Periodontology 2000最新文献

{"title":"Relationship between vitamin D deficiency and early implant failure and osseointegration","authors":"Richard J. Miron, Nathan E. Estrin, Ana Paz, Reinhard Gruber, Nima Farshidfar, Yufeng Zhang, Anton Sculean, Thomas G. Wiedemann, Paras Ahmad","doi":"10.1111/prd.70017","DOIUrl":"https://doi.org/10.1111/prd.70017","url":null,"abstract":"Background This systematic review investigated the relationship between pre‐operative vitamin D levels and implant osseointegration and implant‐related outcomes. It also assessed studies involving vitamin D supplementation before implant placement. Methods <jats:italic>In vivo</jats:italic> experimental and clinical studies published up to May 15, 2025, were reviewed. Out of 151 initially identified publications, 43 met the inclusion criteria. Results In total, 16 animal and 27 human studies were included. Most animal studies investigated vitamin D supplementation before implant placement (nine studies), whereas six studies explored vitamin D coatings on implant surfaces. Animal models included osteoporosis, diabetes mellitus, ultraviolet (UV) light deficiency, chronic kidney disease‐induced uremia, and orchiectomy. A positive effect was found for vitamin D on implant osseointegration in 13 of the 16 studies. The human studies comprised three case reports, 10 retrospective studies, three prospective case series, eight prospective controlled trials (2–4 cohorts), and three randomized clinical trials (RCTs). Collectively, 22 of the 27 human studies supported a beneficial association between adequate vitamin D levels and improved implant osseointegration or reduced early implant failure. Vitamin D deficiency was associated with up to a fourfold increase in early implant failures. Pre‐surgical supplementation with vitamin D <jats:sub>3</jats:sub> enhanced implant osseointegration, improved bone‐implant‐contact (BIC), promoted peri‐implant bone preservation, and reduced early implant failures, even among high‐risk populations (i.e., diabetics). When implant‐related parameters such as pocket depths, radiographic marginal bone levels, or implant stability were measured, significantly poorer outcomes were consistently observed in vitamin D‐deficient groups. Conclusions/Clinical Relevance Evidence from both animal and human studies strongly indicates that vitamin D deficiency impairs both new bone formation and BIC. Supplementation, particularly in patients with systemic conditions, may improve implant osseointegration outcomes. Pre‐operative screening and correction of vitamin D deficiency are recommended to optimize implant success. Additional well‐designed prospective clinical trials and RCTs are needed to further elucidate the extent of the correlation between serum vitamin D deficiency and the risk of implant failure.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"10 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145396911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term stability of soft tissue augmentative procedures at implant sites.","authors":"Lorenzo Tavelli,Shayan Barootchi,Samuel Akhondi,Edward Shih-Chang Tseng,Francisco Salvador Garcia-Valenzuela,Istvan A Urban,Hom-Lay Wang","doi":"10.1111/prd.70016","DOIUrl":"https://doi.org/10.1111/prd.70016","url":null,"abstract":"BACKGROUNDPeri-implant soft tissue phenotype plays a pivotal role in the long-term success of dental implants, influencing health, esthetic, and patient-reported outcomes. This review explores the long-term stability of soft tissue augmentation procedures at implant sites, focusing on keratinized mucosa (KM), mucosal thickness (MT), and supracrestal tissue height (STH), and investigating predictors for the stability of the soft tissue margin over time.MATERIALS AND METHODSA narrative review aiming at identifying clinical studies reporting on the long-term outcomes of soft tissue augmentation procedures at implant sites was conducted.RESULTSRobust evidence demonstrates that an inadequate soft tissue phenotype, particularly limited KM and thin MT, is associated with increased inflammation, soft tissue dehiscence, and marginal bone loss. Clinical trials and longitudinal studies show that augmentative procedures, including autogenous free gingival grafts, connective tissue grafts, and soft tissue substitutes, lead to stable outcomes in terms of soft tissue levels, volume, and esthetics. Techniques targeting MT and STH, especially through bilaminar approaches, further enhance long-term peri-implant tissue stability. Additionally, soft tissue augmentation has proven effective for managing peri-implant soft tissue dehiscences and improving papilla height, with the stability of the outcomes reported for up to 10 years.CONCLUSIONSThis review highlights the synergistic role of KM, MT, and STH in supporting peri-implant health, esthetics, and long-term tissue stability, and underscores the need for personalized treatment planning based on peri-implant phenotype. Clinical recommendations for when and how to intervene are provided based on the best available evidence.CLINICAL RELEVANCELong-term data support the importance of soft tissue augmentation in ensuring implant success, particularly in esthetically demanding zones and compromised sites.