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Root coverage with platelet-rich fibrin or connective tissue graft: a split-mouth randomized trial
Carrera, T. M. I., Machado, L. M., Soares, M. T. R., Passos, G. P., Oliveira, G. J. P., Ribeiro Júnior, N. V., Soares, P. B. F., Pigossi, S. C.
Brazilian oral research. 2023;37:e084
Abstract
This study aimed to compare the use of connective tissue grafts (CTG) and platelet-rich fibrin (PRF) associated with the tunnel technique (TT) for the treatment of multiple gingival recessions (GR). Fourteen patients with multiple bilateral GR [type 1 recession (RT 1)] in the maxillary incisors, canines, and/or premolars were included. The TT was performed on both sides (split-mouth model); CTG (36 GR) was used on one side, and on the other, PRF (36 GR) was used. Clinical parameters, including recession depth (RD), probing depth, clinical attachment level (CAL), and keratinized gingiva thickness/width (GT/KTW), were obtained at baseline and after 1, 3, 6, and 16 months. Lower RD (0.81 ± 0.68 vs. 1.23 ± 0.71 mm) and CAL (2.54 ± 0.63 vs. 2.73 ± 0.82 mm) were observed for CTG compared to PRF after 16 months. Higher GT was obtained for CTG compared to PRF after 3 (1.81 ± 0.56 vs 1.43 ± 0.47 mm) and 6 months (1.67 ± 0.61 vs. 1.38 ± 0.55 mm, p < 0.05). The recession coverage (RC) was higher for CTG (55.42% ± 37.14) in comparison to PRF (29.53% ± 34.08) after 16 months (p < 0.05). Similarly, CTG presented a more complete coverage of the recession (15; 41.66%) than PRF (9; 24.32%). There were no significant differences between the groups in terms of surgery time, postoperative pain, or healing patterns. Greater esthetic satisfaction was obtained with CTG. It was concluded that CTG combined with TT showed clinical and esthetic results superior to those of PRF in multiple GR treatments.
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Clinical evaluation of the combined efficacy of injectable platelet-rich fibrin along with scaling and root planing in the non-surgical periodontal therapy of stage III and grade C periodontitis patients having type 2 diabetes mellitus: A randomized controlled trial
Shunmuga, P. D., Tadepalli, A., Parthasarathy, H., Ponnaiyan, D., Cholan, P. K., Ramachandran, L.
Clinical advances in periodontics. 2023
Abstract
BACKGROUND This randomized controlled trial was aimed to evaluate the combined efficacy of injectable platelet-rich fibrin (i-PRF) and scaling and root planing (SRP) in type 2 diabetes mellitus subjects having periodontitis. METHODS Twenty-six Stage III, grade C periodontitis subjects (HbA1c > 7) were recruited in this split-mouth study. Following SRP, the test sites received subgingival application of i-PRF, while the control sites received saline. Plaque index, bleeding on probing, modified gingival index, probing pocket depth (PPD) and clinical attachment level (CAL) were measured at baseline, 3 and 6 months. RESULTS Twenty-three participants completed the course of research. The Friedman test followed by Dunn's post hoc test, revealed significant improvement in all the clinical parameters from baseline to 3 and 6 months in both the study groups (p ≤ 0.05). The mean PPD and CAL decreased from 6.30 ± 1.25 and 7.48 ± 1.75 at baseline to 3.48 ± 1.34 and 4.39 ± 1.67 at 6 months in control sites and from 6.57 ± 1.56 and 7.61 ± 1.69 to 3.39 ± 1.23 and 4.26 ± 1.81 at 6 months in test sites (p ≤ 0.0001). Intergroup analysis found no statistical significant differences in the evaluated parameters across all time intervals (p > 0.05) CONCLUSION The results indicated that the adjunctive application of i-PRF to SRP provided similar benefits as saline and SRP in diabetes mellitus subjects. KEY POINTS Question: To find the combined efficacy of injectable platelet-rich fibrin (i-PRF) along with scaling and root planing (SRP) in the management of periodontal pockets of Stage III and Grade C periodontitis patients having Type 2 Diabetes Mellitus (T2DM). FINDING All of the treated sites showed satisfactory healing. Both the treatment modalities (i-PRF + SRP and Saline + SRP) were effective in the treatment of periodontal pockets. At 3 and 6 months, there were no significant differences in periodontal parameters between groups. Meaning: The application of i-PRF as an adjunct to SRP provided similar benefits as saline and SRP in improving clinical parameters in subjects with stage III and grade C periodontitis patients having T2DM (HbA1C > 7).
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3.
Comparison between platelet rich fibrin as space filling material versus xenograft and alloplastic bone grafting materials in immediate implant placement: a randomized clinical trial
Elsheikh, H. A., Abdelsameaa, S. E., Elbahnasi, A. A., Abdel-Rahman, F. H.
