Evaluation of the effects platelet-rich fibrin on new bone formation with different centrifugal values applied to the extraction socket in mandible, by histomorphometry

Background

Platelet concentrates are frequently used in recent years to accelerate tissue healing due to the high rate of growth factor they contain PRF is widely used in many maxillo-facial surgical applications like GBR, Mronj, Sinus plastic, Chronic wounds and Joint injection. There are many studies evaluating the effects of different platelet rich fibrin structures on tissue healing separately, but the number of studies comparing the effects of centrifugation value modifications on bone healing is limited.

Aim/Hypothesis

This study was to evaluate the effects of two different PRF protocols on bone healing, histologically and clinically. In our clinical thesis study, histological examinations were performed using the extraction socket model to evaluate the effects of cellular and growth factor rich PRF on bone healing.

Material and Methods

The study was randomly selected among healthy patients over the age of 18 years, who applied for implantation after tooth extraction in the mandibular anterior region.

Patients who applied to the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry in İzmir Katip Çelebi University, who had indications of at least 3 teeth extractions in the lower jaw and following dental implantation after the healing process in the extraction sites were included in this study 20 patients (4 females, 16 males). As the clinical application protocol: 1. Preparation of PRF 2. Tooth extraction Standardization extraction socket (Drill size 3.7 × 10 mm) 3. Bone tissue specimen taken (trephine bur 3.3 × 8 mm) and implant placement 4. Resonance frequency analysis measurements 5. Prevention of prosthetic rehabilitation. In immunohistochemical analysis, staining intensities of alkaline phosphatase (ALP), proliferated cell nuclear antigen (PCNA) and osteocalcin (OCN) versus primary antibodies were scored.

Results

Histomorphometric results of the study were examined, it was seen that the new bone formation in the L-PRF group was 70.74%, in the A-PRF group 61.37% and in the control group 30.26%. New bone formation values were statistically higher in L-PRF (P = 0.001) and A-PRF (P = 0.002) group than in the control group. There was no statistically significant difference between the A-PRF and L-PRF groups (P = 0.25). Connective tissue formation was statistically higher in the control group than the other groups. In immunohistochemical sections, ALP and PCNA showed more severe staining in the L-PRF group but more intense staining in the A-PRF group compared to OCN. ISQ results of the implants in the L-PRF group was 80.73. A-PRF group was 76.21 in control group was 72. The first and 10-week torque values in the PRF group were statistically higher than the control group (P = 0.0001). After 10 days good healing, was in the PRF treated groups but in the control group, the soft tissue was resected to the socket.

Conclusion and Clinical Implications

Considering the results of our study and literature studies, it was seen that PRF application accelerated bone regeneration in the histological and Resonance frequency analysis findings and increased the quality of newly formed bone. PRFs can be said to contribute to the healing process of soft and hard tissues due to the growth factors they contain. Although L-PRF was superior in L-PRF and A-PRF treated groups, no significant difference was found between the two groups. Further studies are needed