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"53 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empiric or individually targeted antimicrobial therapy. Historical perspective and current state.","authors":"Andrea Mombelli,Lindsey Edwards,Luigi Nibali","doi":"10.1111/prd.70008","DOIUrl":"https://doi.org/10.1111/prd.70008","url":null,"abstract":"BACKGROUNDCurrent periodontal treatment strategies are primarily informed by population-level data, emphasizing average patient outcomes. Adjunctive antibiotic use-typically amoxicillin combined with metronidazole-is guided by clinical markers of disease severity and progression risk. However, such broad-spectrum regimens may disrupt the oral and gut microbiota, contributing to antimicrobial resistance.AIMThis chapter evaluates the rationale for empirical versus individualized use of antimicrobial agents in periodontal therapy.MATERIALS AND METHODSA critical review of existing literature was conducted to assess the clinical efficacy and risks of empirical protocols and to explore the potential of personalized antimicrobial strategies.RESULTSEvidence from clinical trials does not consistently support superior outcomes with microbiologically or biologically guided antimicrobial therapy. The cost-effectiveness and patient benefit of such testing remain unclear. Nonetheless, variability in pathogenic profiles, microbiome dynamics, individual host responses, and pharmacological factors supports a move toward personalized therapeutic approaches. Advances in personalized medicine-utilizing genetic testing, biomarkers, and machine learning-enable integration of genomic, proteomic, and metabolomic data to inform targeted interventions, potentially improving efficacy and minimizing adverse effects.CLINICAL RELEVANCEThe future of periodontal therapy is likely to integrate population-based evidence with individualized treatment planning. This hybrid model aims to enhance clinical outcomes by combining broad evidence-based guidelines with patient-specific data, reflecting a shift toward precision medicine in clinical practice.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"71 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Missing teeth and all-cause mortality in US adults.","authors":"Paul I Eke,Liang Wei,Gina Thornton-Evans,Kurt Greenlund,Wenche S Borgnakke","doi":"10.1111/prd.12640","DOIUrl":"https://doi.org/10.1111/prd.12640","url":null,"abstract":"This study explored the associations between tooth loss and all-cause mortality among 8710 community-dwelling US adults aged ≥30 years who participated in the National Health and Nutrition Examination Surveys (NHANES) III in 1988-1994 and subsequently were linked to the 2006 National Center for Health Statistics (NCHS) public-use mortality records. At baseline, 22.3% had all 28 non-third molar teeth, 36.4% were missing 1-5 teeth, 28.0% 6-27 teeth, and 13.3 % all 28 teeth. During 12-18 (mean = 14.2) years, 2,385 participants died with 22.4% of the deceased being edentulous versus 12.7% having 28 teeth. Age-adjusted mortality rate was 29.3 (±0.6)/1000 person-years among the former versus 9.9 (±1.3) among the latter. Age-adjusted mortality was associated with edentulism, with edentate being 2.6 times (HR = 2.58; 95% CI: 1.81-3.69) more likely to have died than fully dentate, though attenuated upon further adjustment to 45% greater risk (HR = 1.45; 95% CI: 1.02-2.05). In contrast, this association between mortality and missing some, but not all teeth, was non-significant upon adjustment for all covariates. In conclusion, edentulism-but not missing <28 teeth-among US adults aged >30 years was statistically significantly associated with all-cause mortality over an average of 14.2 years later.