Mesenquimais/métodos , Doença Arterial Periférica/terapia , Fibrina Rica em Plaquetas , Dedos do Pé/irrigação sanguínea , Administração Intravenosa , Idoso de 80 Anos ou mais , Terapia Combinada/métodos , Feminino , Humanos , Injeções Intralesionais , Isquemia/etiologia , Doença Arterial Periférica/complicações , Transplante Homólogo/métodos , Cordão Umbilical/citologia
12.
Clin Oral Investig ; 25(5): 2461-2478, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33609186

RESUMO

OBJECTIVES: This study aims to compare the treatment outcomes of periodontal intrabony defects by using platelet-rich fibrin (PRF) with other commonly utilized modalities. MATERIALS AND METHODS: The eligibility criteria comprised randomized controlled trials (RCTs) comparing the clinical outcomes of PRF with that of other modalities. Studies were classified into 10 categories as follows: (1) open flap debridement (OFD) alone versus OFD/PRF; (2) OFD/bone graft (OFD/BG) versus OFD/PRF; (3) OFD/BG versus OFD/BG/PRF; (4-6) OFD/barrier membrane (BM), OFD/PRP, or OFD/enamel matrix derivative (EMD) versus OFD/PRF; (7) OFD/EMD versus OFD/EMD/PRF; (8-10) OFD/PRF versus OFD/PRF/metformin, OFD/PRF/bisphosphonates, or OFD/PRF/statins. Weighted means and forest plots were calculated for probing depth (PD), clinical attachment level (CAL), and radiographic bone fill (RBF). RESULTS: From 551 articles identified, 27 RCTs were included. The use of OFD/PRF statistically significantly reduced PD and improved CAL and RBF when compared to OFD. No clinically significant differences were reported when OFD/BG was compared to OFD/PRF. The addition of PRF to OFD/BG led to significant improvements in CAL and RBF. No differences were reported between any of the following groups (OFD/BM, OFD/PRP, and OFD/EMD) when compared to OFD/PRF. No improvements were also reported when PRF was added to OFD/EMD. The addition of all three of the following biomolecules (metformin, bisphosphonates, and statins) to OFD/PRF led to statistically significant improvements of PD, CAL, and RBF. CONCLUSIONS: The use of PRF significantly improved clinical outcomes in intrabony defects when compared to OFD alone with similar levels being observed between OFD/BG and OFD/PRF. 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 research investigating PRF at histological level is also needed. CLINICAL RELEVANCE: The use of PRF in conjunction with OFD statistically significantly improved PD, CAL, and RBF values, yielding to comparable outcomes to OFD/BG. The combination of PRF with bone grafts or small biomolecules may offer certain clinical advantages, thus warranting further investigations.


Assuntos
Perda do Osso Alveolar , Fibrina Rica em Plaquetas , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/tratamento farmacológico , Perda do Osso Alveolar/cirurgia , Transplante Ósseo , Regeneração Tecidual Guiada Periodontal , Humanos , Perda da Inserção Periodontal , Retalhos Cirúrgicos/cirurgia
13.
Medicina (Kaunas) ; 57(2)2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33562581

