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Radiographic assessments of the representative case. a Preoperative periapical radiograph of the tooth in position 14 to be extracted. b At the baseline just after the implant insertion. c At 1 year of loading. d At 3 years of loading. e At 5 years of loading
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Purpose:
The purpose of this study was comparison of clinical and radiographic outcomes of immediate post-extraction implants with or without the use of pure platelet-rich plasma (P-PRP) in the short- and medium-term follow-up.
Methods:
A retrospective analysis was performed to assess soft tissue healing, implant and prosthesis survival, margina...
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Background
The healing process of burns includes coagulation, inflammation, and remodeling. Vascular endothelial growth factor (VEGF) is involved throughout this healing process. Stem cells from the platelet-rich plasma (PRP) with stromal vascular fraction (SVF) can increase concentrations of growth factors, including VEGF. This is expected to acce...
Citations
... PRP's effectiveness in bone healing can be attributed significantly to the rich assortment of growth factors contained in the alpha-granules of platelets. Of the numerous growth factors that have been defined in the literature, [26][27][28][29] the three that appear to play the most prominent role in bone healing include PDGF, TGF-β, and IGF-1. 10 PDGF is a critical growth factor in PRP that plays a pivotal role in the early phases of bone healing by initiating several essential processes upon release from activated platelets. ...
Despite significant advances in the understanding and delivery of osteosynthesis, fracture non-union remains a challenging clinical problem in orthopaedic surgery. To bridge the gap, basic science characterization of fracture healing provides a platform to identify and target biological strategies to enhance fracture healing. Of immense interest, Platelet-rich plasma (PRP) is a point of care orthobiologic that has been extensively studied in bone and soft tissue healing given its relative ease of translation from the benchtop to the clinic. The aim of this narrative review is to describe and relate pre-clinical in-vitro and in-vivo findings to clinical observations investigating the efficacy of PRP to enhance bone healing for primary fracture management and non-union treatment. A particular emphasis is placed on the heterogeneity of PRP preparation techniques, composition, activation strategies, and delivery. In the context of existing data, the routine use of PRP to enhance primary fracture healing and non-union management cannot be supported. However, it is acknowledged that extensive heterogeneity of PRP treatments in clinical studies adds obscurity; ultimately, refinement (and consensus) of PRP treatments for specific clinical indications, including repetition studies are warranted.
... [30][31][32][33] Researchers believe that PRP shows beneficial effects on bone healing in critical sized defects and defects with reduced vascularization and has no adjunct role in augmentation surgeries involving smaller defects like maxillary sinus. 11,33 Some studies highlighted that PRP is beneficial when immediate loading protocol for implants is opted where PRP may promote faster healing, [34][35][36] and that PRP effects on delayed healing protocol seem to be nugatory. Given the reported benefits of PRP, the complexity of the augmentation procedure, and the conflicting reports on the effects of PRP on implant survival, further investigation is needed to validate the evidence. ...
Background
Platelet-rich plasma is considered an effective modality to promote bone regeneration, improve hard and soft tissue healing in surgical procedures including sinus augmentation. However, the survival of dental implants in sinus augmented sites with platelet-rich plasma has shown equivocal results in recent studies.
Purpose
In this systematic review, data on dental implants' survival in sinus augmentation sites with platelet-rich plasma were examined.
Materials and methods
Randomized controlled trials on the topic with a minimum mean follow-up of 6 months with no language restriction were considered. Other study designs on the topic were excluded. Accordingly, relevant articles were searched in Clinicaltrials.gov, Cochrane databases, PubMed/Medline, and Scopus up to April 2021. Using the Cochrane risk of bias assessment tool, the listed studies’ risk of bias was evaluated. From the included studies, the pertinent information was taken and pooled for qualitative and quantitative analysis using R software 4.1.1.
Results
Six randomized controlled trials involving 188 patients who underwent sinus augmentation with and without platelet-rich plasma, and 781 implants were included for qualitative and quantitative analysis. Four hundred and eleven implants were placed in the intervention group (with platelet-rich plasma) and 370 implants were placed in the control group (without platelet-rich plasma). The pooled estimate (OR 0.84, 95% CI 0.37 to 1.91; I² = 0%) indicated that there was no statistically significant difference observed between the groups. The test for subgroup differences showed no statistically significant differences between the subgroups (p = 0.45) with no heterogeneity (I² = 0%).
