Auto-concentrated growth factor (CGF) constitutes the latest generation of plasma extract, and has high concentrations of growth factors and white blood cells. Due to the continuous variable speed centrifugation used during preparation, the tensile strength of the fibrin is also higher. CGF preparation does not involve the use of animal serum, minimizing the risk of infection and immune rejection. Therefore, it has wide potential applications in various fields of regenerative medicine. This paper summarizes the history behind CGF development, reviews the clinical applications and research progress concerning single CGF therapy and CGF used in combination with other treatments in multiple wound repair, and summarizes its potential value as therapeutic agent. Finally, some constructive suggestions and research perspectives for the application of CGF in wound healing are put forward. The available evidence indicates that CGF can promote the healing of chronic refractory wounds and acute wound, promote the growth of granulation, accelerate the speed and improve the quality of wound healing, reduce scar formation, minimize the need for repeated wound dressing, and ameliorate the pain experienced by patients.

Background/Objectives: Autogenous palatal free gingival graft (FGG) harvesting presents challenges for patients due to the increased risk of postoperative morbidity related to a second intraoral surgical wound that heals with secondary intention. This parallel-group, randomized, controlled, open-label trial aimed to evaluate the efficacy of the application of leukocyte- and platelet-rich fibrin (L-PRF) membrane to the palatal donor site on wound healing, hemostasis, and pain control after FGG harvesting. Methods: Twenty-eight adult patients with insufficient attached gingiva underwent soft tissue augmentation using FGG harvested from the palate at the Department of Oral and Maxillofacial Surgery, Baskent University, Turkey. Patients were randomized to either an L-PRF group or a control group. In the L-PRF group, the L-PRF membrane was sutured to the donor sites, whereas in the control group, donor sites healed by secondary intention. Postoperative evaluations were conducted on days 1, 3, 5, and 7 and at weeks 2, 3, 4, 5, and 6. Donor sites were evaluated clinically for pain, burning sensation, bleeding, wound healing, and color match to adjacent tissues. Donor site wound areas were analyzed using digital images. Results: Two patients were excluded from the analysis due to loss of contact, leaving 26 (n = 13, n = 13) patients for analysis. Donor site pain and burning sensation were significantly lower in the L-PRF group compared to the control group during the first two postoperative weeks (p < 0.001). Bleeding was significantly lower in the L-PRF group on postoperative days 1 and 3 (p < 0.001). Clinical healing index scores were significantly higher in the L-PRF group at weeks 3 and 4 (p < 0.001). Additionally, palatal wound area reductions from baseline were significantly greater in the L-PRF group at all follow-up intervals (p < 0.001). Conclusions: The application of an L-PRF membrane to palatal donor wounds after FGG harvesting significantly reduces postoperative pain, decreases bleeding, and accelerates healing, providing a valuable autologous biomaterial for enhanced wound healing and improved patient comfort.

Currently, autologous platelet concentrates (APCs) are frequently used for soft- and hard-tissue regeneration, not only within the oral cavity, but also extra-orally including chronic wounds, burns, joints, dermatological conditions, among others. The benefits of APCs are largely influenced by the treatment strategy but also their preparation. This paper therefore discusses in detail: the physical properties of blood cells, the basic principles of blood centrifugation, the impact of the centrifugation protocol (rotations/revolutions per minute, g-force, variation between centrifuges), the importance of timing during the preparation of APCs, the impact of the inner surface of the blood tubes, the use/nonuse of anticoagulants within APC tubes, the impact of the patient's hematocrit, age, and gender, as well as the important requirements for an optimal centrifugation protocol. All these variables indeed have a significant impact on the clinical outcome of APCs.

The survival of an organism relies on its ability to repair the damage caused by trauma, toxic agents, and inflammation. This process involving cell proliferation and differentiation is driven by several growth factors and is critically dependent on the organization of the extracellular matrix. Since autologous platelet concentrates (APCs) are fibrin matrices in which cells, growth factors, and cytokines are trapped and delivered over time, they are able to influence that response at different levels. The present review thoroughly describes the molecular components present in one of these APCs, leukocyte- and platelet-rich fibrin (L-PRF), and summarizes the level of evidence regarding the influence of L-PRF on anti-inflammatory reactions, analgesia, hemostasis, antimicrobial capacity, and its biological mechanisms on bone/soft tissue regeneration.

Autologous platelet concentrates (APCs) applied alone or combined with other biomaterials are popular bioactive factors employed in regenerative medicine. The main biological rationale of using such products is to concentrate blood-derived growth factors and cells into the wound microenvironment to enhance the body's natural healing capacity. First-generation APC is represented by platelet-rich plasma (PRP). While different protocols have been documented for PRP preparation, they overall consist of two cycles of centrifugation and have important limitations related to the use of an anticoagulant first and an activator afterward, which may interfere with the natural healing process and the release of bioactive molecules. The second generation of platelet concentrates is represented by leukocyte and platelet-rich fibrin (L-PRF). L-PRF protocols involve a single centrifugation cycle and do not require the use of anticoagulants and activators, which makes the preparation more straight forward, less expensive, and eliminates potential risks associated with the use of activators. However, since no anticoagulant is employed, blood undergoes rapid clotting within the blood collection tube; hence, a timely management of L-PRF is crucial. This review provides an overview on the most documented protocols for APC preparations and critically discusses the main differences between first- and second-generation APCs in terms of cell content, protein release, and the formation of a 3D fibrin network. It appears evident that the inconsistency in reporting protocol parameters by most studies has contributed to conflicting conclusions regarding the efficacy of different APC formulations and has significantly limited the ability to interpret the results of individual clinical studies. In the future, the use of a standardized classification system, together with a detailed reporting on APC protocol parameters is warranted to make study outcomes comparable. This will also allow to clarify important aspects on the mechanism of action of APCs (like the role of leukocytes and centrifugation parameters) and to optimize the use of APCs in regenerative medicine.

Background and objectives: Due to the regeneration potential of growth factors (GFs) and platelet concentrates (PCs), facial rejuvenation has been a major area of attention in esthetic medicine. The effectiveness and safety of PCs and GFs in promoting face rejuvenation are examined in this systematic review, which is complemented by a case series. GFs are essential for collagen production and dermal matrix remodeling, while PCs, like Platelet-Rich Plasma (PRP), are abundant in bioactive chemicals that promote tissue healing and cellular regeneration. Materials and Methods: A comprehensive literature search was performed on PubMed, Web of Science, and Scopus, focusing on human clinical trials published between February 2019 and February 2024 related to PRP and facial esthetics. Results: Thirteen studies met the inclusion criteria and were analyzed. Conclusions: The review summarizes the most recent data on patient outcomes, treatment regimens, and possible hazards. The case series that goes with it shows real-world examples of how to improve skin elasticity, texture, and general facial appearance with little negative side effects. These results highlight the potential use of PCs and GFs as minimally invasive procedures.

