1. Growth factors are proteins that stimulate cellular growth, proliferation, and differentiation. They play an important role in wound healing.
2. Platelet concentrates like PRP, PRF, and CGF are autologous products prepared from centrifuged blood that contain increased levels of growth factors.
3. PRF is prepared by low-speed centrifugation without anticoagulants and provides a fibrin matrix that slowly releases growth factors over 1-2 weeks to aid healing. CGF involves higher centrifugation speeds and forms a denser fibrin network rich in growth factors.
Surgical v/s Non surgical periodontal therapy Achi Joshi
Both surgical and nonsurgical therapy produced improvement in the periodontal health.
Treatment approach was based on the comfort level of the practitioner.
In the late 60’s and continuing into the 70’s and 80’s, many series of longitudinal studies were conducted, aimed to document the immediate and most importantly long term clinical results following several types of periodontal therapy.
Vertical ridge augmentation is sometimes required for dental implant placement. The presentation looks at various conventional and newer techniques for ridge augmentation in the oral cavity.
JOURNAL CLUB ON CORONALLY ADVANCED FLAP vs THE POUCH TECHNIQUE COMBINED WITH ...Shilpa Shiv
CORONALLY ADVANCED FLAP vs THE POUCH TECHNIQUE COMBINED WITH A CONNECTIVE TISSUE GRAFT TO TREAT MILLER'S CLASS I GINGIVAL RECESSION, JCP 2014;41(4):387-395.
Platelet rich fibrin | Dental Implants with PRF | PRF In regenerative surgeri...Dr. Rajat Sachdeva
PRF is a by product of blood that is exceptionally rich in platelets.
PRF is a second generation PRP where autologous platelets and leucocytes are present in a complex fibrin matrix to accelerate the healing of soft and hard tissue and used as a tissue engineering scaffold for endodontics .
PRF has been used to accelerate the body's own healing process.
Call us regarding Dental Treatment:-
Dr. Rajat Sachdeva
+919818894041,01142464041
drrajatsachdeva@gmail.com
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Learn more:-
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
Surgical v/s Non surgical periodontal therapy Achi Joshi
Both surgical and nonsurgical therapy produced improvement in the periodontal health.
Treatment approach was based on the comfort level of the practitioner.
In the late 60’s and continuing into the 70’s and 80’s, many series of longitudinal studies were conducted, aimed to document the immediate and most importantly long term clinical results following several types of periodontal therapy.
Vertical ridge augmentation is sometimes required for dental implant placement. The presentation looks at various conventional and newer techniques for ridge augmentation in the oral cavity.
JOURNAL CLUB ON CORONALLY ADVANCED FLAP vs THE POUCH TECHNIQUE COMBINED WITH ...Shilpa Shiv
CORONALLY ADVANCED FLAP vs THE POUCH TECHNIQUE COMBINED WITH A CONNECTIVE TISSUE GRAFT TO TREAT MILLER'S CLASS I GINGIVAL RECESSION, JCP 2014;41(4):387-395.
Platelet rich fibrin | Dental Implants with PRF | PRF In regenerative surgeri...Dr. Rajat Sachdeva
PRF is a by product of blood that is exceptionally rich in platelets.
PRF is a second generation PRP where autologous platelets and leucocytes are present in a complex fibrin matrix to accelerate the healing of soft and hard tissue and used as a tissue engineering scaffold for endodontics .
PRF has been used to accelerate the body's own healing process.
Call us regarding Dental Treatment:-
Dr. Rajat Sachdeva
+919818894041,01142464041
drrajatsachdeva@gmail.com
Follow us here:-
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
Learn more:-
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
Periodontal plastic surgery is defined as the surgical procedures performed to correct deformities of the gingiva or alveolar mucosa. It includes widening of attached gingiva,
deepening of shallow vestibules, resection of the aberrant frena, depigmentation of gingiva.In all of these procedures, blood supply is the most significant concern and must be the underlying issue for all decisions regarding the individual surgical procedure.
