scholarly journals Effects of Leukocyte-Platelet-Rich Fibrin (L–PRF) on Pain, Soft Tissue Healing, Growth Factors, and Cytokines after Third Molar Extraction: A Randomized, Split-Mouth, Double-Blinded Clinical Trial

2021 ◽  
Vol 11 (4) ◽  
pp. 1666
Author(s):  
Madelaine Torres da Silva ◽  
Carlos Fernando de Almeida Barros Mourão ◽  
Rafael Coutinho Mello-Machado ◽  
Pietro Montemezzi ◽  
Renata de Lima Barbosa ◽  
...  

This study assessed the effects of leukocyte-platelet-rich fibrin (L–PRF) on soft tissue healing and the correlation with the local concentration of growth factors (GF) and cytokines in the dental socket of lower third molars. Forty lower-third molars (20 participants) were included in this randomized, double-blinded, split-mouth study. After extractions, randomized sides received alveolar filling with L–PRF on one side and a natural blood clot on the other side. The pain was assessed for up to seven days and soft tissue healing (Landry index) for 14 days post-extraction. Swabs were collected from the surgical sites for GF and cytokine assessment by flow luminometry. Participants reported lower postoperative pain on the sides grafted with L–PRF, which also presented increased tissue healing scores (p < 0.05). There were increased levels of all GFs and several cytokines at the L–PRF site at day one, while vascular endothelial growth factor (VEGF), IL–10, and IL1–RA remained higher throughout for seven days (p < 0.05). VEGF concentration at L–PRF sites correlated positively with the participants’ blood platelet content (ρ = 0.769). PDGF correlated negatively with pain experience on days 2 and 3, and positively with soft tissue healing scores, while FGFb presented a weak correlation with a reduction of pain on day 3. The use of L–PRF improves the soft tissue healing process and decreases postoperative pain after the third molar extractions, which correlates with an increase in the local concentration of growth factors such as PDGF and FGFb.

2019 ◽  
Vol 63 (2) ◽  
pp. 235-242
Author(s):  
Joanna Wessely-Szponder ◽  
Tomasz Szponder ◽  
Ryszard Bobowiec ◽  
Joanna Michalska

AbstractIntroduction: Antimicrobial peptides (AMP) are a large group of innate immune effectors, which apart from antimicrobial activity show immunomodulative properties. Platelet-rich plasma (PRP) is a source of autologous growth factors and is used for stimulation of bone and soft tissue healing. The purpose of this study was to assess the influence of PRP and AMP extract on ovine monocyte-derived macrophage cultures. Material and Methods: The study was conducted on ovine macrophages (Mfs) previously stimulated with LPS or dexamethasone and then with preparations of PRP or AMP. Following activation of the Mfs their morphological and functional features were assessed. Results: The study revealed pro-inflammatory influence of both examined preparations on Mfs cultures on the basis of morphology, ROS generation and arginase activity. Both preparations enhanced the pro-inflammatory response of cultured Mfs. Conclusion: This activity may intensify the antimicrobial action of Mfs, however, in cases of excessive and prolonged inflammation the use of these preparations should be limited.


2021 ◽  
pp. 62-65
Author(s):  
S.P. Indra Kumar ◽  
Kavin T ◽  
Narendar R ◽  
E. Gayathri Priyadharshini ◽  
Akshaya murugan ◽  
...  

AIM: The aim of this study is to comparatively evaluate the post extraction socket healing clinically and radiographically with and without using Platelet Rich Fibrin (PRF). MATERIALS AND METHODS: Fifty, otherwise healthy individuals undergoing dental treatment in the department of Oral and Maxillofacial surgery, Vivekananda Dental College for women, Thiruchengode, were randomly selected and the participants were divided into two groups – test group(PRF, n=25) and control group (Blood clot, n=25). Blood was freshly obtained from the participants of the test group and PRF was prepared. PRF was placed in the sockets of the test group and followed by the pressure application and suturing. Control group were allowed to heal naturally. Clinically, soft tissue healing and socket closure were assessed. Radiographic analysis of socket healing done by comparison of pre- and post-operative radiographs. The clinical follow-up assessments were done at an interval of 3 days, 1 week and 4 weeks and the data obtained were assessed. The patients were aged above 18 years, i RESULT: ncluding 33 females and 17 males. The soft tissue and socket healing were higher in the test group when compared with the control group clinically and the mean proportion of radiographic bone ll was signicantly higher in the test group in all the time intervals of 3 days, 1 week and 4 weeks, respectively. Outcome of the study CONCLUSION: demonstrate that the PRF placement in the extraction socket accelerates soft tissue healing and socket healing and increases the bone ll and reduces the bone resorption using clinical and radiographic methods.


Author(s):  
Negin Karimi ◽  
Behnam Khorrami ◽  
Reza Nezhadnasrollah ◽  
Yamin Haghani

Introduction: This study aimed, effect of platelet-rich plasma (PRP) on soft tissue healing after mandibular third molar surgery. Materials & Methods: In this semi-blinded clinical trial study,30 selected patients requiring surgical extraction of soft tissue impacted mandibular third molar participated from cases referred to the Department of Surgery, Faculty of Dentistry, Isfahan Azad University 2017.Patients divided into both test and control groups. PRP was placed in the extracted socket of the test group, whereas the control group had no PRP. Arzhangian standard kit utilized for preparation of PRP. The outcome variables in this study were pain, swelling, inter incisal mouth opening, wound dehiscence, dry socket, bleeding, and tissue color. The collected data analyzed using statistical tests followed independent T-test, Mann-Whitney, and fisher (p value < 0.05). Results: The mean postoperative pain score (Visual Analog Scale) lowered for the test group after several wound dehiscence on the third and seventh days after surgery which was statistically significant (p value < 0.001). Although the mean bleeding time on the third day after surgery decreased in the test group, this difference was not statistically significant (p value = 0.59). There were no statistically significant between both groups for The dry socket incidence on the seventh day and the mean of inter incisal mouth opening in the third and seventh days after surgery as well. Conclusion: The usage of topical PRP has beneficial advantages on soft tissue healing after mandibular third molar surgery. Unlike the control group, The PRP group provided reduced pain and better soft tissue healing.