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"108 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nitrate metabolism and periodontal health: The roles of nitric oxide in microbial killing and immunoregulation.","authors":"Bob T Rosier,George Hajishengallis,David A Wink,Alex Mira","doi":"10.1111/prd.70006","DOIUrl":"https://doi.org/10.1111/prd.70006","url":null,"abstract":"BACKGROUNDDietary nitrate, primarily sourced from vegetables, is reduced by oral bacteria to nitrite and subsequently to nitric oxide (NO), a molecule with antimicrobial and immunoregulatory properties, as well as vasodilatory and other cardiometabolic effects. Studies have shown that nitrate supplementation can lower blood pressure, reduce gingival inflammation, and lead to a shift toward microbial eubiosis in the periodontium. However, a paradox arises: nitrate and nitrite-when produced via NO synthase (NOS) activity during chronic inflammation-can serve as biomarkers of periodontitis.AIMThis narrative review aims to (1) examine the molecular mechanisms underlying the health benefits of NO, particularly those stimulated by nitrate-rich vegetable intake; and (2) explore how chronic inflammation can alter the local environment leading to nitrate and nitrite accumulation.MATERIALS AND METHODSA targeted literature search was conducted in PubMed and Google Scholar to identify articles related to NO, nitrate metabolism, inflammation, and/or periodontitis.RESULTSUnder homeostatic conditions, NO can react with bacterial iron-sulfur clusters, promoting the elimination of sensitive species, and with host soluble guanylyl cyclase (sGC), activating cGMP signaling pathways that suppress inflammation. In contrast, the inflammatory milieu of periodontitis is characterized by elevated levels of reactive oxygen species (ROS) and free heme, both of which act as NO scavengers, thereby diminishing its bioavailability. Importantly, the reaction of NO with ROS generates various reactive nitrogen species (RNS), which differ functionally from NO. These RNS can be converted into nitrate and/or nitrite (e.g., peroxynitrite, ONOO-, decomposes into nitrate), contributing to their accumulation. Additionally, oxidative stress promotes NOS uncoupling, converting NOS from a NO-producing to a ROS-producing enzyme. Furthermore, periodontitis is associated with an impaired nitrate-reduction capacity of the oral microbiota, further decreasing NO levels.CLINICAL RELEVANCEOxidative stress and reduced NO availability may drive periodontal dysbiosis and contribute to the systemic impact of periodontitis. These disease-related conditions could be mitigated through dietary interventions with nitrate-rich vegetables and adjunctive use of nitrate-reducing probiotics, which warrants further investigation.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"17 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel and emerging antimicrobial strategies in the management of oral infections.","authors":"Ozge Unlu,Nil Yakar,Alpdogan Kantarci","doi":"10.1111/prd.70015","DOIUrl":"https://doi.org/10.1111/prd.70015","url":null,"abstract":"BACKGROUNDAntibiotics marked a pivotal turning point in human civilization, enhancing social interactions and extending human life expectancy. In addition to their success in treating systemic infectious diseases, they have significantly improved periodontal treatment outcomes as an adjunct therapy. The current status of systemic antibiotics in periodontal therapy is well established. However, antibiotic-resistant bacteria emerged as a result of their overuse and misuse. It is estimated that by 2050, infections caused by multidrug-resistant bacteria could result in the deaths of 10 million people annually. Beyond promoting the expansion of resistant species, broad-spectrum antimicrobials also eliminate commensal microorganisms and disrupt the microbial balance in distant organs, both of which are essential for maintaining overall health.AIMThis narrative review acknowledges how the use of systemic antibiotics has contributed to our understanding of the role of microbial factors as therapeutic targets, presents novel and emerging technologies that will advance the field, and highlights emerging strategies aimed at eliminating oral disease-related microbial species without inducing antimicrobial resistance or causing dysbiosis in distant parts of the body.MATERIALS AND METHODSA literature search of the National Library of Medicine (MEDLINE/PubMed) database was conducted to identify publications related to new and developing antimicrobial approaches for treating oral infections without triggering antibiotic resistance or creating dysbiosis in other parts of the body.RESULTSPrevious studies suggest