Platelet Rich Fibrin (PRF) is an autologous fibrin based biomaterial derived from human blood discovered by Choukroun and coworkers in the year 2006. The future of PRF has enormous therapeutic implications. Therefore, more clinicians should adopt this technology for the benefit of the patients.
Role of genetics in periodontal diseasesAnushri Gupta
Terminologies in Genetics
Genetic study design
genetic syndrome and disease associated with periodontal diseases, heretibility of periodontal disease, gene library, gene therapy
"Exploring Regenerative Endodontics: A Paradigm Shift in Root Canal Therapy" aims to delve into the groundbreaking approach of regenerative endodontics, which has revolutionized traditional root canal treatments. This presentation serves as a comprehensive guide for dental professionals, researchers, and students who are keen on understanding the shift towards biologically-based procedures designed to replace damaged tooth structures, including dentin and root structures, as well as cells of the pulp-dentin complex.
Key Points Covered:
Introduction to Traditional Endodontics: A brief overview of conventional root canal treatments, setting the stage for the limitations that regenerative endodontics aims to address.
Fundamentals of Regenerative Endodontics: Understand what regenerative endodontics is, its aims, and the principles guiding this new approach.
Materials and Techniques: Discover the novel materials and technologies used in regenerative endodontics including scaffolds, growth factors, and stem cells.
Clinical Applications and Benefits: Discuss various case studies and clinical trials that demonstrate the effectiveness and benefits of regenerative procedures.
Challenges and Future Prospects: A balanced view on the hurdles facing regenerative endodontics and what the future holds.
This presentation is essential viewing for anyone interested in the future of dental science and how regenerative approaches can offer effective and more natural alternatives to traditional endodontic treatments."
Feel free to modify this description to better suit your specific needs and focus points.
Periodontal plastic surgery is defined as the surgical procedures performed to correct deformities of the gingiva or alveolar mucosa. It includes widening of attached gingiva,
deepening of shallow vestibules, resection of the aberrant frena, depigmentation of gingiva.In all of these procedures, blood supply is the most significant concern and must be the underlying issue for all decisions regarding the individual surgical procedure.
Platelet Rich Fibrin (PRF) is an autologous fibrin based biomaterial derived from human blood discovered by Choukroun and coworkers in the year 2006. The future of PRF has enormous therapeutic implications. Therefore, more clinicians should adopt this technology for the benefit of the patients.
Role of genetics in periodontal diseasesAnushri Gupta
Terminologies in Genetics
Genetic study design
genetic syndrome and disease associated with periodontal diseases, heretibility of periodontal disease, gene library, gene therapy
"Exploring Regenerative Endodontics: A Paradigm Shift in Root Canal Therapy" aims to delve into the groundbreaking approach of regenerative endodontics, which has revolutionized traditional root canal treatments. This presentation serves as a comprehensive guide for dental professionals, researchers, and students who are keen on understanding the shift towards biologically-based procedures designed to replace damaged tooth structures, including dentin and root structures, as well as cells of the pulp-dentin complex.
Key Points Covered:
Introduction to Traditional Endodontics: A brief overview of conventional root canal treatments, setting the stage for the limitations that regenerative endodontics aims to address.
Fundamentals of Regenerative Endodontics: Understand what regenerative endodontics is, its aims, and the principles guiding this new approach.
Materials and Techniques: Discover the novel materials and technologies used in regenerative endodontics including scaffolds, growth factors, and stem cells.
Clinical Applications and Benefits: Discuss various case studies and clinical trials that demonstrate the effectiveness and benefits of regenerative procedures.
Challenges and Future Prospects: A balanced view on the hurdles facing regenerative endodontics and what the future holds.
This presentation is essential viewing for anyone interested in the future of dental science and how regenerative approaches can offer effective and more natural alternatives to traditional endodontic treatments."
Feel free to modify this description to better suit your specific needs and focus points.
Platelet Rich Plasma ( PRP ) is very popular in the treatment of musculo skeletal pathologies. This ppt gives a brief introduction to platelets and in sights into developing a PRP kit.
