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Does the application of autologous injectable Platelet-Rich Fibrin (i-PRF) affect the patient's daily performance during the retraction of upper canines? A single-centre randomized split-mouth controlled trial
Zeitounlouian, T., Haddad, R., Brad, B., Ballouk, M. A., Fudalej, P.
BMC oral health. 2023;23(1):872
Abstract
BACKGROUND Previous studies have assessed different aspects concerning the applications of i-PRF in the oral cavity. However, nothing is known regarding patients' perceptions of the injection of autologous platelet-rich fibrin (i-PRF). OBJECTIVES To investigate patients' perceptions after injecting platelet-rich fibrin (i-PRF) in the course of retracting upper canines. METHODS Twenty-one patients, whose treatments required extractions of both upper first premolars, were recruited. Extraction side was randomly allocated to the intervention or control sides. After the alignment phase, i-PRF was injected twice with a one-month interval on the buccal and palatal aspects of the extraction sites (intervention side). Patients' perceptions were evaluated with two questionnaires: the first was used to assess the level of pain, discomfort, swelling, eating and swallowing difficulties as well as jaw movement restriction after 1 h (T1), 2 h (T2), 6 h (T3), 24 h (T4) and 48 h (T5) of the second injection; the second questionnaire was used to assess the acceptance of the i-PRF injection and overall satisfaction with this technique at the end of canine retraction phase. Visual Analogue Scale (VAS) was adopted for this purpose. Wilcoxon Signed Rank Test was used to compare between both sides at all time points while Friedman's Test was the selected test for detecting variables' changes over time. Post-hoc Wilcoxon Matched-Pairs Signed-Rank Tests were applied when any of the results were significant. As to the multiplicity of tests, Bonferroni Correction was implemented. RESULTS Pain and swelling levels were significantly higher on the experimental compared to the control sides at T1, T2, and T3 (P < 0.05), whereas they declined sharply and went back to almost normal values at T4 (after 24 h). At T5 they were 0. Discomfort and difficulty in mastication on intervention sides were significant only at T1 and T2. Pain, swelling, and chewing difficulties were significant (P < 0.001) during the 4 assessed time points. The increase was insignificant regarding swallowing difficulties and jaw movement limitations at all time intervals. CONCLUSIONS Injecting autologous (i-PRF) during orthodontic canine retraction is a well-perceived and well-tolerated method due to the limited discomfort which significantly diminishes 24 h afterwards. TRIAL'S REGISTRATION ClinicalTrials.gov (Identifier Number: NCT03399422. 16/01/2018).
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Comparative Evaluation of the Regenerative Potential of Blood Clot and Platelet-rich Fibrin in Young Permanent Teeth Based on the Revised American Academy of Endodontics Clinical Considerations for Regenerative Procedure: 2016
Prakash, A. J., Naik, S. V., Attiguppe, P.
International journal of clinical pediatric dentistry. 2023;16(Suppl 2):149-154
Abstract
AIM: To compare and evaluate the regenerative potential of blood clots and platelet-rich fibrin (PRF) in IYNPT based on the revised American Academy of Endodontics (AAE) clinical considerations for regenerative endodontics 2016. MATERIALS AND METHODS A total of 20 patients (7-12 years) with immature young necrotic permanent teeth were included and irrigation and disinfection were done using the revised AAE protocol. Teeth were randomly categorized into PRF scaffolding and conventional bleeding technique. The cases were followed up for 1, 3, and 6 months for clinical and radiographic evaluation. RESULT At 6 months there was no significant difference between the groups in terms of clinical healing and periapical healing. A significant statistical difference was noted at the end of 6 months with respect to apical closure within the PRF group. A significant difference was seen in the increase in dentin thickness between groups with PRF showing more increase. CONCLUSION The PRF scaffold can be used as it induces the regenerative potential of stem cells at the apex. HOW TO CITE THIS ARTICLE Prakash AJ, Naik SV, Attiguppe P. Comparative Evaluation of the Regenerative Potential of Blood Clot and Platelet-rich Fibrin in Young Permanent Teeth Based on the Revised American Academy of Endodontics Clinical Considerations for Regenerative Procedure: 2016. Int J Clin Pediatr Dent 2023;16(S-2):S149-S154.
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A randomized trial of the effects of platelet- rich plasma on postoperative complications after meningomyelocele sac repair
Arabacı, Ö, Akyol, M. E., Çelikkaleli, E., Sönmez, B., Çetin, E., Beger, B.
