Randomized double-blind clinical trial evaluation of bone healing after third molar surgery with the use of leukocyte- and platelet-rich fibrin

Ritto, Fabio; Pimentel, Thaís; Canellas, João Vitor dos Santos; Junger, B; Cruz, Matheus Ramos da; Medeiros, Paulo José

doi:10.1016/j.ijom.2019.01.020

Cited by 55 publications

(52 citation statements)

References 32 publications

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“…The design and hypothesis of the current study were mainly based on the likely benefits of L-PRF for ordinary tooth extractions in healthy patients: soft tissue and bone healing improvement, inflammation control, and postoperative pain reduction ( 19 ). These effects are thought to occur as L-PRF is a rich source of growth factors, cytokines, and other proteins (e.g., transforming growth factor β, platelet-derived growth factor, and vascular endothelial growth factor), which may impact positively on healing processes such as angiogenesis and immune control ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

“…These effects are thought to occur as L-PRF is a rich source of growth factors, cytokines, and other proteins (e.g., transforming growth factor β, platelet-derived growth factor, and vascular endothelial growth factor), which may impact positively on healing processes such as angiogenesis and immune control ( 20 ). Moreover, L-PRF seems to induce and stimulate the proliferation of osteoblasts, fibroblasts, and keratinocytes, as well as to promote an important differentiation of osteoblasts ( 19 ). Further advantages include mechanical protection to surgical wounds, ease of preparation and manipulation, and low cost ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

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Leukocyte- and platelet-rich fibrin does not provide any additional benefit for tooth extraction in head and neck cancer patients post-radiotherapy: a randomized clinical trial

Palma¹,

Marcucci²,

Remondes³

2020

Med Oral

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Background One of the most important complications of radiotherapy (RT) for head and neck cancer (HNC) is osteoradionecrosis (ORN) of the jaws, arising mainly from tooth extractions. Thus, the present study aimed to evaluate the efficacy of leukocyte- and platelet-rich fibrin (L-PRF) in preventing ORN following tooth extraction in post-irradiated HNC patients, as well as other postoperative complications. Material and Methods 23 patients previously submitted to conventionally fractionated 3D-conformational RT for HNC underwent atraumatic tooth extractions with perioperative antibiotic therapy. Besides, they were randomly assigned to receive L-PRF clots to fill and cover the extraction sockets (n=11, Test Group) or not (n=12, Control Group). A visual analog scale was used to quantify postoperative pain on the 3rd and 7th days. For ORN diagnosis, patients were clinically assessed for up to 180 days. Other postoperative complications (edema, alveolitis, suture dehiscence, continuous bleeding, and oroantral communication) were also evaluated within this period. Results No case of ORN or another surgical complication was observed and there were no differences in the postoperative pain scores between the groups on the 3rd and 7th days. Conclusions L-PRF did not seem to provide any additional benefits than those achieved by the combination of the surgical and drug protocols used for tooth extractions in the post-irradiated HNC patients. Key words: Radiotherapy, osteoradionecrosis, tooth extraction, head and neck cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Leukocyte- and platelet-rich fibrin does not provide any additional benefit for tooth extraction in head and neck cancer patients post-radiotherapy: a randomized clinical trial

Palma¹,

Marcucci²,

Remondes³

2020

Med Oral

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“…The primary outcomes (pain and tissue healing) were chosen to calculate the sample size based on the availability of supporting data from the literature. The data from previous studies related to third molars extraction and L-PRF placement [5,10] and a pilot study with 5 patients (included in the present research) shows that a sample size of at least 16 extractions in each group is required to achieve 80% power at a significance level of 5% (α = 0.05) [16]. Therefore, a sample size of 20 extractions for each group was adopted (two extractions per patient, for a total of 20 participants).…”

Section: Sample Calculation and Randomizationmentioning

confidence: 99%

“…One of the current strategies is the implantation of the leukocyte-platelet-rich fibrin (L-PRF) immediately after tooth extraction. Prior studies have demonstrated the effectiveness of this autologous biomaterial in reducing postoperative complications in third molars [4,5]. This second-generation autologous blood-derived biomaterial contains a dense fibrin mesh with increased contents of platelets and leukocytes, as well as increased concentrations of essential growth factors and cytokines that will assist in tissue repair, especially concerning soft tissue healing [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…Several studies on post-extraction sockets assessing the contribution of L-PRF have shown evaluations that indicated better postoperative and substantial improvements in soft tissue healing and pain reduction, employing tools such as the Landry index for soft tissue repair, and the Visual Analogue Scale (VAS) for pain [4,5,10,11]. These analyses contribute to a qualitative assessment related to the patient's recovery in the postoperative period.…”

Section: Introductionmentioning

confidence: 99%

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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

et al. 2021

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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.

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From Basic Science to Clinical Practice: A Review of Current Periodontal/Mucogingival Regenerative Biomaterials

De Lauretis,

Øvrebø,

Romandini

et al. 2024

Advanced Science

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Periodontitis is a dysbiosis‐driven inflammatory disease affecting the tooth‐supporting tissues, characterized by their progressive resorption, which can ultimately lead to tooth loss. A step‐wise therapeutic approach is employed for periodontitis. After an initial behavioral and non‐surgical phase, intra‐bony or furcation defects may be amenable to regenerative procedures. This review discusses the regenerative technologies employed for periodontal regeneration, highlighting the current limitations and future research areas. The search, performed on the MEDLINE database, has identified the available biomaterials, including biologicals (autologous platelet concentrates, hydrogels), bone grafts (pure or putty), and membranes. Biologicals and bone grafts have been critically analyzed in terms of composition, mechanism of action, and clinical applications. Although a certain degree of periodontal regeneration is predictable in intra‐bony and class II furcation defects, complete defect closure is hardly achieved. Moreover, treating class III furcation defects remains challenging. The key properties required for functional regeneration are discussed, and none of the commercially available biomaterials possess all the ideal characteristics. Therefore, research is needed to promote the advancement of more effective and targeted regenerative therapies for periodontitis. Lastly, improving the design and reporting of clinical studies is suggested by strictly adhering to the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement.

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Randomized double-blind clinical trial evaluation of bone healing after third molar surgery with the use of leukocyte- and platelet-rich fibrin

Cited by 55 publications

References 32 publications

Leukocyte- and platelet-rich fibrin does not provide any additional benefit for tooth extraction in head and neck cancer patients post-radiotherapy: a randomized clinical trial

Leukocyte- and platelet-rich fibrin does not provide any additional benefit for tooth extraction in head and neck cancer patients post-radiotherapy: a randomized clinical trial

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

From Basic Science to Clinical Practice: A Review of Current Periodontal/Mucogingival Regenerative Biomaterials

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