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Kemikiçi Defektin Trombositten Zengin Fibrin ile Tedavisi: 2 Yıllık Takip Vaka Raporu

Year 2022, Volume: 3 Issue: 2, 37 - 41, 31.12.2022

Abstract

Periodontitis, dişi destekleyen dokuların ileri derecede yıkımına neden olan bir hastalıktır. Klinik ataşman kaybı, radyografik alveolar kemik kaybı, periodontal cepler ve diş eti kanaması periodontitisin semptomlarındandır. Tedavi edilmediğinde diş kaybına yol açabilen inflamatuar yükü olan polimikrobiyal bir hastalıktır. Periodontitisin altın standart tedavisi diş taşı temizliği ve kök yüzeyi düzleştirmesidir, hem başlangıç aşamalarında hem de bakım fazında periodontal tedavinin amacı, bağ dokusunun mümkün olan en büyük ölçüde bağlanmasını sağlayan biyolojik olarak kabul edilebilir diş yüzeyleri oluşturmaktır. Derin cepler genellikle enfleme kök yüzeyine ulaşabilmek ve enfekte dokuları uzaklaştırmak adına cerrahi müdahaleye ihtiyaç duymaktadır, açık flep debridmanı ile otolog veya sentetik rejeneratif materyallerin kullanımı daha iyi sonuç vermektedir. Trombositten zengin fibrin (TZF), çok çeşitli uygulamalara sahip yeni nesil otolog trombosit tedavisidir. Fibrin matrisi, hücresel bileşenleri ve büyüme faktörlerinin sürekli salınımı nedeniyle, TZF yara iyileşmesinde birincil veya yardımcı bir yaklaşım olarak kullanılabilir. Büyüme faktörlerinin A-TZF'den daha yavaş salınması nedeniyle L-TZF kullanıldı. Ayrıca orijinal L-TZF protokolü, A-TZF protokolünden daha büyük pıhtıların/membranların üretilmesine ve büyüme faktörlerinin daha yoğun salınmasına izin vermektedir. TZF'nin elde edilmesi kolaydır, ucuzdur ve topikal olarak veya diğer cerrahi prosedürlerle birlikte kullanılabilir. Bu vaka çalışmasında açık flep debridmanı ile birlikte TZF kullanılmış ve 2 yıllık takip sonucu bu tedavi protokolünün etkinliğini göstermiştir.