Finding a protocol that could prevent bone resorption and be implemented in clinical practice would be crucial in providing sufficient bone to replace missing teeth with implants.

The study aimed to determine the effectiveness of different centrifugation platelet-rich fibrin (PRF) protocols in new bone formation and bone regenerative markers.

This randomized clinical trial was conducted at Izmir Katip Çelebi Research Hospital, a population-based facility in Izmir, Turkey. Study subjects were composed of patients who required extraction of anterior teeth. Exclusion criteria included periodontal disease, resorption of alveolar bone, defects, smoking, alcoholism, and systemic diseases.

The independent variable was the PRF protocol. The subjects were randomly assigned to one of three groups: leukocyte platelet-rich fibrin (L-PRF), advanced platelet-rich fibrin (A-PRF) and control groups (healing naturally).

The primary outcome of interest was the percentage of new bone formation, determined by analyzing the staining intensity in histomorphometric assessments of bone samples collected 8 weeks after extraction. The secondary outcomes were regenerative effects measured by the immunohistochemical expression of markers such as osteocalcin, alkaline phosphatase, and proliferating cell nuclear antigen. Potential benefits were evaluated by clinical observations of pain, swelling, membrane visibility and healing.

The covariates were age, sex and health conditions.

Histologic comparative staining intensities and biomarkers expression between groups were evaluated by one way analysis of variance. A difference of P < .05 was considered statistically significant.

The study included 57 subjects, with a mean age of 45 years (±5.6); 30 were male (53%) and 27 female (47%). The control group had a mean new bone formation of 32.68% (±2.5), the A-PRF group 61.37% (±3.0), and the L-PRF group 70.74% (±3.5) (P < .001). The A-PRF group showed significantly higher osteocalcin expression than the control group (P = .013). Alkaline phosphatase and proliferating cell nuclear antigen expression scores for PRF groups were significantly higher than the control group's (P = .001). Both groups demonstrated significantly lower pain scores, reduced gingival swelling, better membrane visibility, and healing compared to the control group.

PRF enhanced bone formation rates, with L-PRF showing the most significant effect.

Cerebrospinal fluid (CSF) leakage frequently complicates endoscopic endonasal transsphenoidal pituitary resections, despite the use of lumbar drains, nasoseptal flaps, or commercial dura sealants. Managing this complication often requires revision surgery and increases the risk of infection. Platelet-rich fibrin (PRF), an affordable autologous biomaterial derived from the patient's blood through short, angulated centrifugation, contains growth factors and leukocytes embedded in a fibrin matrix. PRF exhibits regenerative properties in various surgical disciplines. This study assesses a three-layer sellar reconstruction method employing solid membranous (s-PRF) and high-viscosity injectable (i-PRF) forms of PRF.

We present our initial experience on a series of 22 patients with pituitary macroadenomas. For all patients, an endoscopic transnasal transsphenoidal approach was selected. Following the resection of the pathology, sellar reconstruction was accomplished using a three-layer orthobiologic technique. A membranous s-PRF was utilized as an inlay inside the opened sellar floor, followed by a layer of injectable i-PRF finally covered with another s-PRF membrane over the top to the sellar corridor.

In all cases the implementation of the proposed three-layer PRF reconstruction strategy was feasible and safe. During the 12-month follow-up period there were no adverse effects reported associated with the PRF application. 77% (17/22) of the patients demonstrated intraoperatively a cerebrospinal fluid (CSF) leak (Esposito Grade 1-3). In total, the proposed PRF reconstruction effectively prevented postoperative CSF leaks in 95% of the patients and in 94% of those with an Esposito Grade 1-3. One of the two patients with intraoperative Esposito Grade 3 developed a CSF leak on the first postoperative day, which was successfully managed with a lumbar drain for 5 days.

Sellar reconstruction after endoscopic endonasal transsphenoidal resection of pituitary adenomas with PRF is feasible and safe. The three layer PRF augmentation is a novel technique to prevent CSF-leakage.

Blood concentrates like platelet rich fibrin (PRF) have been established as a potential autologous source of cells and growth factors with regenerative properties in the field of dentistry and regenerative medicine. To further analyze the effect of PRF on bone tissue regeneration, this study investigated the influence of liquid PRF matrices on human healthy primary osteoblasts (pOB) and co-cultures composed of pOB and human dermal vascular endothelial cells (HDMEC) as in vitro model for bone tissue regeneration. Special attention was paid to the PRF mediated influence on osteoblastic differentiation and angiogenesis. Based on the low-speed centrifugation concept, cells were treated indirectly with PRF prepared with a low (44 g) and high relative centrifugal force (710 g) before the PRF mediated effect on osteoblast proliferation and differentiation was assessed via gene and protein expression analyses and immunofluorescence. The results revealed a PRF-mediated positive effect on osteogenic proliferation and differentiation accompanied by increased concentration of osteogenic growth factors and upregulated expression of osteogenic differentiation factors. Furthermore, it could be shown that PRF treatment resulted in an increased formation of angiogenic structures in a bone tissue mimic co-culture of endothelial cells and osteoblasts induced by the PRF mediated increased release of proangiogenic growth factors. The effects on osteogenic proliferation, differentiation and vascularization were more evident when low RCF PRF was applied to the cells. In conclusion, PRF possess proosteogenic, potentially osteoconductive as well as proangiogenic properties, making it a beneficial tool for bone tissue regeneration.

Platelet concentrates are biomaterials with significant potential in tissue regeneration, functioning as scaffolds with greater leukocyte inclusion and a flexible fibrin mesh. However these concentrates have different preparation methods and biological properties. The objective of this clinical investigation was to evaluate the effects of utilizing platelet-rich fibrin (PRF) materials (L-PRF and A-PRF) as a palatal bandage following free gingival graft (FGG) on patients' morbidity and oral health-related quality of life.

Thirty-nine participants received FGG to promote keratinized tissue and treat gingival recession. Participants were randomly assigned to L-PRF, A-PRF, and control groups, with 13 participants in each. They used a visual analog scale (VAS) to rate their pain, analgesic medication use, dietary changes, discomfort, and bleeding at 1-7 days, 14 days and 1 month during the healing process. Patients' quality of life was assessed using the Oral Health Impact Profile (OHIP-14) at baseline, 1-7 days, 14 days, 1 month, and 6 months.

There was no difference in anxiety levels between the all groups. (p > 0.05). The control group had higher OHIP-14 total scores than the other groups, but the differences were not statistically significant, especially in the first seven days (p > 0.05). In addition, the PRF groups showed an improvement in quality of life after 14 days, 1 month, and 6 months (p < 0.05). Patients' pain and suffering decreased with healing. The control group took more postoperative analgesics than PRF groups. In addition, there was a significant decrease in patient complaints about medicine intake, bleeding, pain, perceived sensitivity, and dietary modifications in all groups during follow-up.

PRF palatal bandages may improve patient's quality of life, donor site healing, postoperative pain and morbidity.

This study found that preserving the palate in FGG and employing PRF materials that speed palate healing reduce discomfort and morbidity.