Conclusion
The bias associated with selective reporting of outcome data was considered as some concern for bias. This systematic review revealed that the effect of platelet-rich plasma is uncertain on the survival of dental implants.
... During implantation, PRP liquid mixed with bone material and applied to the implant socket was less important for long-term survival of the implant. [85][86][87][88][89] When GBR is used for dental implants, PRF and CGF can be compressed like a membrane for mineralizing blood clots while also preventing excess cells from entering the area of osseointegration and providing space for the migration of osteoblasts and angiogenic cells. 90,91 The use of PRF and CGF improves the stability of the implant, provides for rapid osseointegration, and enhances the integration of the implant and the marginal bone volume around the implant. ...
Platelet concentrates (PCs) are easily obtained from autogenous whole blood after centrifugation and have evolved through three generations of development to include platelet-rich plasma, platelet-rich fibrin, and concentrated growth factor. Currently, PCs are widely used for sinus floor elevation, alveolar ridge preservation, periodontal bone defects, guided bone regeneration, and treatment of gingival recession. More recently, PCs have been leveraged for tissue regeneration to promote oral soft and hard tissue regeneration in implant dentistry and regenerative periodontology. PCs are ideal for this purpose because they have a high concentration of platelets, growth factors, and cytokines. Platelets have been shown to release extracellular vesicles (P-EVs), which are thought to be essential for PC-induced tissue regeneration. This study reviewed the clinical application of PCs and P-EVs for implant surgery and periodontal tissue regeneration.
... When the marginal bone loss was assessed we observed that there was no significant variation among the groups. Our observations are in accordance with the study of Attia et al., [4] Saravi et al., [5] Taschieri et al., [6] and Kundu et al., [7] where they also detected no significant variation in the marginal bone loss after dental implantation. However, our study was contrary to the study of Uppala et al., [8] where they observed that there increased bone levels in the application of PRP along with the "β-Tricalcium Phosphate Bone Graft". ...
Introduction:
Various materials are used to improve the longevity of the dental implants. In our study, we assessed the marginal bone loss around dental implants after implantation with platelet-rich plasma.
Materials and methods:
We conducted a prospective clinical study among 200 subjects who were grouped equally as those with and without the application of PRF in the implantation. The radiographic and clinical features for the marginal bone loss were assessed and compared keeping P < 0.05 as statistically significant.
Results:
We observed no significant variation between the groups for the mobility, bleeding on probing, plaque index, and marginal bone loss.
Conclusion:
We can conclude that the application of PRP concentrate did not significantly affect the marginal bone loss in the dental implantation.
... Tooth loss is a distressing experience and affects the quality of life [1]. Implants provide a fixed replacement option improving the patient's confidence and have psychological benefits [1,2]. Bone requires approximately 2 to 3 months for remodeling after extraction of the tooth, and it has been suggested healing time of common commercial titanium implants is 3-6 months before loading becomes clinically feasible [1,3]. ...
... The immediate implant placement in an extraction socket seems to have some benefit when compared to delayed implant placement, such as less time and reduced surgical procedures [2,4]. Previously, many studies have concluded that immediate implant placement minimizes bone resorption by maintaining the periodontal architecture [2,5,6]. ...
... The immediate implant placement in an extraction socket seems to have some benefit when compared to delayed implant placement, such as less time and reduced surgical procedures [2,4]. Previously, many studies have concluded that immediate implant placement minimizes bone resorption by maintaining the periodontal architecture [2,5,6]. However, recent clinical studies have reported increased failure rates due to a decrease in primary stability and a reduction in bone volume around immediately placed implants, suggesting that it did not effectively prevent vertical and horizontal changes in ridge volume [2,7,8]. ...
... Alveolar bone preservation following immediate implant placement was reported when platelet concentrates were applied (Kutkut et al., 2013); (Rosano et al., 2013). On the other hand, studies have shown insufficient evidence to establish the effectiveness of platelet concentrate with immediate implant placement (Taschieri et al., 2017 ). A recent systematic review reported that platelet concentrate combined bone graft show a small unimportant effect or no effect on marginal bone loss of immediate implants when compared to bone grafting alone (Fortunato et al., 2020). ...
