Dr.Hussein Ali Almomani Assistant Professor, petra University, Jordan, Dr.Adnan Habib,Associate Professor, Endodontist, Dean of faculty of dentistry in Mary University / Syria, Dr Mohammed Ali El Maaytah Head of Oral & Maxillofacial Surgery, Oral Medicine, periodontology and Radiology Departments, Associate Professor Vice Dean of Dental School for Academic and Administrative Affairs
Member of the University of Petra.
Platelet-rich plasma (PRP) has the ability to enhance tissue regeneration and accelerate wound healing by inducing stem cell differentiation through its growth factors (GFs). It is widely used in various surgical fields including maxillofacial surgery.
PRP has been used as first-generation since PRP has the ability to enhance tissue regeneration and accelerate wound healing by inducing stem cell differentiation through its growth factors. A second-generation platelet concentrates to address the drawbacks of PRP. The platelet-rich fibrin (PRF)preparation could be done with minimal experience because it is a simple single step not, as PRP, that requires a two-step centrifugation, purification and coagulant addition. Through its inherent growth factors, PRF has been proven to improve the regeneration of dental soft and hard tissues. Concentrated growth factors (CGF), a third-generation platelet concentrate, were reported to have an advantage over PRP and PRF in terms of cell proliferation and osteoblastic differentiation, as well as a higher growth factor concentration.
Mineral trioxide aggregate (MTA) is a unique material and is one of the most multipurpose materials in last decades in the field of dentistry particularity in endodontic. MTA was developed by Mohmoud Torabinejad at Loma Linda University, California,USA in 1993.
Several in-vitro and in-vivo studies have shown hopeful results when MTA used as an endodontic material. It was primarily recommended as repair material for root perforations. It was then widely used as a root-end filling material and in direct pulp capping and pulpotomy of immature teeth with vital pulps (apexogenesis). and as an apical barrier in the treatment of teeth with opened apices and necrotic pulps (apexification) or coronal barrier for regenerative endodontics. It has been also suggested to use MTA as root canal sealer or as root canal filling material for the entire root canal system.
Usually, MTA material mixes with vehicle to facilitate the application of this material since MTA has the form of powder, several vehicles have been used to mix MTA as saline, distilled water or propyleneglycol. Recently, in regeneration techniques, platelet concentrates have been advocated as a scaffold (matrix)with MTA.
Because of its biocompatibility MTA is one of the potential candidates for bone regenerating biomolecules. It can help in bone repair because its composition allows the rapid adhesion and proliferation of cells on its structure. There is evidence that MTA promotes a favorable response in the osseous environment with direct bone apposition. MTA surfaces support osteoblast cell attachment, matrix synthesis and RunX2 expression which are essential for osteogenesis.
MTA with Biphasic calcium phosphate as a carrier may be effective for achieving favorable new bone formation in large critical sized defects as both materials have an osteoconductive property. Another study show that MTA has a better effect on restoration and regeneration of alveolar bone in patients with maxillary extraction than PRF, while combined application of the two has the best long-term effect in alveolar bone regeneration.