Trauma is a common cause of cutaneous surgical disease with an increased risk of secondary infection in cat clinics. Platelet-rich fibrin (PRF), a platelet and leukocyte concentrate containing multiple cytokines and growth factors, is known to accelerate the healing of wounds. However, how PRF affects wound healing in the cat trauma model has not been fully investigated. The study aimed to examine the impact of PRF on skin wound healing in the cat trauma model. In this study, PRF from cats was successfully produced for our investigation. The models of feline trauma were effectively established. A total of 18 cats were randomly divided into 3 groups (n = 6): (1) Control group (CON); (2) PRF group; (3) Manuka honey group (MAN, as a positive control). Experiments were performed separately on days 7, 14, 21, and 28. Our results showed that PRF was a safe and efficient method of wound healing that did not influence the cat's body temperature, respiration rate, and heart rate (HR). PRF accelerated skin wound healing in the cat trauma model based on the rate and histological observation of wound healing. In addition, PRF promoted the production of growth factors and suppressed inflammation during wound healing. PRF accelerated wound healing by increasing the formation of collagen fibers, as shown by Masson-trichrome staining. The outcomes of the PRF and MAN groups were comparable. In conclusion, PRF improves the healing of skin wounds in cats by boosting the synthesis of growth factors, reducing inflammation, and enhancing the synthesis of collagen fibers.

The development of effective biomaterials for tissue regeneration has led to the exploration of blood derivatives such as leucocyte- and platelet-rich fibrin (L-PRF). A novel variant, Albumin-Enriched Platelet-Rich Fibrin (Alb-PRF), has been introduced to improve structural stability and bioactivity, making it a promising candidate for bone regeneration. This study aimed to evaluate Alb-PRF's capacity for cytokine and growth factor release, along with its effects on the proliferation, differentiation, and mineralization of human osteoblasts in vitro. Alb-PRF membranes were analyzed using histological, scanning electron microscopy, and fluorescence microscopy techniques. Cytokine and growth factor release was quantified over seven days, and osteoinductive potential was evaluated with MG-63 osteoblast-like cells. Structural analysis showed Alb-PRF as a biphasic, highly cellularized material that releases lower levels of inflammatory cytokines and higher concentrations of platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) compared to L-PRF. Alb-PRF exhibited higher early alkaline phosphatase activity and in vitro mineralization (p < 0.05) and significantly increased the OPG/RANKL mRNA ratio (p < 0.05). These results indicate that Alb-PRF has promising potential as a scaffold for bone repair, warranting further in vivo and clinical assessments to confirm its suitability for clinical applications.

Objectives: This randomized controlled clinical trial compared the histological, clinical, and radiographic outcomes of postextraction ridge preservation by allogenic bone grafting with and without injectable platelet-rich fibrin (I-PRF). Materials and Methods: Twenty single-rooted maxillary and mandibular teeth to be extracted and replaced by dental implants were randomly divided into two groups (n = 10). Cone-beam computed tomography (CBCT) scans were obtained preoperatively to assess bone dimensions and ridge width. The teeth were then extracted, and tooth socket preservation was performed with allograft and collagen type 1 in the control group and allograft, collagen type 1, and I-PRF in the intervention group. CBCT scans were obtained again 3 months after the first stage of surgery, and the second stage of surgery was performed for implant placement, ridge width measurement, and obtaining a biopsy sample. Radiographic bone width, clinical bone width, and radiographic bone height were measured. A histomorphometric method was applied to quantify residual graft material, new bone formation, and nonmineralized tissues. The data were analyzed with Student's t-test and Mann-Whitney U test (α = 0.05). Results: The intervention group showed a significantly smaller reduction in radiographic bone width (P=0.038) and clinical bone width (P=0.033), reduction in radiographic bone height (P=0.213) was not significant. A significantly lower percentage of residual graft particles (P=0.021) and a significantly higher mean percentage of newly formed bone (P=0.038) than the control group. However, the difference in the percentage of nonmineralized tissue (P=0.208) was not significant. Conclusion: Despite the optimal outcome of ridge preservation in both groups, the application of allograft plus I-PRF yielded superior histological, clinical, and radiographic results compared with allograft alone, and this difference was significant in most variables.

Since its introduction in 2001, multiple platelet-rich fibrin (PRF) centrifugation protocols have emerged, but the variations in growth factor release that result from these protocols remain unclear. This review aimed to evaluate growth factor release across three PRF protocols: leukocyte-PRF (L-PRF), advanced-PRF (A-PRF/+), and injectable-PRF (i-PRF). A comprehensive search was conducted using the MEDLINE and Embase databases, identifying 14 studies that met the inclusion criteria. Due to significant heterogeneity in study designs and methodologies, a meta-analysis was not feasible. However, our findings suggest that lower-speed centrifugation protocols, such as A-PRF/+ and i-PRF, tend to provide a more uniform cell distribution and sustain higher growth factor release over time compared to the conventional L-PRF protocol. Despite these observations, the current evidence is insufficient to draw definitive conclusions about the growth factor release levels among L-PRF, A-PRF/+, and i-PRF. Further well-designed, comparative studies are required to clarify these differences and establish optimal protocols for clinical use.

Leukocyte- and platelet-rich fibrin (L-PRF) is an autologous platelet concentrate, prepared by centrifugation of blood and consisting of a dense fibrin network with incorporated leukocytes and platelets. This study aims to perform an in-depth analysis of the cells, growth factors, and transcriptome of L-PRF.

Fresh, 1 week and 2 weeks cultured human L-PRF membranes and liquid L-PRF glue were characterized on cellular and transcriptional level using flow cytometry (n = 4), single-cell RNA sequencing (n = 5) and RT-qPCR. Growth factor kinetics were investigated using ELISA (EGF, VEGF, PDGF-AB, TGF-β1, bFGF). L-PRF contained a large number of viable cells (fresh 97.14 ± 1.09%, 1 week cultured 93.57 ± 1.68%), mainly granulocytes in fresh samples (53.9 ± 19.86%) and T cells in cultured samples (84.7 ± 6.1%), confirmed with scRNA-seq. Monocytes differentiate to macrophages during 1 week incubation. Specifically arterial L-PRF membranes were found to release significant amounts of VEGF, EGF, PDGF-AB and TGF-β1.

We characterized L-PRF using in vitro experiments, to obtain an insight in the composition of the material including a possible mechanistic role for tissue healing. This was the first study characterizing L-PRF at a combined cellular, proteomic, and transcriptional level.

The aim of this study was to investigate the effect of liquid platelet-rich fibrin (PRF) during tonsillectomy on postoperative results.

This study included 41 patients who underwent tonsillectomy between April 2022 and January 2023. Liquid-PRF at a dose of 1 ​cc was injected to three different points of one of the tonsil fossae, selected at random intraoperatively. The same amount of physiological saline was injected to the symmetrical points on the opposite tonsil fossa using the same size injector. Pain, wound healing, and bleeding were evaluated on postoperative days 1, 7, and 14. The data of both sides were compared statistically as the study and control sides.