References

  • 1. De Pablo P, Chapple ILC, Buckley CD, Dietrich T. Periodontitis in systemic rheumatic diseases. Nat Rev Rheumatol. 2009;5(4):218.
  • 2. Garrett S. Periodontal regeneration around natural teeth. Ann Periodontol. 1996;1(1):621–66.
  • 3. Wang H-L, Cooke J. Periodontal regeneration techniques for treatment of periodontal diseases. Dent Clin. 2005;49(3):637–59.
  • 4. Bosshardt DD, Sculean A. Does periodontal tissue regeneration really work? Periodontol 2000. 2009;51(1):208–19.
  • 5. Hammarström L, Heijl L, Gestrelius S. Periodontal regeneration in. J Clin Periodontol. 1997;24:669–77.
  • 6. Choukroun J, Adda F, Schoeffler C, Vervelle A. Une opportunité en paro-implantologie: le PRF. Implantodontie. 2001;42(55):e62.
  • 7. Miron RJ, Choukroun J. Platelet rich fibrin in regenerative dentistry: biological background and clinical indications. John Wiley & Sons; 2017.
  • 8. Choukroun J, Diss A, Simonpieri A, Girard M-O, Schoeffler C, Dohan SL, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2006;101(3):e56–60.
  • 9. Raja VS, Naidu EM. Platelet-rich fibrin: evolution of a second-generation platelet concentrate. Indian J Dent Res. 2008;19(1):42.
  • 10. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJJ, Mouhyi J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2006;101(3):e45–50.
  • 11. Cabaro S, D’Esposito V, Gasparro R, Borriello F, Granata F, Mosca G, et al. White cell and platelet content affects the release of bioactive factors in different blood-derived scaffolds. Platelets. 2018;29(5):463–7.
  • 12. Ehrenfest DMD, Diss A, Odin G, Doglioli P, Hippolyte M-P, Charrier J-B. In vitro effects of Choukroun’s PRF (platelet-rich fibrin) on human gingival fibroblasts, dermal prekeratinocytes, preadipocytes, and maxillofacial osteoblasts in primary cultures. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2009;108(3):341–52.
  • 13. Ehrenfest DMD, Doglioli P, Giuseppe M, Del Corso M, Charrier J-B. Choukroun’s platelet-rich fibrin (PRF) stimulates in vitro proliferation and differentiation of human oral bone mesenchymal stem cell in a dose-dependent way. Arch Oral Biol. 2010;55(3):185–94.
  • 14. Toffler M, Toscano N, Holtzclaw D, Corso M Del, Ehrenfest DD. Introducing Choukroun’s platelet rich fibrin (PRF) to the reconstructive surgery milieu. J Implant Adv Clin Dent. 2009;1(6):21–30.
  • 15. Sharma A, Pradeep AR. Treatment of 3‐wall intrabony defects in patients with chronic periodontitis with autologous platelet‐rich fibrin: A randomized controlled clinical trial. J Periodontol. 2011;82(12):1705–12.
  • 16. Patel GK, Gaekwad SS, Gujjari SK, SC VK. Platelet‐rich fibrin in regeneration of intrabony defects: a randomized controlled trial. J Periodontol. 2017;88(11):1192–9.
  • 17. Christie WH, Holthuis AF. The endo-perio problem in dental practice: diagnosis and prognosis. J Can Dent Assoc. 1990;56(11):1005–11.
  • 18. Whyman RA. Endodontic-periodontic lesions. Part I: Prevalence, aetiology, and diagnosis. N Z Dent J. 1988;84(377):74–7.

Treatment of Intra-bony Defect Using Platelet Rich Fibrin: A 2 Years Follow-Up Case Report

Year 2022, Volume: 3 Issue: 2, 37 - 41, 31.12.2022

Abstract

Periodontitis is a disease that causes progressive destruction of the tooth-supporting tissues. Clinical attachment loss, radiographic alveolar bone loss, periodontal pockets, and gingival bleeding are all symptoms of periodontitis. It is a poly-microbial disease with an inflamatory burden which can lead to tooth loss in the absence of proper treatment. The gold standard treatment of periodontitis is scaling and root planning, the purpose of periodontal therapy, both during the initial phases and during maintenance stages, is to make biologically acceptable tooth surfaces through subgingival and supragingival cleaning, which enables binding of the connective tissue to the biggest extent possible. Deep pockets usually need surgical intervention to provide a sufficient and enough cleaning to the root surface, open flap debridement along with the use of regenerative materials whether it is autologous or synthetized have given better results. Platelet-rich fibrin (PRF) is a next-generation autologous platelet treatment with a wide range of applications. Because of its fibrin matrix, cellular components, and sustained release of growth factors, PRF can be used as a primary or auxiliary approach in wound healing. Also the original L-PRF protocol allowed making larger clots / membranes and a more intensive releasing of growth factors than the modified A-PRF protocol. L-PRF is easy to get, can be used topically or in combination with other surgical procedures. In this case study open flap debridement along with L-PRF had been used and a 2 years follow up result showed the effectiveness of this treatment protocol.