BMC oral health. 2023;23(1):977
Abstract
BACKGROUND This study aimed to compare the efficacy of different gap filling materials in immediate implant in anterior and premolar regions of maxilla. MATERIALS AND METHODS Thirty-six implants were inserted in patients seeking for replacement of non-restorable maxillary anterior and premolar teeth (esthetic zone) by immediate implant. Patients were randomly distributed into three equal groups, twelve implants in each group. Group 1 received Platelet Rich Fibrin (PRF) into the jumping distance, Group 2 received Xenograft into the jumping distance and Group 3 received Alloplastic bone grafting material into the jumping distance. Implant stability by measuring the changes in Resonance Frequency Analysis (RFA), peri-implant pocket depth, marginal bone loss and changes in buccal bone thickness were evaluated during follow up periods. All the clinical and radiographic data were subjected to statistical analysis by One Way ANOVA test and the Post Hoc Tukey test. RESULTS This study involved 19 female patients and 17 male patients who received 36 dental implants. There was no significant difference between the study groups regarding implant stability, peri-implant pocket depth and palatal bone loss, while there was a significant difference between PRF Group (Group 1) and the other Groups regarding buccal bone loss and changes in buccal bone thickness. CONCLUSION PRF can be used as a gap filling material in conjunction with immediate implant placement, but other bone grafting materials give superior result regarding buccal bone loss and changes in buccal bone thickness. TRIAL REGISTRATION The study was listed on www. CLINICALTRIALS gov with registration number (NCT05878392) on 26/05/2023. The Institutional Review Board (IRB) of the Faculty of Dentistry, Mansoura University, Mansoura, Egypt, approved the current study in compliance with the seventh revision of the Helsinki Declaration in 2013 (A0103023OS).
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Surgical treatment methods of medication-related osteonecrosis of the jaw. A systematic review
Zigmantavi, čius, , J., Kilinskaitė, , G., Kubilius, , R.
Stomatologija. 2023;24(4):91-99
Abstract
Objective: Relevance of the problem and the aim: A variety of surgical treatment modalities are analyzed to treat medication-related osteonecrosis of the jaw, using different adjuvant therapies (fluorescence-guided surgery, autologous platelet concentrates) and thus to improve bone and mucosa healing in the postoperative period and reduce the risk of recurrence of osteonecrosis. The purpose of the present systematic review is to compare the effectiveness of different surgical treatments for medication-related osteonecrosis of the jaw (with applications of autologous platelet concentrates, fluorescence guidance, or without adjuvant measures). Materials and methods: The protocol for the systematic review was prepared according to the PRISMA and Cochrane guidelines for systematic reviews. Electronic databases used: PubMed, The Cochrane Library, Science Direct, Wiley Online Library. The review includes articles investigating surgical treatment methods for medication-related osteonecrosis of the jaw. Results: Twelve scientific articles were included in the review. The studies evaluated the efficacy of autologous platelet concentrates, fluorescence-guided surgery, or standard surgical treatment techniques without adjuvant therapies. The efficiency of curettage, sequestrectomy, and the use of autologous platelet concentrates have been found to range from 80% to 96.7%. The efficiency of fluorescence-guided surgery varied from 83.3% to 94.4%. The highest efficiency range of treatment results was determined by evaluating the surgical treatment without adjuvant therapies, which can reach from 22.22% to 93.2%. Conclusions: The best and most stable results in the surgical treatment of medication-related osteonecrosis of the jaw are achieved by the application of autologous platelet concentrates after surgical removal of necrotic bone or fluorescence-guided surgery.
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Effectiveness of the use of platelet-rich fibrin associated with open flap debridement compared to open flap debridement alone for the treatment of periodontal intrabony defects: Overview of systematic reviews
Padrón-Molina, O. J., Parise-Vasco, J. M., Zambrano-Achig, P. E., Montesinos-Guevara, C.
Journal of Indian Society of Periodontology. 2023;27(3):262-272
Abstract
In the recent years, platelet-rich fibrin (PRF) has gained importance in regenerative medicine due to its attributed tissue-inducing properties. However, it is still unclear whether there are benefits from using PRF with open flap debridement (OFD) for the treatment of intrabony defects compared to OFD alone. For this reason, in this study, we performed an overview of systematic reviews with Friendly Summaries of the Body of Evidence using Epistemonikos methodology on the use of PRF with OFD compared to OFD alone for the treatment of intrabony defects. We performed a systematic search in the Epistemonikos database. We extracted data from the included systematic reviews and reanalyzed the data of primary studies and generated a summary of the findings table. We used Review Manager (RevMan) v5.3 software and GRADEpro software for data analysis and data presentation. Eighteen systematic reviews were included after full-text screening, which had 16 clinical trials. Results were reported by the mean difference (MD); the following outcomes were analyzed: change in intrabony defect depth (MD: 1.37 mm more), change in radiographic bone defect filling (MD: 37.26% more), change in probing depth (MD: 1.22 mm more), change in clinical attachment level (MD: 1.32 mm more), and change in gingival margin level (MD: 0.31 more). We concluded that applying PRF with OFD to treat an intrabony defect has some clinical advantages compared to OFD alone.
