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      Uncommon Odontogenic Orocutaneous Fistula of the Jaw Treated with Platelet-Rich Fibrin

      Case Reports in Dentistry
      Hindawi Limited

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          Abstract

          Orocutaneous fistula (OCF) of dental origin is a relatively rare condition and continues to be a challenging diagnosis. Misdiagnosis of OCF usually leads to unnecessary and noneffective treatment. A 21-year-old male referred with a complaint of a lesion on the chin which was misdiagnosed as a carbuncle (lesion of nonodontogenic origin) by a physician. After radiological examination, there was a lesion around the apical region of right central incisor. These findings indicated a sinus tract associated with dental origin. After root canal treatment, apical surgery was performed and platelet-rich fibrin (PRF) was administered to the cavity of the lesion as a gel form to improve healing and also used as a membrane form to cut off the relation between infected area and the skin. All procedures were performed intraorally; no extraoral intervention was performed. Three months later, clinical and radiological examination showed total healing without scar formation. The key to successful treatment of OCF is accurate diagnosis. Additionally, the use of PRF after surgical interventions is an effective and innovative therapy to improve healing.

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          In vitro immunological and biological evaluations of the angiogenic potential of platelet-rich fibrin preparations: a standardized comparison with PRP preparations

          Background Platelet-rich fibrin (PRF), a platelet-rich plasma (PRP) derivative mainly composed of fibrin networks, has been increasingly demonstrated to be effective in wound healing in clinical and pre-clinical animal studies. However, there has still been a concern that major growth factors may significantly be loss from PRF during its preparation through the slow clotting process. To address this concern, we compared the angiogenic potential of PRF and PRP by standardization of procedures based on volume ratios. Methods PRP, PRF, and platelet-poor plasma (PPP) were prepared from the peripheral blood of healthy donors. PRF preparations were squeezed or homogenized to produce exudate (PRFexu) or extract (PRFext), respectively. Concentrations of the angiogenic factors and their bioactivities were determined using ELISA kits, a scratch assay using endothelial cells and a chicken chorioallantoic membrane (CAM) assay. Results In PRP and PRF preparations, both VEGF and PDGF-BB were significantly more concentrated than PPP. In the scratch assay, PRFexu and PRFext were the most effective for wound closure. In the CAM assay, PRF membranes were the most effective for neovascularization. Conclusions It is suggested that PRF preparations efficiently preserve the angiogenic factors and function not only as a scaffolding material but as a reservoir of angiogenic factors in wound healing.
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            Diagnosis and treatment of odontogenic cutaneous sinus tracts of endodontic origin: three case studies.

            To describe three cases of extraoral sinus tracts, related to infected teeth, which were initially misdiagnosed as skin lesions and inappropriately treated. The extraoral sinus tracts were initially misdiagnosed as skin lesions. Dermatological surgery was performed and antibiotics prescribed but the lesions did not resolve. Then, a dental cause was sought, and identified. Endodontic intervention resulted in resolution of the problem, confirming the initial misdiagnosis. Dermatologists and other medical practitioners should be aware that dental extraoral sinus tracts can be confused with skin lesions. A dental aetiology, as part of a differential diagnosis, should be kept in mind with oro-facial skin lesions. If an extraoral sinus tract is of endodontic origin, then elimination of infection through effective endodontic treatment will lead to resolution of the sinus tract. Early correct diagnosis can prevent unnecessary and ineffective antibiotic therapy and/or surgical intervention.
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              Facial cutaneous sinuses of dental origin - a diagnostic challenge.

              It is common for practitioners to misdiagnose the cause of facial cutaneous sinus tracts, failing to recognise that many have an odontogenic cause. Chronic infection around the apex of a dental root can drain to the mouth or less commonly to the skin via a sinus tract. Dental symptoms are not always present and this confuses the clinical picture further. Failure to identify an odontogenic cause may result in unnecessary and ineffective treatment. Elimination of dental infection via tooth extraction or root canal treatment leads to resolution of the cutaneous sinus. We present a series of cutaneous draining sinuses of dental origin that resolved rapidly following dental treatment and hope to highlight the importance of including odontogenic infection in the differential diagnosis of such a lesion in the head and neck.
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                Author and article information

                Journal
                10.1155/2017/7174217
                http://creativecommons.org/licenses/by/4.0/

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