Platelet-rich fibrin for wound healing of palatal donor sites of free gingival grafts: Systematic review and meta-analysis

Abstract

Background Platelet-rich fibrin (PRF) has been referred to as a second-generation platelet concentrate, associated with improvements on the healing of palatal wounds followed by FGG harvesting. The aim of this systematic review and meta-analysis was to assess the complete wound epithelialization and postoperative pain when PRF was used in palatal wounds following free gingival graft (FGG) harvesting. Material and Methods PubMed (Medline), EMBASE and Scopus were searched by two independent individuals up to and including March 2020 in order to identify controlled and randomized controlled clinical trials on the use of PRF at palatal donor sites of FGG. The outcomes assessed were epithelialization and postoperative pain. The risk of bias of the included studies was evaluated using Cochrane Collaboration’s domain-based two-part tool. Random effects meta-analyses were conducted with 95% confidence intervals. Results The search strategy identified 555 potentially eligible articles, of which 6 randomized controlled clinical trials were included. In the qualitative analysis, most studies (83.3%) reported lower postoperative pain in treatment groups, while all studies accessing epithelialization demonstrated earlier complete wound closure in groups treated with PRF. The discomfort and complete re-epithelialization were more favorable in groups PRF when compared to control groups ( P <0.00001). Conclusions Within the limits of the present study, it can be concluded that the use of PRF for wound healing of palatal donor sites of FGG may decrease postoperative pain and induce earlier complete wound epithelialization. Key words: Wound healing, oral surgery procedures, pain, postoperative.

Patient Reported Outcome of Palatal Donor Site After Harvesting Connective Tissue Graft With or Without Platelet-rich Fibrin: A Prospective Clinical Study

“…This may be related to the fact that PRF produces large amounts of primary growth factors during the first 7 days. Lektemur-Alpan and Torumtay-Cin, 19 Gusman et al, 20 and Basma et al 21 also observed better healing properties with PRF. Within the group also, there was a statistically significant higher mucosal thickness in Group A (PRF) as compared with statistical decrease in Group B (Control) after 10 days.…”

“…This may be related to the fact that PRF produces large amounts of primary growth factors during the first 7 days. Lektemur-Alpan and Torumtay-Cin, 19 Gusman et al, 20 and Basma et al 21 also observed better healing properties with PRF.…”

The use of platelet‐rich fibrin in vestibuloplasty: A 36‐month follow‐up technique report

“…These results are similar to those obtained with PRF, 3 so its use could be considered in secondary epithelialization, as well as an alternative to FGGs. Compared to the latter, the use of PRF decreased operative time (29.10 min [±4.80] vs. 48.10 min [±4.40]; p < 0.01), as well as pain and discomfort during the 6 postoperative days 3 as it does not require a second surgical area and acts as a local modulator of the immune system, controlling inflammation and reducing the rate of postoperative infections, 14 resulting in fewer doses of analgesics 15 . On the other hand, the tissue color and consistency are more natural as it does not produce a “patch effect.”…”

Modifications in the Free Gingival Graft Technique: A Systematic Review

“…A study by Gusman et al evaluated the healing process and pain levels after using PRF in palatal wounds post-free gingival graft (FGG) removal. Their findings suggested that using PRF in palatal donor sites of FGG could potentially reduce postoperative pain and accelerate complete wound healing [ 27 ]. Gul and colleagues conducted a longitudinal clinical study to investigate the relationship between creeping attachment and baseline recession depth following the placement of free gingival grafts (FGG) below class I, II, and III Miller's recession defects.…”