Aim: To assess the possible added value of using i-PRF in association with bone replacement graft filling the buccal gap distance at immediately placed dental implant on hard and soft tissues after 6 months observation period. Materials and methods: Sixteen non-smoking periodontally free patients with single non restorable tooth in the esthetic zone were included in the study. Patients were randomly assigned into two groups each of 8 implants, Test group, immediate implant placement and filling of a buccal gap of > 2mm between the implant surface and the inner bony wall with bovine bone mineral mixed with injectable platelet rich fibrin, control group; immediate implant placement and filling of a buccal gap of > 2mm with only bovine bone graft. Horizontal buccal bone changes, crestal bone level and bone density at 6 months were evaluated using cone beam computed tomography (CBCT). Thickness of attached gingiva was also evaluated at 6 months compared to the initial levels Results: The mean buccal horizontal bone thickness was insignificantly reduced at 6 month evaluation period in both groups with no significant differences between groups. No significant difference was observed in crestal bone height between the two groups. At 6 month evaluation period bone density was significantly increased in the test group (p =0.002) compared to control. No significant differences were found between the pre-operative and post-operative gingival biotype in both groups Conclusion: This study demonstrated that immediate implantation in fresh extraction socket together with xenograft in combination with i-PRF could have an added value of improved bone density, a factor that could be associated with long term crestal bone level stability.
... In clinical trials, Taschier et al. demonstrated a beneficial effect of PRP in combination with implants placed in fresh extraction sockets on the healing of soft tissues. To date, clinical findings indicate that local use of PRP preparations during routine implant surgery may accelerate the healing of soft tissues, damaged oral mucosa, and hard tissues in the places where dental implants are inserted [8,9]. (Tables 1-3). ...
... • Mitogenic to endothelial cells and hepatocytes • Cytotoxic for selected tumors • It stimulates the release of insulin in the pancreatic cell, thus controlling blood glucose levels • Participates in the development of hair follicles • Has anti-inflammatory, anti-apoptotic properties • It protects the liver, heart, kidneys, and brain [7][8][9] • Acceleration of the healing process of soft and hard tissues • Greater stability of the implants placed in the sockets • Less resorption • To stimulate the formation of new bone • Regeneration of peripheral nerves Augmentation and lifting of the bottom of the maxillary sinus [7,8,[10][11][12] • Strengthened bone regeneration potential • Faster bone formation • Promoting the migration of osteoprogenitor cells • Promotion of angiogenesis Endodontics [8,11,[13][14][15] • Reconstruction of periapical lesions • Thickening of the tooth root walls • Healing of pulp, dentin and periapical tissues • Reduction of postoperative pain • Faster regeneration process Orthopedics, sports medicine Tendiopathy [28][29][30][31][32]35,37,50] • Pain reduction • Faster tissue regeneration • Improvement in terms of mobility • Functional improvement of tendons • Long-term effects Osteoarthritis [43,[45][46][47][48][49][50] • Faster regeneration of cartilage • Slowed tissue destruction • Pain reduction • Relieve inflammation • Relief of OA symptoms • Improving the functionality of the joints Muscle injuries [30,42,[53][54][55] • Stimulation of muscle regeneration • Reduction of the occurrence of fibrosis • Faster recovery • Pain reduction Broken bones [57,58] • Promote bone healing and the formation of new blood vessels [71] • Increased fat allograft survival • Relief of itching and irritation • Improved labia tone • Improving the lesions of lichen sclerosus Thin endometrium [73,75,76] • Promote the growth of the endometrium • Successes in in vitro embryo implantation Sexual dysfunction [72] • Reduction in the amount of fibrosis old or necrotic tissues, such as dentin, pulp, and root structures. Due to the high content of GFs, PRP may support the growth and differentiation of stem cells in the pulp canal after pulp disinfection, which enhances endodontic regeneration. ...
