ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 35 of 67
УЖМБС 2020, 5(4): 265–272

Clinical Evaluation of the Efficacy of Platelet-Rich Fibrin Application and its Compositions after Atypical Removal of the Lower Third Molars

Vares Ya. E., Slipyi V. Z.

The purpose of the study was to evaluate the clinical efficacy of applying platelet-rich fibrin (A-PRF+®) and its compositions for substitution of post-extraction sockets after atypical removal of the lower third molars. Material and methods. 26 patients (14 women and 12 men aged 17-49 years) were examined and treated with retention and dystopia, caries complications, and “wisdom teeth” pericoronitis. The course of the postoperative period in patients after atypical “wisdom teeth” removal was studied by establishing the duration and level of pain, local thermometry, evaluation of dental health and quality of life of patients, timing of complete epithelialization of the wound and removal of sutures. Additionally, CT scans were performed on a cone-beam computed tomograph "Veraviewepocs 3D R100" (J. Morita Manufacturing Corporation, Japan) for assessment of dimensional changes of alveolar processes, bone tissue volume and bone density in the defect area using i-Dixel 2.1 tomography viewer software. Results and discussion. Intraoperative use of A-PRF+® and its compositions after atypical removal of the lower third molars significantly reduced the duration and intensity of pain, the period of local hyperthermia, stimulated wound epithelization, which ultimately had a positive effect on subjective assessment of dental health and quality of life of patients. Inflammatory complications weren't detected in patients of the basic groups, while in 1 (16.6%) patients of the control group “dry socket” syndrome with subsequent development of acute alveolitis was observed. After 6 months of observation, we noted the decrease in the distance between the occlusal plane and the level of the bone behind the second molar. Accordingly, the bone growth compared to baseline preoperative measurements was 22.4% in patients of the main group A, 27.5% in patients of the main group B, 29.2% in patients of the main group C against 12.9% in the patients of the control group. The level of horizontal atrophy of alveolar processes in this period compared with baseline measurements was 10.1% in patients of the main group A, 6.2% in patients of the main group B, 5.0% in patients of the main group C against 21.2% in patients of the control group. Indicators of bone density at the end of the observation period were recorded at 559.16 ± 31.01 units HU in patients of the main group A, 619.62±31.53 units HU in patients of the main group B, 652.70±48.41 units HU in patients of the main group C, reaching the level of bone density of adjacent areas, while this figure in patients of the control group was only 381.38±35.58 units HU and did not reach the level of mineral density of neighboring bone massifs. Conclusion. The results of the clinical study indicated that intraoperative use of A-PRF+® and its compositions had positive effect on the postoperative period flow, reduced the level of vertical and horizontal atrophy and prevented alveolitis and other inflammatory complications after atypical removal of the lower third molars.

Keywords: advanced platelet rich fibrin (A-PRF), “wisdom teeth”, retention, dystopia

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  1. Al-Hamed FS, Tawfik MAM, Abdelfadil E. Clinical effects of platelet-rich fibrin (PRF) following surgical extraction of lower third molar. The Saudi Journal for Dental Research. 2017; 8(1-2): 19-25.
  2. Eshghpour M, Dastmalchi P, Nekooei AH, Nejat AH. Effect of Platelet-Rich Fibrin on Frequency of Alveolar Osteitis Following Mandibular Third Molar Surgery: A Double-Blinded Randomized Clinical Trial. Journal of Oral and Maxillofacial Surgery. 2014; 72(8): 1463-7.
  3. Hoaglin DR, Lines GK. Prevention of Localized Osteitis in Mandibular Third-Molar Sites Using Platelet-Rich Fibrin. International Journal of Dentistry. 2013; 2013: 1-4.
  4. Vares YaE, Kiyak SV. Structure and Peculiarities of Third Molar Retention. Visnyk problem biolohii i medytsyny. 2015; 2(3): 355-8. [Ukrainian]
  5. Gudarjan AA, Idashkina NG, Nekhanevych ZhM. Using different fractions of autoplazma's blood (PRF, a-PRF, i-PRF) in the surgical treatment of impacted mandibular third molars. Visnyk problem biolohii i medytsyny. 2017; 1(135): 352-6. [Ukrainian]
  6. Pyptiuk TV, Piuryk VP, Pyptiuk VM. Surgical Treatment of Patients with Difficult Eruption of the Lower Third Molars. Halytskyi likarskyi visnyk. 2012; 19(1): 161-4. [Ukrainian]
  7. Khomych NМ. Comprehensive topical treatment of postoperative complications after atypical extraction of lower third molars. Abstr. PhDr. (Med.). Lviv nats med un-t im Danyla Halytskoho; 2017. 20 p. [Ukrainian]
  8. Kumar N, Prasad K, Ramanujam L, Ranganath K, 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. Journal of Oral and Maxillofacial Surgery. 2015; 73(6): 1042-9.
  9. Ruga E, Gallesio C, Boffano P. Platelet-rich fibrin and piezoelectric surgery: a safe technique for the prevention of periodontal complications in third molar surgery. Journal of Craniofacial Surgery. 2011; 22(5): 1951-5.
  10. Mourão CF de AB, de Mello-Machado RC, Javid K, Moraschini V. The use of leukocyte- and platelet-rich fibrin in the management of soft tissue healing and pain in post-extraction sockets: A randomized clinical trial. Journal of Cranio-Maxillofacial Surgery. 2020; 48(4): 452-7.
  11. Srinivas B, Das P, Rana MM, Qureshi AQ, Vaidya KC, Raziuddin SJA. Wound healing and bone regeneration in postextraction sockets with and without platelet-rich fibrin. Annals of Maxillofacial Surgery. 2018; 8(1): 28-34.
  12. Fujioka-Kobayashi M, Miron RJ, Hernandez M, Kandalam U, Zhang Y, Choukroun J. Optimized Platelet-Rich Fibrin With the Low-Speed Concept: Growth Factor Release, Biocompatibility, and Cellular Response. Journal of Periodontology. 2017; 88(1): 112-21.
  13. El Bagdadi K, Kubesch A, Yu X, Al-Maawi S, Orlowska A, Dias A et al. Reduction of relative centrifugal forces increases growth factor release within solid platelet-rich-fibrin (PRF)-based matrices: a proof of concept of LSCC (low speed centrifugation concept). European Journal of Trauma and Emergency Surgery. 2017; 45(3): 467-79.
  14. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJJ, Mouhyi J et al. Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part III: Leucocyte activation: A new feature for platelet concentrates? Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2006; 101(3): e51-e55.
  15. Collins SL, Moore RA, McQuay HJ. The visual analogue pain intensity scale: what is moderate pain in millimetres? Pain. 1997; 72(1): 95-7.
  16. Bezrukov SG, Shchepelev AA. Evaluation of efficiency of a method preventing postextraction bone-tissue atrophy by perialveolar injection of plasma enriched with platelets. Tavricheskij mediko-biologicheskij vestnik. 2012; 4(60): 51-6. [Russian]
  17. Dimofte M, Choukroun J, Moscalu M, Popescu E. Quality of Life after using of Platelet Rich Fibrin (PRF) in Patients with Alveoloplastic Extraction. Revista de cercetare si interventie sociala. 2016; 55: 31-46.
  18. Malanchuk VO, Kopchak AV. Evaluation of the quality of facial bones and skull classification of its type on the basis of biomechanical parameters. Ukr med chasopys. 2013; 1(93): 126-31. [Ukrainian]