Search Results (9)

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. Full article

Promising research results have been obtained on the tissue-regeneration properties of PRF (platelet-rich fibrin) in dentistry and maxillofacial surgery. PRF presumably promotes healing and accelerates ossification. In this case report, the patient had a history of Gorlin–Goltz syndrome, also called nevoid basal cell carcinoma syndrome, an autosomal dominant neurocutaneous disease that was known for many years. As a consequence, cysts were detected in both the mandible and maxilla. We performed decompression on this 37-year-old patient, followed by a cystectomy on an extensive lesion in the right angle of the mandible. One cyst from each side of the body mandible and one from the maxilla were completely enucleated, as determined using an intraoral exploration. The resulting bone defect was filled with a composite graft composed of a mixture of A-PRF and a serum albumin-coated bone allograft (BoneAlbumin). The wound was then covered with a PRF membrane. The surgical sites were closed per primam. The postoperative period was uneventful. Biopsies were performed after three and six months of healing for histological micromorphometry analyses. Dental implants were placed at the sampling site. Three months after the implantation, the ossified implants were fitted with superstructures. To date, no complications have appeared with the bone augmentation. The authors interpret from the findings that the combination of A-PRF and BoneAlbumin can be validated as a prosperous bone substitute. It can be safely implanted after a 3-month ossification period. Full article

Platelet concentrates are used for cell induction and stimulation in tissue repair processes. The aim of the present systematic review and meta-analysis was to compare the biological and cellular properties of advanced platelet-rich fibrin (A-PRF) to those of other platelet concentrates. Searches were conducted on the PubMed/Medline, Scopus, Web of Science, Embase and LILACS databases using a search strategy oriented by the guiding question. A total of 589 records were retrieved. Seven articles of in vitro experimental studies were selected for qualitative data analysis and four were selected for meta-analysis. The release of growth factors, distribution of cells in the fibrin membrane, and cell viability, the fibrin network, and fibroblast migration were investigated. In the final analysis, statistically significant differences were found for the A-PRF group with regard to platelet-derived growth factor, transforming growth factor, epidermal growth factor and vascular endothelial growth factor at all assessment times. A difference was found with regard to bone morphogenetic protein only in the later assessment, and no differences among groups were found with regard to platelet-derived growth factor or insulin-like growth factor. The results of this systematic review and meta-analysis suggest that A-PRF has superior cellular properties and better release of growth factors compared to other platelet concentrates. Full article

Background: Dental extraction can initiate a sequence of biological events that may lead to an insufficient bone volume, which can compromise implant placement. To minimize bone loss, alveolar ridge preservation procedures were developed. However, smoking has been shown to adversely affect the outcomes of the procedures. Hence, this clinical study aimed to assess the ability of platelet-rich fibrin to maintain ridge volume and its ability to generate vital bone in smokers. Methods: Eighteen current heavy smokers with a total of forty upper molars indicated for extraction and implant placement were randomly allocated to four different groups: an advanced platelet-rich fibrin group (A-PRF) (n = 10), a factor-enriched bone graft matrix covered by A-PRF group (A/S-PRF) (n = 10); a freeze-dried bone allograft covered by a crosslinked collagen membrane group (FDBA/CM) (n = 10), which served as a positive control; and a negative-control resorbable collagen plug group (RCP) (n = 10). Two consecutive high-resolution CBCT images were taken for each augmented socket to evaluate the bone volume, one at baseline and the other after six months, and four different measurements (vertical height, horizontal 1 mm H1, horizontal 3 mm, and horizontal 5 mm) were taken for each image. To evaluate the bone vitality, three bone samples were harvested for each group and were analyzed histologically using H and E staining. The results were analyzed using SPSS version 26.0 through the Wilcoxon sign rank test and Kruskal–Wallis test. Results: In terms of preserving bone volume, A/S-PRF showed no significant reduction in bone after six months, while A-PRF showed a significant loss according to two measurements (vertical and horizontal 5 mm), and the last two groups showed a significant loss in all four measurements. For vital bone formation, three groups (A-PRF, A/S-PRF, and RCP) showed the generation of only vital bone, while the fourth group (FDBA/CM) showed the generation of a mixture of vital and non-vital bone. Conclusions: Based on the outcomes of this study, PRF was able to minimize bone loss following dental extraction and generate vital bone in smokers. Full article

This article aims to prove dentin bridge formation in two cases after direct pulp capping in reversible pulpitis using the platelet concentrate A-PRF+ and preservation of the vitality of the dental pulp. The hemostasis process for the pulp wound and cavity disinfection with gaseous ozone was performed under anesthesia. A large A-PRF+ membrane was prepared from blood plasma and applied to the pulp wound. After placing an MTA, the cavity was closed using glass-ionomer cement. Clinical and cone beam computed tomography findings demonstrated the formation of a dentin bridge in both cases. After the definitive restoration was conducted during the sixth month, the teeth from both patients were asymptomatic and had normal electric pulp testing values. Conclusions: Via clinical and CBCT examinations, we observed the dentin bridge formation after placing the platelet concentrate A-PRF+ in both cases. The vitality of the dental pulp was preserved. Further research is needed to refine the clinical protocol, recommended period for control examination, clarification of the precise indications of platelet concentrates, etc. Full article