European review for medical and pharmacological sciences. 2023;27(12):5552-5558
Abstract
OBJECTIVE Meningomyelocele is a common congenital neural tube defect. To reduce complications, we need early surgery and a multidisciplinary approach. In this study, we administered platelet-rich plasma (PRP) to babies with meningomyelocele following corrective surgery to minimize cerebrospinal fluid (CSF) leakage and accelerate the healing of the immature pouch tissue. We compared these with a control group that did not receive PRP. PATIENTS AND METHODS Of the 40 babies who had surgery with the diagnosis of meningomyelocele, 20 patients received PRP after surgical repair, and 20 were followed up without PRP. In the PRP group, 10 of the 20 patients underwent primary defect repair, the other 10 underwent flap repair. In the group that did not receive PRP, primary closure was performed in 14 patients and flap closure in six. RESULTS In the PRP group, CSF leakage occurred in one (5%) patient, and none developed meningitis. Partial skin necrosis occurred in three (15%) patients and wound dehiscence in three (15%) patients. In the group that did not receive PRP, CSF leakage occurred in nine (45%) patients, meningitis in seven (35%), partial skin necrosis in 13 (65%), and wound dehiscence in seven (35%) patients. The rate of CSF leakage and skin necrosis in the PRP group was significantly (p<0.05) lower than that in the PRP group. Furthermore, wound closure and healing were also improved in the PRP group. CONCLUSIONS We have shown that PRP treatment of postoperative meningomyelocele infants facilitates healing and lowers the risk of CSF leakage, meningitis, and skin necrosis.
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Pulp Revascularization/Revitalization of Bilateral Upper Necrotic Immature Permanent Central Incisors with Blood Clot vs Platelet-rich Fibrin Scaffolds-A Split-mouth Double-blind Randomized Controlled Trial
Rizk HM, Salah Al-Deen MS, Emam AA
International journal of clinical pediatric dentistry. 2020;13(4):337-343
Abstract
OBJECTIVES Clinical and radiographic evaluation of the regeneration of bilateral necrotic upper permanent central incisors with open apex using blood clot (BC) and platelet-rich fibrin (PRF) scaffolds. TRIAL DESIGN Split-mouth double-blind parallel arm randomized controlled clinical trial. MATERIALS AND METHODS Randomization and blinding: The study started with 15 patients with bilateral necrotic upper permanent central incisors with open apex. Computer-generated tables were used to allocate treatments. The two maxillary central incisors were randomly assigned to either the control (BC scaffold) or the examined (PRF scaffold) groups. Participants: Thirteen patients aged 8-14 years fulfilled the study requirements. Follow-up was performed for 3, 6, 9, and 12 months. Standardized radiographs were collected each 3 months, and difference in measurements was calculated using Image J software. Primary outcomes measured were sinus/fistula formation, pain complaint, mobility grade, and swelling presence/absence. Radiographic: Root length elongation and increase in root thickness. Secondary outcomes were sensibility test and crown color change. Radiographic: Change in bone density and apical diameter. Radiographs that were standardized used during the follow-up time, and occurred changes were calculated using Image J software. RESULTS One patient was lost during follow-up; therefore, 24 treated teeth were analyzed, they showed 100% success rate. Platelet-rich fibrin teeth displayed a statistically significant growth in radiographic root length and width, increased periapical bone density, and a reduction in apical diameter when compared with BC. At the end of the follow-up period, all treated teeth were negative to sensibility test. Blood clot displayed greater crown discoloration in comparison to PRF group. CONCLUSION For teeth with open apex and necrotic pulp, revascularization using PRF is an appropriate substitute to BC. HOW TO CITE THIS ARTICLE Rizk HM, Salah AL-Deen MS, Emam AA. Pulp Revascularization/Revitalization of Bilateral Upper Necrotic Immature Permanent Central Incisors with Blood Clot vs Platelet-rich Fibrin Scaffolds-A Split-mouth Double-blind Randomized Controlled Trial. Int J Clin Pediatr Dent 2020;13(4):337-343.
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Efficacy of Platelet-Rich Fibrin Combined with Autogenous Bone Graft in the Quality and Quantity of Maxillary Alveolar Cleft Reconstruction
Omidkhoda M, Jahnabin A, Khoshandam F, Eslami F, Hosseini Zarch SH, Tavakol Afshari J, Kermani H
Iranian journal of otorhinolaryngology. 2018;30((101):):329-334.
