Effect of injectable platelet-rich fibrin (i-PRF) on the rate of tooth movement:: A randomized clinical trial

ObjectivesTo evaluate the efficiency of injectable platelet-rich fibrin (i-PRF) in accelerating canine tooth movement and to examine levels of the matrix metalloproteinase-8 (MMP-8), interleukin-1β (IL-1β), receptor activator of nuclear factor kappa-light-chain-enhancer of activated B cells ligand (RANKL), and osteoprotegerin (OPG) in the gingival crevicular fluid during orthodontic treatment.Materials and MethodsTwenty patients (mean age = 21.4 ± 2.9 years) with Class II Division 1 malocclusion were included in a split-mouth study. The treatment plan for all patients was extraction of maxillary first premolars followed by canine distalization with closed-coil springs using 150 g of force on each side. The study group received i-PRF two times, with a 2-week interval, on one side of the maxilla. The contralateral side served as the control and did not receive i-PRF. Maxillary canine tooth movement was measured at five time points (T1–T5) on each side. Also, the activity of inflammatory cytokines was evaluated at three time points in the gingival crevicular fluid samples.ResultsThere was a significant difference in canine tooth movement between the two groups (P < .001). i-PRF significantly increased the rate of tooth movement, and stimulation in the levels of inflammatory cytokines supported this result (P < .001). The levels of cytokines changed in both groups between T1 and T2. The IL-1β, MMP8, and RANKL values were significantly increased in the study group compared with the control group, while the OPG values were significantly decreased.Conclusionsi-PRF-facilitated orthodontics is an effective and safe treatment modality to accelerate tooth movement, and this method can help shorten orthodontic treatment duration.     

富血小板纤维蛋白对牙髓干细胞体外增殖与分化特性的影响

目的:探讨不同浓度富血小板纤维蛋白(platelet-rich fibrin,PRF)对犬牙髓干细胞(dental pulp stem cells,DPSCs)体外增殖及成牙本质/成骨分化能力的影响.方法:酶消法分离培养犬DPSCs,经流式细胞术和多向分化鉴定后分别在含自体PRF体积比为1/8、2/8、3/8的3种浓度的培养基中进行培养;采用MTT法检测1、2、3、4、5、6、7d各时间点的细胞增殖活性;实时定量PCR检测培养7、14、21 d时ALP、DSPP、DMPl mRNA的表达水平.结果:成功分离并获得克隆化培养的犬DPSCs,DPSCs具有成骨和成脂分化能力;3种浓度PRF均能促进DPSCs的增殖,1周内促增殖作用有时间依赖性而无PRF浓度依赖性;不同浓度PRF可通过上调成牙本质/成骨早期标志基因ALP、DSPP mRNA及晚期标志基因DMP1mRNA的表达来促进犬DPSCs成牙本质/成骨向分化,该效应既具时间依赖性又具有PRF浓度依赖性.结论:自体PRF可以不同方式同时促进犬DPSCs的增殖及分化.     

Injectable platelet-rich fibrin as treatment for temporomandibular joint osteoarthritis: A randomized controlled clinical trial

The purpose of this study was to assess the treatment outcomes of intraarticular injection of injectable platelet-rich fibrin (i-PRF) after arthrocentesis in patients with temporomandibular joint osteoarthritis (TMJ-OA). Patients were randomly assigned to one of two treatment groups: those who received intraarticular injection of i-PRF after arthrocentesis procedure – the i-PRF group; and those who underwent the arthrocentesis procedure alone – the control group. The primary outcome variable was pain, the level of which was measured preoperatively and at 1, 2, 3, 6, and 12 months postoperatively. The secondary outcome variables included maximum mouth opening (MMO), and lateral and protrusive movements. Of the total of 36 patients, 18 were analyzed in the i-PRF group and 18 in the control group. There were significant differences between the groups in terms of pain levels and measurements of MMO, lateral movement, and protrusive movement over the 12 months of follow-up (p < 0.001). Significant increases in pain levels and decreases in measurements of MMO, lateral movement, and protrusive movement were observed in the control group from the 6th to 12th month postoperatively (p < 0.001). In contrast, no significant differences were found in both pain levels and measurements of MMO, lateral, and protrusive movements for the i-PRF group from the 2nd to the 12th month postoperatively. Within the limitations of the study it seems that intraarticular injection of i-PRF after arthrocentesis should be preferred whenever appropriate because when reducing pain intensity and improving functional jaw movement is the priority.     

