Guided bone regeneration: materials and biological mechanisms revisited

European Journal Of Oral Sciences, Journal Year: 2017, Volume and Issue: 125(5), P. 315 - 337

Published: Aug. 19, 2017

Guided bone regeneration ( GBR ) is commonly used in combination with the installment of titanium implants. The application a membrane to exclude non‐osteogenic tissues from interfering key principle . Membrane materials possess number properties which are amenable modification. A large membranes have been introduced for experimental and clinical verification. This prompts need an update on biological outcomes, as well critical assessment mechanisms governing defects covered by membranes. relevant literature this narrative review was assessed after MEDLINE /PubMed database search. Experimental data suggest that different modifications physicochemical mechanical may promote regeneration. Nevertheless, precise role porosities barrier function still awaits elucidation. Novel findings also active compartment per se promoting regenerative processes underlying defect during , instead being purely passive barrier. optimization systematically addressing both bioactive important strategy field research.

Language: Английский

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Regenerative surgery versus access flap for the treatment of intra‐bony periodontal defects: A systematic review and meta‐analysis

Journal Of Clinical Periodontology, Journal Year: 2019, Volume and Issue: 47(S22), P. 320 - 351

Published: Dec. 20, 2019

Abstract Background The aim of this systematic review was to compare clinical, radiographic and patient‐reported outcomes (PROMs) in intra‐bony defects treated with regenerative surgery or access flap. Materials Methods A protocol written following the PRISMA checklist. Electronic hand searches were performed identify randomized clinical trials (RCTs) on treatment deep (≥3 mm) a follow‐up at least 12 months. Primary outcome variables probing pocket depth (PPD) reduction, attachment level (CAL) gain tooth loss. Secondary Rec, bone gain, “closure,” PROMs adverse events. Meta‐analysis carried out when possible. To evaluate effect, odds ratios combined for dichotomous data mean differences continuous using random‐effect model. Results total 79 RCTs (88 articles) published from 1990 2019 accounting 3,042 patients 3,612 included review. Only 10 studies rated low risk bias. 13 meta‐analyses performed. All procedures provided adjunctive benefit terms CAL (1.34 mm; 0.95–1.73) compared open flap debridement alone. Both enamel matrix derivative (EMD) guided tissue regeneration (GTR) superior OFD alone improving (1.27 0.79–1.74 mm 1.43 0.76–2.22, respectively), although moderate–high heterogeneity. Among biomaterials, addition deproteinized bovine mineral (DBBM) improved both GTR resorbable barriers EMD. Papillary preservation flaps enhanced outcomes. strength evidence moderate. Conclusion EMD combination papillary should be considered choice residual pockets defects.

Language: Английский

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A novel method for evaluating and quantifying cell types in platelet rich fibrin and an introduction to horizontal centrifugation

Journal of Biomedical Materials Research Part A, Journal Year: 2019, Volume and Issue: 107(10), P. 2257 - 2271

Published: May 31, 2019

Abstract Platelet rich fibrin (PRF) has been utilized clinically as a platelet concentrate capable of stimulating tissue regeneration. Interestingly, several protocols have proposed with little data obtained regarding the final cell counts following centrifugation. The aim present study was to compare different commercially available centrifuges and their respective utilizing novel method quantify cells. One millimeter blood layers centrifugation were sequentially pipetted from upper layer downward until all 10 mL harvested in sequential samples. Thereafter, each sample sent for CBC analysis accurately precisely numbers within separate results this revealed that L‐PRF (2700 rpm × 12 min) produced clot majority platelets leukocytes concentrated buffy coat relatively no cells found first 4 L‐PRF. Slower using A‐PRF (1300 8 more evenly distributed number throughout PRF. Injectable‐PRF (i‐PRF) highest concentration leukocytes/platelets, however, total significantly lower owing decreased volume collected. Horizontal significant increase both (up 3.5× higher either solid/liquid PRF). When compared fixed or angled centrifuge (InstraSpin, Process In conclusion, novel/accurate PRF protocols. Furthermore, via horizontal accumulated platelets/leukocytes when fixed‐angle

