Top

Clinical Oral Investigations

Published in:

01-01-2020 | Analgesics in Dentistry | Original Article

PRF improves wound healing and postoperative discomfort after harvesting subepithelial connective tissue graft from palate: a randomized controlled trial

Authors: Aysan Lektemur Alpan, Gizem Torumtay Cin

Published in: Clinical Oral Investigations | Issue 1/2020

Abstract

Objectives

The aim of this study is to determine the use of platelet-rich fibrin (PRF) in the management of soft tissue donor site healing after harvesting connective tissue graft (CTG) from the palate and evaluate the postoperative discomfort (pain, bleeding, analgesic consumption, tissue color match) of patients.

Materials and methods

Forty patients were randomly assigned to PRF or control group. In the PRF group, PRF membrane was placed into CTG donor site. After surgery, delayed bleeding, early healing index (EHI), tissue color match, and analgesic consumption were recorded. The visual analog scale (VAS) was used to observe the postoperative pain and tissue color match. Data were analyzed using the independent sample t test and the repeated measure ANOVA test.

Results

The patients in the PRF group reported significantly lower pain scores at all-time points. Postoperative 3rd and 7th day, EHI scores were lower in the favor of the PRF group. VAS score values of tissue color match were lower in the control group at 7th and 14th day, compared with the PRF group. Analgesic intake was significantly lower in the PRF group postoperatively at 1st and 3rd day that of control group.

Conclusion

PRF application at the palatal donor site demonstrates promising results in terms of better wound healing and reduced postoperative discomfort in the patients after harvesting CTG.

Clinical relevance

Patients may avoid surgical operations because of the discomfort or pain feeling. Reducing postoperative pain and discomfort and accelerating recovery meet the wishes of every patient and physician. PRF can provide these requirements as an easy method to obtain and implement.

Chambrone L, Sukekava F, Araujo MG, Pustiglioni FE, Chambrone LA, Lima LA (2010) Root-coverage procedures for the treatment of localized recession-type defects: a Cochrane systematic review. J Periodontol 81:452–478. https://doi.org/10.1902/jop.2010.090540 CrossRefPubMed

Zuhr O, Baumer D, Hurzeler M (2014) The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution. J Clin Periodontol 41(Suppl 15):S123–S142. https://doi.org/10.1111/jcpe.12185 CrossRefPubMed

Karthikeyan BV, Khanna D, Chowdhary KY, Prabhuji ML (2016) The versatile subepithelial connective tissue graft: a literature update. Gen Dent 64:e28–e33PubMed

Del Pizzo M, Modica F, Bethaz N, Priotto P, Romagnoli R (2002) The connective tissue graft: a comparative clinical evaluation of wound healing at the palatal donor site. a preliminary study. J Clin Periodontol 29:848–854CrossRef

Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, Dohan AJ, Mouhyi J, Dohan DM (2006) 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 101:e56–e60. https://doi.org/10.1016/j.tripleo.2005.07.011 CrossRefPubMed

Miron RJ, Zucchelli G, Pikos MA, Salama M, Lee S, Guillemette V, Fujioka-Kobayashi M, Bishara M, Zhang Y, Wang HL, Chandad F, Nacopoulos C, Simonpieri A, Aalam AA, Felice P, Sammartino G, Ghanaati S, Hernandez MA, Choukroun J (2017) Use of platelet-rich fibrin in regenerative dentistry: a systematic review. Clin Oral Investig 21:1913–1927. https://doi.org/10.1007/s00784-017-2133-z CrossRefPubMed

Canellas J, Medeiros PJD, Figueredo C, Fischer RG, Ritto FG (2018) Platelet-rich fibrin in oral surgical procedures: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 48:395–414. https://doi.org/10.1016/j.ijom.2018.07.007 CrossRefPubMed

Choukroun J, Adda F, Schoeffler C, Vervelle A (2000) Une opportunité en paro-implantologie: le PRF. Implantodontie 42:55–62

Rudagi KB, Rudagi B (2012) One-step apexification in immature tooth using grey mineral trioxide aggregate as an apical barrier and autologus platelet rich fibrin membrane as an internal matrix. J Conserv Dent 15:196–199. https://doi.org/10.4103/0972-0707.94582 CrossRefPubMedPubMedCentral

10.