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World Workshop on Oral Medicine VII: Platelet count and platelet transfusion for invasive dental procedures in thrombocytopenic patients: A systematic review
Karasneh J, Christoforou J, Walker JS, Manfredi M, Dave B, Diz Dios P, Lockhart PB, Patton LL
Oral diseases. 2019;25 Suppl 1:174-181
Abstract
OBJECTIVES To evaluate the evidence for a 50,000/mul platelet count threshold for platelet transfusion for invasive dental procedures in thrombocytopenic patients. SUBJECTS AND METHODS We searched in MEDLINE/PubMed, EMBASE, the Cochrane Library (Wiley) and Scopus from 1960 through April 2018 for studies on patients with quantitative platelet disorders not related to medical co-morbidities or medications and undergoing invasive dental procedures. Two reviewers conducted assessments independently. RESULTS We found a total of 176 non-duplicate articles, of which 9 cohort studies met our inclusion criteria. The incidence of postoperative bleeding in thrombocytopenic patients was low (4.9%), and we found no difference in bleeding incidence between patients who had platelet transfusion and those who did not. There was no difference in the mean platelet count for patients with and without bleeding. Different modalities are now available to prevent and control bleeding, which may reduce the need for platelet transfusion. CONCLUSIONS There is no evidence to support the long-standing dogma of a need for a platelet count ≥ 50,000/mul for safe invasive dental procedures. Platelet transfusion effectiveness for haemostasis support could not be determined based on available data. Local measures and antifibrinolytics are the mainstay for the prevention and management of bleeding.
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Use of platelet gel with connective tissue grafts for root coverage: a randomized-controlled trial
Keceli HG, Sengun D, Berberoglu A, Karabulut E
Journal of Clinical Periodontology. 2008;35((3):):255-62.
Abstract
BACKGROUND Platelet-rich plasma (PRP) was speculated to be a promoter of periodontal regeneration. There are only a few clinical comparative studies using PRP in the treatment of gingival recession. Aim: The aim of the present study was to compare connective tissue graft (CTG)+PRP with CTG alone in the treatment of gingival recession. MATERIAL AND METHODS Forty patients with Miller I/II recessions were included. Each recession was randomly treated with either CTG+PRP or CTG. Clinical variables were recorded at baseline and at 6 weeks, 6 and 12 months. Root coverage (RC) and attachment gain (AG) were also calculated. RESULTS Probing depth, recession depth, clinical attachment level, keratinized tissue width and recession width (RW) were improved in both study groups. However, no difference was observed between groups, except RW. RW in the control group was statistically lower than the test group at all follow-up periods. CONCLUSION Treatment of recession with CTG or a CTG-PRP combination resulted in favourable clinical outcomes. However, no difference could be found between CTG and CTG+PRP. Whether much longer follow-up studies with higher statistical power may change these results remains questionable.
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8.
Recovery from deep-plane rhytidectomy following unilateral wound treatment with autologous platelet gel: a pilot study
Powell DM, Chang E, Farrior EH
Archives of Facial Plastic Surgery. 2001;3((4):):245-50.
Abstract
OBJECTIVE To determine the effects of treatment with autologous platelet-rich plasma mixed with thrombin and calcium chloride to form an autologous platelet gel (APG) on postoperative recovery from deep-plane rhytidectomy. STUDY DESIGN A prospective, randomized, controlled pilot study. SETTING An accredited ambulatory facial plastic surgery center. PATIENTS Healthy volunteer women (N = 8) undergoing rhytidectomy. INTERVENTION Unilateral autologous platelet-rich plasma wound treatment during standard deep-plane rhytidectomy. MAIN OUTCOME MEASURES Staged postoperative facial photographs were graded in a blinded fashion by 3 facial plastic surgeon reviewers for postoperative ecchymosis and edema. Each facial side treated with APG that demonstrated less edema or ecchymosis than the non-APG-treated side was designated a positive response; otherwise, the response was equal (no difference) or negative (untreated side had less edema or ecchymosis). RESULTS Twenty-one positive and 21 equal responses were observed compared with 8 negative ones. Of 20 unanimous observations, 15 were positive, only 3 equal, and 1 negative. CONCLUSIONS Treatment with APG may prevent or improve edema or ecchymosis after deep-plane rhytidectomy. This trend is more apparent for ecchymosis than for edema, and is chiefly demonstrable in the early phases of recovery. These observations are consistent with previous reports of cell tissue culture and wound response to concentrated platelet product.