New therapies that accelerate musculoskeletal tissue recovery are highly desirable. Platelet-rich fibrin (PRF) is a leukocyte- and platelet-rich fibrin biomaterial that acts as a binding site for both platelets and growth factors. Through increasing the local concentration of growth factors at specific tissues, PRF promotes tissue regeneration. PRF has been frequently used in combination with bone graft materials to reduce healing times and promote bone regeneration during maxillofacial surgery. However, its benefits during muscle repair and recovery are less well-documented. Here, we perform a narrative review on PRF therapies and muscle injuries to ascertain its beneficial effects. We reviewed the factors that contribute to the biological activity of PRF and the published pre-clinical and clinical evidence to support its emerging use in musculoskeletal therapy. We include in vitro studies, in vivo animal studies and clinical articles highlighting both the success and failures of PRF treatment. PRF can promote the healing process when used in a range of orthopaedic and sports-related injuries. These include cartilage repair, rotator cuff surgery and anterior cruciate ligament surgery. However, conflicting data for these benefits have been reported, most likely due to inconsistencies in both PRF preparation protocols and dosing regimens. Despite this, the literature generally supports the use of PRF as a beneficial adjuvant for a range of chronic muscle, tendon, bone or other soft tissue injuries. Further clinical trials to confirm these benefits require consistency in PRF preparation and the classification of a successful clinical outcome to fully harness its potential.

Squamous cell carcinoma (SCC) is the most frequent cancer in oral cavity and its prognosis has exhibited little improvement in the last decades. Although much less common palate SCCs manifests a higher local aggression invading very quickly the adjacent muscles and jawbones, thus being able frequently to lead to dysfunctions in chewing, swallowing, and speech. To elucidate what underlies such local aggression, we investigated the immunohistochemical expression in palate SCCs of Podoplanin (D2-40), Galectin-3 (Gal-3), mammary serine protease inhibitor (Maspin) and minichromosome maintenance complex component 7 (MCM7), markers that are known to be involved in tumor invasiveness. We found a progressive increase in reactivity for D2-40 and MCM7 from the normal epithelium toward dysplastic epithelium and respectively to SCC, which suggests the intervention of these markers in the early stages of squamous cell carcinogenesis in the palate. The highest D2-40, Gal-3 and MCM7 reactivity was observed in basaloid and in poorly differentiated (G3) palate SCCs, while for Maspin the well-differentiated (G1) palate SCCs were the most reactive. The first three markers mentioned above were most intensely expressed at the invasion front, while the Maspin reactivity was low or absent at this level. Statistically, we found significant stratification on localization, grading, muscle invasion, and survival for all investigated markers, but with very high direct correlations between D2-40, Gal-3, and MCM7 immunoreactive score (IRS) values, while between the Maspin and each of the previous markers there were very high inverse correlations. Overall, all these investigate markers proved to be responsible for the local invasiveness and regional lymph node metastasis, thus allowing a prognostic and therapeutic stratification of patients with palate SCCs.

Oral cancer remains an important global health issue and despite recent diagnostic and therapeutic advances, it continues to have an unfavorable prognostic and decreased survival. Although palatal tumors represent one of the rarest locations of oral squamous cell carcinomas (SCCs), they are among the most aggressive local tumors, leaving behind important morpho-functional disabilities. In order to explain such local aggressiveness, the present study aims to investigate the immunohistochemical expression in palate SCCs of some markers known to be involved in the process of tumor invasiveness, such as Wiskott-Aldrich syndrome like (WASL), Claudin-1 (CLDN1), Integrin beta-6 (ITGB6) and c-Mesenchymal to epithelial transition protein (c-Met). We have found here a higher tumor WASL and CLDN1 reactivity in well-differentiated (G1) palate SCCs, and regardless the histological type, degree of differentiation or tumor topography, an overexpression at the invasion front, and in those palate' SCC cases with muscular invasiveness and with lymph node (LN) dissemination. ITGB6 and c-Met had a higher reactivity in moderately differentiated (G2) palate SCCs, especially at the periphery of tumor proliferations, at the invasion front and in those high invasive cases and as well as in those that associated LN dissemination. All four investigated markers were also positive at the level of LN metastatic proliferations. None of the markers could statistically stratify on age group and pain, and on bone and perineural invasion while all of them statistically stratified on survival and grading. We concluded that these markers have a prognostic role allowing the identification of those cases with an unfavorable clinical evolution and decreased survival.

Bone graft substitute materials play an important role in oral rehabilitation and understanding the biological effects of these materials is important for an optimum use. Many bone graft substitutes have been approved for clinical use but this large variability make it hard to select a graft materials. The present study aimed to evaluate the methods that we can today use to assess the degree of osseointegration of the synthetic bone augmentation materials.For this study we made three study groups, each of them consisting of six laboratory rats. On the maxilla of this animals 3-mm diameter experimental cavities were carried out. For the first study group the cavities were augmented with the collagen fleece Alveoprotect, for the second group with the synthetic bone graft Ossceram nano, and in the third group the experimental cavities were left unaugmented. The obtained samples were subjected to three examination methods: clinical and radiological examination, Optical Coherence Tomography (OCT), and a histological study.The evaluation methods of bone graft materials may be divided in two categories: in vivo and in vitro methods. In vivo methods include clinical evaluation and imagistic such as radiological or computer tomography (CT) evaluation. Even a minimal but careful direct clinical observation allows observing the appearance of the bone defect healing at its different stages. CBCT scan is the imaging method of choice in the graft materials repairment of the osseous defects because provides 3D volumetric measurements of newly formed hard tissues.Optical Coherence Tomography (OCT) is a constantly growing imaging method characterized by high spatial resolution and noninvasive subsurface detection. The OCT allowed us to evaluate the surface and subsurface of the ongoing healing bone defects in a non-destructive manner.For the in vitro methods histological methods represents the classical evaluation of the bone graft materials biological integration. On the histological samples we generally noticed the experimental defects filling with connective tissuewith various bone ingrowths from the surrounding bone tissue.However new emerging methods give new opportunities to a more accurate research of this materials. The microcomputed tomography analysis may determine the relationships and differences in three-dimensional bone mineral density and microtrabecular structures between bone grafts and their adjacent native boneTo design and produce an efficient bone graft, the researchers and clinicians should have sufficient knowledge of the characteristics of grafts such as osteogenesis, osteoinductivity, and osteoconductivity, and their other advantages and disadvantages.