Reprogramming to pluripotency is possible from adult cells of different tissues and species through the ectopic expression of defined factors. The generated induced Pluripotent Stem Cells (iPSCs) are relevant for various purposes, including disease modeling, drug or toxicity screening and autologous cell therapy. Over the last few years, increased efforts are being made to improve the reprogramming techniques, the efficiency and quality of the generated iPSCs, as well as to identify the best cell source to be reprogrammed. Cells derived from fetal tissues, such as amniotic fluid, placenta and umbilical cord, offer distinct advantages in terms of reprogramming compared to adult somatic cells. Importantly, fetal cells are more primitive, easily achievable in sufficient numbers and are devoid of any ethical concern. They show great plasticity, high proliferation rate, low immunogenity and absence of teratoma formation. Therefore, they can be reprogrammed much faster and more efficiently than adult cells. Here, we provide a comprehensive overview of the advantages of reprogramming fetal sources in comparison to other commonly used cell types.
Platelet rich fibrin: an autologous bioactive membraneApollo Hospitals
Platelet-Rich Fibrin (PRF) is a new second-generation platelet concentrate, with simplified processing, and no biochemical blood handling. It has several advantages over traditionally prepared PRP, which has been widely used for accelerating soft tissue and hard tissue healing for years. Strictly autologous preparation, the amount of PRF obtained is limited, includes its disadvantages. Choukroun’s PRF incorporates leucocytes, platelets and a wide range of healing proteins within a dense fibrin matrix. It is a natural bioactive membrane, which can enhance soft/hard tissue healing, at the same time, can also protect surgical sites, grafted materials from external aggressions. This article describes the evolution of this second-generation platelet concentrate and its multiple uses in various surgical procedures.
Platelet-Rich Fibrin (PRF) is a new second-generation platelet concentrate, with simplified processing, and no biochemical blood handling. It has several advantages over traditionally prepared PRP, which has been widely used for accelerating soft tissue and hard tissue healing for years. Strictly autologous preparation, the amount of PRF obtained is limited, includes its disadvantages. Choukroun's PRF incorporates leucocytes, platelets and a wide range of healing proteins within a dense fibrin matrix. It is a natural bioactive membrane, which can enhance soft/hard tissue healing, at the same time, can also protect surgical sites, grafted materials from external aggressions. This article describes the evolution of this second-generation platelet concentrate and its multiple uses in various surgical procedures.
The Effects of Genetic Alteration on Reprogramming of Fibroblasts into Induc...remedypublications2
Induced Pluripotent Stem Cells (iPSCs) can be generated from somatic cells by ectopic expression of
Yamanaka factors (
Oct4
,
Sox2
,
Klf4
and
c-Myc
) or combination of other factors. Genetic alteration
of fibroblasts exhibits an effect on reprogramming efficiency through multiple signaling pathways,
including epigenetic modifications, metabolic shifts, Mesenchymal-To-Epithelial Transition
(MET) and cell proliferation. In order to better understand the underlying mechanisms in cell fate
determination, in this review we will summarize several genetic alterations involved in the regulation
of reprogramming fibroblasts into iPSCs.
Platelet Rich Fibrin (PRF) in Dentistry, What is PRF ? , What are the difference between PRP,PRGF and PRF ?, Preparation of PRF , shapes of PRF, Role of PRF in wound healing, APPLICATIONS OF PRF, Applications of PRF In Oral and Maxillofacial Surgery, Applications of PRF In Periodontics, Applications of PRF In Endodontics, Applications of PRF In Tissue Engineering
Femoral Head Bone vs Acetabular Subchondral Bone: Selecting the Optimal Anat...remedypublications2
Mesenchymal Stromal Cells (MSC) have a great importance for the field of regenerative
medicine. However, there is high variability in existing protocols for MSC
in vitro
expansion, which
can lead to low reproducibility of pre-clinical studies and, even more critically, the reduced safety
of patients undergoing clinical trials. Although bone marrow is one of the most important sources
for the isolation and
in vitro
culture of MSC, the preferred anatomical location for obtaining bone
marrow is often unclear, and this information is relevant for the interpretation of results obtained
from preclinical and clinical trials.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
2. Introduction
FDA approved growth factors
Platelet Concentrate( 1st , 2 nd, 3th and 4 th generation)
Applications of Growth Factors
Different cases application
Growth Factor Classification
Conclusions
ILOS:
• When ,Where To decide?
