Evaluation of the Effectiveness of Using Platelet Rich Fibrin (PRF) With Bone Graft in the Reconstruction of Alveolar Cleft, A Prospective Study

Abstract

Clefts of the lip, alveolus, and palate are the most common congenital malformation of the orofacial region. Bone grafting of the alveolar cleft is necessary for rehabilitation of oral function. Platelet rich fibrin (PRF), an autologous fibrin matrix is a secondgeneration platelet concentrate that has a positive effect on bone healing.Aim of the Study: The aim of this prospective study is to investigate and evaluate the quality and quantity of the bone graft that mixed with PRF when used in reconstruction of alveolar cleft in terms of bone density and resorption rate of the bone graft. Materials and Methods: Sixteen patients with unilateral alveolar clefts were treated. The control group received bone grafts without PRF, while the remaining patients comprised the PRF group and received grafts with PRF. Postoperative bone graft density and rate of bone resorption were assessed by CBCT at 1 month and 6 months after surgery Results: Satisfactory bone bridging formation was observed in all patients and the mean of bone resorption in PRF group within 6 months after surgery lower than control group. The bone density of the PRF group was lower than that of the control group at 1 st month, which later after 6 months increased to be more than the control group. Conclusions: Platelet rich fibrin that mixed with autogenous bone graft was significantly reduce postoperative bone resorption. PRF may provide a higher bone density in the long postoperative course.

Manejo quirúrgico del injerto alveolar en pacientes con fisura alveolopalatina en las gestiones 2011 a 2021, Sucre-Bolivia

“…El plasma rico en fibrina (PRF) es una matriz de fibrina autóloga, un concentrado de plaquetas de segunda generación que ayuda mucho en la reparación ósea. 7 Según últimos estudios, el plasma rico en fibrina (PRF) con sus factores de crecimiento osteoinductivos y osteoconductivos mejoran en forma importante la reparación ósea de la FAP. 8 En la presente investigación, se muestra la experiencia a lo largo de 10 años en el manejo de la cirugía de injertos alveolares para la fisura alveolopalatina, a través de los procedimientos quirúrgicos.…”

A New Technique of Two Iliac Cortical Bone Blocks Sandwich Technique for Secondary Alveolar Bone Grafting in Cleft Lip and Palate Patients

“…PRF-mixed particulate autogenous bone graft was used in the treatment of bone defects. Some studies demonstrated that PRF increase new bone formation and has a positive effect on early bone healing [20,29,30]. Based on PRP and PRF, Florian N. et al developed a new material termed mineralized plasmatic matrix (MPM), which contains platelets and fibrin concentrate in a liquid state; these materials can become bound to bone particles.…”

From Blood to Bone—The Osteogenic Activity of L-PRF Membranes on the Ex Vivo Embryonic Chick Femur Development Model

“…Moreover, the use of bone grafts alone requires a long healing process, which may lead to some rate of relapse (bone resorption can reach up to 40%), compromising the clinical outcome and increasing the need for reintervention [1,4]. Thus, more recently, the concomitant use of natural-or synthetic-derived growth factors has been proposed to enhance the biological response, namely, by increasing the bone healing [5,6].…”

“…Rexhepi et al found that L-PRF or collagen membrane combined with inorganic bovine bone graft presented a similar effect on clinical attachment level in the treatment of infrabony defects, but L-PRF showed more radiographic defect bone level gain [18]. Al-Mahdi et al evaluated sixteen patients and reported that the L-PRF group (L-PRF mixed with an autogenous bone graft) increased bone density after 6 months and significantly reduced postoperative bone resorption compared with the control group [6]. Conversely, Omidkhoda et al showed no significant differences in the density and height of maxillary alveolar cleft reconstruction at three months with L-PRF [16].…”

“…These distinct findings may be due to the lack of standardization across the studies regarding the protocol of L-PRF preparation, outcome measurement methods (two or three dimensional image diagnostic tool or unit of measurement-cubic centimeter or percentage of newly formed bone) and follow-up times (which varies from days to months). On the other hand, it must be pointed out that the current evidence comes from in vitro, in vivo and clinical studies with small sample sizes [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Thus, the heterogeneous results present in the literature reinforce the need for an experimental approach with a representative model to validate the potential effects of L-PRF-mediated osteogenic modulation.…”