{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T03:29:51Z","timestamp":1794540591725,"version":"4.9.1"},"reference-count":23,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T00:00:00Z","timestamp":1674691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>This article aims to prove dentin bridge formation in two cases after direct pulp capping in reversible pulpitis using the platelet concentrate A-PRF+ and preservation of the vitality of the dental pulp. The hemostasis process for the pulp wound and cavity disinfection with gaseous ozone was performed under anesthesia. A large A-PRF+ membrane was prepared from blood plasma and applied to the pulp wound. After placing an MTA, the cavity was closed using glass-ionomer cement. Clinical and cone beam computed tomography findings demonstrated the formation of a dentin bridge in both cases. After the definitive restoration was conducted during the sixth month, the teeth from both patients were asymptomatic and had normal electric pulp testing values. Conclusions: Via clinical and CBCT examinations, we observed the dentin bridge formation after placing the platelet concentrate A-PRF+ in both cases. The vitality of the dental pulp was preserved. Further research is needed to refine the clinical protocol, recommended period for control examination, clarification of the precise indications of platelet concentrates, etc.<\/jats:p>","DOI":"10.3390\/medicina59020225","type":"journal-article","created":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T01:30:30Z","timestamp":1674696630000},"page":"225","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Direct Pulp Capping with Advanced Platelet-Rich Fibrin: A Report of Two Cases"],"prefix":"10.3390","volume":"59","author":[{"given":"Janet N.","family":"Kirilova","sequence":"first","affiliation":[{"name":"Department of Conservative Dentistry, Faculty of Dental Medicine, Medical University, 1000 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitar","family":"Kosturkov","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry, Faculty of Dental Medicine, Medical University, 1000 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1111\/iej.13688","article-title":"Present status and future directions\u2014Vital pulp treatment and pulp preservation strategies","volume":"55","author":"Duncan","year":"2022","journal-title":"Int. Endod. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.jdsr.2018.09.001","article-title":"Current and future options for dental pulp therapy","volume":"55","author":"Takahiko","year":"2019","journal-title":"Jpn. Dent. Sci. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1111\/iej.13080","article-title":"European Society of Endodontology position statement: Management of deep caries and the exposed pulp","volume":"52","author":"Duncan","year":"2019","journal-title":"Int. Endod. J."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Galler, K.M., Weber, M., Korkmaz, Y., Wildbiller, M., and Feuerer, M. (2021). Inflamatory Response Mechanisms of the dentin-pulp complex and periapical tissues. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22031480"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1111\/iej.12719","article-title":"Capping carious exposures in adults: A randomized controlled trial investigating mineral trioxide aggregate versus calcium hydroxide","volume":"50","author":"Kundzina","year":"2017","journal-title":"Int. Endod. J."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Kunert, M., and Lukomska-Szymanska, M. (2020). Bio-Inductive Materials in Direct and Indirect Pulp Capping\u2014A Review Article. Materials, 13.","DOI":"10.3390\/ma13051204"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1111\/iej.13128","article-title":"Management of deep caries and the exposed pulp","volume":"52","author":"Simon","year":"2019","journal-title":"Int. Endod. J."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"(2021). AAE Position Statement on Vital Pulp Therapy. J. Endod., 47, 1340\u20131344.","DOI":"10.1016\/j.joen.2021.07.015"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1563\/aaid-joi-D-14-00138","article-title":"Advanced platelet-rich fibrin: A new concept for cell-based tissue engineering by means of inflammatory cells","volume":"40","author":"Ghanaati","year":"2014","journal-title":"J. Oral. Implantol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1007\/s00068-017-0785-7","article-title":"Reduction of relative centrifugal forces increases growth factor release within solid platelet-rich-fibrin (PRF)-based matrices: A proof of concept of LSCC (low speed centrifugation concept)","volume":"45","author":"Kubesch","year":"2019","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_11","first-page":"39","article-title":"Concentrated Growth Factor, Platelet-rich Fibrin, Mineral Trioxide Aggregate as Direct Pulp capping Agents: Case Reports","volume":"5","author":"Swathi","year":"2020","journal-title":"J. Oper. Dent. Endod."},{"key":"ref_12","first-page":"114","article-title":"Efficacy of Platelet Rich Plasma and Platelet Rich Fibrin for Direct Pulp Capping in Adult Patients with Carious Pulp Exposure\u2014A Randomised Controlled Trial","volume":"7","author":"Shobana","year":"2022","journal-title":"Eur. Endod. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1080\/13102818.2019.1606733","article-title":"Types of microorganisms in proximal caries lesion and ozone treatment","volume":"33","author":"Kirilova","year":"2019","journal-title":"Biotechnol. Biotechnol. Equip."},{"key":"ref_14","unstructured":"Kosturkov, D. (2019). Pulse Oximetry in Dental Medicine. [Ph.D. Dissertation, Medical University]."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s00068-017-0767-9","article-title":"Reduction of relative centrifugation force within injectable platelet-rich-fibrin (PRF) concentrates advances patients\u2019 own inflammatory cells, platelets and growth factors: The first introduction-speed low-speed centrifugation concept","volume":"44","author":"Choukroun","year":"2018","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1634\/stemcells.2007-0054","article-title":"The In vitro migration capacity of human bone marrow mesenchymal stem cells: Comparison of chemokine and growth factor chemotactic activities","volume":"25","author":"Ponte","year":"2007","journal-title":"Stem Cells"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1002\/term.2475","article-title":"Platelet-rich fibrin-based matrices to improve angiogenesis in an in vitro co-culture model for bone tissue engineering","volume":"12","author":"Dohle","year":"2018","journal-title":"J. Tissue Eng. Regen. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1902\/jop.2016.160443","article-title":"Optimized Platelet-Rich Fibrin with the Low-Speed Concept: Growth Factor Release, Biocompatibility, and Cellular Response","volume":"88","author":"Miron","year":"2017","journal-title":"J. Periodontol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1080\/13102818.2022.2108338","article-title":"Endodontic and surgical treatment of chronic apical periodontitis: A randomized clinical study","volume":"36","author":"Kirilova","year":"2022","journal-title":"Biotechnol. Biotechnol. Equip."},{"key":"ref_20","unstructured":"Kirilova, J. (2013). Glass-Ionomer Cement As a Biomaterial for the Treatment of Proximal Dental Caries of Chewing Teeth (\u201cSandwich\u201d Restoration). [Ph.D. Dissertation, Medical University]."},{"key":"ref_21","unstructured":"Miron, R.J. (2021). Understanding Platelet-Rich Fibrin, Quintessence Publishing Co., Inc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"11166","DOI":"10.1038\/s41598-021-90824-0","article-title":"Treatment of symptomatic, deep, almost cariously exposed lesions using ozone","volume":"11","author":"Alqahtani","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S89","DOI":"10.4103\/0975-7406.113304","article-title":"Application of ozone in the treatment of periodontal disease","volume":"5","author":"Srikanth","year":"2013","journal-title":"J. Pharm. Bioallied Sci."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/2\/225\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:15:50Z","timestamp":1760120150000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/2\/225"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,26]]},"references-count":23,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["medicina59020225"],"URL":"https:\/\/doi.org\/10.3390\/medicina59020225","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,26]]}}}