Clinical and Radiographic Analysis of Novabone Putty with Platelet-Rich Fibrin in the Treatment of Periodontal Intrabony Defects: A Randomized Control Trial
Contemporary clinical dentistry. 2021;12(2):150-156
BACKGROUND Periodontal regeneration remains one of the crucial issues in the field of periodontology. Periodontal intrabony defects could be treated by surgical intervention through various alloplastic bone graft substitutes. The Food and Drug Administration approved, Novabone putty is one of the recently marketed bone graft substitutes, which has been used in the present study. This study also incorporates the placement of platelet-rich fibrin (PRF) in combination with Novabone putty. MATERIALS AND METHODS Twenty patients were included in the study and were allocated to either Group A or Group B through randomization. Group A included the placement of Novabone putty in the periodontal intrabony defects, whereas Group B included the placement of Novabone putty along with PRF. Statistical analysis of plaque index, gingival index, probing pocket depth, relative attachment level, and intraoral periapical radiographs was performed. RESULTS Statistical more significant difference (P < 0.05) in probing pocket depth, and relative attachment level was observed in Group B (Novabone putty and PRF) in comparison to Group A (Novabone putty). CONCLUSION Evaluation of efficacy of Novabone putty along with PRF produced more favorable results in relative attachment level gain and more reduction in probing pocket depth when compared to Novabone putty alone.
Three-dimensional evaluation of the effects of injectable platelet rich fibrin (i-PRF) on alveolar bone and root length during orthodontic treatment: a randomized split mouth trial
BMC oral health. 2021;21(1):92
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).
A comparative evaluation of Advanced Platelet-Rich Fibrin (A-PRF) and Platelet-Rich Fibrin (PRF) as a Scaffold in Regenerative Endodontic Treatment of Traumatized Immature Non-vital permanent anterior teeth: A Prospective clinical study
Journal of clinical and experimental dentistry. 2021;13(5):e463-e472
BACKGROUND Regenerative endodontic treatment (RET) is a promising treatment alternative for traumatized immature non-vital teeth. Advanced platelet-rich fibrin (A-PRF) contains significantly more growth factors than Platelet-rich fibrin (PRF) and has not been evaluated as a scaffold in RET. The aim of the present study was to evaluate and compare A-PRF and PRF as scaffolds in the RET concerning periapical healing, and root development of traumatized immature non-vital teeth. MATERIAL AND METHODS In the present study, RET was performed on 30 traumatized immature non-vital maxillary incisors in 28 patients aged between 8-27 years. Minimal mechanical debridement and irrigation with 1.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid was performed. Canals were disinfected using modified triple antibiotic paste consisting of ciprofloxacin, metronidazole and cefaclor. Based on the type of scaffold, teeth were randomly assigned into A-PRF (n=15) and PRF groups (n=15). Periapical healing, apical response and quantitative root dimensions (length and thickness) were analyzed radiographically after 12 months follow-up. RESULTS Nineteen patients with 21 teeth (A-PRF n=11, PRF n=10) completed the follow-up and 9 patients were excluded. Clinically, patients in both the groups were asymptomatic. The survival rates for A-PRF and PRF were 78.5% and 77.5%, respectively. No statistically significant differences were detected between A-PRF and PRF regarding periapical healing and type of apical response (p& 0.05). The difference in the pre-operative and follow-up root thickness and root length in both A-PRF and PRF groups were statistically significant (p< 0.05). CONCLUSIONS Based on short-term results of 13 months, both A-PRF and PRF can be used as scaffold in regenerative endodontic treatment of traumatized immature non-vital teeth. A-PRF could be recommended in such cases since it yielded more root dentin thickness which is crucial for reinforcing immature teeth. Key words:Regenerative endodontic treatment, dental trauma, Non-vital teeth, immature teeth, platelet-rich fibrin, advanced platelet-rich fibrin.
Effect of injectable platelet-rich fibrin (i-PRF) in accelerating orthodontic tooth movement : A randomized split-mouth-controlled trial
Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie. 2021
BACKGROUND The role of platelet-rich fibrin (PRF) in accelerating orthodontic tooth movement has been controversially discussed in available clinical studies. OBJECTIVE To investigate the effectiveness of i‑PRF in accelerating maxillary canine retraction. MATERIALS AND METHODS A split-mouth design was applied in 21 participants (6 men, 15 women; mean age: 20.85 ± 3.85 years) whose class II division I malocclusion required the extraction of both maxillary first premolars. The right and left canines were randomized into intervention and control sides. After the initial leveling and alignment phase and immediately before canine retraction, i‑PRF obtained from the brachial vein was injected into the mucosa on the buccal and palatal aspects of the intervention sides. The injection was repeated one month later. Study casts were taken at the initiation of canine retraction (T0) and at monthly visits up to 5 months (T1 through T5). The paired t‑test was used to compare the total and monthly rates of canine retraction, canine rotation, and anchorage loss. RESULTS The average rates of canine retraction were greater on the experimental side at T2, T3, and T4, but this difference with the control side was statistically significantly different only at T2 (P < 0.05). Differences in canine rotation and anchorage loss were not statistically significant. CONCLUSION The rates of canine retraction following the injection of platelet-rich fibrin were not statistically significantly greater on the experimental than the control sides except at the second month (T2). This apparently transient rate of tooth movement indicates that repeated injections might be needed for sustained effects, a premise meriting more focused research.
