Platelet-rich plasma (PRP) in dental and oral surgery: from the wound healing to bone regeneration

Platelet-rich plasma (PRP) is a new approach to tissue regeneration and it is becoming a valuable adjunct to promote healing in many procedures in dental and oral surgery, especially in aging patients. PRP derives from the centrifugation of the patient's own blood and it contains growth factors that influence wound healing, thereby playing an important role in tissue repairing mechanisms. The use of PRP in surgical practice could have beneficial outcomes, reducing bleeding and enhancing soft tissue healing and bone regeneration. Studies conducted on humans have yielded promising results regarding the application of PRP to many dental and oral surgical procedures (i.e. tooth extractions, periodontal surgery, implant surgery). The use of PRP has also been proposed in the management of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with the aim of enhancing wound healing and bone maturation. The aims of this narrative review are: i) to describe the different uses of PRP in dental surgery (tooth extractions and periodontal surgery) and oral surgery (soft tissues and bone tissue surgery, implant surgery and BRONJ surgery); and ii) to discuss its efficacy, efficiency and risk/benefit ratio. This review suggests that the use of PRP in the alveolar socket after tooth extractions is certainly capable of improving soft tissue healing and positively influencing bone regeneration but the latter effect seems to decrease a few days after the extraction. PRP has produced better results in periodontal therapy in association with other materials than when it is used alone. Promising results have also been obtained in implant surgery, when PRP was used in isolation as a coating material. The combination of necrotic bone curettage and PRP application seem to be encouraging for the treatment of refractory BRONJ, as it has proven successful outcomes with minimal invasivity. Since PRP is free from potential risks for patients, not difficult to obtain and use, it can be employed as a valid adjunct in many procedures in oral and dental surgery. However, further RCTs are required to support this evidence

Hastening of wound healing of mucosa by means of aminoacids combined to sodium hyaluronate after oral biopsy: an open trial.

Sodium hyaluronate has been widely used in order to promote wound healing in oral cavity for its anti-inflammatory effects. Aim of this clinical trial was to evaluate the efficacy of aminoacids added to topical sodium hyaluronate, in minor oral surgery. After surgery by means of Quantic molecular resonance scalpel, in 27 patients a gel with sodium hyaluronate has been applied directly on the surgical wound, in order to favorite healing by secondary intention. Furthermore, gel has been applied 3-4times/day, after meals and oral hygiene. Hemostatic effect, edema and pain symptoms by VAS (Visual Analogue Scale;0-100), and clinical healing (full, partial, absent) have been evaluated at T#1(2hrs after surgery), T#2(after 24hrs), T#3(after 72hrs), T#4(after 7days) and T#5(after 14days). Regarding pain symptom, mean values registered were at T#0 6.7(± 20 DS;range: 0-60), at T#1 12.2(± 25,4 DS,range: 0-70), at T#2 4.4(± 7.3 DS,range: 0-20), at T#3 1.1(± 4,4 DS;range 0-10), while at T#4 and T#5 no patient complained pain. Evaluation of the intra-group symptom score at T#0, T#1, T#2 and T#3 showed no statistically significant differences in T#1 vs T#0(p = 0.5930,z = -0.535), T#2 vs T#1(p = 0.2850,z = -1.069) and T#3 vs T#2(p = 0.1088,z = -1.604), revealing a good early performance. In all patients have been found to complete clinical resolution of the surgical wound within 2 weeks after surgery. Only one slight bleeding at T#1 was observed, post-operative edema until T#3 was never present. In historical control1(cold scalpel), regarding about pain evaluation, mean values were in general worst [at T#0 was 20(±17,97), at T#1 15,0(±14,4) and at T#4 5,8(±9,5)]. In conclusion, aminoacids combined to sodium hyaluronate application seems to be advantageous in oral surgery, due to its hemostatic effect, reduction of pain symptoms, simple application, absence of infectious complications, and rapid healing of surgical wounds

Relevance of Prehospital Stroke Code Activation for Acute Treatment Measures in Stroke Care: A Review

Background: The use of emergency services with prehospital stroke assessment and early notification to the treatment hospital (stroke code) is a crucial determinant of delay time for acute stroke treatment. We reviewed and summarized the literature on prehospital stroke code system implementation. Methods: Two databases were explored (last update June 20, 2011) with 3 key words (stroke code, stroke prehospital management and stroke prehospital services). Inclusion criteria were: randomized and quasirandomized controlled trials, cohort and case-control studies, and hospital-and emergency-based registers, with no year or language restrictions. We examined the reference lists of all included articles. All potentially relevant reports and abstracts were transcribed into a specifically designed data abstraction form. Results: Only 19 of the 680 studies which were initially retrieved, published from 1999 to 2011, fulfilled our inclusion criteria. One clinical trial was identified. Large differences in stroke code procedures and study designs within and across countries prohibited the pooling of the data. Most studies were carried out in urban areas. Assuming the rate of tissue-plasminogen activator treatment as the performance measure, most studies report a significant increase in the rate of treatment (increase between 3.2 and 16%) with only 1 study not reporting any increase. Conclusions: Despite its limitations, this review suggests that the use of prehospital stroke code is an important intervention to improve the accessibility of the benefits of thrombolysis, especially when implemented together with educational campaigns to optimize the awareness and behavior of patients and bystanders. Copyright (C) 2012 S. Karger AG, Base

Migrazioni. Responsabilità della filosofia e sfide globali. Atti del XXXIX Congresso Nazionale della Società filosofica Italiana

La filosofia è chiamata a svolgere un ruolo sempre più attivo nel definire le molteplici sfaccettature di una nuova responsabilità, che si colloca al punto d’intersezione di dilemmi cruciali, che investono l’etica, il diritto, la politica, la tecnica, le neuroscienze, la comunicazione, le nuove realtà virtuali e le scienze dell’educazione, fondamentali per promuovere nelle giovani generazioni il senso dell’appartenenza e la consapevolezza di essere inseriti in un sistema di regole fondato sulla tutela e sul riconoscimento di diritti e di doveri. Solamente l’educazione alla convivenza, alla comprensione dei valori dell’inclusione e dell’integrazione, e all’esercizio attivo della cittadinanza potrà, infatti, sviluppare una partecipazione autentica e responsabile – come individui e come cittadini – alla vita civile del proprio paese e dello spazio-mond

Handbook of Cell Biosensors

Handbook of Cell Biosensor