Efficacy of platelet rich fibrin in the reduction of the pain and swelling after impacted third molar surgery: Randomized multicenter split-mouth clinical trial

Head & Face Medicine

Fethi Atil⁵  Ismail Doruk Kocyigit⁵  Alper Alkan²  Hakan Hıfzı Tuz⁴  Umut Tekin⁵  Nilay Er³  Fatma Senses⁵  Ozkan Ozgul¹ 

[1] Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Ufuk University, Ankara, Turkey;Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Kayseri,, Turkey;Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Trakya University, Edirne, Turkey;Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hacettepe University, Ankara, Turkey;Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kırıkkale University, Kırıkkale, Turkey

关键词: Swelling;    Pain;    Third molar surgery;    PRF;   

Others  :  1234488
DOI  :  10.1186/s13005-015-0094-5

 received in 2015-05-21, accepted in 2015-11-23,  发布年份 2015

【 摘 要 】

Background

Impacted third molar removal is a routine procedure in oral and maxillofacial surgery. Platelet-rich fibrin (PRF) is a second generation platelet concentration which is produced by simplified protocol. The aim of this study was to assess the effectiveness of PRF in the healing process by evaluating the changes in pain and swelling after third molar surgery.

Methods

Fifty-six patients (23 male, 33 female) who provide the inclusion criteria were selected to participate in this study. The evaluation of the facial swelling was performed by using a horizontal and vertical guide. The pain was evaluated in the postoperative period using a visual analog scale (VAS) of 100 mm.

Results

Horizontal and vertical measurements showed more swelling at the control side (without PRF) in 3th day postoperatively (p < 0.05). There were no statistically significant differences regarding pain among the groups.

Conclusion

As a conclusion, PRF seems to be effectiveness on postoperative horizontal swelling after third molar surgery. PRF could be used on a routine basis after third molar extraction surgery.