The pain scores were the highest for both sides on postoperative day 1, and gradually decreased in the following days, with no significant difference determined between the sides (p ​> ​0.05). Wound healing rates in the 1st week and 2 ​nd ​week were similar for both sides. Although there were more patients who have 100 ​% epithelization in the PRF group on the postoperative day 14, the difference between the groups was not statistically significant (p ​> ​0.05).

The injection of PRF following tonsillectomy had no significant effect on postoperative pain, wound healing, or bleeding.

Segmental bone defects can arise from trauma, infection, metabolic bone disorders, or tumor removal. Hydrogels have gained attention in the field of bone regeneration due to their unique hydrophilic properties and the ability to customize their physical and chemical characteristics to serve as scaffolds and carriers for growth factors. However, the limited mechanical strength of hydrogels and the rapid release of active substances have hindered their clinical utility and therapeutic effectiveness. With ongoing advancements in material science, the development of injectable and biofunctionalized hydrogels holds great promise for addressing the challenges associated with segmental bone defects. In this study, we incorporated lyophilized platelet-rich fibrin (LPRF), which contains a multitude of growth factors, into a genipin-crosslinked gelatin/hyaluronic acid (GLT/HA-0.5 % GP) hydrogel to create an injectable and biofunctionalized composite material. Our findings demonstrate that this biofunctionalized hydrogel possesses optimal attributes for bone tissue engineering. Furthermore, results obtained from rabbit model with segmental tibial bone defects, indicate that the treatment with this biofunctionalized hydrogel resulted in increased new bone formation, as confirmed by imaging and histological analysis. From a translational perspective, this biofunctionalized hydrogel provides innovative and bioinspired capabilities that have the potential to enhance bone repair and regeneration in future clinical applications.

Periodontitis is a highly prevalent disease that damages the supporting tissues of a tooth, including the alveolar bone. Alveolar bone loss owing to periodontitis is broadly categorized as supra-alveolar and intra-alveolar bone loss. In intra-alveolar bone loss, the defect has an angular or oblique orientation to the long axis of the tooth in an apical direction. In contrast, the defect is perpendicular to the long axis of the tooth in supra-alveolar bone loss. Unlike intra-alveolar bone defects, supra-alveolar bone defects lack supporting adjacent space, which makes supra-alveolar bone regeneration more challenging. In addition, the limited availability of resources in terms of vascularity and underlying tissues is another obstacle to supra-alveolar bone regeneration. Currently, supra-alveolar bone loss is the least predictable periodontal defect type in regenerative periodontal therapy. In addition, supra-alveolar bone loss is much more common than other alveolar bone loss. Despite its prevalence, research on supra-alveolar bone regeneration remains sparse, indicating an unmet need for significant research efforts in this area. This review summarize recent advances, obstacles, and future directions in the field of supra-alveolar bone regeneration. We discuss the biomaterials, bioactive molecules, and cells that have been tested for supra-alveolar bone regeneration, followed by pre-clinical and clinical approaches employed in this field. Additionally, we highlight obstacles and present future directions that will propel supra-alveolar bone research forward.

Background and Objectives: Unfavorable intrabony defects (IBDs) are associated with the progression of periodontal disease and tooth loss. Growing scientific evidence has demonstrated the effectiveness of platelet concentrations in periodontal treatment. The aim of our study was to demonstrate the non-inferiority of an autogenous bone graft (ABG) associated with leukocyte- and platelet-rich fibrin (L-PRF) compared to ABG + Collagen Membrane in the treatment of IBDs. Material and Methods: Sixty-four patients with at least one IBD were randomly assigned to two groups: ABG+L-PRF and CM+ABG. Clinical and radiographic evaluations were performed at baseline and 12-month follow-up. Clinical attachment level (CAL), gingival recession (GR), probing pocket depth (PPD), and radiograph defect bone level (DBL) were compared between the two treatments. To evaluate the effectiveness of ABG+L-PRF, a non-inferiority margin of =1 mm (-1 mm for GR) was chosen; a second non-inferiority margin of =0.5 mm (-0.5 mm for GR) was set for clinical relevance. Results: At 12-month follow up, both treatments showed clinical and radiographic improvements. The 90% confidence intervals of the CM+ABG-L-PRF+ABG mean difference for CAL gain (-0.0564 mm [-0.316 to 0.203]), DBL gain (-0.433 mm [-0.721 to -0.145]), and PPD reduction (0.232 mm [0.015 to 0.449]) were below the 0.5 mm non-inferiority margin; the GR increase (0.255 mm [0.0645 to 0.445]) stayed above the -0.5 mm. Conclusions: the L-PRF+ABG treatment of unfavorable IBDs is non-inferior with respect to the CM+ABG therapy for CAL gain, but with a lower GR, a slightly higher PPD, and DBL gain.

This case report explores the application of platelet-rich fibrin (PRF) as an autologous biomaterial in the surgical management of a periapical cyst in an 18-year-old female patient. The patient presented with pain, discoloration, and swelling in the maxillary left central incisor region, indicative of an asymptomatic periapical lesion associated with a history of trauma. Despite initial endodontic treatment with calcium hydroxide, the lesion persisted, necessitating surgical intervention. PRF, prepared from the patient's blood, was utilized during periapical surgery to promote healing and tissue regeneration. The surgical procedure included enucleation of the cyst, apicoectomy, and retrograde filling with Biodentine. Clinical and radiographic assessments at follow-up visits (three, six, and nine months post-surgery) revealed successful healing with no signs of inflammation or discomfort. The use of PRF demonstrated favorable outcomes in enhancing wound healing and maintaining a favorable environment for tissue remodeling. This case underscores the potential of PRF as an effective biomaterial in periapical surgery, advocating for its integration into dental therapeutic strategies for its regenerative properties and cost-effectiveness.

Graphite tattoos are rarely reported because they are mainly caused by an accidental injury or habits during childhood that cause a pencil to penetrate the oral mucosa. Unlike other pigmentations, it stains layers that are deeper than the subepithelial and mucosal layers, and in most cases, it takes the form of a grayish black macule. This case report describes depigmentation with the denudation technique that was followed by a novel approach of using platelet-rich fibrin to cover exposed bone. A 41-year-old male patient presented with an aesthetic complaint from a grayish black staining on the labial gingiva near the maxillary central and lateral incisors. The lesion was diagnosed as a graphite tattoo due to the patient's history of sticking his gum with pencils when he was young. The entire pigmented gingiva was surgically removed and covered with two layers of PRF membrane to protect the exposed bone surface and provide an extracellular matrix for migration of gingival fibroblasts. Healing patterns were observed at 1, 2, 4, and 8 weeks, and satisfactory clinical and aesthetic results were obtained. Creeping attachment was observed at 8 years postop, and there was no recurrence for a long-term period of 13 years.