Abstract
Introduction: The aim of this study was to evaluate the effect of platelet-rich fibrin (PRF) on the quality and quantity of bone formation in unilateral maxillary alveolar cleft reconstruction using cone beam computed tomography. Materials and Methods: This study was conducted on 10 non-syndromic patients with unilateral cleft lip and palate within the age group of 9-12 years. The study population was randomly assigned into two groups of PRF and control, each of which entailed 5 cases. In the PRF group, the autogenous anterior iliac crest bone graft was used in combination with PRF gel. On the other hand, the control group was subjected to reconstruction only by bone graft. The dental cone beam CT images were obtained immediately (T0) and 3 months (T1) after the operation to assess the quality and quantity of the graft. Independent and paired sample t-tests and analysis of covariance were used to analyze and compare the data related to the height, thickness, and density of the new bone. Results: The mean thickness difference of the graft in both PRF and control groups at T0 and T1 was not significantly different (P>0.05). Furthermore, the reduction changes of bone height at the graft site from T0 to T1 were not statistically significant for both groups (P=0.78). The mean total bone loss of the regenerated bone from T0 to T1 was lower in the control group than that in the PRF group; however, this difference was not statistically significant. Conclusion: The usage of PRF exerted no significant effect on the thickness, height, and density of maxillary alveolar graft.
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Use of platelet-rich plasma for regeneration in non-vital immature permanent teeth: clinical and cone-beam computed tomography evaluation
Alagl A, Bedi S, Hassan K, Al Humaid J
The Journal of International Medical Research. 2017;45((2)):583-593.
Abstract
Objective This study was performed to assess the clinical and radiological outcomes of a revascularization procedure in immature teeth with apical periodontitis using platelet-rich plasma (PRP). The PRP protocol and conventional revascularization protocol, which used a blood clot as the scaffold, were compared. Methods Thirty non-vital immature permanent teeth were randomly categorized into two groups. After disinfecting the root canal space with triple antibiotic paste (1:1:1 ciprofloxacin, metronidazole, and cefaclor), a tissue scaffold was created using either PRP or a blood clot (control) and covered with white mineral trioxide aggregate. All cases were followed up clinically and radiographically for 12 months. Differences in bone density, root length, and lesion size were calculated using preoperative and postoperative computed tomography images. The means of the differences in individual parameters in the blood clot and PRP groups were compared using the Mann-Whitney U test. Results After 5 months, sensitivity tests (cold and electric pulp tests) elicited a delayed positive response in 23 sites. At 12 months, cone-beam computed tomography revealed resolution or a decrease in lesion size and an increase in bone density in all 30 (100%) teeth. Additionally, continued root development was observed in 22 (73%) teeth and early root growth was observed in the test group (mineral trioxide aggregate with PRP). Conclusions The results of this study suggest that PRP can serve as a successful scaffold for regenerative endodontic treatment. With the exception of a significant increase in root length, the results of treatment with PRP were not significantly different from those of the conventional protocol using a blood clot as the scaffold.
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Efficacy of platelet-rich-plasma (PRP) in bone regeneration after cyst enucleation in pediatric patients--a clinical study
Nagaveni NB, Praveen RB, Umashankar KV, Pranav B, Sreedevi R, Radhika NB
The Journal of Clinical Pediatric Dentistry. 2010;35((1):):81-7.
Abstract
BACKGROUND Platelet-rich-plasma (PRP) is a type of natural source of autologous growth factors, and has been used successfully in various fields. However the use of PRP in children is not well documented. OBJECTIVE To evaluate the efficacy of adding PRP to a bone graft in the bone regeneration of cystic bony defects following cystectomy. Study design: Study sample included 20 children who were randomly divided into two groups with 10 patients in each group; all underwent cystectomy In the first group (test group), after cystectomy the cystic defect was filled with PRP and bone graft. In the second group (control group) bone graft alone (without PRP) was used. Radiographs were recorded at 1 month, 2 months, 4 months and 6 months intervals after surgery to evaluate the defect bone fill in both groups. RESULTS The post-operative successive radiographs in the test group showed a significantly greater regeneration of bone in the height of bony defects with application of PRP to bone graft as compared to the control group. In the test group, by the first post operative month, about 58% of the defect was filled, which gradually increased in each month and showed about 94% of defect-fill by 6 months. In the control group, similar observation revealed only 31% of defect-fill by the first post-operative month and a 47% defect-fill at 6 months. CONCLUSION The addition of PRP to bone graft appeared to enhance bone regeneration considerably. The combination of PRP and bone graft might have a potential for routine clinical use for regeneration of cystic bony defects in children.