富血小板纤维蛋白膜(PRF)引导成骨能力的比较研究

目的:探讨及比较富血小板纤维蛋白膜(PRF)、海奥生物膜联合骨粉用于新西兰大白兔下颌骨缺损处早期引导骨生成的能力。方法:选取雌性新西兰大白兔9只,在其双侧下颌骨下缘上2mm做圆形骨缺损,A组植入骨粉后覆盖PRF,B组植入骨粉后覆盖海奥生物膜,C组植入骨粉。术后2,4,8周分期分组处死动物,取下颌骨缺损植骨区标本。标本行大体观察、CT及组织学观察成骨情况。结果:大体观察,骨缺损区早期骨愈合坚硬度A组>B组>C组。CT观察,骨缺损区骨密度早期A组>B组>C组,统计学分析,2周、4周时A组B组C组之间骨密度值分别具有统计学差异,8周组A组B组无统计学差异,与C组分别存在统计学差异。组织学观察,同期比较A组新生骨组织及再生血管化均优于B组、C组,新生骨排列较B组、C组规则。结论:PRF在骨缺损的修复中能够促进新骨的形成,提高新骨形成的时间和质量,对引导成骨起到有效促进作用。     

BMSCs复合PRF修复牙槽骨缺损中OPG和RANKL的表达及意义

目的：探讨骨髓间充质干细胞（BMSCs）复合富血小板纤维蛋白（PRF）修复牙槽骨缺损中骨保护素（OPG）和核因子B受体活化因子配体（RANKL）的表达及意义。方法：取健康雄性2月龄新西兰兔36只,随机分为A、B、C、D 4组,均在全麻下微创拔除下颌左侧中切牙。 A组植入BMSCs与PRF复合物,B组植入PRF,C组植入BMSCs,D组为空白对照组。按术后4,8,12周3个时间点（每个时间点9只）处死动物并立即于骨缺损部位取材,免疫组织化学方法检测OPG和RANKL的表达。结果：4,8,12周时A组、B组、C组OPG的表达高于D组（P＜0．05）;4,8,12周时A组、B组、C组RANKL的表达高于D组（P＜0．05）;析因分析显示自体BMSCs复合PRF修复牙槽骨缺损中OPG,RANKL的表达高于单独使用BMSCs或PRF（P＜0．05）。结论：自体BMSCs复合PRF修复牙槽骨缺损会增加OPG,RANKL的表达,有助于牙槽骨改建。     

Tooth movement rate and anchorage lost during canine retraction: A maxillary and mandibular comparison

Objectives:To investigate the canine retraction rate and anchorage loss during canine retraction using self-ligating (SL) brackets and conventional (CV) brackets. Differences between maxillary and mandibular rates were computed.Materials and Methods:Twenty-five subjects requiring four first premolar extractions were enrolled in this split-mouth, randomized clinical trial. Each patient had one upper canine and one lower canine bonded randomly with SL brackets and the other canines with CV brackets but never on the same side. NiTi retraction springs were used to retract canines (100 g force). Maxillary and mandibular superimpositions, using cephalometric 45° oblique radiographs at the beginning and at the end of canine retraction, were used to calculate the changes and rates during canine retraction. Paired t-tests were used to compare side and jaw effects.Results:The SL and CV brackets did not show differences related to monthly canine movement in the maxilla (0.71 mm and 0.72 mm, respectively) or in the mandible (0.54 mm and 0.60 mm, respectively). Rates of anchorage loss in the maxilla and in the mandible also did not show differences between the SL and CV brackets. Maxillary canines showed greater amount of tooth movement per month than mandibular canines (0.71 mm and 0.57 mm, respectively).Conclusions:SL brackets did not show faster canine retraction compared with CV brackets nor less anchorage loss. The maxillary canines showed a greater rate of tooth movement than the mandibular canines; however, no difference in anchorage loss between the maxillary and mandibular posterior segments during canine retraction was found.     

富血小板纤维蛋白促进组织愈合机制的探讨

目的:通过检测富血小板纤维蛋白(platelet-rich fibrin,PRF)中多种细胞因子的表达,探讨其在组织再生修复中的作用.方法:取健康志愿者肘静脉全血制备PRF标本,通过免疫组化的实验方法,检测标本中IL-1 β、IL-4、IL-6、TNF、PDGF-BB和TGF-β 1的表达.结果:免疫组化结果表明富血小板纤维蛋白标本中IL-1 β、IL-4、IL-6、TNF、PDGF-BB和TGF-β 1均为阳性表达.结论:富血小板纤维蛋白中含有多种细胞因子,这些细胞因子与纤维蛋白共同发挥作用使PRF具有减少术后反应、降低术后感染风险和促进组织愈合的作用.     