Language: Английский

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Use of platelet-rich fibrin for the treatment of periodontal intrabony defects: a systematic review and meta-analysis

Clinical Oral Investigations, Journal Year: 2021, Volume and Issue: 25(5), P. 2461 - 2478

Published: Feb. 20, 2021

Abstract 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 clinical PRF that Studies were classified into 10 categories as follows: (1) open flap debridement (OFD) alone versus OFD/PRF; (2) OFD/bone graft (OFD/BG) (3) OFD/BG OFD/BG/PRF; (4–6) OFD/barrier membrane (BM), OFD/PRP, or OFD/enamel matrix derivative (EMD) (7) OFD/EMD OFD/EMD/PRF; (8–10) OFD/PRF OFD/PRF/metformin, OFD/PRF/bisphosphonates, OFD/PRF/statins. Weighted means forest plots calculated for probing depth (PD), attachment level (CAL), radiographic bone fill (RBF). Results From 551 articles identified, 27 RCTs included. use statistically significantly reduced PD improved CAL RBF when compared OFD. No clinically significant differences reported was OFD/PRF. addition led improvements in RBF. between any following groups (OFD/BM, OFD/EMD) also added OFD/EMD. all three biomolecules (metformin, bisphosphonates, statins) PD, CAL, Conclusions OFD similar levels being observed Future research geared toward better understanding potential ways enhance regenerative properties various small may prove valuable future applications. investigating at histological is needed. Clinical relevance conjunction values, yielding comparable OFD/BG. combination grafts offer certain advantages, thus warranting further investigations.

Language: Английский

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Applications of the regenerative capacity of platelets in modern medicine

Cytokine & Growth Factor Reviews, Journal Year: 2021, Volume and Issue: 64, P. 84 - 94

Published: Dec. 2, 2021

Language: Английский

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Guided bone regeneration in implant dentistry: Basic principle, progress over 35 years, and recent research activities

Periodontology 2000, Journal Year: 2023, Volume and Issue: 93(1), P. 9 - 25

Published: Oct. 1, 2023

Abstract Bone augmentation procedures are frequent today in implant patients, since an should be circumferentially anchored bone at completion of healing to have a good long‐term stability. The best documented surgical technique achieve this goal is guided regeneration (GBR) utilizing barrier membranes combination with fillers. This clinical review paper reflects 35 years development and progress GBR. In the 1990s, GBR was developed by defining indications for GBR, examining various membranes, grafts, substitutes. Complications were identified reduced modifications technique. Today, selection criteria approaches much better understood, particular, post‐extraction placement. majority biodegradable collagen used, mainly horizontal augmentation, whereas bioinert PTFE preferred vertical ridge augmentation. leading surgeons using composite graft autogenous chips accelerate formation, low‐substitution filer maintain augmented volume over time. addition, major efforts been made millenium change reduce trauma patient morbidity as possible. At end, some open questions related discussed.

Language: Английский

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Antibiotic-Loaded Platelet-Rich Fibrin (AL-PRF) as a New Carrier for Antimicrobials: A Systematic Review of In Vitro Studies

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(5), P. 2140 - 2140

Published: Feb. 27, 2025

Platelet-rich fibrin (PRF) has emerged as a promising scaffold for drug delivery, particularly in the context of antimicrobial therapies. This systematic review evaluates incorporation antibiotics into PRF to determine its efficacy localized delivery system compared plain without antibiotics. A was conducted according Preferred Reporting Items Systematic Reviews and Meta-Analyses (PRISMA) guidelines, including 13 vitro studies with moderate risk bias. Antibiotics were incorporated using different methodologies, systemic administration before blood collection, addition centrifugation, injection formed matrices. Outcomes analyzed regarding antibacterial efficacy, structural integrity PRF, release kinetics. Antibiotic-enhanced demonstrated significant activity against various bacterial strains. The enhanced dependent on type antibiotic, concentration, method. Encapsulation approaches facilitated sustained antibiotic release, while higher concentrations occasionally disrupted integrity. Systemic collection enriches effectively, producing inhibition zones. effects outperformed alternative carriers, such collagen sponges. Antibiotic-loaded is potent tool applications clinical settings. Further research needed standardize preparation protocols explore impact methods PRF's regenerative properties.

