Evaluation of low-level laser therapy and platelet-rich fibrin on donor site healing after vascularized interpositional periosteal connective tissue flap: a randomized clinical study

Abstract

Aim To evaluate the effectiveness of platelet-rich fibrin (PRF) and low-level laser therapy (LLLT) on donor site healing after vascularized interpositional periosteal connective tissue (VIP-CT) flap. Materials and methods For the present clinical study, the selected patients requiring VIP-CT flap were randomly assigned into either of the two treatment groups (VIP-CT/PRF and VIP-CT/LLLT). For VIP-CT/PRF, palatal donor site treated with platelet-rich fibrin (PRF, n = 15) after harvesting VIP-CT flap; and for VIP-CT/LLLT, palatal donor site treated with low-level laser therapy (LLLT, n = 16) after harvesting VIP-CT flap. Results The mean thickness of palatal mucosa at surgical site was increased from 2.91 ± 0.65 to 2.93 ± 0.55 mm after 1 week and to 3.02 ± 0.55 mm after 12 weeks while in PRF-treated site, while in LLLT-treated sites, palatal mucosal thickness decreased after 1 week from 3.35 ± 0.56 mm to 1.83 ± 0.48 mm and then increase to 3.35 ± 0.55 mm after 12 weeks, and the mean difference was significantly higher for PRF-treated group compared to LLLT-treated group. In regard to contour, absence of hypertrophic tissue was observed in VIP-CT/LLLT compared with VIP-CT/PRF group (40% of patients, p = 0.003) at 4 weeks. “Absence” of pain and burning sensation were observed as early as at 1 week in LLLT-treated palatal donor sites compared to PRF-treated palatal donor site after VIP-CT. Improvement in post-surgical complications like ecchymosis, tissue necrosis, swelling, and infection were observed almost 100% at 4 weeks in both the groups. Conclusion Favourable clinical outcomes in terms of tissue thickness, consistency, color, contour, scar, pain, and burning sensation and patient comfort were obtained in both LLLT- and PRF-treated donor palatal sites at 12 weeks. Non-significant increase in tissue thickness was observed compared to baseline in PRF-treated donor sites at 12 weeks compared to LLLT-treated donor sites. Clinical significance Both low-level laser therapy (LLLT) using 940 nm wavelength and autologous platelet-rich fibrin (PRF) can be utilized to enhance early wound healing and reduce the palatal donor site morbidity.

Wound‐healing agents for palatal donor area: A network meta‐analysis

“…Mukhtar et al. (2023) also showed superior results for pain control using laser therapy in comparison to L‐PRF. No differences between L‐PRF, collagen hemostatic sponge (Sharma et al., 2019), and hemostatic agent with oxidized and regenerated cellulose (Gatti et al., 2023) were observed for pain levels.…”

“…Eight studies (Bitencourt et al., 2022; da Silva Neves et al., 2016; Dias et al., 2015; Heidari et al., 2017; Lafzi et al., 2019; Lavu et al., 2022; Morshedzadeh et al., 2022; Mukhtar et al., 2023) reported superior wound healing with the use of diode laser in comparison to spontaneous healing (Bitencourt et al., 2022; da Silva Neves et al., 2016; Dias et al., 2015; Heidari et al., 2017; Lafzi et al., 2019; Lavu et al., 2022), palatal stent (Morshedzadeh et al., 2022) and L‐ PRF (Mukhtar et al., 2023). Laser modulation using LED also promoted higher wound healing in comparison to spontaneous healing (Vieira et al., 2010).…”

“…One case series (with three patients per group) showed superior results for collagen hemostatic sponge in comparison to L-PRF in terms of pain duration and analgesic consumption (Belkhede et al, 2019). Mukhtar et al (2023) also showed superior results for pain control using laser therapy in comparison to L-PRF. No differences between L-PRF, TA B L E 1 Articles excluded with the reasons after evaluating the full text.…”