富血小板血纤蛋白在牙槽嵴位点保存中的应用

牙齿拔除后,牙槽嵴会有一定程度的吸收并伴有软组织的退缩,致使种植修复效果不理想.富血小板血纤蛋白(PRF)富含的血小板、白细胞、白细胞细胞因子、转化生长因子、血小板衍生生长因子、血管内皮生长因子、成纤维细胞生长因子、胰岛素样生长因子等,可有效地调控与组织再生相关的细胞的增殖、分化和程序性死亡,促进手术位点的血管化,增强术区抗感染能力及促进拔牙创软硬组织的再生.PRF多孔网状的三维空间结构有利于生长因子和氧气的弥散,新生骨组织的爬行替代及新生血管的长入,可为骨组织的血管化提供足够的空间,促进拔牙区软硬组织的再生.PRF取自患者自身血液经离心后制得,制备时间短,操作过程简便,较之富血小板血浆有更好的生物安全性和生物活性.PRF既可以单独应用,也可以联合应用.     

自体富血小板纤维蛋白治疗重度慢性牙周炎临床效果观察

目的观察自体富血小板纤维蛋白(PRF)用于重度慢性牙周炎手术治疗中的临床效果。方法选择2009年1月至2011年8月需要进行翻瓣术的重度慢性牙周炎患者18例(18颗患牙),分为试验组和对照组各9例。行常规翻瓣术,将PRF植入牙周组织缺损处(试验组)或仅行翻瓣术(对照组),术前及术后4个月测量探诊深度(PD)与临床附着水平(CAL)。结果两组各自术前与术后4个月的PD和CAL值比较,差异均有统计学意义(P<0.05)。试验组术前、术后的PD和CAL差值分别与对照组比较,差异均有统计学意义(P<0.05)。结论将PRF用于重度慢性牙周炎手术治疗中,可促进患牙牙周组织修复、改善牙周状况。     

Comparison of the effect of tranexamic acid at various concentrations on the degradation time of platelet-rich fibrin

This study aimed to compare platelet-rich fibrin (PRF) membranes obtained using a conventional method and those obtained using the tranexamic acid-mixed method at various concentrations in terms of appearance, weight, and degradation period. In this in vitro study, 20 PRF membranes were divided into four groups, including a conventional group manipulated using the conventional method. The remaining groups were prepared using tranexamic acid at concentrations of 50, 150, and 200 mg. The PRF membranes were evaluated for gross weight, degradation period, and daily remaining weight for 28 days. There were no statistically significant differences in gross weight among all the groups (p = 0.985). The 150 and 200 mg groups had a longer degradation period (more than 28 days), which was significantly longer than that of the control and 50 mg groups (p = 0.048). The daily remaining weights of the 150 and 200 mg groups were significantly greater than that of the control group observed from day 13 to the end of the experiment. The tranexamic acid-mixed technique had no effect on the appearance and weight of the PRF membranes. Moreover, the technique could delay their degradation.     

Interseptal bone reduction on the rate of maxillary canine retraction

Objective:To propose and evaluate a novel surgical approach with minimal trauma, termed interseptal bone reduction, combined with the use of a conventional orthodontic fixed appliance to accelerate canine retraction.Materials and Methods:A split-mouth design study was conducted in 18 female subjects (mean age, 21.9 years) whose bilateral upper first premolars were extracted and who subsequently received canine distalization. The extraction socket on the experimental side was deepened, and interseptal bone distal to the maxillary canine was reduced in thickness using a surgical bur; conventional extraction was performed on the control side. The canines were then distalized using elastomeric chains on both the labial and palatal sides, with a net force of 150 g. The extent of canine movement and rotation was determined from study models, and the angulation was analyzed based on lateral cephalograms.Results:A Wilcoxon signed rank test demonstrated that the extent of canine movement in the mesio-distal direction after 3 months was significantly greater on the experimental side than on the control side (5.4 and 3.4 mm, respectively, P  =  .002). However, there was no statistically significant difference in canine angulation or rotation after 3 months between the experimental and control sides.Conclusions:In combination with the use of conventional orthodontic appliances, interseptal bone reduction can enhance the rate of canine movement when interseptal bone is sufficiently reduced in both thickness and depth following surgical criteria.     

