The Effectiveness of Advanced Platelet-Rich Fibrin in comparison with Leukocyte-Platelet-Rich Fibrin on Outcome after Dentoalveolar Surgery

Abstract

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.

Third-Generation Platelet Concentrates in Periodontal Regeneration: Gaining Ground in the Field of Regeneration

“…When compared to PRF, A-PRF improves periodontal weakened sites by regenerating tissues by increasing parameters like probing depth, lowering relative attachment loss, and increasing bone height, which is similar to infrabony pocket treatment [8]. A-PRF improves soft tissue recovery at extraction sites and reduces postoperative discomfort and the requirement for analgesics [7]. The increase of VEGF expression by A-PRF had a beneficial effect on the angiogenesis of the gingiva.…”

“…The tubes of the A-PRF group underwent 14-minute centrifugation at 1500 rpm. The final tube product was composed of the following three layers: the very first layer that is of acellular plasma, A-PRF clot that lies in the center, and RBCs that last at the bottom [7].…”

Effect of Leucocyte and Platelet Rich Fibrin (L-PRF) in Postoperative Sequelae of Impacted Mandibular Third Molar Surgery - A Split Mouth Randomized Controlled Trial

“…However, no difference in the postoperative swelling was observed between L-PRF and A-PRF (15). Contradictory to this, in the study by Makki et al, it was observed that the A-PRF group responded better than the L-PRF group in terms of postoperative pain score and number of painkillers (16). This can be attributed to the disadvantages of PRF that they're not useful for large wounds as the PRF quantity reduces if the autologous blood sample quantity is low (17,18).…”

Healing of Extraction Sites after Alveolar Ridge Preservation Using Advanced Platelet-Rich Fibrin: A Retrospective Study

“…Following the filling of the post-extraction alveolus with the PRF clot, neovascularization is established, and an epithelial covering develops. Although there is potential for infection and inflammation of the extraction socket, rapid wound healing occurs without pain or other complications [ 54 , 55 , 56 , 65 , 66 ]. The next generation of PRF, advanced platelet-rich fibrin (A-PRF), is obtained in low-speed centrifugation, and is considered a new autologous material that has numerous benefits in implant dentistry [ 58 ].…”

“…A-PRF helped increase bone density, epithelial healing, and control postoperative pain and swelling after tooth extraction [ 46 ]. In the study carried out by Makki et al comparing the use of A-PRF with L-PRF in post-extraction alveoli, it was shown that the use of A-PRF significantly reduced postoperative pain and improved early soft tissue healing [ 66 ]. The same results were obtained in other studies in the literature [ 67 , 68 , 69 , 70 , 71 ].…”