【 授权许可】

   
2015 Ozgul et al.

【 图 表 】

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【 参考文献 】

• [1]Koerner KR, Medlin KE. Clinical procedures for third molar surgery. 2nd ed. PennWell, South Sheridan; 1995.
• [2]Szmyd L. Impacted teeth. Dent Clin North Am. 1971; 15:299-318.
• [3]Comma incision for impacted third molars. J Oral Maxillofac Surg. 2002; 60(12):1506-1509.
• [4]Fonseca RJ, Frost DE, Hersh EV, Levin LM. Oral and maxillofacial surgery: anaesthesia/dentoalveolar surgery/office management. 1st ed. Saunders, Philadelphia; 2001.
• [5]Kirk DG, Liston PN, Tong DC, Love RM. Influence of two different flap designs on incidence of pain, swelling, trismus, and alveolar osteitis in the week following third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 104:e1-e6.
• [6]Bagan JV, Lopez JS, Valencia E. Clinical comparison of dexketoprofen trometamol and dipyrone in postoperative dental pain. J Clin pharmacol. 1998; 38:55-64.
• [7]Björnsson GA, Haanaes HR, Skoglund LA. Naproxen 500 mg bid versus acetaminophen 1000 mg qid: effect on swelling and other acute postoperative events after bilateral third molar surgery. J Clin Pharmacol. 2003; 43:849-858.
• [8]Spilka CJ. The placebo of corticosteroids and antihistamines in oral surgery. Oral Surg Oral Med Oral Pathol. 1961; 14:1034-1042.
• [9]Skjelbred P, Løkken P. Post-operative pain and inflammatory reaction reduced by injection of a corticosteroid. A controlled trial in bilateral oral surgery. Eur J Clin Pharmacol. 1982; 21(5):391-6.
• [10]Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J et al.. Platelet-rich fibrin (PRF): A second-generation platelet concentrate.Part III: Leucocyte activation: A new feature for platelet concentrates? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 101:E51-5.
• [11]Gaultier F, Navarro G, Donsimoni JM, Dohan D. Platelet concentrates. Part 3: Clinical applications. Implantodontie. 2004; 13:3-11.
• [12]Simonpieri A, Choukroun J, Girard MO, Ouaknine T, Dohan D. Immediate post-extraction implantation: interest of the PRF. Implantodontie. 2004; 13:177-89.
• [13]Simonpieri A, Del Corso M, Sammartino G, Dohan Ehrenfest DM. The Relevance of Choukroun’s Platelet-Rich Fibrin and Metronidazole During Complex Maxillary Rehabilitations Using Bone Allograft. Part I: A New Grafting Protocol. Implant Dent. 2009; 18:102-111.
• [14]Choukroun J, Adda F, Schoeffler C, Vervelle A. Une opportunité en paro-implantologie: le PRF. Implantodontie. 2001; 42:55-62.
• [15]Aroca S, Keglevich T, Barbieri B, Gera I, Etienne D. Clinical evaluation of a Modified Coronally Advanced Flap Alone or in Combination With a Platelet-Rich Fibrin Membrane for the Treatment of Adjacent Multiple Gingival Recessions: A 6-Month Study. J Periodontol. 2009; 80:244-52.
• [16]Singh A, Kohli M, Gupta N. Platelet rich fibrin: a novel approach for osseous regeneration. J Maxillofac Oral Surg. 2012; 11(4):430-4.
• [17]Kumar N, Prasad K, Ramanujam L, K R, Dexith J, Chauhan A. Evaluation of Treatment Outcome After Impacted Mandibular Third Molar Surgery With the Use of Autologous Platelet-Rich Fibrin: A Randomized Controlled Clinical Study. J Oral Maxillofac Surg. 2014 Dec 13. doi: 10.1016/j.joms.2014.11.013. [Epub ahead of print]
• [18]Pell GJ, Gregory BT. Impacted mandibular third molars: classification and modified techniques for removal. Dent Digest. 1933; 39:330-338.
• [19]Alcântara CE, Falci SG, Oliveira-Ferreira F, Santos CR, Pinheiro ML. Pre-emptive effect of dexamethasone and methylprednisolone on pain, swelling, and trismus after third molar surgery: a split-mouth randomized triple-blind clinical trial. Int J Oral Maxillofac Surg. 2014; 43:93-8.
• [20]Grossi GB, Maiorana C, Garramone RA, Borgonovo A, Creminelli L, Santoro F. Assesing postoperative discomfort after third molar surgery:A prospective study. J Oral Maxillofacial Surg. 2007; 65:901-17.
• [21]Baqain Z, Karaky AA, Sawair F, Khraisat A, Duaibis R, Rajab LD. Frequency estimates and risk factors for post operative morbidity after third molar removal:A prospective cohort study. J Oral Maxillofac Surg. 2008; 66(11):2276-83.
• [22]Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL et al.. Platelet-rich fibrin (PRF): A second-generation platelet concentrate.Part IV: Clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 101:E56-60.
• [23]Su CY, Kuo YP, Tseng YH, Su CH, Burnouf T. In vitro release of growth factors from platelet-rich fibrin (PRF): a proposal to optimize the clinical applications of PRF. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108(1):56-61.
• [24]Lee JW, Kim SG, Kim JY, Lee YC, Choi JY, Dragos R et al.. Restoration of a peri-implant defect by platelet- rich fibrin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2012; 113(4):459-63.
• [25]Zhang Y, Tangl S, Huber CD, Lin Y, Qiu L, Rausch-Fan X. Effects of Choukroun’s platelet-rich fibrin on bone regeneration in combination with deproteinized bovine bone mineral in maxillary sinus augmentation:A histological and histomorphometric study. J Cranio-Maxillofac Surg. 2012; 40(4):321-8.
• [26]Mozzatti M, Martinasso G, Pol R, Polastri C, Cristiano A, Muzio G et al.. The impact of plasma rich in growth factors on clinical and biological factors involved in healing processes after third molar extraction. J Biomed Mater Res. 2010; 95(3):741-6.
• [27]Alissa R, Esposito M, Horner K, Oliver R. The influence of platelet-rich plasma on the healing of extraction sockets: an explorative randomised clinical trial. Eur J Oral Implantol. 2010; 3(2):121-34.
• [28]Thorat MK, Pradeep AR, Pallavi B. Clinical effect of autulogous platelet-rich fibrin in the treatment of intra-bony defects : a controlled clinical trial. J Clin Periodontol. 2011; 38:925-932.