Effect of platelet-rich fibrin in reducing postoperative complications after impacted third molar surgery: a prospective, randomized controlled clinical trial

Yıl 2017, Cilt: 34 Sayı: 2, 46 - 49, 15.03.2017

Alparslan Esen , Dilek Menziletoğlu , Bozkurt Kubilay Işık

https://doi.org/10.17214/gaziaot.281897

Öz

Objective: The first aim of this study was to evaluate the effect of platelet-rich fibrin (PRF) on pain, swelling, and trismus after mandibular impacted third molar surgery without the use of postoperative antibiotics. A second aim was to evaluate the patients’ quality of life (QOL) during the postoperative period.

Materials and Method: Forty patients, who had bony impacted, mesio-angular mandibular third molars that were fully covered with mucosa, were selected. Patients were divided into two groups: PRF was placed in the socket in the first group and, traditional surgery was performed in the second group (the socket was left empty). The same surgeon performed all surgeries under local anesthesia. No antibiotics were prescribed after surgery. The outcome variables were pain, swelling, trismus, and QOL over a follow-up period of seven days.

Results: The mean age of the patients was 23.3 (±3.9) years in the first group, and 23.3 (±4.6) years in the second group. Statistical analyses of the postoperative results showed that there were no significant differences between the groups with regard to pain, swelling, trismus, and QOL scores (p>0.05).

Conclusion: The present study showed that PRF use had no significant effect on the postoperative pain, swelling, trismus, and QOL after impacted third molar surgery.

Anahtar Kelimeler

Oral surgery, pain, quality of life, tooth, impacted, trismus

Trombositten zengin fibrinin gömülü yirmi yaş dişi cerrahisi sonrası postoperatif komplikasyonların azaltılmasına etkisi: prospektif, randomize kontrollü klinik araştırma

Öz

Amaç: Bu çalışmanın birincil amacı, mandibular gömülü yirmi yaş dişi cerrahisi sonrası, antibiyotik kullanılmaksızın trombositten zengin fibrinin postoperatif ağrı, şişlik ve trismus üzerine etkilerini incelemektir. Ayrıca, diğer bir amaç da hastaların postoperatif dönemdeki yaşam kalitelerini değerlendirmektir.

Gereç ve Yöntem: Bu çalışmaya kemik retansiyonlu, üzeri tamamen mukoza ile kapalı, meziyo-angular pozisyonda gömülü dişlere sahip toplam 40 hasta dahil edildi. Hastalar iki gruba ayrıldı. Birinci gruptaki hastaların çekim soketine trombositten zengin fibrin yerleştirildi; ikinci gruba sadece geleneksel cerrahi uygulandı (soket boş bırakıldı). Bütün cerrahi işlemler lokal anestezi altında aynı cerrah tarafından yapıldı. Cerrahi sonrası hastalara antibiyotik reçete edilmedi. Yedi günlük takip periyodunda hastaların ağrı, şişlik, trismus ve yaşam kalitesi kayıtları değerlendirildi.

Bulgular: Hastaların yaş ortalaması birinci grupta 23.3 (±3.9) ve ikinci grupta 23.3 (±4.6) olarak bulundu. İstatistiksel analizler iki grup arasında postoperatif ağrı, şişlik, ağız açıklığı ve yaşam kalitesi skorları açısından fark olmadığını gösterdi (p>0.05).

Sonuç: Gömülü yirmi yaş dişi cerrahisinde trombositten zengin fibrin kullanımının postoperatif ağrı, şişlik, trismus ve yaşam kalitesi üzerine önemli bir etkisi olmadığı sonucuna varıldı.

Anahtar Kelimeler

Ağrı, diş, gömülü, oral cerrahi, trismus, yaşam kalitesi

Kaynakça

• Conrad SM, Blakey GH, Shugars DA, Marciani RD, Phillips C, White RP. Patients' perception of recovery after third molar surgery. J Oral Maxillofac Surg 1999;57:1288-94.
• Savin J, Ogden GR. Third molar surgery a preliminary report on aspects affecting quality of life in the early postoperative period. Br J Oral Maxillofac Surg 1997;35:246-53.
• Ogundipe OK, Ugboko VI, Owotade FJ. Can autologous platelet-rich plasma gel enhance healing after surgical extraction of mandibular third molars? J Oral Maxillofac Surg 2011;69:2305-10.
• Kumar N, Prasad K, Ramanujam L, Dexith J, Chauhan A. Evaluation of treatment outcome after impacted mandibular third molar surgery with the use of autologous platelet-rich fibrin: a randomized controlled clinical study. J Oral Maxillofac Surg 2015;73:1042-49.
• Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:37-44.
• Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:45-50.
• Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part V: histologic evaluations of PRF effects on bone allograft maturation in sinus lift. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:299-303.
• Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:56-60.
• Magremanne M, Baeyens W, Awada S, Vervaet C. Solitary bone cyst of the mandible and platelet rich fibrin (PRF). Rev Stomatol Chir Maxillofac 2009;110:105-8.
• Ozgul O, Senses F, Er N, Tekin U, Tuz HH, Alkan A, et al. Efficacy of platelet rich fibrin in the reduction of the pain and swelling after impacted third molar surgery: randomized multicenter split-mouth clinical trial. Head Face Med 2015;11:37.
• Hyland ME, Sodergren SC. Development of a new type of global quality of life scale, and comparison of performance and preference for 12 global scales. Qual Life Res 1996;5:469-80.
• Xue P, Wang J, Wu B, Ma Y, Wu F, Hou R. Efficacy of antibiotic prophylaxis on postoperative inflammatory complications in Chinese patients having impacted mandibular third molars removed: a split-mouth, double-blind, self-controlled, clinical trial. Br J Oral Maxillofac Surg 2015;53:416-20.
• Singh A, Kohli M, Gupta N. Platelet rich fibrin: a novel approach for osseous regeneration. J Maxillofac Oral Surg 2012;11:430-4.
• Arteagoitia I, Ramos E, Santamaria G, Barbier L, Alvarez J, Santamaria J. Amoxicillin/clavulanic acid 2000/125 mg to prevent complications due to infection following completely bone-impacted lower third molar removal: a clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol 2015;119:8-16.
• Ren YF, Malmstrom HS. Effectiveness of antibiotic prophylaxis in third molar surgery: a meta-analysis of randomized controlled clinical trials. J Oral Maxillofac Surg 2007;65:1909-21.
• Delilbasi C, Saracoglu U, Keskin A. Effects of 0.2% chlorhexidine gluconate and amoxicillin plus clavulanic acid on the prevention of alveolar osteitis following mandibular third molar extractions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94:301-4.
• Kumar YR, Mohanty S, Verma M, Kaur RR, Bhatia P, Kumar VR, et al. Platelet-rich fibrin: the benefits. Br J Oral Maxillofac Surg 2016;54:57-61.
• Gürbüzer B, Pikdöken L, Tunali M, Urhan M, Küçükodaci Z, Ercan F. Scintigraphic evaluation of osteoblastic activity in extraction sockets treated with platelet-rich fibrin. J Oral Maxillofac Surg 2010;68:980-9.