• How to use in proper
way?
• What you can do in
complex augmentation
cases?
• What are the precaution
3. Growth factors
Transferring information
between cell populations
&their
micro-environment
Acting as signaling
molecules between cells
Introduction Polypeptide proteins that enable
and lead different cellular
processes
4. When tissue undergo trauma,
Growth factors are released either from cells or extracellular matrix
19. 1st Generation (Platelet Rich Plasma)
• Whitman and Marx et al. in 1998
• two-steps centrifugation process
• anti-coagulant using EDTA, acid citrate dextrose (ACD)
or bovine thrombin
1st step : (Soft Spin) of centrifugation
(300g for 5 min at 12°C or 240g for 8 min at 16°C),
three layers are demarcated: red blood cells (RBCs)
on the bottom, middle layer that contains platelets
and leukocyte and platelet poor plasma (PPP) plasma
on top
Whitman DH, Berry RL, Green DM.Platelet gel: an autologous alternative to fbrin glue with applications in oral and maxillofacial surgery. Journal of oral and
maxillofacial surgery. 1997;55(11):1294–9.
Marx RE, Carlson ER, Eichstaedt RM,Schimmele SR, Strauss JE, Georgeff KR. Platelet-rich plasma: growth factorenhancement for bone grafts. Oral
Surgery,Oral Medicine, Oral Pathology, OralRadiology, and Endodontology. 1998;85(6):638–46.
20. 2nd step : PPP and middle layerare
transferred to another tube then centrifugedfor
a second time (Hard Spin) to ensure proper
plasma separation
Modifications
21. Comparing the efficacy of dual Platelet-Rich Plasma (PRP) and Hyaluronic Acid
(HA) therapy with PRP-alone therapy in the treatment of knee osteoarthritis: a
systematic review and meta-analysis
•Angeline Ai Ling Aw, ,Jun Jie Leeu, , Xinyu Tao & Hamid Rahmatullah Bin Abd Razak (2021)
22.
23. Clinical application
- PRP in skin lesions and wound healing
- Dermatological and autoimmune conditions
- genital fistulae
- premature ovarian failure implantation process, including
embryo quality, endometrial receptivity aesthetic
reconstruction
- Hair Loss
24. PRP Drawbacks
⮚the several handling steps (1 hr) … not suitable for clinicalwork
⮚Adding anticoagulant .. Unnatural, retard healing, crossinfection
⮚Liquid … Not suitable to be combined with graft likeother
generations
⮚Higher centrifugation forces leads to fragmented platelets and
decrease enrichment
⮚the lack of standardized protocol …different centrifugation
devices and tubes
25. Magalon J, Chateau AL, Bertrand B, Louis ML, Silvestre A, Giraudo L, et al. DEPA classification: a proposal for
standardising PRP use and a retrospective application of available devices. BMJ Open Sport Exerc Med. 2016
DEPA Classification (2016)
D dose of injected platelets
E efficiency of production
P purity of the PRP
Aactivation of the PRP
28. 2nd generation (PRF) by Choukroun et al 2001
1 No adding anticoagulant
2 More easy and simple processing technique
Technique
• 10 ml tube (approximately 400 g) which is
immediately centrifuged at 3,000 round per
minute (rpm) for 10 minutes.
29.
