Richard J Miron

• DDS, BMSC, MSc, PhD, Dr. med. dent.
• Nova Southeastern University

Since the discovery of osteoinduction in the early 20th century, innovative biomaterials with osteoinductive potential have emerged. Over the last 50 years, however, our ability to describe biological phenomena accurately has been improved dramatically by advancements in cell and molecular biology. The aim of this review is to divide the osteoinduc...

Objectives The use of platelet concentrates has gained increasing awareness in recent years for regenerative procedures in modern dentistry. The aim of the present study was to compare growth factor release over time from platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and a modernized protocol for PRF, advanced-PRF (A-PRF). Materials and m...

Aims: This review article aims to: 1) provide the biological background necessary to understand the rational for the use of EMD for periodontal regeneration, 2) present animal and human histological evidence of periodontal regeneration following EMD application, 3) provide clinically relevant indications for the use of EMD and 4) discuss future av...

The health of peri-implant soft tissues is one of the most important aspects of osseointegration necessary for the long-term survival of dental implants. To review the process of soft tissue healing around osseointegrated implants and discuss the maintenance requirements as well as the possible short-comings of peri-implant soft tissue integration....

Type 2 diabetes mellitus (T2DM) affects millions globally and is strongly associated with oral health issues, particularly periodontitis. The bidirectional relationship between T2DM and periodontitis is well established, with poorly managed T2DM increasing the risk of inflammation, tissue damage, and dental implant failure. Advances in treatment, s...

This clinical narrative review aimed to comprehensively evaluate the effects of platelet-rich fibrin (PRF) on clinically-related and patient-reported outcomes in palatal wound healing following autologous palatal graft harvesting. A systematic and thorough electronic search was performed in the PubMed, Scopus, and Web of Science databases up to Nov...

Mesenchymal stem cells are highly regarded for their potential in tissue repair and regenerative medicine due to their multipotency and self-renewal abilities. Recently, mesenchymal stem cells have been redefined as “medical signaling cells,” with their primary biological effects mediated through exosome secretion. These exosomes, which contain lip...

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 proces...

Aim: 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 articles offers deeper insights into the advantages of H-...

In recognizing the critical role of vitamin D in bone metabolism and osseointegration, research aims to identify whether preoperative vitamin D deficiency serves as a risk factor for early implant failure. By analyzing patient outcomes and their serum vitamin D levels, studies seek to establish evidence‐based recommendations for vitamin D assessmen...

Objectives: Exosomes are essential mediators/communicators of tissue repair via well-established mechanisms of action that include stimulatory effects on angiogenesis and cellular proliferation, differentiation, and matrix biosynthesis. This pioneering clinical study aimed to evaluate the effectiveness of exosomes specifically designed for periodon...

Objectives: Exosomes are essential mediators/communicators of tissue repair via well-established mechanisms of action that include stimulatory effects on angiogenesis and cellular proliferation, differentiation, and matrix biosynthesis. This pioneering clinical study aimed to evaluate the effectiveness of exosomes specifically designed for periodon...

Introduction Platelet‐rich fibrin (PRF) is being increasingly utilized in surgical procedures due to various improvements in clinical outcomes. More recently, a heating process to denature albumin in the platelet poor plasma (PPP) layer has been shown to extend the resorption time of PRF from a typical 2‐week period to 4–6 months. Because of its >...

To provide an overview of the use of autogenous platelet concentrates (APCs) in periodontal regeneration and to conduct a systematic review (SR) of the treatment outcomes of periodontal intrabony defects by using platelet‐rich fibrin (PRF) compared with other commonly utilized modalities. The eligibility criteria comprised randomized controlled tri...

The objective of the study was to compare the treatment outcomes of periodontal furcation defects by using platelet‐rich fibrin (PRF) with other commonly utilized modalities. The eligibility criteria comprised randomized controlled trials (RCTs) comparing the clinical outcomes of PRF with those of other modalities for the treatment of furcation def...

Objectives To reveal the force profiles recorded by haptic autonomous robotic force feedback during the transcrestal sinus floor elevation (TSFE) process, providing a reference for the surgery strategy during TSFE. Materials and methods A total of 42 maxillary sinus models with different angles of the sinus floor (30°, 40°, 50°, 60°, 70°, 80°, and...