Inchingolo F, Tatullo M, Marrelli M, Inchingolo AM, Scacco S, Inchingolo AD, Dipalma G, Vermesan D, Abbinante A, Cagiano R (2010) Trial with platelet-rich fibrin and bio-oss used as grafting materials in the treatment of the severe maxillar bone atrophy: clinical and radiological evaluations. Eur Rev Med Pharmacol Sci 14:1075–1084PubMed

11.

Mazor Z, Horowitz RA, Del Corso M, Prasad HS, Rohrer MD, Dohan Ehrenfest DM (2009) Sinus floor augmentation with simultaneous implant placement using Choukroun’s platelet-rich fibrin as the sole grafting material: a radiologic and histologic study at 6 months. J Periodontol 80:2056–2064. https://doi.org/10.1902/jop.2009.090252 CrossRefPubMed

12.

Lekovic V, Milinkovic I, Aleksic Z, Jankovic S, Stankovic P, Kenney EB, Camargo PM (2012) Platelet-rich fibrin and bovine porous bone mineral vs. platelet-rich fibrin in the treatment of intrabony periodontal defects. J Periodontal Res 47:409–417. https://doi.org/10.1111/j.1600-0765.2011.01446.x CrossRefPubMed

13.

Bansal C, Bharti V (2013) Evaluation of efficacy of autologous platelet-rich fibrin with demineralized-freeze dried bone allograft in the treatment of periodontal intrabony defects. J Indian Soc Periodontol 17:361–366. https://doi.org/10.4103/0972-124X.115663 CrossRefPubMedPubMedCentral

14.

Del Corso M, Mazor Z, Rutkowski JL, Dohan Ehrenfest DM (2012) The use of leukocyte- and platelet-rich fibrin during immediate postextractive implantation and loading for the esthetic replacement of a fractured maxillary central incisor. J Oral Implantol 38:181–187. https://doi.org/10.1563/AAID-JOI-D-12-CL.3802 CrossRefPubMed

15.

Aroca S, Keglevich T, Nikolidakis D, Gera I, Nagy K, Azzi R, Etienne D (2010) Treatment of class III multiple gingival recessions: a randomized-clinical trial. J Clin Periodontol 37:88–97. https://doi.org/10.1111/j.1600-051X.2009.01492.x CrossRefPubMed

16.

Jankovic S, Aleksic Z, Milinkovic I, Dimitrijevic B (2010) The coronally advanced flap in combination with platelet-rich fibrin (PRF) and enamel matrix derivative in the treatment of gingival recession: a comparative study. Eur J Esthet Dent 5:260–273PubMed

17.

Femminella B, Iaconi MC, Di Tullio M, Romano L, Sinjari B, D'Arcangelo C, De Ninis P, Paolantonio M (2016) Clinical comparison of platelet-rich fibrin and a gelatin sponge in the management of palatal wounds after epithelialized free gingival graft harvest: a randomized clinical trial. J Periodontol 87:103–113. https://doi.org/10.1902/jop.2015.150198 CrossRefPubMed

18.

Bahammam MA (2018) Effect of platelet-rich fibrin palatal bandage on pain scores and wound healing after free gingival graft: a randomized controlled clinical trial. Clin Oral Investig 22:3179–3188. https://doi.org/10.1007/s00784-018-2397-y CrossRefPubMed

19.

Eren G, Kantarci A, Sculean A, Atilla G (2016) Vascularization after treatment of gingival recession defects with platelet-rich fibrin or connective tissue graft. Clin Oral Investig 20:2045–2053. https://doi.org/10.1007/s00784-015-1697-8 CrossRefPubMed

20.