Medication-related osteonecrosis of the jaw (MRONJ) is a significant complication which can present following a dental extraction in patients receiving anti-resorptive and anti-angiogenic medications. The purpose of this study was to investigate the possible beneficial effect of L-PRF in the prevention of MRONJ in patients receiving these medications and requiring dental extractions.

Thirty-nine patients were included and divided into two groups, depending on whether L-PRF was used after the required dental extraction or not. Subsequently, the patients were categorised into low and high-risk for developing MRONJ, as recommended by the SDCEP guidance.

None of the patients in the L-PRF group returned with established MRONJ. Five high-risk patients in the control group presented with established MRONJ in the follow-up appointment. A significant statistical difference (p = 0.04) was observed following a comparison of the high-risk patients of the two groups.

These encouraging results suggest that L-PRF may be useful in the prevention of MRONJ following a dental extraction especially in patients of the higher risk category. A protocol for the management of this type of patients is also introduced.

The present study aimed to investigate plastic tubes without additives as alternatives to glass and silica-coated plastic tubes, in the production of PRF membranes.

Nine blood samples were collected from eight volunteers (n = 8) separated into three groups, according to tube material: glass, silica-coated plastic, and plastic without additives. In each group, the samples were centrifuged using different relative centrifugation forces: L-PRF (700 g/12 min), A-PRF (200 g/14 min), and A-PRF + (200 g/8 min). The generated membranes were evaluated by histomorphometry, considering the fibrin network, platelet aggregates, and cellular morphology, by light microscopy. The ultrastructural cellular morphology integrity was evaluated by transmission electron microscopy.

The L-PRF (p < 0.019) and A-PRF (p < 0.001) membranes showed a significantly lower fibrin network density in plastic tubes without additives compared to glass and silica-coated plastic tubes. Plastic tubes without additives revealed a significantly higher platelet percentage, regardless of the protocol (p < 0.005). In all groups, TEM analysis showed preserved normal morphological ultrastructure, maintaining the integrity of cellular components.

Plastic tubes without additives offer a viable alternative for producing PRF membranes. They exhibited a higher platelet density and demonstrated fibrin network and cellular morphology similar to those of glass and silica-coated plastic tubes, irrespective of the centrifugation protocol.

Randomized Clinical Trial.

Mandibular body fractures may result in inferior alveolar nerve damage. This study examined the effectiveness of platelet-rich fibrin (PRF) application to the inferior alveolar nerve during open reduction and internal fixation (ORIF) of mandibular fractures.

This was a double-blind, split-mouth randomized clinical trial. Patients with bilateral mandibular body fractures with minimal displacement (<5 mm) who underwent ORIF were assessed for enrollment. PRF was placed within the fracture site before reduction and fixation on the studied side. Fixation was performed on the contralateral side (control side) without PRF. The study and control groups were randomized using QuickCalcs software. Neurosensory disturbance (NSD) was assessed through two-point discrimination (TPD), self-reported NSD (SR-NSD), and brush directional stroke discrimination test (BDSD) at 6 and 12 months postoperatively.

Twenty-five subjects were enrolled. BDSB recovery was greater in the study group during all time intervals (P < .001). There were no differences between TPD and SR-NSD at the follow-up periods (P > .05).

The results of this split-mouth randomized clinical trial indicate that PRF may enhance the recovery of a damaged inferior alveolar nerve in mandibular body fractures.

Periodontal regeneration therapies frequently involve autologous platelet concentrates (APCs). They can be used in sinus lift surgeries and socket preservation, among other clinical settings. Platelet rich fibrin (PRF) membrane has been used to treat gingival recession in individuals or groups of individuals using a coronally progressed or lateral pedicle flap. In the treatment of mixed periodontic endodontic lesion/furcation defect, PRF functions as a healing and interpositional biomaterial, filling a cystic cavity. PRF is known to help the bone regeneration process. In the last few years, efforts have been made to enhance the PRFs characteristics and quality. One of them is titanium platelet rich fibrin (T-PRF). Third-generation platelet concentrate no longer contains silica, and its preparation in glass vacuum containers, that no longer creates any known concerns. The effectiveness PRF's has been evaluated in connective tissue and bone repair. The aim of this study is to compare T-PRF to other platelet concentrates and different treatment modalities for periodontal regenerative procedures.

A protocol of this systematic review have been registered in prospero (CRD42022293545). The online database searched were PUBMED, COCHRANE for published articles up to November 2022 without language restrictions. Studies in trial registers, handsearching, bibliographic references of relevant articles were also checked. Data collection and analysis was done by individual authors. Independent eligibility assessments were conducted by four review authors. Then, using the standard Cochrane methodology, four review authors extracted the data and evaluated the risk of bias for individual studies. We developed "Summary of findings" tables and used GRADE to evaluate the evidence.

Three studies were included for meta-analysis. Results of meta-analysis supported that T-PRF is effective for correction of both hard and soft tissue defects.

The overall qualitative and quantitative analysis suggest that T-PRF has superior structural properties and thicker fibrin network for ensuring predictable success periodontal regenerative procedures.

This study aimed to assess and compare the concentrations of growth factors, white blood cells (WBCs), and platelets in injectable platelet-rich fibrin (i-PRF) derived from people with healthy periodontal conditions and those with chronic periodontitis.

Venous blood samples were obtained from 30 patients diagnosed with chronic periodontitis (test group) and 30 participants with healthy periodontal conditions (control group). The i-PRF was then acquired from centrifuged blood. The growth factors (VEGF, IGF-1, TGF-β1, PDGF-BB and EGF) released from the i-PRF samples were compared between groups with ELISA testing. The amounts of WBCs and platelets were also compared.

No significant differences in the concentrations of growth factors were found between the groups (the mean values for the control and test groups were, respectively: IGF: 38.82, 42.46; PDGF: 414.25, 466.28; VEGF: 375.69, 412.18; TGF-β1: 21.50, 26.21; EGF: 138.62, 154.82). The test group exhibited a significantly higher WBC count than the control group (8.80 vs. 6.60, respectively). However, the platelet count did not show a statistically significant difference between the groups (control group 242.0 vs. test group 262.50). No significant correlation was observed between WBC count and growth factor level in either group.

The growth factor levels in i-PRFs did not exhibit significant difference between the two groups. This suggests that the levels of these growth factors may be unaffected by the periodontal disease.

Postoperative pain and swelling following third molar (M3) removal can be debilitating, and there is interest in using advanced platelet-rich fibrin (A-PRF) to reduce their severity.

This study compared postoperative pain and swelling between A-PRF and gelatin dressing in extraction sockets following mandibular M3 removal.

This split-mouth, single-blinded, randomized controlled trial was completed at the Oral Surgery clinic of University of Otago between November 2020 and July 2021. Patients aged between 16 and 40 years with bilaterally impacted mandibular M3 of similar Pederson index difficulty and deemed to be American Society of Anesthesiologists (ASA) I or II comprised the study sample.

The exposure variable was M3 socket management. One socket received A-PRF and 1 gelatin dressing, while the other received 2 gelatin dressings.