Objectives To assess the accuracy and effectiveness among operators with different levels of experience in a robot-assisted immediate implant surgery. Materials and methods The study included four participants who had received dental training at the same institution but have varying levels of clinical experience in implant dentistry, denoted as un...

This narrative review summarizes current knowledge on the use of autologous platelet concentrates (APCs) in esthetic medicine, with the goal of providing clinicians with reliable information for clinical practice. APCs contain platelets that release various growth factors with potential applications in facial and dermatologic treatments. This revie...

Currently, autologous platelet concentrates (APCs) are frequently used for soft‐ and hard‐tissue regeneration, not only within the oral cavity, but also extra‐orally including chronic wounds, burns, joints, dermatological conditions, among others. The benefits of APCs are largely influenced by the treatment strategy but also their preparation. This...

Exosomes are the smallest subset of extracellular signaling vesicles secreted by most cells with the ability to communicate with other tissues and cell types over long distances. Their use in regenerative medicine has gained tremendous momentum recently due to their ability to be utilized as therapeutic options for a wide array of diseases/conditio...

Exosomes are the smallest subset of extracellular signaling vesicles secreted by most cells with the ability to communicate with other tissues and cell types over long distances. Their use in regenerative medicine has gained tremendous momentum recently due to their ability to be utilized as therapeutic options for a wide array of various diseases....

Horizontal platelet-rich fibrin (H-PRF) contains a variety of bioactive growth factors and cytokines that play a key role in the process of tissue healing and regeneration. The blood collection tubes used to produce Solid-PRF (plasmatrix (PM) tubes) have previously been shown to have a great impact on the morphology, strength and composition of the...

Bone grafts are typically categorized into four categories: autografts, allografts, xenografts, and synthetic alloplasts. While it was originally thought that all bone grafts should be slowly resorbed and replaced with native bone over time, accumulating evidence has in fact suggested that the use of nonresorbable xenografts is favored for certain...

Osteoporosis is a chronic multifactorial condition that affects the skeletal system, leading to the deterioration of bone microstructure and an increased risk of bone fracture. Platelet-derived biomaterials (PDBs), so-called platelet concentrates, such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), have shown potential for improving...

The use of platelet‐rich fibrin (PRF) has seen widespread advantages over platelet‐rich plasma (PRP) in many fields of medicine. However, until 2014, PRF remained clinically available only in its solid clotted form. Modifications to centrifugation protocols and tube technology have led to the development of a liquid injectable version of PRF (i‐PRF...

Platelet‐rich fibrin (PRF) has been characterized as a regenerative biomaterial that is fully resorbed within a typical 2–3 week period. Very recently, however, a novel heating process was shown to extend the working properties of PRP/PRF from a standard 2–3 week period toward a duration of 4–6 months. Numerous clinicians have now utilized this ext...

Implant dentistry has evolved to the point that standard implant osseointegration is predictable. This is attributed in part to the advancements in material sciences that have led toward improvements in implant surface technology and characteristics. Nonetheless, there remain several cases where implant therapy fails (specifically at early time poi...

Over 40 years have now passed since bone grafting materials were utilized for the regeneration of missing bone around teeth and dental implants. Today an ever-increasing number of bone substitute materials are available, each with various properties and characteristics. While bone grafts are typically classified into autografts, allografts, xenogra...

The use of biomaterials in regenerative medicine has expanded to treat various disorders caused by trauma or disease in orthopedics and dentistry. However, the treatment of large and complex bone defects presents a challenge, leading to a pressing need for optimized biomaterials for bone repair. Recent advances in chemical sciences have enabled the...

Exosomes are the smallest subset of extracellular signaling vesicles secreted by most cells with a diameter in the range of 30–150 nm. Their use has gained great momentum recently due to their ability to be utilized as diagnostic tools with a vast array of therapeutic applications. Over 5000 publications are currently being published yearly on this...

This systematic review (SR) aimed to evaluate the antimicrobial potential of different types of platelet‐rich fibrin (PRF) often used in regenerative treatments. An electronic search was performed in four databases and in Gray literature for articles published until January, 2023. The eligibility criteria comprised in vitro studies that evaluated t...

