Mustafa Tunali

Scintigraphic Evaluation of Osteoblastic Activity in Extraction Sockets Treated With Platelet-Rich Fibrin

PURPOSE To evaluate the effect of platelet-rich fibrin (PRF) on the early bone healing process with bone scintigraphy based on technetium-99m methylene diphosphonate uptake in third molar extraction sockets. PATIENTS AND METHODS Fourteen patients with bilaterally soft tissue impacted third mandibular molars were included in the study. The right and left impacted third molars were surgically extracted in the same session. PRF was randomly administered into one of the extraction sockets, whereas the contralateral sockets were left without treatment. Four weeks after surgery, scintigrams were obtained to evaluate scintigraphic differences between PRF-treated and non-PRF-treated sockets. After completion of the clinical study, PRF samples were evaluated by light and scanning electron microscopy. RESULTS The average increase in technetium-99m methylene diphosphonate uptake as an indication of enhanced bone healing did not differ significantly between PRF-treated and non-PRF-treated sockets 4 weeks postoperatively (P > .05). Abundant fibrin and inflammatory cells were observed by light microscopic examination of PRF samples. Scanning electron microscopic analysis of PRF revealed the existence of platelet aggregates in a fibrin network and crystalline particles on the outer surface of PRF. CONCLUSIONS PRF might not lead to enhanced bone healing in soft tissue impacted mandibular third molar extraction sockets 4 weeks after surgery. PRF exhibits the potential characteristics of an autologous fibrin matrix. However, whether the presence of crystal-like particles on the outer surface of PRF alters bone healing should be investigated further.

In vivo evaluation of titanium-prepared platelet-rich fibrin (T-PRF): a new platelet concentrate

We have developed a new, titanium-prepared, platelet-rich fibrin (T-PRF) together with the protocol for forming it, which is based on the hypothesis that titanium tubes may be more effective at activating platelets than the glass tubes used by Chouckroun in his platelet-rich fibrin (PRF) method. The aim of this study was to find a suitable animal model in which to evaluate the method and to investigate the efficacy of T-PRF for wound healing. Blood samples from 6 rabbits were used to confirm the protocol for formation of T-PRF. We evaluated T-PRF or T-PRF-like clots morphologically using scanning electron microscopy (EM). Blood samples from 5 rabbits were used to develop an experiment in which to evaluate the effects of T-PRF on wound healing. The mucoperiosteal flaps were filled with autologous T-PRF membranes from the vestibule in the anterior mandibular regions. Samples collected from the surgical sites were stained with haematoxylin and eosin. We found a mature fibrin network in T-PRF clots that had been centrifuged for 15 min at 3500 rpm and, 15 days after placement of the membrane, we found newly-forming connective tissue and islets of bony tissue in the T-PRF membrane. These results show that T-PRF could induce the formation of new bone with new connective tissue in a rabbit model of wound healing within 30 days of treatment.

A Novel Platelet Concentrate: Titanium-Prepared Platelet-Rich Fibrin

We developed a new product called titanium-prepared platelet-rich fibrin (T-PRF). The T-PRF method is based on the hypothesis that titanium may be more effective in activating platelets than the silica activators used with glass tubes in Chouckrouns leukocyte- and platelet-rich fibrin (L-PRF) method. In this study, we aimed to define the structural characteristics of T-PRF and compare it with L-PRF. Blood samples were collected from 10 healthy male volunteers. The blood samples were drawn using a syringe. Nine milliliters was transferred to a dry glass tube, and 9 mL was transferred to a titanium tube. Half of each clot (i.e., the blood that was clotted using T-PRF or L-PRF) was processed with a scanning electron microscope (SEM). The other half of each clot was processed for fluorescence microscopy analysis and light microscopy analysis. The T-PRF samples seemed to have a highly organized network with continuous integrity compared to the other L-PRF samples. Histomorphometric analysis showed that T-PRF fibrin network covers larger area than L-PRF fibrin network; also fibrin seemed thicker in the T-PRF samples. This is the first human study to define T-PRF as an autogenous leukocyte- and platelet-rich fibrin product. The platelet activation by titanium seems to offer some high characteristics to T-PRF.

Apoptosis: an underlying factor for accelerated periodontal disease associated with diabetes in rats

ObjectivesDiabetes mellitus (DM) is well-established risk factor for periodontal disease. DM can also lead to changes in the number of apoptotic cells in periodontal tissues. The goal of this study was to evaluate apoptosis, depending on DM, in healthy and diseased periodontal soft tissues.Material and MethodsA total of 43 adult male Sprague–Dawley rats were used in this study. Experimental periodontitis was created by placing silk ligatures around the cervices of the first mandibular molars. Experimental diabetes was induced by intraperitoneal injection of the diabetogenic agent streptozotocin (STZ). Following the induction of both experimental diseases, the animals were divided into four groups: (1) The healthy group (H) (n = 10); (2) The diabetes group (D) (n = 10); (3) The periodontitis group (P) (n = 11); and (4) The diabetes and periodontitis group (DP) (n = 12). Apoptotic cells were determined by immunohistochemistry, and the frequency of apoptotic cells was evaluated by apoptotic index score.ResultsIt was observed that there was less apoptosis in both the epithelial and gingival connective tissue cells of healthy diabetic tissues than in healthy tissues without diabetes. When periodontal disease existed, apoptosis increased in both the epithelial and gingival connective tissues of diabetic and non-diabetic animals.ConclusionsThere may be differences in the apoptotic mechanisms in the periodontal soft tissues of diabetic and non-diabetic animals.Clinical relevanceApoptosis may be one of the underlying factors in increased risk for periodontal disease that is associated with diabetes.