The outcome variables were postoperative pain and swelling over 7 days. Pain was measured using the visual analog scale (VAS), and swelling using stereophotogrammetry.

Demographic characteristics (gender, ethnicity, and age), dental anxiety, smoking status, Pederson index, and intraoperative surgical time were the covariates.

The two sides were compared using cross-tabulations and the McNemar test for categorical and paired t-tests for continuous variables. Statistical analysis used IBM SPSS Statistics for Windows (version 28).The Alpha level was 0.05.

76 (87.3%) of 87 patients who met the eligibility criteria participated in the study, and 70 patients (65.7% female; age range 16-30 years) were included in the analysis. Mean visual analog scale scores showed no statistically significant difference between the A-PRF and control sides, being 29.6 (95% CI 23.9, 35.3) and 29.5 (95% CI 23.5, 35.5) on day 2, and falling to 12.6 (95% CI 8.7, 16.5) and 14.2 (95% CI 10.0, 18.4) by day 7. Likewise, mean peak facial swelling on day 2 was recorded as 6.3 cm3 (95% CI 4.9, 7.7) and 6.6 cm3 (95% CI 5.5, 7.7), and by day 7 they were 1.1 cm3 (95% CI 0.5, 1.7) and 1.0 cm3 (95% CI 0.3, 0.7) on the A-PRF and control sides, respectively.

A-PRF placement in M3 sockets did not reduce postoperative pain and swelling over gelatin dressing alone.

Platelet-rich fibrin (PRF) is a widely used autologous blood concentrate in regenerative medicine. This study aimed to characterize the cellular composition and distribution of different PRF matrices generated by high (710 g) and low (44 g) relative centrifugal forces (RCFs) and to analyze their bioactivity on human primary osteoblasts (pOBs). PRF was separated into upper layer (UL) and buffy coat (BC) fractions, and their cellular contents were assessed using histological and immunohistochemical staining. The release of platelet-derived growth factor (PDGF) and transforming growth factor (TGF-β) was quantified using an ELISA. Indirect PRF treatment on pOBs was performed to evaluate cell viability and morphology. A histological analysis revealed higher quantities of leukocytes and platelets in the low-RCF PRF. TGF-β release was significantly higher in the low-RCF PRF compared to the high-RCF PRF. All PRF fractions promoted pOB proliferation regardless of the centrifugation protocol used. The low-RCF PRF showed higher TGF-β levels than the high-RCF PRF. These findings contribute to understanding the cellular mechanisms of PRF and provide insights into optimizing PRF protocols for bone regeneration, advancing regenerative medicine, and improving patient outcomes.

Platelet-rich fibrin, a classical autologous-derived bioactive material, consists of a fibrin scaffold and its internal loading of growth factors, platelets, and leukocytes, with the gradual degradation of the fibrin scaffold and the slow release of physiological doses of growth factors. PRF promotes vascular regeneration, promotes the proliferation and migration of osteoblast-related cells such as mesenchymal cells, osteoblasts, and osteoclasts while having certain immunomodulatory and anti-bacterial effects. PRF has excellent osteogenic potential and has been widely used in the field of bone tissue engineering and dentistry. However, there are still some limitations of PRF, and the improvement of its biological properties is one of the most important issues to be solved. Therefore, it is often combined with bone tissue engineering scaffolds to enhance its mechanical properties and delay its degradation. In this paper, we present a systematic review of the development of platelet-rich derivatives, the structure and biological properties of PRF, osteogenic mechanisms, applications, and optimization to broaden their clinical applications and provide guidance for their clinical translation.

Although the conventional replacement for lost teeth has been partial or full dentures, the need for a fixed, esthetic, and functional restoration makes dental implants a reliable alternative.

To evaluate the initial and final stability of platelet rich fibrin coated implants using resonance frequency analyzer.

ology: Thirteen patients with two or more missing teeth were informed about the procedure, and a consent form was obtained after cone beam computer tomography evaluation. Blood was drawn from the anticubital area of the patient, which was centrifuged to obtain platelet-rich fibrin. In all, 26 implants were placed, among which 13 were platelet-rich fibrin-coated (test group) and 13 were without platelet-rich fibrin (control group), and implant stability quotient values were recorded.

The mean age of the patients was 34.4 (SD = 4.28). Majority of the patients were males (9; 69.2%) whereas there were only four (30.8%) female patients. When comparison between overall primary implant stability with and without PRF was done, the mean difference was 5.12 and this difference was not statistically significant (p = 0.221) whereas a statistically significant difference (p = 0.019) was found when comparison between overall secondary implant stability was done with and without PRF. The primary and secondary stability values for the control group were 69.18 ± 7.45 and 73.84 ± 8.21 respectively, and the primary and secondary stability values for the test group were 64.06 ± 12.66 and 81.49 ± 7.61 respectively, which showed statistically significant differences among the groups. The difference in these values signify that primary stability is more in control group whereas secondary stability is more in case group. This signifies that PRF enhances the stability of implant.

Implants coated with platelet-rich fibrin exhibited better osseointegration than implants without platelet-rich fibrin.

This case report demonstrates the use of three-dimensional (3D) models produced from a cone beam computed tomographic (CBCT) volume to develop a treatment strategy for a rare type of dens invaginatus (DI) in a mandibular incisor.

A patient with DI Type IIIa presented for endodontic treatment. Following CBCT evaluation, the complex morphologic nature of the invagination required additional diagnostic tools for treatment planning. The fabrication of 3D models provided clarity regarding the treatment strategy. Treatment involved intracanal medication with calcium hydroxide Ca(OH)2, nonsurgical root canal therapy (NS-RCT) of the main canal, and endodontic surgery for the DI anomaly using mineral trioxide aggregate (MTA), bone graft, and platelet-rich fibrin (PRF) membrane.

The use of 3D models provided an invaluable guide for proper treatment. Complicating factors were diagnosed and planned for accordingly.

It is difficult to appreciate the anatomical complexity, the extent, and the nature of the invagination of rare Type III DI morphology. CBCT imaging and 3D models played a critical role in the pre-treatment planning to ensure a predictable outcome. A 3D model is recommended as a diagnostic tool in treating complex cases where the DI morphology is wide, oblique, or the foraminal opening is irregular.

This research intended to compare and evaluate the effectiveness of titanium-prepared platelet-rich fibrin (T-PRF) over demineralized freeze-dried bone allograft (DFDBA) in treating intra-bony defects based on the clinical and radiographic criteria.

This is a prospective randomized controlled, single-blinded split-mouth study where 15 patients with 30 intrabony defects were included. Subjects were randomly divided into T-PRF and DFDBA groups respectively. Plaque index (PI), Gingival index (GI), Probing pocket depth (PPD), Relative- clinical attachment- level (R-CAL), Defect depth, Linear amount of bone fill, Percentage of bone fill, Defect angle were assessed at baseline, 3, 6, and 9 months. For intra- and inter-group comparisons, paired and unpaired t-tests were executed. P<0.05 was set as statistically significant.

