Regenerative potential of autologous platelet-rich fibrin with and without amnion membrane in the treatment of Grade-II furcation defects: A clinicoradiographic study

Abstract

Context:Platelet-rich fibrin (PRF), platelet concentrate composed of cytokines and structural glycoproteins trapped within polymerized fibrin meshwork, has the potential to accelerate healing of periodontal tissues. Amnion membrane has also attracted a lot of attention in periodontal regeneration due to the presence of variety of growth factors.Aims:The aim of the study is to evaluate and compare the regenerative potential of autologous PRF with and without amnion membrane in the treatment of Grade II furcation defects.Settings and Design:This was a double-masked randomized, split-mouth design study.Materials and Methods:Fifteen patients with thirty mandibular degree II furcation defects were randomly allotted into Group I (PRF and amnion membrane) and Group II (PRF). Clinical parameters such as plaque index and gingival index-at defect site along with probing pocket depth, and relative attachment level and furcation defect depth were recorded at baseline, 3 months, and 6 months postoperatively. Assessment of radiographic parameters was done at baseline and 6 months postoperatively aided by computer-assisted tomography (Dentascan).Statistical Analysis Used:For intragroup variations, Wilcoxon signed-rank test, and for comparison between the two groups/intergroup variations, Independent t-test and Mann–Whitney test was performed.Results:All clinical and radiographic parameters showed statistically significant improvement at the sites treated with PRF and amnion membrane compared to those with PRF alone.Conclusions:Within the limitation of this study, there was greater pocket reduction, attachment level gain, and bone fill at sites treated with PRF and amnion membrane as compared to PRF alone.

Platelet-Rich Fibrin as a Bone Graft Material in Oral and Maxillofacial Bone Regeneration: Classification and Summary for Better Application

“…Some controlled trials [66–74] showed better osteogenesis effect when using PRF combined with bone graft materials compared with PRF or materials alone, as shown in Table 4. In most experiments, materials were added to PRF [66–69], and they aimed at promoting effective space maintenance and osteoconductive effect or providing cells and factors. PRF can also improve the properties of graft materials [70–74] by providing cytokines, platelets, leukocytes, and circulating stem cells.…”

“…It is elastic and thin. The amnion membrane consists of pluripotent stem cells and all types of growth factors [90], such as EGF, NGF, VEGF, and TGF- β 1, which could explain how it enhances the osteogenesis ability of PRF in the treatment of grade II furcation defects [69]. Use of the combination of PRF/amnion membrane caused more bone formation at 6 months of growth.…”

Use of Amniotic Membrane and Its Derived Products for Bone Regeneration: A Systematic Review

“…No significant difference was observed between the empty defect and the defect covered either by fresh or cryopreserved AM, whereas lyophilized and decellularized-lyophilized AM significantly enhanced early bone regeneration. Interestingly, both methods are used when AM is applied to guide bone regeneration in humans (Kothiwale et al, 2009 ; Kiany and Moloudi, 2015 ; Kumar et al, 2015 ; Sali and Pauline George, 2016 ; Pajnigara et al, 2017 ; Kaur and Bathla, 2018 ; Akhlaghi et al, 2019 ). This result can be explained by the safe and long term storage of samples at room temperature allowed by lyophilization (Rodríguez-Ares et al, 2009 ), which could also be easily followed by gamma irradiation to sterilize the membrane (Gindraux et al, 2013 ).…”

“…AM was used to cover a bone substitute in six studies. Kaur et al showed that bone formation was enhanced when periodontal furcation defects were filled with a plateletrich fibrin (PRF) membrane then covered by AM (Kaur and Bathla, 2018). However, it is more widely recognized to use a bone substitute rather than a PRF membrane as a filling material to treat periodontal defects.…”

Applications of the Amniotic Membrane in Vitreoretinal Surgery

“…The amniotic membrane showed excellent anti-angiogenic and anti-microbial properties and poor immunogenicity [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. The hAM can secrete a variety of cytokines including: transforming growth factor (TGFα, TGFβ-1, β-2, and β-3), basic fibroblast growth factor, epithelial growth factor, the hepatocyte growth factor and its receptor and the keratinocyte growth factor and its receptor [ 13 , 14 , 15 , 16 , 17 , 18 ].…”