30. Miron RJ, Bosshardt DD. OsteoMacs: Keyplayers around bone biomaterials. Biomaterials. 2016;82:1–19
33. 1st Case of PRF
- Lyell syndrome (Toxic epidermal necrolysis) with repeated
failed antibiotic treatment
-Over the years, science has shown that
infection was often a secondary problem to
poor blood supply
-The idea was that by introducing supra-
physiological doses of growth factors from
blood, one could potentially re-introduce blood
flow into these tissues
Concept
35. PRF Advantages
1. Easy to prepare and use
2. No biochemical modification
3. Cost effective process
4.An immune organizing node … High cytokines content … Accelerates the
healing process …. Helps in hemostasis
7. Elasticity and flexibility due to three dimensional structure of PRF membrane
8. Reservoir of natural GF release over 10-14 days ... GF trapped inside matrix
9. Contain (extremely) low conc. of stem cells
Marx RE. Platelet-rich plasma: evidence to support its use. Journal of oral and maxillofacial surgery : ofcial journal of the American Association of Oral and
Maxillofacial Surgeons. 2004;62(4):489–96.
Kobayashi E, Fluckiger L,Fujioka-Kobayashi M, Sawada K, Sculean A, Schaller B, et al. Comparative release of growth factors from PRP, PRF, and advanced-PRF.
Clinical oral investigations. 2016.
36. PRF Advantages
1.Easy to prepare and use
2.No biochemical modification
3.Cost effective process
4. Reservoir of natural GF release over 10-14 days ... GF
trapped inside matrix
Marx RE. Platelet-rich plasma: evidence to support its use. Journal of oral and maxillofacial surgery : ofcial journal of the American Association of Oral and Maxillofacial Surgeons. 2004;62(4):489–
96. Kobayashi E, Fluckiger L,Fujioka-Kobayashi M, Sawada K, Sculean A, Schaller B, et al. Comparative release of growth factors from PRP, PRF, and advanced-PRF.
Clinical oral investigations. 2016.
37. PRF Advantages
5. High cytokines content … Acceleratesthe healing
process …. Helps in hemostasis
6. Elasticity, flexibility and strength due to three-dimensional
structure of
7. Contain (extremely) low conc. of stem cells
Marx RE. Platelet-rich plasma: evidence to support its use. Journal of oral and maxillofacial surgery : ofcial journal of the American Association of Oral and Maxillofacial Surgeons. 2004;62(4):489–
96.Kobayashi E, Fluckiger L,Fujioka-Kobayashi M, Sawada K, Sculean A, Schaller B, et al. Comparative release of growth factors from PRP, PRF, and advanced-PRF.
Clinical oral investigations. 2016.
38. 1. PRF is totally specific to the donor??
2. Should be used immediately
3. Has dense structure (A-PRF) *******
4.Less amount of leukocytes, uneventful
distribution **** of leucocytes (L-PRF)
5. Cannot be injected (i-PRF) *****
PRF Disadvantages
Kubesch A, Barbeck M, Orlowska A, Booms P, Al-Maawi S, Sader RA, Kirkpatrick CJ, Choukroun J, Ghanaati S. Pre-clinical in vivo evaluation of
Platelet-rich fbrin (PRF) scaffolds: G-force reduction in advanced platelet-rich fbrin (A-PRF) scaffolds increases scaffold integration and
vascularization: First pre-clinical in vivo evaluation, (n.d.)JMSM, submitted.
39. LYMPHOCYTE
Stem Cells
Neutrophile
B lymphocyteCells
Monocyte
Platelets
LYMPHOCYTE
Monocyte
Kubesch A, Barbeck M, Orlowska A, Booms P, Al-Maawi S, Sader RA, Kirkpatrick CJ, Choukroun J, Ghanaati S. Pre-clinical in vivo evaluation of
Platelet-rich fbrin (PRF) scaffolds: G-force reduction in advanced platelet-rich fbrin (A-PRF) scaffolds increases scaffold integration and
vascularization: First pre-clinical in vivo evaluation, (n.d.)JMSM, submitted.
40. PRF LIMITATIONS
1- Adequate sample according to needs.
2. Time gap between sample taking and
centrifuge is a critical point
3. Should be prepared and used immediately.
41. Too High Centrifugation speed pushing
leukocytes down to the bottom of
centrifuge tubes and away from PRF
matrix
Redistibute leuckocytes across the
entire matrix we need to decrease
cell bull down.