that targeted antimicrobials directed against oral pathobionts and locally effective antibiotics applied at disease sites are potential strategies to reduce the large-scale emergence of antimicrobial resistance and minimize microbiota disruption. Selective action is fundamental to the development of a targeted antimicrobial strategy: An ideal antimicrobial treatment should be highly specific to pathogenic microorganisms without harming the host or its commensal microbiota. In addition to targeted antibiotics and localized drug delivery systems, probiotics, antibodies, phage therapy, photodynamic therapy, and vaccination are promising approaches for addressing the issues associated with broad-spectrum antibiotics.FUTURE DIRECTIONSThe WHO has recommended a global action plan that calls for the development of novel antimicrobials or innovative therapeutic approaches for infectious diseases. New methods are required, extensive education programs should be offered worldwide, and stricter criteria for dental antibiotics should be developed using a comprehensive approach.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"28 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145288465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analgesic effects of platelet‐rich fibrin (PRF): A systematic review","authors":"Nathan E. Estrin, Troy B. Tran, Paras Ahmad, Nima Farshidfar, Georgios E. Romanos, Anton Sculean, Richard J. Miron","doi":"10.1111/prd.70014","DOIUrl":"https://doi.org/10.1111/prd.70014","url":null,"abstract":"BackgroundPlatelet‐rich fibrin (PRF), a second‐generation autologous platelet concentrate, has gained significant interest for its anti‐inflammatory and regenerative characteristics. While its role in tissue healing is well‐recognized, the analgesic potential of PRF remains under‐investigated.AimThe primary objective of this systematic review was to critically evaluate any pain‐reported outcome of PRF across all medical and dental procedures in human studies. The secondary objective was to also evaluate outcomes regarding swelling reduction with PRF and other patient‐reported outcomes such as quality of life and analgesic consumption in all included studies.MethodsA systematic search of PubMed, Scopus, Web of Science, and Google Scholar databases was performed for comparative clinical studies assessing PRF's influence on postoperative pain. Eligible studies included human clinical trials comparing PRF with non‐PRF controls, with pain‐reported outcomes as the primary outcome. Data on swelling and other patient‐reported outcomes, including analgesic use and quality of life, was also evaluated as a secondary objective; however, studies that evaluated these outcomes alone were excluded. A total of 200 comparative clinical studies were included, covering a diverse range of procedures including third molar extractions, palatal wound healing, mucogingival procedures, periodontal/bone procedures, maxillary sinus lifts, endodontic procedures, orthodontic procedures, oral lesions, alveolar osteitis, oroantral communications, medically induced osteonecrosis of the jaw, temporomandibular joint disorders, orthopedic procedures, facial surgery and aesthetics, and other fields of medicine. However, heterogeneity in PRF preparation methods and outcome measures precluded a meta‐analysis.ResultsAlmost all studies reported reduced pain levels in the PRF group compared with non‐PRF controls, with additional benefits observed in terms of swelling reduction, decreased analgesic use, and improved patient‐reported outcomes. Importantly, it was observed that procedures that tend to generate the most patient‐reported pain, such as 3rd molar extractions and autogenous soft tissue grafting from the hard palate, generally reported much lower pain scores following PRF use (72%–85% of studies) and significantly reduced postoperative analgesic use (87.5% of studies).ConclusionsThe autologous nature of PRF, along with the sustained release of bioactive factors, likely plays a vital role in modulating inflammation and promoting tissue healing, hence enhancing patient comfort and recovery. As PRF continues to gain traction in clinical practice, integrating well‐designed comparative studies with standardized outcome measures will be necessary to completely understand its therapeutic potential and inform evidence‐based guidelines regarding its application.