Is platelet-rich plasma able to accelerate orthodontic tooth movement?
Evidence-based dentistry. 2021;22(1):36-37
Objectives To examine whether periodontal injection of platelet-rich plasma (PRP) could accelerate orthodontic tooth movement.Methods A split-mouth randomised controlled clinical trial was conducted among 16 female participants. Canines were retracted on 0.017 x 0.025-inch stainless steel archwires through closed-coil springs attached on first molars with mini-screws for anchorage preservation. The intervention side received PRP + CaCl2 solution and the control side CaCl2 only. Intraligamental injections were performed during the canine retraction period every three weeks (zero, three and six weeks). The rate of canine retraction was assessed through superimposition of digital models every month for a total of four months. Assessment of associated pain was conducted by questionnaire.Results During the four-month period, a faster rate of canine retraction was detected on the intervention side only for the first month. Following cessation of PRP injections, the rate of canine retraction on the intervention side was initially slower than and then similar to that on the control side. An increase of pain was reported on both sides.Conclusions PRP could accelerate orthodontic tooth movement in the short term with no prolonged effects.
Efficacy of Platelet-Rich Plasma in Enhancing the Osteogenic Potential of Bone Graft in Oral and Maxillofacial Region
Journal of maxillofacial and oral surgery. 2021;20(2):282-295
BACKGROUND Platelet-rich plasma (PRP) has been a breakthrough in the stimulation and acceleration of bone and soft tissue healing. It represents a relatively new biotechnology that is part of the growing interest in tissue engineering and cellular therapy. METHODS A prospective study was carried out in 50 patients. The cases were selected randomly in the age group of 8-50 years who needed bone grafts for alveolar cleft defects and surgical defects following removal of osteolytic jaw lesions. They were divided into study group with autologous PRP and control group without PRP. Bone density was calculated as per Hounsfield scale preoperatively and post-operatively for both the groups. RESULTS There was significant difference in the Hounsfield units at 06 months and 12 months post-operatively in both the groups showing good amount of bone regeneration. The preoperative volume of the defect and the post-operative volume of the regenerated bone were statistically analysed. The mean V2 was 0.7652 cc for the study group, whereas for control group, it was 0.4840 cc. The volume ratio for study group was 0.9070 and for control group was 0.6740. This showed greater bone regeneration in the study group. The results were statistically significant for both the groups. CONCLUSION PRP is a new application of tissue engineering and a developing area of interest for clinicians and researchers. It is a storage vehicle for growth factors, especially PDGF and TGF-b, both of which influence bone regeneration, and also eliminates the concerns about immunogenic reactions and disease transmission. PRP does enhance the healing of bone grafts in the maxillofacial region as shown by the increase in the density of bone.
Effect of Platelet-Rich Plasma on Bone Healing in Immediate Implants Analyzed by Cone Beam Computerized Tomography: A Randomized Controlled Trial
BioMed research international. 2021;2021:6685991
The possibility of platelet-rich plasma (PRP) on the improvement of bone and adjacent tissue recovery has previously been validated. However, there is insufficient data supporting the use of platelet-rich plasma to improve the healing of bone and adjacent tissues around an implant in the oral cavity. The purpose of this randomized controlled trial was to observe the effect of platelet-rich plasma (PRP) concentrate on marginal bone loss and bone density around immediate implant placement using Cone Beam Computerized Tomography (CBCT). This clinical study was conducted over a period of six months on 12 subjects, who were equally categorized into two groups. Group I was the control, whereas the subjects in Group II received PRP therapy at the surgical site. All subjects were given a standard treatment with a single implant system (DIO UFII hybrid sandblasted acid-etched implants). Inserted implants were analyzed through CBCT, and records were registered at baseline, at the 12(th) week before functional loading and the 26(th) week after functional loading. The bone loss was calculated at the proximal (mesial and distal) side of the implant and bone density at baseline, 12(th) week, and 26(th) week after implant placement. SPSS version 23.0 was used for statistical analysis of data. The changes in bone levels were measured and compared between the two groups using the Mann-Whitney U test, with no significant difference. Bone density was analyzed by an independent sample t-test, p value ≤ 0.05 was considered statistically significant. Again, no significant difference in bone density was observed between both groups at all three instances. Therefore, it can be concluded that local injection of PRP after immediate implant placement did not show any decrease in marginal bone loss or improvement in bone density. This trial is registered with NCT04650763.