(the Low Speed Centrifugation Concept)
(LSCC)
42. The low-speed centrifugation concept (LSCC)
reducing the relevant centrifugation force (RCF) advances PRF matrices
with an enhanced number of inflammatory cells and platelets
Increase of of macrophages
and leukocytes contained
within PRF
a. Secretion of a wide range
of growth factors.
b. Tissue wound healing.
c. New blood vessel
formation.
43. 1- L-PRF
- 2700 rpm for 12 min
- Quick collection (less than 20 sec)
- abundant amount of leukocytes and PC
-(97% PC and 50 % leukocytes)
PRF Modifications
Anti infectious action secrete iL1B,iL6, iL4, TNF alpha
Regulator controlling ability for biomaterials to adapt to new
host.
44. 2- A-PRF
- 1300 rpm for 14 min
- High amount of
macrophages
- Slowly release GF
- More porous
- Eventual distribution of
leukocytes
Ghanaati S, Booms P, Orlowska A, Kubesch A, Lorenz J, Rutkowski J, Landes C, Sader R, Kirkpatrick C, Choukroun J. Advanced Platelet-Rich Fibrin: A
New Concept for Cell-Based Tissue Engineering by Means of Inflammatory Cells, J. Oral Implantol. 2014;40:679–89
45. =
=
=
=
=
=
Kubesch A, Barbeck M, Orlowska A, Booms P, Al-Maawi S, Sader RA, Kirkpatrick CJ, Choukroun J, Ghanaati S. Pre-clinical in vivo evaluation of
Platelet-rich fbrin (PRF) scaffolds: G-force reduction in advanced platelet-rich fbrin (A-PRF) scaffolds increases scaffold integration and
vascularization: First pre-clinical in vivo evaluation, (n.d.)JMSM, submitted.
46. 3- A-PRF +
- Which is not only lower centrifugation speed (1300 rpm) but also time
(8min) has been shown to increase growth factor release of TGF-beta1,
PDGF-AA, PDGF-AB, PDGFBB, VEGF, IGF, and EGF
Fujioka-Kobayashi M, Miron RJ, Hernandez M, Kandalam U, Zhang Y, Choukroun J. Optimized Platelet Rich Fibrin With the Low Speed Concept: Growth Factor
Release, Biocompatibility and Cellular Response. J Periodontol. 2017;88(1):112–121. Epub 2016 Sep 2.
47. 4- i-PRF
- 700 rpm for 3 min (60 gm)
- must be utilized within 15 min.
- Plain vacuum tube
- High amount of macrophages
- injectable
48.
49. Kobayashi E, Fluckiger L,Fujioka-Kobayashi M, Sawada K, Sculean A, Schaller B, et al. Comparative release of growth factors from PRP, PRF, and advanced-PRF.
Clinical oral investigations.2016.
50. • Miron RJ, Fujioka-Kobayashi M, Hernandez M, Kandalam U, Zhang Y, Ghanaati S, Choukroun J. Injectable platelet rich fbrin (i-PRF):
opportunities in regenerative dentistry? Clin Oral Investig. 2017 Feb 2. doi: 10.1007/ s00784-017-2063-9.
51. • sinus lift procedures Zhang et al., 2012
• socket augmentation Hauser et al., 2013
• Furcation treatment Sambhav et al., 2014
• Intrabony defects Mathur et la., 2015
• Gingival recession Aroca et al., 2009
• alveolar bone defect for implant installation
• filling of cystic cavity
PRF Uses
53. Fibrin rich blocks that are much larger, denser and richer
in growth factors. This exhibits better regenerative capacity
and higher versatility when using the fibrin richblock
3rd generation (CGF) by Sacco et al 2006
54. Advantage over PRF
✔higher tensile strength,
✔more growth factors,
✔higher viscosity
✔higher adhesive strength than PRF.
