Does platelet-rich fibrin reduce negative postoperative outcomes in postextraction sockets?

Tautvydas Valiulis1, Andrius Ivanauskas1, Gintaras Janužis2 

1 Department of Maxillofacial Surgery, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania.

2 Department of Maxillofacial Surgery, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Abstract

Background and aim. Nowadays increasing numbers of clinical trials produce evidence that PRF may indeed reduce postoperative pain, swelling and other negative outcomes of invasive tooth extractions. However, despite the evidence in the literature, controversies remain on PRF’s clinical efficiency and postextraction socket (PS) preservation in comparison with blood clots filled in PS. The aim of this study is to quantitatively evaluate the influence of platelet-rich fibrin with leukocytes in postextraction sockets on postoperative pain and swelling outcomes.

Materials and methods. The literature search was conducted in PubMed and ScienceDirect databases. Only split-mouth randomized clinical trials adhering to eligibility criteria were included. Postoperative pain and swelling data were extracted to quantitatively evaluate the effect on different periods: 1st, 3rd, 7th postoperative days.

Results. 5 studies have satisfied all eligibility criteria and been included in this study. Only 3rd postoperative day in pain evaluation statistically significant result favors PRF been noticed. Swelling evaluation could not be analyzed quantitatively because of different facial swelling measurements used between articles. Despite that, 4 of 5 articles showed statistically significant results favors PRF in the 1-4 postoperative days period.

Conclusion. Within the limitations of our study, it seems that PRF shows significant results in a reduction of postoperative pain and swelling outcomes on the most acute inflammation healing period. Despite that, to decide whether or not PRF is relevant in clinical practice, more split-mouth randomized clinical trials with low risk of bias and the same swelling evaluation approach should be done. 

Keywords: platelet-rich plasma [MeSH], post-operative pain [MeSH], socket preservation, post-operative swelling.

 

https://doi.org/10.53453/ms.2021.06.1