Platelets produce platelet growth factors such as PDGF, IGF-1, EGF-, HGF, TGFβ, bFGF, and VEGF, which are crucial in regulating all stages of the wound healing process. The source of these substances is platelet-rich plasma (PRP). Over the past five decades, the interest and use of the regenerative properties of platelets have increased significantly in many different fields of medicine around the world. PRP and PRF plate preparations are used in: 1. Dentistry (they reduce bleeding, facilitate and accelerate soft tissue healing and bone regeneration - FGF 2, IGF-1, IGF-2, TGF-β1, and PDGF); 2. Sports medicine - IGF-1, IGF-2, TGF-β, VEGF, PDGF and bFGF, EGF); 3. dermatology and cosmetology (treatment of alopecia, hair reconstruction - FGF-7, HGF, acne scars, skin rejuvenation and regeneration, treatment of chronic and poorly healing wounds, burns, and acquired vitiligo); 4. Gynecology and reproductive medicine (treatment of infertility, erectile dysfunction - PDGF-β, TGF-β, IGF-1, in sexual dysfunction - PDGF, in vaginal atrophy); 5 Ophthalmology (in the healing of corneal epithelial wounds, in the treatment of dormant corneal ulcers, dry eye syndrome and the reconstruction of the corneal surface; 6. Neurology (regeneration of neurons, pain alleviation, and clinical symptoms - TGF-β 1, IGF-1, PDGF, VEGF) and FGF). Platelet-rich plasma therapy is a very interesting alternative and complement to traditional methods of treatment. However, the potential for using platelets is still not fully understood. The composition of platelet-rich plasma depends on many factors that may affect its use's efficacy and clinical benefits. Further research is necessary to standardize PRP delivery's preparation procedures and methods for a specific disease entity or clinical case.
... The effect is mainly achieved by a large number of released growth factors. These growth factors include PDGF, TGF-β1 and β2, VEGF, fibroblast growth factor (FGF), bone morphogenetic protein (BMP), and insulinlike growth factor (IGF) [46][47][48]. Several in vitro studies have demonstrated the role of these growth factors in promoting bone regeneration and repair. ...
... For MBL, platelet concentrate still had a positive effect at 12 months after insertion in a systematic review and the study by Öncü et al. [22,27]. However, a retrospective study reported no significant difference in MBL between the PRP group and the control group for a longer follow-up period (5 years) [48]. In addition, 37 patients with implants were followed up for an average of 13 years in the study by Attia et al. [55]. ...
Background:
Osseointegration is essential for the success and stability of implants. Platelet concentrates were reported to enhance osseointegration and improve implant stability. The purpose of this review is to systematically analyze the effects of platelet concentrates on implant stability and marginal bone loss.
Methods:
Two researchers independently performed searches in the following databases (last searched on 21 July 2021): MEDLINE (PubMed), Cochrane Library, EMBASE, and Web of Science. In addition, a manual search was carried out on references of relevant reviews and initially included studies. All randomized controlled trials (RCTs) and controlled clinical trials (CCTs) on the application of platelet concentrates in the implant surgery procedure were included. The risk of bias of RCTs and CCTs were assessed with a revised Cochrane risk of bias tool for randomized trials (RoB 2.0) and the risk of bias in non-randomized studies-of interventions (ROBINS-I) tool, respectively. Meta-analyses on implant stability and marginal bone loss were conducted. Researchers used mean difference or standardized mean difference as the effect size and calculated the 95% confidence interval. In addition, subgroup analysis was performed based on the following factors: type of platelet concentrates, method of application, and study design.
Results:
Fourteen studies with 284 participants and 588 implants were included in the final analysis. 11 studies reported implant stability and 5 studies reported marginal bone level or marginal bone loss. 3 studies had high risk of bias. The meta-analysis results showed that platelet concentrates can significantly increase implant stability at 1 week (6 studies, 302 implants, MD 4.26, 95% CI 2.03-6.49, P < 0.001) and 4 weeks (8 studies, 373 implants, MD 0.67, 95% CI 0.46-0.88, P < 0.001) after insertion, significantly reduced marginal bone loss at 3 months after insertion (4 studies, 95 implants, mesial: MD - 0.33, 95% CI - 0.46 to - 0.20, P < 0.001; distal: MD - 0.38, 95% CI - 0.54 to - 0.22, P < 0.001). However, the improvement of implant stability at 12 weeks after insertion was limited (P = 0.10). Subgroup analysis showed that PRP did not significantly improve implant stability at 1 week and 4 weeks after insertion (P = 0.38, P = 0.17). Platelet concentrates only placed in the implant sites did not significantly improve implant stability at 1 week after insertion (P = 0.20).
Conclusions:
Platelet concentrates can significantly improve implant stability and reduce marginal bone loss in the short term. Large-scale studies with long follow-up periods are required to explore their long-term effects and compare effects of different types.