✔Furthermore, part of CGFs can be mixed with bone graft to form
sticky bone ,The Sticky bone provides stabilization of bone
graft in the defect and therefore, accelerates tissue healing and
minimizes bone loss during healing period
55. Hideo Masuki1†, Toshimitsu Okudera1†, Taisuke Watanebe1
, Growth factor and pro-inflammatory cytokine contents in
platelet-rich plasma (PRP), plasma rich in growth factors
(PRGF), advanced platelet-rich fibrin (A-PRF), and
concentrated growth factors (CGF) 2016
Both A-PRF and CGF extracts
contained compatible or higher
levels of platelets and platelet-
derived growth factors
56. • LUIGI FABRIZIO RODELLA,1 LUIGI SACCO,3 TIZIANO BATANI,4 AND RITA REZZANI growth factors, CD34 positive
cells, and fibrin network analysis in concentrated growth factors fraction 2011
Fibrin network (A) in which are trapped multiple platelet cell elements
57.
58. Uses
• sinus augmentation Sohn et al. 2015
• reconstruction of bone defects after removal of large jawcysts
Mirković et al 2015
• ridge augmentation Gheno et al.,
• socket preservation Ayoub et al., 2017
• treatment of gingival recession Doğan et al., 2016
• treatment of intra-bony defects ☺
61. 3rd generation (CGF) Sacco in 2006
• is produced by the centrifugation of venous blood as
same as PRF. However, the technique is different on
centrifugation speed.
• fibrin rich blocks that are much larger, denser and richer
in growth factors.
• This exhibits better regenerative capacity and higher
versatility when using the fibrin rich block
64. Advantage over PRF
✔ease ofpreparation,
✔ ease of application,
✔minimal expense, and
✔ lack of biochemical modification (no bovine thrombin or
_____anticoagulant is required).
✔ It can also serve as a resorbable interpositional membrane which is
not present in PRP preparations
65. Advantage over PRF
✔higher tensile strength,
✔more growth factors,
✔higher viscosity and
✔higher adhesive strength than PRF.
✔Furthermore, part of CGFs can be mixed with bone
graft to form sticky bone ,The sticky bone provides
stabilization of bone graft in the defect and therefore,
accelerates tissue healing and minimizes bone loss
during healing period
66.
67.
68. Uses
• sinus augmentation Sohn et al. 2015
• reconstruction of bone defects after removal of large jaw cysts
Mirković et al 2015
• ridge augmentation Gheno et al.,
• socket preservation Ayoub et al., 2017
• treatment of gingival recession Doğan et al., 2016
• treatment of intra-bony defects ☺
70. Types of growth factors
• Fibroblast Growth Factor (FGF):
- chemo-attractants for endothelial cells as well as for a variety of mesenchymal cells
including: fibroblasts, osteoblasts, chondrocytes, skeletal myoblasts and smooth muscle cells.
• Insulin-like Growth Factors (IGFs):
- increase DNA synthesis in osteoblastsand stimulated the formation of bone matrix
71. • Platelet- derived Growth Factors (PDGF):
- chemoattractant for fibroblasts and inflammatory cells and in addition it
stimulates production of matrix components.
• Transforming Growth Factor (TGF):
-have been shown to affect bone metabolism through modulation of both osteoclastic
and osteoblastic cell differentiation and activity.
•Bone morphogenic proteins (BMPs):
-multi-functionalgrowth factors.
-periodontal regeneration.
•Epithelial Growth Factor (EGF):
-promote re-epithelialization andwound healing.
72.
73.
74. •The active component of INFUSE Bone Graft
- rhBMP-2- is a recombinantly-
produced form of a signaling protein naturally occurring in the
human body.
•Mesenchymal stem cells proliferate, or increase rapidly in
number, at the site due to
Presence of rhBMP-2, supported by increased angiogenesis
at the site.
75. INFUSE Bone Graft:
received approval for use in
sinus augmentation and
for localized ridge
augmentation for defects
associated with extraction
sockets.
1965:
Dr. Marshall R. Urist
discovers
That
demineralized bone
matrix
stimulates the formation of
new bone tissue
in lower-order animal muscle.
This led to :
The isolation of bone
morphogenetic proteins
(BMPs), the only proteins
known to induce new bone
formation(osteoinduction).
2002:
INFUSE Bone
Graft :
received
approval for use
in anterior
lumbar spine
fusion with
Medtronic
titanium
threaded
interbody
devices.
