Impact of platelet-rich fibrin on mandibular third molar surgery recovery: a systematic review and meta-analysis

Abstract

Background The present study investigated and evaluated the efficacy and safety of platelet-rich fibrin (PRF) in patients during bilateral mandibular third molars extraction by systematic review and meta-analysis. Methods The PubMed, Embase, and Cochrane library databases were retrieved, and the effect of PRF on the healing process of the alveolar socket after surgical extraction of the mandibular third molars was evaluated by meta-analysis. The postoperative pain, swelling, trismus, osteoblastic activity, and soft tissue healing were assessed, and the incidence of alveolar osteitis, weighted mean difference (WMD)/standard mean difference (SMD), the risk ratio (RR), and the 95% confidence interval (CI) were calculated. Results The current results showed that the local application of PRF during lower third molar extraction prevented postoperative complications. Subsequently, the pain (SMD = − 0.53, 95% CI: − 1.02–-0.05, P heterogeneity = 0.001, I 2 = 75.7%) and swelling (WMD = − 0.55, 95% CI: − 1.08–-0.01, P heterogeneity = 0.573, I 2 = 0) were relieved and the incidence of alveolar osteitis was reduced (RR = 0.35, 95% CI: 0.16–0.75, P heterogeneity = 0.597, I 2 = 0%). However, no significant difference was observed in trismus, osteoblastic activity, and soft tissue healing between the PRF and non-PRF groups. Conclusion The current study confirms that PRF only reduces some of the postoperative complications but does not prevent all the postoperative complications. PRF significantly relieved the pain and swelling and reduced the incidence of alveolar osteitis after the extraction of an impacted lower third molar. Electronic supplementary material The online version of this article (10.1186/s12903-019-0824-3) contains supplementary material, which is available to authorized users.

The Use of Autogenous Particulated Dentin Mixed With Platelet Rich Fibrin in Surgically Removed Lower Third Molar Socket.

“…They concluded that long-term trials with a larger sample size and more methodically sound assessment tools are needed to obtain more meaningful results on periodontal regeneration. Xiang et al (16) confirmed the beneficial effect of PRF in relieving pain and swelling and reducing the incidence of alveolar osteitis after the extraction of an impacted lower third molar. However, they found no difference with respect to trismus, osteoblastic activity, and soft tissue healing.…”

Case reports of medication-related osteonecrosis of the jaw (MRONJ) treated with uncultured stromal vascular fraction and L-PRF

“…MI could help to determine if L-PRF is stimulating osteoblastogenesis or is a simple dressing. No significant differences have been demonstrated by using PRF or not on the osteoblastic activity after third molar surgery in the systematic review and meta-analysis published by Xiang et al [25]. Farré -Guasch et al have observed, the strong SVF angiogenic properties in a clinical setting, with bone and blood vessel formation [26].…”

Dry socket - clinical procedures review

“…The use of PRGF can help to reduce pain and inflammation after tooth extraction, so a significant effect is observed in the quality of life after the procedure [25], similar effects have been demonstrated with the use of platelet-rich fibrin [26].…”