Trial registration:
This study was registered on PROSPERO, with the Registration Number being CRD42021270214.
... Although numerous surgical techniques have been developed to increase implant stability values [21,22], a recent study showed as primary implant stability is of main importance in the changes of marginal bone level during the early healing period [23]. Regarding periimplant marginal bone, some authors have observed alveolar bone preservation related to IIP when PCs were applied [24,25], while Taschieri et al. [26] in a retrospective study did not find statistically significant differences in MBL of IIP placed with or without P-PRP with a follow-up of up to 5 years. ...
... Moreover, a clinical study showed faster osseointegration in non-immediate implants placed with PRF in comparison to control group [43]. However, Taschieri et al. [26] in a retrospective study found no statistically significant differences between the use of P-PRP vs. non-use in IIP with a follow-up of up to 5 years. This fact may indicate that the application of PCs in IIP may not have a long-term benefit on MBL. ...
Background:
To evaluate marginal bone loss (MBL) in immediate implant procedures (IIP) placed in conjunction with platelet concentrates (PCs) compared to IIP without PCs.
Methods:
A search was performed in four databases. Clinical trials evaluating MBL of IIP placed with and without PCs were included. The random effects model was conducted for meta-analysis.
Results:
Eight clinical trials that evaluated MBL in millimeters were included. A total of 148 patients and 232 immediate implants were evaluated. The meta-analysis showed a statistically significant reduction on MBL of IIP placed with PCs when compared to the non-PCs group at 6 months (p < 0.00001) and 12 months (p < 0.00001) follow-ups. No statistically significant differences were observed on MBL of IIP when compared PCs + bone graft group vs. only bone grafting at 6 months (p = 0.51), and a significant higher MBL of IIP placed with PCs + bone graft when compared to only bone grafting at 12 months was found (p = 0.03).
Conclusions:
MBL of IIP at 6 and 12 months follow-ups is lower when PCs are applied in comparison to not placing PCs, which may lead to more predictable implant treatments in the medium term. However, MBL seems not to diminish when PCs + bone graft are applied when compared to only bone grafting.
... Previous studies showed that plasma rich in growth factors may stimulate faster epithelization, reduce postoperative pain and symptoms, and enhance hard and soft tissue healing in a number of oral surgery procedures in both healthy and medically compromised subjects [1,2,14,[17][18][19][24][25][26]42,46,[48][49][50][51]. Favero et al. in a study on animal model of implant osseointegration, reported that the percentages of new bone increased by 4 times after 2 weeks at the UnicCa ® surface, and higher new bone percentages were found at BTI UnicCa ® , which immediately initiates the regenerative process and reduces implant failure [52,53]. ...
Background: Platelet concentrates are biological, autologous products obtained from the patient’s whole blood, consisting of a supraphysiological concentration of platelets and growth factors, that have proved beneficial in different applications in the medical and dental fields. They are used in several medical and dental applications to enhance tissue healing. Previous evidence shows that platelet concentrates may be beneficial in patients with compromised systemic conditions, in which the healing process is impaired. Aim: To evaluate the 5-year clinical outcome of implant treatment using acid-etched implants with calcium ions-modified surface in association with plasma rich in growth factors, in patients with systemic diseases of a different nature. Methods: Charts of 99 medically compromised patients, who had received a total of 224 dental implants from January 2013 to June 2013, were retrospectively evaluated. Patients were divided into four groups, according to their condition: diabetes (n = 39 patients), osteoporosis (n = 36), lupus erythematosus systemic (n = 5), rheumatoid arthritis (n = 19). The main outcomes were implant survival, marginal bone level (MBL) change and complications throughout follow-up. Results: Mean follow-up was 63.06 ± 1.90 months (range 60.1 to 66.4 months). In total, eight implants failed in 6 diabetic patients and 4 in 3 patients with rheumatoid arthritis. Overall 5-year implant survival was 94.6%. In total, 30 complications occurred in 24 patients, mostly transient, and no severe adverse event occurred. Overall MBL change was 0.45 ± 0.12 mm, with no significant differences among groups. Conclusions: In the present sample of medically compromised patients, rehabilitation with calcium ions-modified surface implants associated with plasma rich in growth factors proved to be a safe and effective treatment. The satisfactory results achieved after 5-year follow-up are comparable to those historically reported for healthy patients.
