Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery


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1. Introduction

The PRF serves as a fibrin matrix [ 9 ], conducts an important mechanical role by supporting the graft particles as well as promotes cellular migration facilitating, neo-angiogenesis [ 10 ], responsible for the viability of the graft [ 11 - 13 ]. It is a simplified, cost effective process which does not require blood handling and usage of anticoagulants. Because of slow polymerization and more potent migration and proliferation of cells, a commendatory healing is obtained with PRF.

In response to tissue injury, platelets gets activated resulting in the formation of platelet plug with subsequent hemostasis. Wound healing is initiated by the release of alpha granules in platelets that contains growth factors Platelet derived growth factor, platelet factor 4, angiopoietins and thrombospondin 1 which promotes proliferation and differentiation at cellular level. Growth factors released from platelets also participate in collagen synthesis, providing a scaffold for migration of osteoblasts [ 15 ].

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Quantity of platelets in any wound determines the quality of healing and platelet rich blood products increases that initial number. Skin and mucosal abrasions: All the platelet rich blood products are effectively used for soft tissue regeneration in the field of dentistry. Face being a highly aesthetic zone, the complexities in healing after any intervention poses a great challenge to the surgeon. Scar formation is one of the most undesirable outcomes of the healing process.

Early primary closure helps minimizes. Any wound gets covered with a blood clot which is a focal point of initiating healing. This increased concentration of platelets can be utilized for the purpose of regeneration.

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Journal of Lancaster General Health - Platelet-rich Plasma

PRF is preferred in soft tissue regeneration over PRP as an additional benefit of fibrin membrane that collects platelet concentrate is obtained. Although cytokines holds an importance, presence of fibrin meshwork of PRF enacts as the determining element responsible for its potential [ 16 ]. The PRF membranes assists in wound repair neither by primary intention nor by pure secondary intention, thus termed as modified secondary intention healing [ 17 ].

Platelet gels can also be used as a reliable and potent healing tool in the management of skin and mucosal ulcers [ 18 ]. Hom et al. Periodontal defects regeneration: Platelet rich products display an effective effect in the regeneration of periodontium. Satisfactory results have been obtained by its use in cases of gingival recession and loss of clinical attachment level [ 20 , 21 ]. It has been proposed by Garg et al.

Platelet rich fibrin is also widely used in root coverage procedures [ 23 ] in mandibular anteriors in combination with flaps. It helps in re-establishing the continuity and integrity of the zone of keratinized gingiva and protects the surgical site, promoting soft tissue healing.

Introduction

Jankovic et al. Augmentation of facial tissues: Platelet rich products along with the adipose tissues are used for the 3-dimensional augmentation of face. Adipocyte grafts can alone be used for this purpose, but the incorporation of these products to the fat mass allows for improved graft vascularization [ 25 , 26 ].

A wide range of bone grafts is available which are in constant use from last few decades. Independent use of blood products or in combination with bone grafts has been reported in various literatures to be a great success in terms of hard tissue regeneration.


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  • Table 1. Miscellaneous clinical applications for PRP?

Various conditions include periodontal intrabony defects [ 27 ], mandibular fractures [ 28 ]. Extraction sockets [ 29 ], maxillary sinus augmentation [ 30 , 31 ], ridge augmentation [ 32 ], restoration of mandibular continuity along with autologous iliac crest bone [ 33 ], and in treatment of periapical defects [ 34 ].

Anand et al. PRP when coated on an implant surface forms a surface which bears potential biological activity.

In , Anitua showed that the osseointegration of implants was enhanced by coating the implant surface with PRP prior to insertion into the alveolus [ 36 ]. The use of PRP has also been proposed in the treatment of cartilage degeneration of TMJ in early stages of osteoarthritis [ 37 ].

INTRODUCTION

Other than these, PRP has been effectively used as an adjunct to the medicinal treatment of various osseous pathologies like osteoporosis, bone metastasis, associated with solid tumors and multiple myeloma, malignant hypercalcemia where drugs like bisphosphonates BPs are indicated however this drug holds a major disadvantage of causing osteonecrosis [ 38 , 39 ].

The incorporation of PRP in such conditions helps in rejuvenation of bone by the help of its growth factors [ 40 ]. Platelet gels has also shown successful reconstructive result in the post-resection cases of jaws, alveolar clefts and established fistulas within maxillofacial region [ 41 ]. James et al.

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PPP being rich in fibrinogen is advantageous to use as a sealant for hemostasis. The same effects can be achieved by Platelet gels and thus can be used alternatively. Art of Tisseeling. Historical background application techniques and indication of fibrin sealing in modern surgery. Vienna: Immuno AG; Wittkampf AR.

Fibrin glue as cement for HA-granules. J Craniomaxillofac Surg ; Demonstration of fibronectin as a major extracellular protein of human fibroblast. J Dent Res ; The use of fibrin sealant in periodontal surgery.

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Clinical and histologic evaluation. In: Schalag G, Redl H, editors. Springer Verlag; Maxillofacial and Dental surgery. In: Schlag G, Real H, editors. Berlin: Spinger - Verlag; Fibrin and fibronectin sealing system in a guided tissue regeneration procedure.


  1. Oral Surgery Books Collection | Medical Yukti.
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  4. On the use of a bioligic sealing system in periodontal therapy. Int J Periodontics Restorative Dent ; Preliminary observation on the use of a biologic sealing system in periodontal surgery. Seelich T. Head Neck Pathol ; Human fibrin glue versus sutures in periodontal surgery. The use of fibrin adhesive in dental practice. In: Sahlag G, Redl H, editors.

    Efficacy of Blood and Its Products-boon for Oral Surgeons: Review

    Berlin: Springer Verlag; This article has been cited by. Search Pubmed for Manimegalai A G. Related articles Fibrin adhesive sealant hemostasis mucogingival surgery periodontal flap surgery.

    Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery
    Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery
    Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery
    Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery
    Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery
    Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery
    Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery
    Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery
    Fibrin Sealant in Operative Medicine: Volume 4 Plastic Surgery — Maxillofacial and Dental Surgery

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