RESUMO

Background and Objectives: The aim of the present systematic review and meta-analysis was to investigate the efficacy of leukocyte-platelet-rich fibrin (L-PRF) in addition to coronally advanced flap (CAF) for the treatment of both single and multiple gingival recessions (GRs) compared to the CAF alone and to the adjunct of connective tissue graft (CTG). Root coverage outcomes using platelet concentrates have gained increased interest. In particular, it has been suggested that adding L-PRF to CAF may provide further benefits in the treatment of GRs. Materials and Methods: An electronic and manual literature search was conducted to identify randomized controlled trials (RTCs) investigating root coverage outcomes with CAF + L-PRF. The outcomes of interest included mean root coverage (mRC), recession reduction, keratinized tissue width (KTW) gain, gingival thickness (GT) gain, and patient-reported outcome measures (PROms) such as pain perception and discomfort. Results: A total of 275 patients and 611 surgical sites were analyzed. L-PRF in adjunct to single CAF seems to show statistically significant results regarding clinical attachment level (CAL) with a weighted means (WM) 0.43 95% CI (-0.04,0.91), p < 0.0001, GT (WM 0.17 95% CI (-0.02,0.36), p < 0.0001, and mRC (WM 13.95 95% CI (-1.99,29.88) p < 0.0001, compared to single CAF alone. Interesting results were obtained from the adjunct of PRF to multiple CAF with respect to multiple CAF alone with an increase in the mRC WM 0.07 95% CI (-30.22,30.35), p = 0.0001, and PPD change WM 0.26 95% CI (-0.06,0.58), p < 00001. On the other hand, no statistically significant data were obtained when L-PRF was added to single or multiple CAF combined with CTG according to the included outcomes such as mRC (p = 0.03 overall). Conclusions: L-PRF is a valid alternative to CAF alone. L-PRF compared to CTG in single and multiple CAF showed statistically significant results regarding pain perception and discomfort PROms (p < 0.0001). However, CTG remains the gold standard for treating gingival recession.


Assuntos
Retração Gengival , Fibrina Rica em Plaquetas , Tecido Conjuntivo , Retração Gengival/cirurgia , Humanos , Retalhos Cirúrgicos , Resultado do Tratamento
14.
Int J Oral Maxillofac Implants ; 36(1): 137-145, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33600535

RESUMO

PURPOSE: To evaluate the clinical and radiographic outcomes of endoscope-assisted maxillary sinus floor elevation with platelet-rich fibrin grafting and simultaneous implant placement (PESS) in atrophic maxillae. MATERIALS AND METHODS: Twenty-three implants were placed to rehabilitate atrophic maxillae. Patient satisfaction was measured with a visual analog scale (VASpain). CBCT was taken to assess the bone changes for the elevated sites. RESULTS: Twenty-two of 23 implants fulfilling the survival criteria represented a 1-year survival rate of 95.65%. The VASpain score decreased with time. The residual bone height was 4.45 ± 1.44 mm. The elevation height was 6.72 ± 1.84 mm. The definitive restoration was completed in the 4th month postsurgery. The peri-implant bone level value was 6.04 ± 2.30 mm, 6.32 ± 2.25 mm, and 6.71 ± 1.97 mm at the 3rd, 9th, and 15th month postsurgery. The crestal bone level value decreased by 0.22 ± 0.56 mm from the 3rd month to the 15th month postsurgery (P > .05). Bone mineral density increased with time at the neck, middle, and root site of implant. CONCLUSION: PESS in the maxilla resulted in predictable peri-implant bone formation. This strategy is a relatively safe and effective approach with less invasion, which provides new insights into the choice of implant treatment plans.


Assuntos
Implantes Dentários , Fibrina Rica em Plaquetas , Levantamento do Assoalho do Seio Maxilar , Implantação Dentária Endo-Óssea , Endoscópios , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Estudos Prospectivos , Resultado do Tratamento
16.
Artigo em Inglês | MEDLINE | ID: mdl-33430249

RESUMO

Implantation is currently the best option for tooth replacement in periodontitis. Some major contraindications for the immediate implant are acute periodontitis and active infection. We present the case of a 51-year-old female patient with the highest grade and stage periodontitis treated with advanced platelet-rich fibrin-enriched zirconia implants and with hyperbaric oxygen therapy (HBOT). In particular, HBOT before and after implantation promoted bone regeneration and implant integration, also providing an antiseptic effect. After six months, the implants were well established and fully healed from periodontal disease within 14 months. Further research could confirm a new indication for HBOT in treating periodontitis and dental implantation.