富血小板纤维蛋白与富血小板血浆体外释放生长因子的比较及其对脂肪干细胞增殖分化的影响

目的比较富血小板纤维蛋白（PRF）与富血小板血浆（PRP）体外释放生长因子的质量浓度及其对脂肪干细胞（ADSCs）增殖和成骨分化的影响。方法抽取兔耳中央动脉血,一次离心法制备PRF,二次离心法制备PRP,分别将其置于5 mL新鲜的α-MEM培养液中,分别于37 ℃下静置1、7、14、21、28 d,收集PRF与PRP析出液,检测析出液中转化生长因子-β1（TGF-β1）及血小板源性生长因子-AB（PDGF-AB）的质量浓度。将收集的PRF与PRP析出液配置成条件培养液培养ADSCs,观察其对ADSCs增殖及碱性磷酸酶（ALP）活性的影响。结果1）生长因子释放情况：不同时间点的PRF析出液中,14 d时TGF-β1的质量浓度达到最高,7 d时PDGF-AB的质量浓度最高;不同时间点的PRP析出液中,1 d时TGF-β1与PDGF-AB的质量浓度即达最高,以后逐渐下降。2）对ADSCs增殖及ALP活性的影响：PRF析出液中,14 d时对其影响最大;PRP析出液中,1 d时对其影响最大。结论与PRP相比,PRF能够缓慢持久地释放生长因子,更有力地刺激ADSCs的增殖和分化。     

The role of titanium-prepared platelet-rich fibrin in palatal mucosal wound healing and histoconduction

Objective: We aimed to determine the clinical effects of titanium-prepared, platelet-rich fibrin (T-PRF) on human palatal mucosal wound healing (PMWH) and to identify its effect on time-dependent changes in palatal soft-tissue thickness (PSTT) in terms of histoconduction, which is a new concept.

Materials and methods: Free gingival graft (FGG) donor sites were treated with T-PRF and compared with an untreated control group. The results of colour match and H₂O₂-bubbling tests for complete wound epithelization (CWE) were recorded on days 3, 7, 14 and 21. Pain level, number of analgesics used and bleeding status were recorded for the first 7 days. PSTT was measured at baseline and after 1 and 6 months.

Results: Colour match scores of the test group were significantly higher than those of the control group at 7 and 14 days. CWE was observed at a higher frequency in the test group than in the control group on day 14. Post-operative bleeding prevalence was lower in the test group than in the control group for the first 2 days. A time-dependent decrease in PSTT was observed at 1 and 6 months in the control group compared with baseline (baseline, 4.23?±?0.62?mm; 1 month, 4.01?±?0.68?mm; and 6 months, 3.93?±?0.69?mm). However, no significant difference was found in the test group (baseline, 4.29?±?0.64?mm; 1 month, 4.61?±?0.51?mm; and 6 months, 4.51?±?0.58?mm).

Conclusion: The T-PRF membrane exhibited positive effects on PMWH. T-PRF, which is a promising autogenous matrix for histoconduction, may also be preferred as an autogenous alternative to connective tissue grafts in the treatment of gingival recessions and peri-implant mucosal recessions.     

富血小板纤维蛋白对体外培养的成骨细胞生物学特性的影响

目的探讨富血小板纤维蛋白（platelet-rich fibrin, PRF）对成骨细胞生物学特性的影响。方法体外培养成骨细胞MG63,实验组采用PRF,对照组为正常高糖DMEM培养液。以MTT法检测细胞增殖,碱性磷酸酶（ALP）染色法检测ALP活性,免疫组织化学法检测Ⅰ型胶原、骨保护素(OPG)及其配体(RANKL)的表达。采用SPSS17.0软件包对数据进行统计学分析。结果PRF能够促进细胞增殖、ALP分泌、Ⅰ型胶原和骨保护素的表达,对骨保护素配体的表达影响不明显。结论PRF能够促进成骨细胞增殖、分化及骨保护素的表达,PRF可能通过对骨保护素及其配体的调节,参与骨的重建过程。     

富血小板纤维蛋白在下颌第三磨牙拔除术的应用系统评价与Meta分析

目的 通过系统评价及Meta分析的方法评估下颌第三磨牙拔除术中使用富血小板纤维蛋白(PRF)的有效性,为缓解术后并发症提供建议.方法 对Pubmed、EMBASE、Web of Science和中国生物医学文献数据库针对在下颌第三磨牙术中使用PRF的临床随机对照试验进行电子检索,检索时间截至2020年2月.评价者使用C...