Do the New Protocols of Platelet-Rich Fibrin Centrifugation Allow Better Control of Postoperative Complications and Healing After Surgery of Impacted Lower Third Molar? A Systematic Review and Meta-Analysis

Ramos, Edith Umasi; Bizelli, Vinícius Ferreira; Baggio, Ana Maira Pereira; Ferriolli, Stéfani Caroline; Prado, Guilherme Alexandre Silva; Bassi, Ana Paula Farnezi

doi:10.1016/j.joms.2022.03.011

Cited by 5 publications

(5 citation statements)

References 43 publications

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“…Among 19 meta-analyses, 12 studies [ 12 , 27 , 29 , 32 ] [ 33 ], [ 35 – 38 ]; [ 7 , 11 , 24 ] showed a high risk of bias regarding eligibility criteria (due to unclear restrictions regarding publication date or language and weakly described inclusion/exclusion criteria). Six studies [ 7 , 12 , 13 , 27 , 30 , 32 ] had a high risk of bias regarding the study selection process (due to lack of specified databases' searched strategy or potential risk of selection of RCTs by only one reviewer instead of 2≤ independent reviewers). Seven studies [ 10 ]; [ 27 , 29 , 32 , 35 , 36 , 39 ] had a high risk of bias regarding the data collection step (according to unclear efforts made to minimize errors in data collection and quality assessment).…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies [ 10 ]; [ 27 , 29 , 32 , 35 , 36 , 39 ] had a high risk of bias regarding the data collection step (according to unclear efforts made to minimize errors in data collection and quality assessment). In terms of synthesis, 9 studies [ 10 ]; [ 8 , 11 , 27 ]; [ 13 , 30 , 35 – 37 ] showed a high risk of bias (due to lack of appropriate interpretation and justification of the observed high heterogeneity or due to lack of sensitivity analysis where possible) ( Figure 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…The studies conducted by Bao et al [ 27 ] and Xiang et al [ 32 ] had a high risk of bias and were excluded. Among 3 other meta-analyses [ 12 , 29 , 30 ] with adequate quality, the study conducted by Ramos et al [ 30 ] was the most recent and comprehensive (with more included RCTs), accordingly, was included in the sensitivity analysis to test the robustness of the results. Moreover, the study conducted by Vitenson et al [ 31 ] had the lowest overlap with other meta-analyses (due to evaluating only new centrifugation protocols) and completely addressed our eligibility criteria.…”

Section: Resultsmentioning

confidence: 99%

“…This shows that the way of PRF preparation (such as centrifuging speed and time) is a very important factor in the effectiveness of PRF application because it affects fibrin structure, the concentration of cytokines, growth factors, cells, and platelets [ 27 , 46 ]. A-PRF application in the extraction socket performed better than the L-PRF in controlling early pain, and both were better than PRF at the beginning of the inflammatory process [ 30 ]. A-PRF has a higher proportion of monocytes than L-PRF, which allows for a faster vascularization of the area and a greater release of cytokines than PRF/L-PRF; these monocytes are crucial for the growth of blood vessels and bone regeneration.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, 19 eligible meta-analyses were retrieved (Figure 1). Seven types of complementary interventions were identified among the retrieved meta-analyses including PRF application [12,[27][28][29][30][31][32], LLLT [33], [6,[34][35][36][37], Kinesio taping [8,38], cryotherapy [11], surgical drainage [9], ozone therapy [7], and hyaluronic acid application [10].…”

Section: Identification Of the Eligible Meta-analysesmentioning

confidence: 99%

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Nonpharmacological Complementary Interventions for the Management of Pain after Third Molar Surgery: An Umbrella Review of Current Meta-Analyses

Firoozi

Falci

Kim

et al. 2022

Pain Research and Management

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Objectives. To provide a nonbiased, complete assessment of what the evidence from meta-analyses informs us about complementary and nonpharmacological treatment options for the management of pain after third molar surgery, as well as highlight any discordancy, gaps, or lack of evidence among meta-analyses. Methods. The quality of the included systematic reviews was assessed using the ROBIS tool. Corrected covered area (CCA) was calculated for pairs of similar meta-analyses to identify the amount of overlap. Reviews that were the most recent, comprehensive, and had adequate quality were considered for analyses when reviews showed a high overlap. In cases with a low amount of overlap among meta-analyses, all eligible studies were included. Also, citation matrices were constructed to address overlap. A network meta-analytical approach was adopted to rank different interventions. Results. Ten meta-analyses were included for quantitative synthesis. The quantitative analysis revealed that platelet-rich fibrin and its derivatives as well as ozone therapy reduce early and late pain better than the other complementary interventions compared to control (no complementary intervention). Conclusions. Despite the shortcomings of included meta-analyses, consolidated evidence suggests that platelet-rich-fibrin and its derivatives as well as ozone therapy outperform the other nonpharmacological complementary interventions in reducing early and late postsurgical pain following third molar extraction. However, the results should be interpreted with caution due to an unclear risk of bias and lack of firm evidence in the included meta-analyses. Moreover, there is a need for a standard protocol for the application of nonpharmacological complementary interventions.

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