Peri‐implantitis is a pathogenic inflammatory condition characterized by progressive bone loss and clinical inflammation that may compromise the stability of dental implants. Therapeutic modalities have been advocated to arrest the disorder and to establish peri‐implant health. Reconstructive therapy is indicated for bone defects exhibiting contain...

Contemporary oral tissue engineering strategies involve recombinant human growth factor approaches to stimulate diverse cellular processes including cell differentiation, migration, recruitment, and proliferation at grafted areas. Recombinant human growth factor applications in oral hard and soft tissue regeneration have been progressively research...

The use of platelet‐rich fibrin (PRF) has gained tremendous popularity in recent years owing to its ability to speed wound healing postsurgery. However, to date, many clinicians are unaware of methods designed to optimize the technology. This overview article will discuss the advancements and improvements made over the years aimed at maximizing cel...

Implantable biomaterials are widely used in bone tissue engineering, but little is still known about how they initiate early immune recognition and the initial dynamics. Herein, the early immune recognition and subsequent osteoinduction of biphasic calcium phosphate (BCP) after implantation to the protein adsorption behavior is attributed. By liqui...

Tissue engineering focuses on wound healing and tissue regeneration. Platelet-rich fibrin (PRF) is a fibrin matrix contain- ing cytokines, growth factors and cells that are gradually released into the wound over time. This study aimed to evaluate the effect of PRF membranes on wound repair and microbial control in infected wounds. Skin wounds were...

Plain Language Summary After tooth loss, the alveolar bone (which supports the teeth) undergoes a natural process called bone remodeling, which can lead to significant decreases in bone height and thickness over time. Faced with the need to replace missing teeth, especially when it comes to dental implants, the lack of supporting tissues can compro...

Partial extraction therapy (PET) is a set of surgical techniques that preserve a portion of the patient's own root structure to maintain blood supply derived from the periodontal ligament complex in order to maintain the periodontium and peri-implant tissues during restorative and implant therapy. PET includes the socket shield technique (SST), pro...

Partial extraction therapy (PET) is a group of surgical techniques that preserves the periodontium and peri-implant tissues during restorative and implant therapy by conserving a portion of the patient's own root structure to maintain blood supply derived from the periodontal ligament complex. PET includes the socket shield technique (SST), proxima...

Objectives The aim of the present study was to compare the barrier function during bacterial invasion and wound healing properties of 3 commonly used membranes including horizontal platelet-rich fibrin (H-PRF) against two commercially available resorbable collagen membranes. Materials and methods H-PRF membranes were prepared by collecting venous...

Zirconium implants have gained popularity among clinicians due to their superior mechanical properties. However, zirconium implants usually perform less well in early osseointegration than titanium implants. And the degree of severity of the acute inflammation resulting from macrophage activation after implantation determines the result of the impl...

Objectives: The effects of horizontal platelet-rich fibrin (H-PRF) bone block on the healing and immune response during sinus augmentation have not been fully investigated histologically at early time points. Materials and Methods: Eighteenth male New Zealand white rabbits underwent bilateral sinus augmentation and were divided into two groups: dep...

Background: While suggested to be effective in tissue regeneration, the effects of horizontal platelet-rich fibrin (H-PRF) bone block in sinus augmentation have not been verified in an animal model. Methods: Twelve male New Zealand white rabbits that underwent sinus augmentation were divided into two groups: deproteinized bovine bone mineral (DB...

Platelet-rich fibrin (PRF) has a potent anti-inflammatory activity but the components mediating this effect remain unknown. Blood lipids have anti-inflammatory properties. The question arises whether this is also true for the lipid fraction of PRF. To answer this question, lipid fractions of solid and liquid PRF were tested for their potential to l...

Implants are widely used in medical applications and yet macrophage-mediated foreign body reactions caused by implants severely impact their therapeutic effects. Although the extensive use of multiple surface modifications has been introduced to provide some mitigation of fibrosis, little is known about how macrophages recognize the stiffness of th...

Sepsis is a dysregulation of the immune response to pathogens and has high morbidity and mortality worldwide. However, the unclear mapping and course of dysregulated immune cells currently hinders the development of advanced therapeutic strategies to treat sepsis. Here, evidence is provided using single‐cell RNA sequencing from peripheral blood mon...