He Y, Chen J, Huang Y, Pan Q, Nie M (2017) Local application of platelet-rich fibrin during lower third molar extraction improves treatment outcomes. J Oral Maxillofac Surg 75:2497–2506. https://doi.org/10.1016/j.joms.2017.05.034 CrossRefPubMed

21.

Ustaoglu G, Ercan E, Tunali M (2016) The role of titanium-prepared platelet-rich fibrin in palatal mucosal wound healing and histoconduction. Acta Odontol Scand 74:558–564. https://doi.org/10.1080/00016357.2016.1219045 CrossRefPubMed

22.

Fickl S, Fischer KR, Jockel-Schneider Y, Stappert CF, Schlagenhauf U, Kebschull M (2014) Early wound healing and patient morbidity after single-incision vs. trap-door graft harvesting from the palate--a clinical study. Clin Oral Investig 18:2213–2219. https://doi.org/10.1007/s00784-014-1204-7 CrossRefPubMed

23.

Akpinar A, Toker H, Lektemur Alpan A, Calisir M (2016) Postoperative discomfort after Nd:YAG laser and conventional frenectomy: comparison of both genders. Aust Dent J 61:71–75. https://doi.org/10.1111/adj.12333 CrossRefPubMed

24.

Dohan Ehrenfest DM, Del Corso M, Diss A, Mouhyi J, Charrier JB (2010) Three-dimensional architecture and cell composition of a Choukroun’s platelet-rich fibrin clot and membrane. J Periodontol 81:546–555. https://doi.org/10.1902/jop.2009.090531 CrossRefPubMed

25.

Dohan Ehrenfest DM, Bielecki T, Jimbo R, Barbe G, Del Corso M, Inchingolo F, Sammartino G (2012) Do the fibrin architecture and leukocyte content influence the growth factor release of platelet concentrates? An evidence-based answer comparing a pure platelet-rich plasma (P-PRP) gel and a leukocyte- and platelet-rich fibrin (L-PRF). Curr Pharm Biotechnol 13:1145–1152CrossRef

26.

Thibault MM, Hoemann CD, Buschmann MD (2007) Fibronectin, vitronectin, and collagen I induce chemotaxis and haptotaxis of human and rabbit mesenchymal stem cells in a standardized transmembrane assay. Stem Cells Dev 16:489–502. https://doi.org/10.1089/scd.2006.0100 CrossRefPubMed

27.

Jain V, Triveni MG, Kumar AB, Mehta DS (2012) Role of platelet-rich-fibrin in enhancing palatal wound healing after free graft. Contemp Clin Dent 3:S240–S243. https://doi.org/10.4103/0976-237X.101105 CrossRefPubMedPubMedCentral

28.

Yen CA, Griffin TJ, Cheung WS, Chen J (2007) Effects of platelet concentrate on palatal wound healing after connective tissue graft harvesting. J Periodontol 78:601–610. https://doi.org/10.1902/jop.2007.060275 CrossRefPubMed

29.

Nawshad A, LaGamba D, Hay ED (2004) Transforming growth factor beta (TGFbeta) signalling in palatal growth, apoptosis and epithelial mesenchymal transformation (EMT). Arch Oral Biol 49:675–689. https://doi.org/10.1016/j.archoralbio.2004.05.007 CrossRefPubMed

30.

Dohan Ehrenfest DM, Pinto NR, Pereda A, Jimenez P, Corso MD, Kang BS, Nally M, Lanata N, Wang HL, Quirynen M (2018) The impact of the centrifuge characteristics and centrifugation protocols on the cells, growth factors, and fibrin architecture of a leukocyte- and platelet-rich fibrin (L-PRF) clot and membrane. Platelets 29:171–184. https://doi.org/10.1080/09537104.2017.1293812 CrossRefPubMed

31.

Sharma A, Aggarwal N, Rastogi S, Choudhury R, Tripathi S (2017) Effectiveness of platelet-rich fibrin in the management of pain and delayed wound healing associated with established alveolar osteitis (dry socket). Eur J Dent 11:508–513. https://doi.org/10.4103/ejd.ejd_346_16 CrossRefPubMedPubMedCentral

32.