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

Abstract 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.

İkinci nesil trombosit konsantrasyonunun klinik uygulamaları

The therapeutic use of autologous platelet-rich fibrin constitutes a relatively new biotechnology that has been a breakthrough in the stimulation and acceleration of soft-tissue and bone healing. The efficiency of this process lies in the local and continuous delivery of a wide range of growth factors and proteins, mimicking the needs of the physiological wound healing and reparative tissue processes. Platelet-rich fibrin (PRF) belongs to a new generation of platelet concentrates, with simplified processing and without biochemical blood handling. This easy protocol allows the production of leukocyte and platelet-rich fibrin clots starting from autologous blood samples. PRF is used especially in clinical Periodontal and Oral and Maxillofacial Surgery applications. The significance of the PRF is gradually increasing Keywords: Platelet, Autogenous Fibrine, Growth hormone. OZET Trombositten zengin otojen urunlerin tedavi amaci ile kullanilmasi, guncel bir yaklasim olarak dikkati cekmektedir. Sert ve yumusak doku iyilesmelerinde kullanilan ve cok cesitli buyume faktorleri ve proteinlerin kontrollu salinimlarini iceren bu preparatlarin dogal yara iyilesmesi icin gerekli olan maddeleri yogun olarak icerdikleri bilinmektedir. Platelet-rich fibrin (PRF), yeni jenerasyon trombositten zengin otojen urun olarak bilinmektedir. Kolay uygulanabilir ve biyokimyasal herhangi bir islem gerektirmeyen PRF protokolu, kisinin kendisinden alinan kan orneklerinden lokositten ve trombositten zengin bir otolog biyomateryal elde edilmesine izin vermektedir. Dis Hekimliginde ozellikle Periodontoloji ve Agiz, Dis ve Cene Cerrahisi’ndeki klinik uygulamalarda kullanilmaya baslanan PRF’nin onemi giderek artmaktadir.

Derin miller sınıf II dişeti çekilmelerin çift cerrahi yöntemle tedavisi: bir olgu sunumu

Tissue trauma caused by traumatic toothbrushing is considered to be a dominating causative factor for the development of recessions, particularly in young individuals. Recessions resulting from improver toothbrushing techniques are often found at sites with clinically healthy gingiva and where the exposed root has a wedgeshaped defect, the surface of which is clean, smooth and polished. Free connective tissue graft combined with a double papilla flap surgery and semi-lunar coronally repositioned flap methods leads to a significantly favorable clinical improvement of treatment of deep Class II Miller gingival recession defects OZET Ozellikle genc kisilerde, diseti cekilmelerinin en onemli nedeni travmatik fircalama sonucu olusan doku hasaridir. Yanlis fircalama teknikleri sonucu olusan cekilmeler genellikle klinik olarak saglikli diseti bolgelerinde gorulur. Diseti cekilmesi sonucunda acikta kalan kok yuzeyi ise temiz, duz ve parlaktir. Ayrica kok yuzeyinde kama seklinde defektler de goze carpar. Serbest bag dokusu grefti ile cift papil flep ve semi-lunar koronale pozisyone flep tekniklerinin birlikte kullanimi derin Miller Sinif II diseti cekilmelerinde klinik olarak olumlu sonuclar vermektedir.

Endodontik-periodontal kombine kemik içi defektlerin tedavisinde trombositten zengin fibrin membran ile otojen kemik greftinin kombine kullanımı: olgu sunumu

Platelet-rich fibrin (PRF) is a new generation product of blood sourced material. Its major advantages are ease of preparation, and that blood contents are not changed by biochemical processing which reinforce the product’s autogenous nature. In our study, a 51 years-old male patient attending to our clinic with endodontic- periodontal intraosseous defect was treated with PRF membrane combined with autogenous bone graft in addition to endodontic treatment demonstrated successful results in hard and soft tissue healing. OZET Trombositten zengin fibrin (TZF), kan kaynakli maddelerin yeni jenerasyon urunudur. Yonteminin kolayligi ve elde edilirken iceriginin herhangi bir biyokimyasal islemle degistirilmemis olmasi TZF’nin onemli bir artisi olup bu avantajlar urunun otojen ozelligini pekistirirler. Calismamizda, klinigimize basvuran 51 yasindaki erkek hastanin endodontik-periodontal kemik ici defektinde endodontik tedavinin yani sira TZF membran ile otojen kemik greftin kombine olarak kullanilmasi sert ve yumusak doku iyilesmelerinde basarili sonuclar sergilemistir. Anahtar Kelimeler: Trombositten zengin fibrin (TZF), Otojen kemik grefti