There were statistically significant differences (P<0.05) in clinical and radiographic parameters in both T-PRF and DFDBA groups from baseline values to 9 months in intragroup comparisons. However, on intergroup comparison, no statistical significance was seen.

The clinical parameters and radiographic outcomes showed marked improvement at 9 months with both T-PRF and DFDBA in the treatment of intrabony defects from baseline values.

T-PRF has shown favorable results that are comparable to DFDBA for the treatment of intrabony periodontal defects.

To compare and evaluate the clinical efficacy of "ofloxacin incorporated L-PRF" and "L-PRF alone" when used as an adjuvant to non-surgical periodontal therapy.

A split-mouth study was conducted in 50 patients diagnosed as chronic periodontitis with pocket depth ≥6 with at least one site in each quadrant. All patients underwent scaling and root planning. Test site received with ofloxacin incorporated L-PRF and control site received L-PRF alone. Clinical parameters pocket depth (PD), plaque index (PI), and gingival bleeding index (GBI) were recorded at baseline and 1 month after scaling and root planning.

In total, 100 sites were treated (50 test group and 50 control group) with no uneventful healing effects. Statistically significant decreases in PD (P = .0001 for both test and control groups), PI (P = .001), GBI (P = .001 for both groups), between pre-treatment and 1 month post-treatment were noted in both test and control groups. For intergroup comparisons, there was a statistically significant difference in all clinical indices (P > .005).

Use of L-PRF with ofloxacin as an adjuvant to non-surgical periodontal therapy showed better improvements in clinical parameters.

In this study, we aimed to investigate the effectiveness of the use of polypropylene mesh and platelet-rich fibrin (PRF) in nasal septal perforation (NSP) repair.

Prospective experimental study.

Laboratory.

Twenty-four adult male New Zealand rabbits were used in our study. In all subjects, a 10 × 10 mm perforation was created in the septum. The subjects were divided into 3 equal groups according to the different methods used in perforation closure. The bilateral mucosal flap was used in the control group, polypropylene mesh + bilateral mucosal flap in the mesh group, and polypropylene mesh + bilateral mucosal flap + PRF in the mesh + PRF group.

NSP treatment success rate was found to be significantly higher in the mesh (4/6, 66.7%) and mesh + PRF (6/6, 100%) groups compared to the control group (0/6, 0%). Re-epithelialization score was higher in the mesh + PRF group and the control group compared to the mesh group. While the necrosis, neutrophil, and abscess scores were highest in the mesh group, they were similar to the control group in the mesh + PRF group.

While polypropylene mesh significantly increases the success rate in NSP repair, it causes severe inflammatory responses. However, when polypropylene mesh is combined with PRF, it both increases the rate of perforation closure and significantly reduces the complications associated with the use of mesh.

Rotator cuff (RC) injuries include a wide range of pathologic states. Athletes are perhaps the most susceptible to RC injuries ranging from tendinopathy to partial or full-thickness tears, due to functional overload and repetitive movements, causing abstention from sports for long periods. Regenerative medicine keeps giving us multiple choices to fight the disability caused by these pathologies. A literature search was performed, and findings related to the structure-function of rotator cuff units, pathophysiology of injuries, regenerative medicine treatments, and future strategies were outlined. Platelet-rich plasma (PRP) has a greater number of articles and clinical trials, accompanied by stem cells progenitor, prolotherapy, and new approaches such as microfragmented adipose tissue and exosomes. RC injuries in athletes can cause pain, functional impotence, and the risk of recurrence, and can lead them to stop playing sports. Regenerative medicine offers a range of treatments, but some of them need further studies to underline their actual validity.

Secretomes of mesenchymal stromal cells (MSC) represent a novel strategy for growth-factor delivery for tissue regeneration. The objective of this study was to compare the efficacy of adjunctive use of conditioned media of bone-marrow MSC (MSC-CM) with collagen barrier membranes vs. adjunctive use of conditioned media of leukocyte- and platelet-rich fibrin (PRF-CM), a current growth-factor therapy, for guided bone regeneration (GBR).

MSC-CM and PRF-CM prepared from healthy human donors were subjected to proteomic analysis using mass spectrometry and multiplex immunoassay. Collagen membranes functionalized with MSC-CM or PRF-CM were applied on critical-size rat calvaria defects and new bone formation was assessed via three-dimensional (3D) micro-CT analysis of total defect volume (2 and 4 weeks) and 2D histomorphometric analysis of central defect regions (4 weeks).

While both MSC-CM and PRF-CM revealed several bone-related proteins, differentially expressed proteins, especially extracellular matrix components, were increased in MSC-CM. In rat calvaria defects, micro-CT revealed greater total bone coverage in the MSC-CM group after 2 and 4 weeks. Histologically, both groups showed a combination of regular new bone and 'hybrid' new bone, which was formed within the membrane compartment and characterized by incorporation of mineralized collagen fibers. Histomorphometry in central defect sections revealed greater hybrid bone area in the MSC-CM group, while the total new bone area was similar between groups.

Based on the in vitro and in vivo investigations herein, functionalization of membranes with MSC-CM represents a promising strategy to enhance GBR.

This study aimed at comparing the regenerative potential of injectable platelet-rich fibrin (i-PRF) (Group 1) and platelet-rich plasma (Group 2) scaffolds.

Twenty-three patients, aged from 9 to 24 years, having 24 immature traumatized necrotic maxillary anterior teeth, were enrolled. Teeth trauma was confirmed by patients' history. Preoperative three-dimensional scans were done. In the first visit, canals were irrigated with 1.5% sodium hypochlorite then medicated with calcium hydroxide. After 2 weeks, patients were randomly assigned into one of the treatment groups (n = 12). The platelet concentrate was applied after centrifuging 10 mL of autologous venous blood with respect to the centrifugation protocol for each platelet concentrate. Patients were recalled at 6 and 12 months posttreatment, during which clinical and radiographic examinations and assessment of pulp sensitivity were done. Three-dimensional scanning was done after 12 months. The increase in root length and decrease in root canal diameters were calculated at three canal levels. Statistical analysis was done using the paired t-test and the independent t-test. The significance level was set at p < .05.

There was no statistically significant difference between both groups regarding the increase in root length, decrease in coronal and middle canal diameters and the response to the electric pulp tester. Group (1) showed significantly greater decrease in apical canal diameter than Group (2) (p = .008).

I-PRF can be considered as a valid regenerative scaffold for clinical use and with regards to the easier preparation technique, it is more recommended than platelet-rich plasma.

Treatment of soft tissue wounds with bone or tendon exposure remains a tough clinical challenge for surgeons. The current clinical approaches include various types of flap reconstruction and artificial dermis grafting as well as negative pressure wound therapy (NPWT), which are time-consuming and often result in graft failure or significant scarring. Concentrated growth factor (CGF) is a novel blood extract that contains many growth factors, platelets and fibrin to promote an orderly healing process. However, few reports have focused on wounds with bone or tendon exposure. We present a limited series and two specific cases of skin wound with bone or tendon exposed that received surgical debridement followed by CGF treatment. CGF appeared to facilitate wound closure effectively and also reduced scar formation. Our findings provide a novel therapeutic option for refractory wounds with bone or tendon exposure.