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"25 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esthetical and patient-reported outcomes after root coverage procedures for multiple gingival recessions: A systematic review and meta-analysis.","authors":"Martina Stefanini, Ilham Mounssif, Elena Figuero, Giovanni Zucchelli, Anton Sculean, Raluca Cosgarea","doi":"10.1111/prd.70050","DOIUrl":"10.1111/prd.70050","url":null,"abstract":"<p><strong>Background: </strong>Multiple gingival recessions can lead to esthetic impairments and may require surgical root coverage. Esthetic outcome measures can be assessed from both professional and patient perspectives. Several objective and subjective outcome measures have been applied for these evaluations.</p><p><strong>Aim: </strong>To systematically review and conduct a meta-analysis of the available literature on professional esthetic assessments and patient-related outcome measures (PROMs) following surgical root coverage procedures for the treatment of multiple gingival recessions.</p><p><strong>Materials and methods: </strong>A computerized systematic search was conducted in the MEDLINE (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials databases up to May 2024 to identify eligible studies meeting the inclusion criteria.</p><p><strong>Results: </strong>A total of 32 randomized controlled trials involving 1012 patients and 3589 multiple gingival recessions were included. No case-series studies meeting the inclusion criteria were retrieved. Meta-analyses demonstrated that root coverage procedures statistically significantly improved both professionally assessed and patient-reported esthetic outcomes. The overall weighted mean Root Coverage Esthetic Score (RES) was 8.31 (95% CI: 8.11-8.50), with comparable results across coronally advanced flap (CAF) and tunnel (TUN) techniques, particularly when combined with autogenous connective tissue grafts or graft substitutes. Patient-reported esthetic satisfaction, measured primarily by visual analog scales (VAS), showed a pooled mean of 8.59 (95% CI: 8.29-8.89). Mean root coverage (MRC) reached 82.6% (95% CI: 71.3-93.9), and complete root coverage (CRC) was 62.7% (95% CI: 57.0-68.4). Statistically significant reductions in recession depth (mean difference = 2.22 mm) and gains in keratinized tissue (0.74 mm), gingival thickness (0.56 mm), and clinical attachment level (2.17 mm) were observed. Postoperative pain was low across techniques (VAS 0-10 mean: 2.67; VAS 0-100 mean: 24.34). Metaregression revealed a positive association between MRC and RES (R² = 0.345) but no significant correlation between MRC and patient esthetic perception (R² = 0.091), underscoring the divergence between clinical and patient-reported outcomes.</p><p><strong>Conclusions: </strong>The results of this systematic review and meta-analysis, focusing on multiple gingival recessions, suggest that (a) CAF and TUN with the adjunctive use of autogenous graft support esthetic improvement from both professional and patient perspectives and (b) CAF and TUN with the adjunctive use of autogenous graft or graft substitutes are effective in root coverage outcomes with a minimal postoperative morbidity.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":"21-41"},"PeriodicalIF":17.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147932432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advantages of horizontal centrifugation of platelet-rich fibrin in regenerative medicine and dentistry.","authors":"Nima Farshidfar, Karol Alí Apaza Alccayhuaman, Nathan E Estrin, Paras Ahmad, Anton Sculean, Yufeng Zhang, Richard J Miron","doi":"10.1111/prd.12625","DOIUrl":"10.1111/prd.12625","url":null,"abstract":"<p><p>The aim of this comprehensive review was to evaluate comparative studies on horizontal and fixed-angle centrifugation methods for preparing platelet-rich fibrin (PRF). Furthermore, additional studies utilizing horizontal PRF (H-PRF) were systematically investigated. This overview review article offers deeper insights into the advantages of H-PRF when compared to fixed-angle methods across a wide range of regenerative medical and dental applications. A comprehensive search was conducted in PubMed and Web of Science up to December 5, 2024. Grey literature was also searched via Google Scholar for additional relevant studies, and reference lists of eligible studies were screened for further potential inclusion. All in vitro, in vivo, and clinical studies that utilized horizontal or swing-out centrifugation to prepare solid or liquid PRF, along with their subfractions such as the buffy coat, platelet-poor plasma (PPP), or heated variants like albumin gel or albumin gel with liquid PRF (Alb-PRF) as interventions, were included