References

  • 1. De Pablo P, Chapple ILC, Buckley CD, Dietrich T. Periodontitis in systemic rheumatic diseases. Nat Rev Rheumatol. 2009;5(4):218.
  • 2. Garrett S. Periodontal regeneration around natural teeth. Ann Periodontol. 1996;1(1):621–66.
  • 3. Wang H-L, Cooke J. Periodontal regeneration techniques for treatment of periodontal diseases. Dent Clin. 2005;49(3):637–59.
  • 4. Bosshardt DD, Sculean A. Does periodontal tissue regeneration really work? Periodontol 2000. 2009;51(1):208–19.
  • 5. Hammarström L, Heijl L, Gestrelius S. Periodontal regeneration in. J Clin Periodontol. 1997;24:669–77.
  • 6. Choukroun J, Adda F, Schoeffler C, Vervelle A. Une opportunité en paro-implantologie: le PRF. Implantodontie. 2001;42(55):e62.
  • 7. Miron RJ, Choukroun J. Platelet rich fibrin in regenerative dentistry: biological background and clinical indications. John Wiley & Sons; 2017.
  • 8. Choukroun J, Diss A, Simonpieri A, Girard M-O, Schoeffler C, Dohan SL, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2006;101(3):e56–60.
  • 9. Raja VS, Naidu EM. Platelet-rich fibrin: evolution of a second-generation platelet concentrate. Indian J Dent Res. 2008;19(1):42.
  • 10. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJJ, Mouhyi J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2006;101(3):e45–50.
  • 11. Cabaro S, D’Esposito V, Gasparro R, Borriello F, Granata F, Mosca G, et al. White cell and platelet content affects the release of bioactive factors in different blood-derived scaffolds. Platelets. 2018;29(5):463–7.
  • 12. Ehrenfest DMD, Diss A, Odin G, Doglioli P, Hippolyte M-P, Charrier J-B. In vitro effects of Choukroun’s PRF (platelet-rich fibrin) on human gingival fibroblasts, dermal prekeratinocytes, preadipocytes, and maxillofacial osteoblasts in primary cultures. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2009;108(3):341–52.
  • 13. Ehrenfest DMD, Doglioli P, Giuseppe M, Del Corso M, Charrier J-B. Choukroun’s platelet-rich fibrin (PRF) stimulates in vitro proliferation and differentiation of human oral bone mesenchymal stem cell in a dose-dependent way. Arch Oral Biol. 2010;55(3):185–94.
  • 14. Toffler M, Toscano N, Holtzclaw D, Corso M Del, Ehrenfest DD. Introducing Choukroun’s platelet rich fibrin (PRF) to the reconstructive surgery milieu. J Implant Adv Clin Dent. 2009;1(6):21–30.
  • 15. Sharma A, Pradeep AR. Treatment of 3‐wall intrabony defects in patients with chronic periodontitis with autologous platelet‐rich fibrin: A randomized controlled clinical trial. J Periodontol. 2011;82(12):1705–12.
  • 16. Patel GK, Gaekwad SS, Gujjari SK, SC VK. Platelet‐rich fibrin in regeneration of intrabony defects: a randomized controlled trial. J Periodontol. 2017;88(11):1192–9.
  • 17. Christie WH, Holthuis AF. The endo-perio problem in dental practice: diagnosis and prognosis. J Can Dent Assoc. 1990;56(11):1005–11.
  • 18. Whyman RA. Endodontic-periodontic lesions. Part I: Prevalence, aetiology, and diagnosis. N Z Dent J. 1988;84(377):74–7.
There are 18 citations in total.

Details

Primary Language English
Subjects Endodontics, Periodontics
Journal Section Case Report
Authors

Mohammed F.a Alkhatıb This is me

Hacer Şahin Aydınyurt This is me

Nasser Shoshaa This is me

Publication Date December 31, 2022
Published in Issue Year 2022 Volume: 3 Issue: 2

Cite

APA Alkhatıb, M. F., Şahin Aydınyurt, H., & Shoshaa, N. (2022). Treatment of Intra-bony Defect Using Platelet Rich Fibrin: A 2 Years Follow-Up Case Report. Van Diş Hekimliği Dergisi, 3(2), 37-41.