2004:
INFUSE Bone
Graft:
received approval
for use in open
tibial fractures with
intramedullary (IM)
nail fixation.
2007:
76. •Reasons to consider INFUSE Bone Graft:
•Eliminates the need for a second bone harvest surgery.
•Regenerates 100% vital, vascular de novo bone with no residual graft
material remaining to destabilize bone formation.
• complex augmentation cases.
•Supported by over 20 years of research and clinical results,
including 60 preclinical studies and 5 clinical trials.
77. •Important Information about INFUSE® Bone Graft:
•The potential for prolonged swelling may occur in some (but not
all) patients. This is most likely due to:The influx of the patient’s own
cells and fluids into the treatment site.
•INFUSE Bone Graft has not been studied in patient who are
skeletally immature (<18 years of age) or no radiographic
evidence of epiphyseal closure.)
78. •INFUSE Bone Graft should not be used in patients with an active
infection at the operative site.
•INFUSE Bone Graft should not be used in the vicinity of a resected or
extant tumor, in patients with any active malignancy or patients
undergoing treatment for malignancy.
•This product has not been tested in pregnant women to determine if it
could harm a developing fetus. This product has also not been studied
in nursing mothers.
79. Women of childbearing age should not become pregnant
for one year following treatment with the product. Women
of childbearing age should be warned of potential risks to
a fetus and should discuss other possible treatments with
their doctor.
80.
81.
82. i-FACTOR BIOLOGIC BONE GRAFT
P-15/ABM has been in
human clinical use for
more than 17 years in an
estimated 500,000
patients worldwide
83. i-FACTOR technology is based on the biological activity of a 15 amino acid peptide naturally
found in Type I human collagen. The only bone graft that combines a unique anorganic bone
ABM particles are a natural form of hydroxyapatite [Ca10(PO4 ) 6 OH2] mineral (ABM) particles
are a natural form of hydroxyapatite [Ca10(PO4 ) 6 OH2]
SYNTHETIC REPLICATE OF P-15
84. 1
ATTRACT
P-15 facilitates and
expedites ingrowth of bone
by promoting the
immigration of reparative
cells from the surrounding
tissues.
ATTACH
2
The high affinity between cells and
P-15 supports the physiological
mechanism in which cells bind to
collagen via the domain simulated
by P-15 and continue to organize
the matrix by tractional forces. Cells
attach to and migrate on Type I
collagen by haptotactic
mechanisms.
ACTIVATE
P-15 enhances bone formation by
facilitating cellular attachment with
subsequent increase in cell binding,
proliferation, and differentiation of
cells increasing TGFb-1, BMP-2, and
BMP-7 levels that positively
influence all processes of new bone
formation.
3
91. Emdogain is a biological product consisting of a
unique group of proteins that are found in
developing teeth( enamel matrix derivative) an
extract of porcine fetal tooth
Amelogenin: The Dominant Protein in
Emdogain
92. • Act in a process mimics normal root
development by stimulating release
of autocrine growth factors from periodontal
ligament undifferentiated mesenchymal cells.
• EMD also, stimulates osteoprotegerin, serving to
trigger osteoblasts and indirectly inhibit both
osteoclastogenesis and osteoclastic function,
both of which are important in attaining alveolar
bone growth in the area of desired regeneration.
94. 1 million viable cells/cc, 100%
Mesenchymal Stem Cells and/or
Osteoprogenitor Cells*
Higher amounts of BMPs-2
and BMPS-7
95.
96.
97. CBMs on the Market
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
2005 2020
Osteocel
TrinityMatrix™
TrinityEvolution™
Osteocel Plus
Cellentra
TrinityELITE™
Ovation OS
Osteocel Pro
PrimaGen
OsteoVive
V92
ViaGraft
ViviGen
Bio4
map3
BioFuse
ViaCell
Orios
AlloFuse SelectCM
ViviGenFormable
ViBone
Scylla
FiberCel
All third party trademarks used herein are the
trademarks of their respective owners.