Most available antiseptic solutions have strong antibacterial effects, but many also possess major cytotoxic effects on gingival fibroblasts, osteoblasts, osteoprogenitor cells, and/or epithelial cells. A novel VEGA Oral Care Recovery Kit (StellaLife) consisting of 16 active ingredients that are monographed in the Homeopathic Pharmacopeia of the Un...

Dental implant failure cannot always be explained by clinical risk factors. Recent literature suggests that immune cells are pivotal players in the integration of biomaterials and have a co-relationship within a set of osteal macrophages known as "OsteoMacs." These cells have been known to polarize quickly between a M1 pro-infl ammatory and a M2 wo...

Objectives Platelet-rich fibrin (PRF) in liquid form has shown advantages in tissue engineering including acting as injectable fillers and drug carriers. However, few studies have investigated the best relative centrifugal force (RCF) for preparing liquid PRF. The aim of the present study was to find out optimal centrifugation force for preparing l...

Tissue engineering focuses on wound healing and tissue regeneration. Platelet-rich fibrin (PRF) is a fibrin matrix containing cytokines, growth factors and cells that are gradually released into the wound over time. This study aimed to evaluate the effect of PRF membranes on wound repair and microbial control in infected wounds. Skin wounds were pe...

Conventional approaches to full-arch implant dentistry require a verified master model created by luting together impression jigs. This process involves numerous steps and is sometimes prone to errors that require subsequent correction. A novel approach involving an extraoral scanning technique using an Imetric 4D Imaging system demonstrates an alt...

Lasers are increasingly utilized in the non-surgical treatment of periodontal disease. The aim of the present systematic review with meta-analysis was to investigate the combination use of Nd:YAG and Er:YAG laser therapy in the treatment of severe periodontitis. A systematic review of the literature including searches in PubMed/Medline, Cochrane Li...

Objective To evaluate the effect of resting and compression time after centrifugation on the physical properties of platelet rich fibrin (PRF) membranes, and to provide optimal guidance regarding the clinical preparation of PRF. Materials and methods A total of 12 volunteers enrolled in this study divided into 2 groups equally. For each volunteer,...

Purpose: The aim of the present systematic review with meta-analysis was to investigate the clinical effectiveness of EMD (enamel matrix derivative) using a minimally invasive surgical technique (MIST) or flapless approach for the treatment of severe periodontal probing depths. Materials and methods: A systematic review of the literature includi...

The preparation of platelet-rich fibrin (PRF) requires blood centrifugation to separate the yellow plasma from the red erythrocyte fraction. PRF membranes prepared from coagulated yellow plasma are then transferred to the defect sites to support tissue regeneration. During natural wound healing, however, it is the unfractionated blood clot (UBC) th...

The current study evaluated the healing of critical-size defects (CSD) created in rat calvaria treated with platelet concentrates produced by high-speed (Leukocyte- and Platelet-Rich Fibrin - L-PRF) and low-speed (Advanced Platelet-Rich Fibrin - A-PRF) protocols of centrifugation. Twenty-four rats were distributed into three groups: Control, L-PRF,...

With the rapid development of nanotechnology, nanoparticles (NPs) are widely used in all fields of life. Nowadays, NPs have shown extraordinary antimicrobial activities and become one of the most popular strategies to combat antibiotic resistance. Whether they are equally effective in combating bacterial persistence, another important reason leadin...

Liquid platelet-rich fibrin (PRF) is produced by fractionation of blood without additives that initiate coagulation. Even though liquid PRF is frequently utilized as a natural source of fibrinogen to prepare sticky bone, the concentration of fibrinogen and the overall amount of “clottable PRF” components have not been evaluated. To this aim, we pre...

Stem and progenitor cells play important roles in the development and maintenance of teeth and bone. Surface markers expressed in bone marrow–derived mesenchymal stem cells are also expressed in dental tissue–derived stem cells. Mouse skeletal stem cells (mSSCs, CD45 ⁻ Ter119 ⁻ Tie2 ⁻ CD51 ⁺ Thy ⁻ 6C3 ⁻ CD105 ⁻ CD200 ⁺ ) and human skeletal stem cel...