Assuntos
Oxigenação Hiperbárica , Periodontite , Fibrina Rica em Plaquetas , Regeneração Óssea , Feminino , Humanos , Pessoa de Meia-Idade , Periodontite/terapia , Próteses e Implantes
17.
Angle Orthod ; 91(3): 285-292, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33459765

RESUMO

OBJECTIVES: To evaluate the efficiency of injectable platelet-rich fibrin (i-PRF) in accelerating canine tooth movement and to examine levels of the matrix metalloproteinase-8 (MMP-8), interleukin-1ß (IL-1ß), receptor activator of nuclear factor kappa-light-chain-enhancer of activated B cells ligand (RANKL), and osteoprotegerin (OPG) in the gingival crevicular fluid during orthodontic treatment. MATERIALS AND METHODS: Twenty patients (mean age = 21.4 ± 2.9 years) with Class II Division 1 malocclusion were included in a split-mouth study. The treatment plan for all patients was extraction of maxillary first premolars followed by canine distalization with closed-coil springs using 150 g of force on each side. The study group received i-PRF two times, with a 2-week interval, on one side of the maxilla. The contralateral side served as the control and did not receive i-PRF. Maxillary canine tooth movement was measured at five time points (T1-T5) on each side. Also, the activity of inflammatory cytokines was evaluated at three time points in the gingival crevicular fluid samples. RESULTS: There was a significant difference in canine tooth movement between the two groups (P < .001). i-PRF significantly increased the rate of tooth movement, and stimulation in the levels of inflammatory cytokines supported this result (P < .001). The levels of cytokines changed in both groups between T1 and T2. The IL-1ß, MMP8, and RANKL values were significantly increased in the study group compared with the control group, while the OPG values were significantly decreased. CONCLUSIONS: i-PRF-facilitated orthodontics is an effective and safe treatment modality to accelerate tooth movement, and this method can help shorten orthodontic treatment duration.


Assuntos
Fibrina Rica em Plaquetas , Adolescente , Adulto , Dente Pré-Molar , Dente Canino , Líquido do Sulco Gengival , Humanos , Técnicas de Movimentação Dentária , Adulto Jovem
18.
Angle Orthod ; 91(2): 213-219, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33347530

RESUMO

OBJECTIVE: To investigate the efficiency of platelet-rich fibrin (PRF) injection on maxillary incisor retraction rate. MATERIALS AND METHODS: The study included 40 patients (23 women and 17 men; mean age; 20.7 ± 1.45) with Class II Division 1 malocclusion. The treatment plan for all patients was extraction of the maxillary first premolars and canine distalization, followed by retraction of the maxillary incisors. Patients were randomly divided into two groups. The study group received injectable platelet-rich fibrin (i-PRF) two times with an interval of 2 weeks; the control group did not receive i-PRF. In both groups, the measurements were bilaterally assessed as the distances between the lateral and canine teeth on the plaster models at five time points. The rate of incisor movement was evaluated by Student's t-test, analysis of variance, and Tukey honestly significant difference tests. Statistical significance was set as P < .05. RESULTS: The average movements of incisors were significantly higher in the study group than the control group at all time points (P < .05). According to the within-group comparison, none of the measurements showed any significant differences between the right and left sides in both groups at all time points (P > .05). While the movement of incisors was significantly higher in the study group in the week following the PRF injection compared to the other weeks (P < .05), there were no significant differences in the control group at all-time points (P > .05). CONCLUSIONS: Applying i-PRF significantly increased the rate of maxillary incisor retraction at all time intervals. Platelet-rich fibrin injection can be an effective method for shortening treatment duration.


Assuntos
Má Oclusão de Angle Classe II , Fibrina Rica em Plaquetas , Adulto , Dente Canino , Feminino , Humanos , Incisivo , Masculino , Maxila , Adulto Jovem
19.
Exp Eye Res ; 203: 108402, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33326809