Language: Английский

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Standardization of relative centrifugal forces in studies related to platelet‐rich fibrin

Journal of Periodontology, Journal Year: 2019, Volume and Issue: 90(8), P. 817 - 820

Published: Feb. 7, 2019

Platelet-rich fibrin (PRF), a second-generation platelet concentrate, has been the focus of intensive research endeavors over past 2 decades. Over years, however, numerous reports have inaccurately reported relative centrifugal force (RCF) values, which caused considerable confusion in field. Furthermore, use trade names such as leukocyte and platelet-rich (L-PRF) advanced (A-PRF) further confused many readers, since studies not always used centrifugation parameters with equal rotor sizes, angulation tubes, and/or tube design. This led to misperception report force. Herein is described necessary pivotal for future RCF related PRF, include: 1) dimensions (radius at clot end tube); 2) holder; 3) revolutions per minute (RPM) time; 4) value calculated either RCF-minimum, RCF-clot, or RCF-maximum; 5) composition size tubes produce PRF; 6) model used. editorial aims minimize field create more transparent reporting values studies.

Language: Английский

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The use of platelet‐rich fibrin to enhance the outcomes of implant therapy: A systematic review

Clinical Oral Implants Research, Journal Year: 2018, Volume and Issue: 29(S18), P. 6 - 19

Published: Oct. 1, 2018

Abstract Objective To assess the impact of platelet‐rich fibrin ( PRF ) on implant dentistry. The primary focused question was as follows: What are clinical, histological, and radiographic outcomes administration for bone regeneration therapy? Method A systematic literature search comprised three databases: MEDLINE , EMBASE Cochrane followed by a hand relevant scientific journals. Human studies using therapy were considered articles published up to December 31, 2017 included. Eligible selected based inclusion criteria. Randomized controlled trials RCT clinical CCT Results In total, 5,963 titles identified with terms search. total 12 randomized met criteria chosen data extraction. Included alveolar ridge preservation after tooth extraction, osseointegration process, soft tissue management, augmentation, sinus floor elevation surgical peri‐implantitis treatment. Overall, risk bias moderate or unclear. Nine showed superior any evaluated variables, such dimension, regeneration, healing. Three failed show beneficial effects . No meta‐analysis could be performed due heterogeneity study designs. Conclusions There is evidence supporting benefit in early phase osseointegration. It remains unclear whether can reduce pain improve More research support necessary comment role other outcomes.

Language: Английский

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Antibacterial effects of platelet-rich fibrin produced by horizontal centrifugation

International Journal of Oral Science, Journal Year: 2020, Volume and Issue: 12(1)

Published: Nov. 26, 2020

Abstract Platelet-rich fibrin (PRF) has been widely used owing to its ability stimulate tissue regeneration. To date, few studies have described the antibacterial properties of PRF. Previously, PRF prepared by horizontal centrifugation (H-PRF) was shown contain more immune cells than leukocyte- and platelet-rich (L-PRF). This study aimed compare antimicrobial effects PRFs against Staphylococcus aureus Escherichia coli in vitro determine whether correlated with number cells. Blood samples were obtained from eight healthy donors prepare L-PRF H-PRF. The sizes weights H-PRF first evaluated, their S. E. then tested using inhibition ring plate-counting test methods. Flow-cytometric analysis cell components also performed. No significant differences size or weight observed between groups. group contained leukocytes group. While both had notable activity , demonstrated a significantly better effect L-PRF. Furthermore, solid less efficient that wet In conclusion, exhibited L-PRF, which might attributed having

Language: Английский

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