Objectives We previously showed that accelerated degradation of collagen membranes (CMs) in diabetic rats is associated with increased infiltration of macrophages and blood vessels. Since pre-implantation immersion of CMs in cross-linked high molecular weight hyaluronic acid (CLHA) delays membrane degradation, we evaluated here its effect on the nu...

Objectives Platelet-rich fibrin (PRF) has been utilized in regenerative medicine as a concentration of autologous platelets and growth factors that stimulates tissue regeneration. More recently, liquid-PRF (also called injectable-PRF; i-PRF) has been brought to market utilizing PET plastic tubes. Due to new advances made in tube technology, the fir...

Objectives: To investigate physicochemical properties, dentin bonding, cytotoxicity, and in vivo pulp response of experimental self-adhesive composites tailored to direct pulp capping. Materials and methods: Experimental composites were prepared with beta-tricalcium phosphate and hydroxyapatite nanoparticles adsorbed with simvastatin and glutath...

Platelet-rich fibrin (PRF) has been utilized as a substitute for resorbable membranes during guided bone regeneration (GBR) therapy as it is a more bioactive biomaterial with living cells and growth factors than resorbable membranes. Nevertheless, PRF poses obvious disadvantages in its mechanical strength since its rapid degradability has been show...

Purpose: To histologically compare the effects of platelet-rich fibrin (PRF) produced using different protocols on periodontal wound healing/regeneration in periodontal defects in dogs. Materials and methods: Dehiscence-type gingival recession and two-wall intrabony defects were created bilaterally in the maxillary canines and mandibular premola...

Chronic inflammation is a pathological process where cells of the mesenchymal lineage become a major source of inflammatory mediators. Platelet-rich fibrin (PRF) has been shown to possess potent anti-inflammatory activity in macrophages, but its impact on mesenchymal cells has not been investigated. The aim of this study was, therefore, to expose m...

Objectives The aim of this study was to evaluate the in vitro effect of enamel matrix derivative (EMD) and hyaluronic acid (HA) and their synergistic combination on lipopolysaccharides (LPS)-induced inflammation in human keratinocytes and osteoblasts.Material and methodsCells were challenged with LPS (1 μg/ml) and cultured in the following treatmen...

Purpose: To investigate the effect of platelet-rich fibrin on bone formation by investigating its use in guided bone regeneration, sinus elevation and implant therapy. Materials and methods: This systematic review and meta-analysis were conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analys...

Alveolar bone defects caused by tooth loss often lead to challenges in implant dentistry, with a need for development of optimal bone biomaterials to predictably rebuild these tissues. To address this problem, we fabricated a novel bone block using platelet-rich fibrin (PRF) and Deproteinized Bovine Bone Mineral (DBBM), and characterized their mech...

Solid platelet-rich fibrin (PRF), consisting of coagulated plasma from fractionated blood, has been proposed to be a suitable carrier for recombinant bone morphogenetic protein 2 (BMP2) to target mesenchymal cells during bone regeneration. However, whether solid PRF can increase the expression of BMPs in mesenchymal cells remains unknown. Proteomic...

Biomineralization is a chemical reaction that occurs in organisms in which collagen initiates and guides the growth and crystallization of matched apatite minerals. However, there is little known about the demand pattern for calcium salts and collagen needed by biomineralization. In this study, natural bone biomineralization is analyzed, and a nove...

Purpose: To investigate the use of platelet-rich fibrin for alveolar ridge preservation compared to natural healing, bone graft material and platelet-rich fibrin in combination with bone graft material. Materials and methods: The present systematic review was conducted and reported according to the Preferred Reporting Items for Systematic Review...

Objectives This study aims to compare the treatment outcomes of periodontal intrabony defects by using platelet-rich fibrin (PRF) with other commonly utilized modalities. Materials and methods The eligibility criteria comprised randomized controlled trials (RCTs) comparing the clinical outcomes of PRF with that of other modalities. Studies were cl...

Accelerated degradation of collagen membranes (CMs) in diabetic rats is associated with increased infiltration of macrophages and blood vessels. Since pre-implantation immersion of CMs in cross-linked high molecular weight hyaluronic acid (CLHA) delays membrane degradation, we evaluated its effect on the number of macrophages and endothelial cells...