Histological evaluation of combined platelet-rich fibrin membrane and piezo-incision application in orthodontic tooth movement.

The aim of this study was to evaluate the effect of platelet-rich fibrin (PRF) membrane on tooth movement in comparison with shunt control and piezoelectric surgery. Sixteen White Vienna rabbits were included in the study and divided into two groups. Reciprocal forces (20 g) were applied on the maxillary incisors by an orthodontic appliance. In group 1, PRF membrane was placed sub-periosteally on the distal alveolar bone surface of the right central incisors and the left side was kept as control. In group 2, piezo-incisions 3 mm in depth were performed and combined with PRF membrane on the distal alveolar bone surface of the right central incisors, while the left side was kept as control. All rabbits were euthanized on day 21 and bilateral alveolar bone segments from the distal regions were removed for histological evaluation. Isolated PRF membrane application increased the blood vessel (8.3 ± 1.0; P =  0.026), osteoblast (6 ± 0.8; P =  0.027), and osteoclast (2.3 ± 0.8; P =  0.026) counts significantly compared to shunt control. Combined application of PRF membrane + piezo-incision increased the blood vessel (15.3 ± 0.8; P =  0.027), osteoblast (9.8 ± 1.4; P =  0.026), and osteoclast (3.3 ± 0.8; P =  0.024) counts significantly compared to shunt control. The increases in blood vessel count and osteoblast cell count were more evident in the combined application group (both P =  0.002). PRF membrane application significantly increased bone turnover, and the combined application of PRF membrane + piezo-incision was found to be the best method for increasing bone turnover.