The Effectiveness of Advanced Platelet-Rich Fibrin in comparison with Leukocyte-Platelet-Rich Fibrin on Outcome after Dentoalveolar Surgery
International journal of dentistry. 2021;2021:6686857
METHODS The study included 60 patients according to sample size calculation, recruited from patients seeking tooth extraction at oral and maxillofacial surgery clinic at Umm Al-Qura University, Faculty of Dentistry. Patients were divided into three groups. Group Ӏ included 20 patients managed by advanced platelet-rich fibrin after extraction. Group ӀӀ included 20 patients managed by leukocyte-platelet-rich fibrin after tooth extraction. Group ӀII included 20 patients left without any addition. Each group was further subdivided into surgical and nonsurgical extraction. Afterwards, patients in each group were assessed for postextraction pain by VAS, number of analgesics, and early soft tissue healing by LWHI. RESULTS The study outcomes demonstrate that the use of A-PRF significantly reduces postoperative pain in the 1(st) and 2(nd) day. VAS pain scores on the first day were significantly higher in the control surgical extraction group and L-PRF nonsurgical extraction group. In early soft tissue healing. The Landry Wound Healing Index (LWHI) was used after 1 and 2 weeks of extraction to evaluate the extraction site. In first week, the A-PRF group and L-PRF group (nonsurgical extraction) had a better healing index when compared to control group, and A-PRF group (surgical extraction) had a best healing index when compared to L-PRF and control groups. In the second week, individuals in the A-PRF group (surgical and nonsurgical extraction) had a better healing index when compared to L-PRF and control groups.
Clinical evaluation of the treatment of multiple gingival recessions with connective tissue graft or concentrated growth factor using tunnel technique: a randomized controlled clinical trial
Clinical oral investigations. 2021
OBJECTIVE To assess the effectiveness of the combination of tunnel technique (TT) and concentrated growth factor (CGF) for root coverage in treating multiple gingival recessions (GR) and compare with the connective tissue graft (CTG). MATERIALS AND METHODS Forty patients with Miller Class I and II maxillary or mandibular GR were randomly divided into two groups as follows: TT + CTG and TT + CGF. The results at baseline and 6 months were evaluated for the following clinical parameters: complete root coverage (CRC), mean root coverage (MRC), gingival thickness (GT), gingival recession width (RW), gingival recession depth (RD), and keratinized tissue width (KTW). RESULTS At 6 months, a statistically significant difference was found in RD, RW, MRC, CRC, KTW, and GT compared with the baseline (p < 0.05). MRC was determined 89.52±16.36% in the TT + CTG and 76.60±24.10% in the TT + CGF (p < 0.05). CRC was achieved in 66.7% of the TT + CTG and 47.4% of the TT + CGF (p < 0.05). The increase in KTW and GT was significantly better in the TT + CTG group compared to the TT + CGF (p < 0.05). CONCLUSIONS The study showed that TT + CGF did not improve the results as much as TT + CTG in the treatment of Miller Class I and II GR. However, this finding is not sufficient to advocate the true clinical effects of CGF on GR treatment with TT. CLINICAL RELEVANCE CGF could not serve as a direct alternative biomaterial to the gold standard CTG. TRIAL REGISTRATION ClinicalTrials.gov Identification Number: NCT04561947.
Evaluation of the Histomorphometric and Micromorphometric Performance of a Serum Albumin-Coated Bone Allograft Combined with A-PRF for Early and Conventional Healing Protocols after Maxillary Sinus Augmentation: A Randomized Clinical Trial
Materials (Basel, Switzerland). 2021;14(7)
The aim of this study was to compare the microarchitecture of augmented bone following maxillary sinus augmentation (MSA) after healing periods of 3 (test) and 6 (control) months using the combination of advanced platelet-rich fibrin (A-PRF) and a serum albumin-coated bone allograft (SACBA). Twenty-six patients with 30 surgical sites who required two-stage MSA were enrolled and grafted with the combination of A-PRF and SACBAs. The surgical sites were randomly allocated to the test or control group. During implant site preparation, 17 bone core biopsy samples were collected from each study group for histological, histomorphometric and micromorphometric analysis. Resonance frequency analysis was performed at the time of implant placement and 6, 8, 10, and 12 weeks postoperatively. The percentage of newly formed bone was 44.89 ± 9.49% in the test group and 39.75 ± 8.15% in the control group (p = 0.100). The results of the µCT analysis showed no significant differences in morphometric parameters between the study groups. The implant stability quotient was not significantly different between the two groups at 10 and 12 weeks postoperatively. Based on these findings, the total treatment time may be reduced by 3 months with the use of A-PRF and SACBAs for two-stage MSA.