Platelet-rich fibrin (PRF), which has been shown to promote wound and bone regeneration, has demonstrated antimicrobial properties against periodontal pathogens. However, in veterinary medicine, no study has determined the antimicrobial effects of canine platelet-rich fibrin (cPRF). Therefore, this study aimed to determine the antimicrobial effect of cPRF against E. coli and S. pseudintermedius found in dogs' wounds and against the standard strain S. aureus. Additionally, the mechanism of the existing antibacterial activity of cPRF, which involves the formation of reactive oxygen species (ROS), was tested. Blood samples from six dogs were processed for cPRF. The antimicrobial properties of three groups (growth control, cPRF, and drug control) were evaluated at 0.5, 4, 8, and 24 h using a time-kill assay. The killing mechanisms involving ROS were evaluated using horseradish peroxidase (HRP) to suppress ROS production in PRF (PRF-SR). Subsequently, tests for antimicrobial properties and ROS generation were compared to those of the growth control and cPRF groups. The results showed that cPRF had significant antimicrobial properties against E. coli but no antimicrobial properties against S. pseudintermedius. After the ROS suppression, PRF-SR did not show an antimicrobial property against E. coli. Moreover, cPRF-treated bacteria exhibited significantly greater intracellular ROS than PRF-SR. In conclusion, canine PRF showed an antimicrobial effect against E. coli, and its antibacterial mechanism was related to releasing ROS.

Osteoporosis is a chronic multifactorial condition that affects the skeletal system, leading to the deterioration of bone microstructure and an increased risk of bone fracture. Platelet-derived biomaterials (PDBs), so-called platelet concentrates, such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), have shown potential for improving bone healing by addressing microstructural impairment. While the administration of platelet concentrates has yielded positive results in bone regeneration, the optimal method for its administration in the clinical setting is still debatable. This comprehensive review aims to explore the systemic and local use of PRP/PRF for treating various bone defects and acute fractures in patients with osteoporosis. Furthermore, combining PRP/PRF with stem cells or osteoinductive and osteoconductive biomaterials has shown promise in restoring bone microstructural properties, treating bony defects, and improving implant osseointegration in osteoporotic animal models. Here, reviewing the results of in vitro and in vivo studies, this comprehensive evaluation provides a detailed mechanism for how platelet concentrates may support the healing process of osteoporotic bone fractures.

To investigate, through a network meta-analysis, the effectiveness of blood concentrates in reducing pain perception, trismus, and edema after mandibular third molar extraction.

An electronic search was performed in nine databases to locate randomized clinical trials comparing blood concentrate use after mandibular third molar extraction. Two authors selected and extracted the data independently. The individual risk of bias in the studies was assessed with the RoB v2.0 tool. A network meta-analysis compared postoperative pain and trismus scores after applying different blood concentrates, using the mean difference (MD) as an effect estimate. The GRADE approach assessed the certainty of evidence.

Thirty-one randomized clinical trials were included in the review and 18 in the meta-analysis. Leukocyte- and platelet-rich fibrin (L-PRF) was the most used blood concentrate, followed by platelet-rich plasma (PRP). The network meta-analysis, depending on the analyzed period, evaluated up to 1240 surgeries. Among the analyzed blood concentrates, advanced platelet-rich fibrin (A-PRF) performed better among the analyzed blood concentrates, decreasing postoperative pain in 1, 2, 3, and 7 days and reducing trismus up to the inflammatory peak compared to blood clots. Only two studies had a low risk of bias.

Based on very low certainty of evidence, using concentrates seemed efficient compared to blood clots in reducing pain and trismus after mandibular third molar surgeries. A-PRF decreased postoperative pain throughout the evaluated time and trismus during the acute inflammatory peak.

A-PRF after mandibular third molar extractions performed better among the analyzed blood concentrates and seemed efficient in improving postoperative quality by decreasing inflammatory signs and symptoms.

Concentrated platelet derivatives (PDs) such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have been extensively applied in tissue engineering, and particularly in various fields of regenerative dentistry. The purpose of the present citation analysis was to compile the 100 top-cited articles on the PDs uses in oral and maxillofacial surgery.

A cross-sectional search of the relevant studies in the Web of Science citation database was conducted to identify the 100 most-cited articles. All the included papers consisted of independent variables of this analysis. Covariates that were further considered were basic bibliometric indexes, such as publication year, publishing journal, authorship, institution and country of origin, study design, and field of study. The primary outcome variables were citation counts and citation density. A descriptive analysis of secondary outcome variables, namely bibliographic data such as keyword, abstract, title term co-occurrence analysis, thematic map and wordcloud analysis, was performed using the bibliometrix R and VOSviewer software.

The total citation count for the 100 most-cited articles ranged from 85 to 1821, with 2002 being the most productive year. With 15 articles, the Journal of Periodontology was the most represented journal, followed closely by the Journal of Oral and Maxillofacial Surgery and Clinical Oral Implants Research. The United States published the largest number of papers. Original basic science research studies on implantology and biology dominated the top-cited list. Randomized clinical trials and systematic reviews were adequately represented in the top-cited list. Platelet-derived growth factor and osteoprotegerin represented emerging minimally developed themes, while PRP, growth factors and fibrin, along with the applications of PRF in gingival recession and intra bony defects, were considered important motor themes.

The current study provides a complete list and in-depth analysis of the 100 most-cited publications relevant to PDs use in oral and maxillofacial surgery, identifying the most important research topics, most impactful authors, institutions, and countries. Though PRP studies were leading the top-cited list, publications focusing on PRF pesented higher citation density values, indicating a continuously increasing citation rate.

In this retrospective study stabilities of 24 implants simultaneously placed at posterior maxillae with sinuses grafted by advanced platelet rich fibrin (A-PRF) and newly formed bone around them were evaluated.

Fourteen augmented maxillary sinuses of 11 patients with a mean residual alveolar bone height of 4.55 mm were involved in this study. Maxillary sinus lifting via lateral window approach and implant site osteotomy were performed, and prepared A-PRF clots were used as sole graft material. Each of the implants was immediately placed with a good primary stability. Postoperative sixth month tomography images were compared with preoperative ones in order to calculate the gained bone height and implant stability quotient (ISQ) values were recorded.

The new vertical mean bone height of 24 implant sites was 12.21 mm with an implant survival rate of 100%. ISQ values of the implants were ranging from 62 to 75 with a mean value of 68. Statistically the diameter of implant did not have any effect on new bone formation and the ISQ values, however the length of them did.

A-PRF as a graft material for sinus lifting with simultaneous implant placement is a reliable technique with its low cost and lack of immunogenic reaction risk.