Mosesson MW, Siebenlist KR, Meh DA (2001) The structure and biological features of fibrinogen and fibrin. Ann N Y Acad Sci 936:11–30CrossRef

33.

Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B (2006) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101:e37–e44. https://doi.org/10.1016/j.tripleo.2005.07.008 CrossRefPubMed

34.

Daugela P, Grimuta V, Sakavicius D, Jonaitis J, Juodzbalys G (2018) Influence of leukocyte- and platelet-rich fibrin (L-PRF) on the outcomes of impacted mandibular third molar removal surgery: a split-mouth randomized clinical trial. Quintessence Int 49:377–388. https://doi.org/10.3290/j.qi.a40113 CrossRefPubMed

35.

Al-Hamed FS, Tawfik MA, Abdelfadil E, Al-Saleh MAQ (2017) Efficacy of platelet-rich fibrin after mandibular third molar extraction: a systematic review and meta-analysis. J Oral Maxillofac Surg 75:1124–1135. https://doi.org/10.1016/j.joms.2017.01.022 CrossRefPubMed

36.

Ozcan M, Ucak O, Alkaya B, Keceli S, Seydaoglu G, Haytac MC (2017) Effects of platelet-rich fibrin on palatal wound healing after free gingival graft harvesting: a comparative randomized controlled clinical trial. Int J Periodontics Restorative Dent 37:e270–e278. https://doi.org/10.11607/prd.3226 CrossRefPubMed

37.

Ozgul O, Senses F, Er N, Tekin U, Tuz HH, Alkan A, Kocyigit ID, Atil F (2015) 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 Med 11:37. https://doi.org/10.1186/s13005-015-0094-5 CrossRefPubMedPubMedCentral

38.

Dohan Ehrenfest DM, Andia I, Zumstein MA, Zhang CQ, Pinto NR, Bielecki T (2014) Classification of platelet concentrates (platelet-rich plasma-PRP, platelet-rich fibrin-PRF) for topical and infiltrative use in orthopedic and sports medicine: current consensus, clinical implications and perspectives. Muscles Ligaments Tendons J 4:3–9CrossRef

39.

Shimokado K, Raines EW, Madtes DK, Barrett TB, Benditt EP, Ross R (1985) A significant part of macrophage-derived growth factor consists of at least two forms of PDGF. Cell 43:277–286CrossRef

40.

Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B (2006) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101:e45–e50. https://doi.org/10.1016/j.tripleo.2005.07.009 CrossRefPubMed

Title: PRF improves wound healing and postoperative discomfort after harvesting subepithelial connective tissue graft from palate: a randomized controlled trial
Authors: Aysan Lektemur Alpan
Gizem Torumtay Cin
Publication date: 01-01-2020
Publisher: Springer Berlin Heidelberg
Keyword: Analgesics in Dentistry
Published in: Clinical Oral Investigations / Issue 1/2020
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-019-02934-9

2024 ASCO Annual Meeting

Springer Medicine

PRF improves wound healing and postoperative discomfort after harvesting subepithelial connective tissue graft from palate: a randomized controlled trial

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

Please log in to get access to this content

Other articles of this Issue 1/2020

Maxillofacial injuries in severely injured patients after road traffic accidents—a retrospective evaluation of the TraumaRegister DGU® 1993–2014

Letter to the editor regarding “Impact of cigarette smoking and vaping on the outcome of full-mouth ultrasonic scaling among patients with gingival inflammation: a prospective study”

Increase in pulse pressure on administration of a dental local anesthetic solution, prilocaine hydrochloride with felypressin in male diabetic patients with coronary heart disease

Effects of a full-mouth disinfection protocol on the treatment of type-2 diabetic and non-diabetic subjects with mild-to-moderate periodontitis: one-year clinical outcomes

Histomorphometrical assessment of vertical alveolar ridge augmentation using extracted tooth roots in the canine

Residual monomer elution from different conventional and CAD/CAM dental polymers during artificial aging