Introduction: Chlorhexidine (CHX) has been used for some time in clinical practice as a local antiseptic agent with excellent efficacy. The combination of CHX with APRF (Advanced-platelet rich fibrin) membrane has the potential to stimulate tissue regeneration and to provide a bactericidal effect. We hypothesize that this may reduce the rate of infections development and protect cell viability. Aim: The aim of this study was two-fold—to create a stable APRF membrane treated with different concentrations of CHX (0.01% and 0.02%) and to monitor its effect on the viability of PDL cells in vitro. This benefits the introduction of a new protocol for APRF membrane production -CHX-PRF and enriches the available evidence on the effect of this antiseptic agent on PDL (Periodontal ligament) cells. Materials and methods: APRF membranes were prepared by the addition of two concentrations (0.01% and 0.02%) of CHX. Membranes without the antiseptic were also prepared and used as control samples. PDL cells were cultivated on the membranes for 72 h. Cell number and vitality were examined by fluorescent cell viability assays. Results: Our results demonstrated that a concentration of 0.01% CHX allowed the production of a stable APRF membrane. This concentration slightly reduced the viability of PDL cells to 96.7%, but significantly decreased the average number of cells attached to the membrane—149 ± 16.5 cells/field compared to controls −336 ± 26.9 cells/field. APRF-CHX 0.02% membranes were unstable, indicating a dose-dependent cytotoxic effect of CHX. Conclusions: The introduced novel protocol leads to the production of a new type of APRF membrane—CHX-PRF. The incorporation of an antiseptic into the APRF membrane can improve its bactericidal activity and might serve as an important step for the prevention of postoperative infections. Full article

Background: Wound healing is essential in any surgical procedure, and multiple factors, such as smoking, can impair it. The aim of this clinical trial was to evaluate the ability of platelet-rich fibrin to enhance socket wound healing in smokers. Methods: A total of 18 smoker participants with forty non-restorable upper molars indicated for extraction were recruited to the study and were randomly allocated to four different groups for the assessment of four techniques: advanced platelet-rich fibrin (A-PRF), factor-enriched bone graft matrix with advanced platelet-rich fibrin (A/S-PRF), freeze-dried bone allograft and crosslinked collagen membrane (FDBA/CM), and resorbable collagen plug (RCP). One examiner clinically measured soft-tissue closure and the healing pattern using a periodontal probe and a healing index. Each subject was given a questionnaire after each follow-up visit to record several patient-reported experience measures (PREMs). This was conducted at baseline and 10, 21, and 28 days after the extraction procedure. Results: Both A-PRF and A/S-PRF showed significant results in terms of mesio-distally (p = 0.012), and healing pattern parameters (p < 0.0001), while RCP showed the least favorable outcome. Conclusions: Different forms of PRF exhibited enhanced wound closure and healing patterns, as well as reduced post-operative complications among smokers. Full article

Predictable outcomes intended by the application of PRF (platelet-rich fibrin) derivative membranes have created a lack of consideration for their consistency and functional integrity. This study aimed to compare the mechanical properties through tensile strength and analyze the structural organization among the membranes produced by L-PRF (leukocyte platelet-rich fibrin), A-PRF (advanced platelet-rich fibrin), and A-PRF+ (advanced platelet-rich fibrin plus) (original protocols) that varied in centrifugation speed and time. L-PRF (n = 12), A-PRF (n = 19), and A-PRF+ (n = 13) membranes were submitted to a traction test, evaluating the maximum and average traction. For maximum traction, 0.0020, 0.0022, and 0.0010 N·mm⁻² were obtained for A-PRF, A-PRF+, and L-PRF, respectively; regarding the average resistance to traction, 0.0012, 0.0015, and 0.006 N·mm⁻² were obtained, respectively (A-PRF+ > A-PRF > L-PRF). For all groups studied, significant results were found. In the surface morphology observations through SEM, the L-PRF matrix showed a highly compact surface with thick fibers present within interfibrous areas with the apparent destruction of red blood cells and leukocytes. The A-PRF protocol showed a dense matrix composed of thin and elongated fibers that seemed to follow a preferential and orientated direction in which the platelets were well-adhered. Porosity was also evident with a large diameter of the interfibrous spaces whereas A-PRF+ was the most porous platelet concentrate with the greatest fiber abundance and cell preservation. Thus, this study concluded that A-PRF+ produced membranes with significant and higher maximum traction results, indicating a better viscoelastic strength when stretched by two opposing forces. Full article

Alveolar osteitis (AO) is one of the complications that occur after tooth extraction. The aim of this study has been to evaluate the efficacy of Advanced Platelet-rich Fibrin (A-PRF) in the management of pain and the acceleration of wound healing in the treatment of AO. Consecutive patients who were diagnosed with AO, recruited from patients referred to the Oral Surgery Department of the University of Naples Federico II, were enrolled. After local anesthesia, the dry socket was curetted and irrigated with saline. The Platelet-rich Fibrin (PRF) clot was placed in the socket and then covered with an A-PRF membrane. Clinical parameters, such as the degree of pain and rate of granulation tissue (GT) formation, were measured before treatment and after 1, 3, 7, 14, and 21 days. The Friedman test for dependent samples was used to detect the treatment and time effect. Four patients with established AO were included. On all the examination days, the post-operative recovery was uneventful. The pain scores progressively reduced, from an average of 8.5 before treatment to 0.25 on the third day, and the GT formation improved over time. The use of A-PRF in the treatment of AO significantly reduced the pain level and enhanced the wound-healing process. Full article