in this study. A total of 75 studies were included. Thirteen studies directly compared horizontal centrifugation to fixed-angle centrifugation for producing PRF, while the remaining 62 studies were non-comparative and focused on expanding the uses and clinical applications of H-PRF. These studies spanned categories such as cell concentrations, fibrin matrix structure, growth factor release, antibacterial and anti-inflammatory properties, and regenerative applications in bone, periodontal, cartilage, skin, hair, regenerative endodontics, corneal defect repair, wound healing, and soft tissue regeneration. Of the studies comparing horizontal to fixed-angle centrifugation, 84.6% favored horizontal centrifugation, while 15.4% found no difference. None of the studies favored fixed-angle centrifugation. Additionally, more optimized methods for concentrating liquid-PRF (C-PRF) using horizontal centrifugation and extending the resorption properties of PRF-ranging from 2 to 3 weeks to membranes lasting 4 months through an albumin denaturation process were-further discussed. Based on these findings, it remains logical to utilize H-PRF in clinical practice owing to the greater superiority in results from the majority of studies. Nevertheless, further comparative clinical studies are needed to support these findings. While the current evidence is limited and further clinical trials are warranted, several studies have now indicated that horizontal centrifugation, compared to fixed-angle, results in higher cell concentrations, more uniform cell distribution, and increased growth factor release. These advantages suggest that the use of H-PRF may lead to enhanced clinical outcomes when the application of PRF is indicated. Since horizontal centrifugation can also lead to better cell separation, it should also be the preferred method for producing C-PRF and Alb-PRF for clinical applications.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":"216-267"},"PeriodicalIF":17.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-rich plasma (PRP) versus injectable platelet-rich fibrin (i-PRF): A systematic review across all fields of medicine.","authors":"Nima Farshidfar, Mohammad Amin Amiri, Nathan E Estrin, Paras Ahmad, Anton Sculean, Yufeng Zhang, Richard J Miron","doi":"10.1111/prd.12626","DOIUrl":"10.1111/prd.12626","url":null,"abstract":"<p><p>This systematic review aimed to evaluate all available evidence across all fields of medicine regarding the comparative effectiveness of platelet-rich plasma (PRP) versus injectable platelet-rich fibrin (i-PRF). A comprehensive search was conducted in PubMed, Scopus, and Web of Science up to September 30, 2024. Following a thorough screening process, studies were divided into in vitro, in vivo, and clinical studies based on their tissue/clinical indications. The initial search generated 2192 articles, of which 23 met the inclusion criteria. The findings demonstrated that i-PRF yielded higher platelet concentrations and offered a more sustained, long-term release of growth factors over time when compared to PRP. Overall, it was determined from in vitro studies that i-PRF significantly improved the activity of many cell types, including for skin, cartilage, periodontal, bone, soft tissue around dental implants, and pulp cells. In vivo outcomes also generally indicated that i-PRF outperformed PRP in cartilage and testicular regeneration. However, in orthodontic tooth movement, PRP was found to lead to superior short-term effects, while i-PRF showed more beneficial long-term effects. Clinical studies also found superior outcomes of i-PRF in skin regeneration, cartilage, and pulp regeneration. Outcomes regarding orthodontic tooth movement utilizing i-PRF or PRP remain controversial. In 72% of studies, i-PRF was found to lead to better outcomes across the various fields of medicine when compared to PRP, whereas 24% found no differences between the groups. Reasons and inconsistencies across the studies may be attributed to protocol differences and tissue types. Overall, additional clinical studies are needed with well-designed research and centrifugation protocols to better understand the regenerative potential of platelet concentrates in medicine. i-PRF offers a more sustained and prolonged release of growth factors and was favored in the majority of studies over PRP and should, therefore, be favored for the majority of medical and dental applications.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":"185-215"},"PeriodicalIF":17.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}