Assessment of the Effect of A-PRF Application during the Surgical Extraction of Third Molars on Healing and the Concentration of C-Reactive Protein

Abstract

Extraction procedures for mandibular third molars are performed all over the world every day. Local inflammation resulting from surgery, and the pain that patients experience, often make it impossible to take up daily life activities, such as work or sports. Growth and anti-inflammatory factors, located in the fibrin network, have a positive effect on tissue-healing processes and should also reduce local inflammation. Advanced platelet-rich fibrin (A-PRF) applied locally influences such processes as: angiogenesis, osteogenesis and collagenogenesis. It also affects mesenchymal cell lines and anti- and pro-inflammatory mediators. Due to the autologous origin of the material, their use in guide bone regeneration (GBR) is more and more widespread in dentistry. The results of previous studies indicate that the use of A-PRF in the treatment area significantly reduces postoperative pain, while the formation of edema is not affected. C-reactive protein (CRP), which is an acute phase protein, appears in the blood as a consequence of inflammation. Due to the dynamics of changes in concentration of CRP, it is a protein that is sufficiently sensitive and is used in studies to monitor the tissue healing process. The effect of A-PRF application on CRP concentrations, before and after surgery, has not been investigated yet. The study was conducted on 60 generally healthy patients. A faster decrease of CRP levels was shown in patients who used A-PRF after the procedure. Additionally, it accelerated healing and reduced the occurrence of a dry socket close to 0.

Comparison of the efficacy of aescin and diclofenac sodium in the management of postoperative sequelae and their effect on salivary Prostaglandin E2 and serum C–reactive protein levels after surgical removal of impacted mandibular third molar: a randomized, double-blind, controlled clinical trial.

“…They also suggested that A-PRF application significantly reduced the symptoms of regional inflammation and incidence of dry socket. 5 In a detailed review of escin, Gallelli (2019) suggested that it has potent anti-inflammatory, antiedematous, venotonic, and endothelial protective properties. They described the basic mechanism of action of escin.…”

“…Various studies have used CRP concentrations to monitor the healing process after drug therapy because of its sensitivity. 5 This study aimed to correlate salivary PGE2 levels and serum C-reactive protein levels with subjective and objective symptoms after surgical extraction of the mandibular third molar and their relationship with drug therapy.…”

Comparison of the efficacy of aescin and diclofenac sodium in the management of postoperative sequelae and their effect on salivary Prostaglandin E2 and serum C–reactive protein levels after surgical removal of impacted mandibular third molar: a randomized, double-blind, controlled clinical trial.

“…Various studies have used CRP concentrations to monitor the healing process after drug therapy because of its sensitivity. 6 This study aimed to correlate salivary PGE2 levels and serum C-reactive protein levels with subjective and objective symptoms after surgical extraction of the mandibular third molar and their relationship with therapeutic use of aescin and diclofenac. The objectives of the study is to compare the efficacy of aescin and diclofenac for managing pain, swelling, mouth opening and the need for rescue analgesics.…”

Imaging Evaluation of Platelet-Rich Fibrin in Post-Exodontic Bone Regeneration: A Systematic Review

“…Similar to that of other platelet concentrates, PRF preparation is by centrifugation but varies in that only one step is involved and does not require anticoagulants or bovine thrombin [11]. Thus, it contains high levels of growth factors slowly released within 7-14 days after its use [12][13][14][15][16][17][18][19].…”