2020 ◽  
Vol 10 (17) ◽  
pp. 5750 ◽  
Author(s):  
Vittorio Moraschini ◽  
Carlos Fernando de Almeida Barros Mourão ◽  
Rafael Coutinho de Mello Machado ◽  
Jhonathan Raphaell Barros Nascimento ◽  
Kayvon Javid ◽  
...  

This overview aimed to evaluate the methods, quality, and outcomes of systematic reviews (SRs) conducted to investigate the effects of platelet-rich fibrin (PRF) in dental sockets on promoting bone regeneration and soft tissue healing and diminishing the incidence of pain, swelling, trismus, and alveolar osteitis after tooth extraction. An electronic search without date or language restriction was done in PubMed/MEDLINE, Cochrane, and Web of Science until March 2020. Eligibility criteria included SRs that assessed the effect of PRF for human alveolar socket preservation. The quality assessment of the included studies was performed using AMSTAR 2 guidelines. The protocol of this overview was recorded in PROSPERO under the number CRD42018089617. The search and selection process yielded 13 studies published between 2011 and 2018. The analysis of the studies showed inconclusive data for the effect of the PRF and the dimensional changes. There is no definitive evidence for the impact of using PRF alone on bone regeneration in post-extraction sockets. The use of PRF improves soft tissue healing and reduces pain, bleeding, and osteitis in post-extraction sockets.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Alaa Z. Makki ◽  
Anoud M. Alsulami ◽  
Arwa S. Almatrafi ◽  
Moroj Z. Sindi ◽  
Shahinaz N. Sembawa

Background and Purpose. Some physiological changes may occur following tooth extraction, and symptoms during the postextraction period may affect the patient’s quality of life. Many techniques have been developed to improve postextraction pain and soft tissue healing. Accordingly, this study will compare the postextraction pain and early soft tissue healing characteristics of extraction sites treated with leukocyte-platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF). The aim is to evaluate the effect of advanced PRF in comparison with L-PRF on soft tissue healing and pain after teeth extraction and to advice dental practitioner to use the advanced PRF in clinic to enhance soft tissue healing and decrease pain. Methods. The study included 60 patients according to sample size calculation, recruited from patients seeking tooth extraction at oral and maxillofacial surgery clinic at Umm Al-Qura University, Faculty of Dentistry. Patients were divided into three groups. Group Ӏ included 20 patients managed by advanced platelet-rich fibrin after extraction. Group ӀӀ included 20 patients managed by leukocyte-platelet-rich fibrin after tooth extraction. Group ӀII included 20 patients left without any addition. Each group was further subdivided into surgical and nonsurgical extraction. Afterwards, patients in each group were assessed for postextraction pain by VAS, number of analgesics, and early soft tissue healing by LWHI. Results. The study outcomes demonstrate that the use of A-PRF significantly reduces postoperative pain in the 1st and 2nd day. VAS pain scores on the first day were significantly higher in the control surgical extraction group and L-PRF nonsurgical extraction group. In early soft tissue healing. The Landry Wound Healing Index (LWHI) was used after 1 and 2 weeks of extraction to evaluate the extraction site. In first week, the A-PRF group and L-PRF group (nonsurgical extraction) had a better healing index when compared to control group, and A-PRF group (surgical extraction) had a best healing index when compared to L-PRF and control groups. In the second week, individuals in the A-PRF group (surgical and nonsurgical extraction) had a better healing index when compared to L-PRF and control groups.


Author(s):  
Anna Starzyńska ◽  
Magdalena Kaczoruk-Wieremczuk ◽  
Michele Antonio Lopez ◽  
Pier Carmine Passarelli ◽  
Paulina Adamska

Surgical removal of impacted mandibular third molars constitutes one of the most frequently performed procedures within oral surgery. This surgery procedure is associated with many post-operative complications. Advanced platelet-rich fibrin (A-PRF) belongs to the second generation of platelet concentrates and is rich in numerous growth factors. The aim of this study was to assess the influence of A-PRF on selected clinical features following the surgical removal of impacted mandibular third molars. The research was conducted on 100 generally healthy patients, who underwent a lower third molar odontectomy in Department of Oral Surgery, Medical University of Gdańsk, Poland, between 2018 and 2019. The research group consisted of 50 patients (immediate A-PRF socket filling) and control group (50 patients without A-PRF socket filling). During the study, the following clinical features were assessed: pain (visual analog scale), analgesics intake, the presence of trismus, edema, hematomas within the surrounding tissues (e.g., cheek), prevalence of pyrexia, dry socket, secondary bleeding, presence of hematomas, skin warmth in the post-operative area, and bleeding time observed by the patient were analyzed on the 3rd, 7th, and 14th day after the procedure. There was a significant association between A-PRF socket filling and pain intensity, the analgesics intake, trismus, and edema on the 3rd and the 7th day (p < 0.05). The presence of hematomas and skin warmth on the 3rd day after the surgery (p < 0.05) were also statistically associated with A-PRF use. The study showed that in reducing the incidence of postoperative complications, A-PRF was more important than the position of the tooth or the duration of the procedure. The growth factors in A-PRF reduce postoperative complications, such as pain, trismus, edema, analgesics intake, presence of hematomas, and skin warmth, after mandibular wisdom teeth odontectomy.


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