RESUMO

PURPOSE: To develop and characterize a new type of plasma rich in growth factors (PRGF) membrane for patients in which immune system is involved in the disease etiology. METHODS: Blood from three healthy donors was collected to obtain the different fibrin membranes by PRGF technology. PRGF obtained volumes were activated and divided into two groups: PRGF membrane (mPRGF) obtained after incubation at 37 °C for 30 min (control); and is-mPRGF: mPRGF obtained after incubation for 30 min at 56 °C. The concentration of several growth factors, proteins, immunoglobulin E and the complement activity was determined in the different mPRGF. The proliferative potential of heat-inactivated mPRGF were assayed on keratocytes (HK) and conjunctival fibroblasts (HConF). In addition, morphological and physical features of the inactivated mPRGF were evaluated in contrast to the control mPRGF. RESULTS: Heat-inactivation of the mPRGF preserves the content of most of the growth factors involved in the ocular wound healing while reducing drastically the content of IgE and the complement activity. The heat-inactivated mPRGF conserve the morphological and physical characteristics of the fibrin meshwork in comparison with the control mPRGF. Furthermore, no significant differences were found in the biological activity of the control mPRGF regarding the heat-inactivated mPRGF (is-mPRGF) in any of both ocular cell types evaluated. CONCLUSIONS: The heat-inactivation of the PRGF membranes (is-mPRGF) reduces drastically the content of IgE and complement activity while preserving the content of most of the proteins and morphogens involved in ocular wound healing. Furthermore, the morphological and physical features of the immunosafe mPRGF were also preserved after heat-inactivation.


Assuntos
Membrana Celular/metabolismo , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Fibrina Rica em Plaquetas/metabolismo , Tecnologia Biomédica , Doadores de Sangue , Células Cultivadas , Via Clássica do Complemento/fisiologia , Túnica Conjuntiva/citologia , Ceratócitos da Córnea/metabolismo , Ensaio de Imunoadsorção Enzimática , Fator de Crescimento Epidérmico/metabolismo , Fator 2 de Crescimento de Fibroblastos/metabolismo , Fibroblastos/metabolismo , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Imunoglobulina E/imunologia , Microscopia Eletrônica de Varredura , Fator de Crescimento Derivado de Plaquetas/metabolismo , Fator de Crescimento Transformador beta1/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo
20.
J Craniomaxillofac Surg ; 49(2): 104-109, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33349509

RESUMO

The aim of this study was to evaluate the level of mineralized tissue and expression of bone markers in sockets grafted with platelet-rich fibrin and bone marrow aspirate concentrate (BMAC). Patients requiring extraction of one maxillary anterior tooth were randomized into three groups. After tooth extraction, the sockets in the control group (CG) were permitted to fill with blood clot. In the platelet-rich fibrin group (PRFG), after blood processing, the sockets were grafted with PRF plug. In the bone marrow aspirate concentrate combined with platelet-rich fibrin group (BM/PG), after blood and bone marrow processing, the sockets were grafted with a mixture of PRF plug and BMAC. After 6 months, the sites were reopened and bone cores were harvested and prepared for histomorphometric and immunohistochemical evaluation. The following levels were measured: mineralized tissue, expression of RUNX-2, and osteocalcin. Fifteen patients were included in this study. The histomorphometric analysis showed a more pronounced level of mineralized tissue in PRFG and BM/PG (54.20 ± 4.31% and 64.70 ± 6.74%, respectively) when compared with CG (40.60 ± 5.98%) (p = 0.0283 and p = 0.0090, respectively). The expression of RUNX-2 was very low in BM/PG (0.80 ± 0.84%) and absent in CG and PRFG (p = 0.0528). Osteocalcin expression was higher for BM/PG (23.40 ± 1.52%) when compared with CG and PRFG (18.40 ± 2.07% and 16.20 ± 1.92%, respectively) (p = 0.0117 and p = 0.0088, respectively). This preliminary study indicates that clinical use of bone marrow aspirate concentrate, when combined with platelet-rich fibrin as a carrier, might have some potential to increase mineralization in fresh extraction sockets.


Assuntos
Fibrina Rica em Plaquetas , Extração Dentária , Alvéolo Dental , Medula Óssea , Humanos , Alvéolo Dental/cirurgia , Cicatrização
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