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CC BY-NC-ND 4.0 · Eur J Dent 2020; 14(01): 063-069
DOI: 10.1055/s-0040-1702259
Original Article

Effect of A-PRF Application on Palatal Wound Healing after Free Gingival Graft Harvesting: A Prospective Randomized Study

Filipa Sousa
1   Department of Periodontology, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
,
Vanessa Machado 
1   Department of Periodontology, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
,
João Botelho 
1   Department of Periodontology, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
,
Luís Proença 
2   Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
,
José João Mendes 
2   Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
,
Ricardo Alves 
1   Department of Periodontology, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
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Abstract

Objective The aim of this study was to investigate the healing effect of advanced platelet-rich fibrin (A-PRF) clot membranes in palatal wounds, resulting from free gingival graft (FGG) harvesting, on the reepithelization rate and on the pain experience after surgery.

Materials and Methods Twenty-five patients requiring FGG have participated in this prospective cohort study. After FGG harvesting, the test group (n = 14) received A-PRF clot membranes at the palatal wound and the control group (n = 11) received a gelatin sponge. Epithelialization rate of the palatal wound, wound healing area, correspondent percentage of reduction, and postsurgical pain experience were assessed at 2, 7, 14, 30, and 90 days.

Results A-PRF group had higher palatal wound reduction than the control group, at 7, 14, and 30 days of follow-up. The highest difference between the groups was attained at 30 days (91.5% for A-PRF vs. 59.0% control group). At 14 days, a significant difference in the proportion of patients showing total epithelization was found: 64.3% for A-PRF versus 9.1% for the control group. At 90 days, both groups showed total recovery. The control group experienced higher pain level and discomfort until the 14th day, being notably higher on the second day.

Conclusion The results suggest that A-PRF membranes haste the healing process, and promote greater reduction along the recovery period and less painful postoperative period.

Keywords

advanced platelet-rich fibrin - biomaterials - free gingival graft - pain - wound healing


Publikationsverlauf

Artikel online veröffentlicht:
13. März 2020

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Thieme Medical and Scientific Publishers Private Ltd.
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  • References

  • 1 Dragan IF, Hotlzman LP, Karimbux NY, Morin RA, Bassir SH. Clinical outcomes of comparing soft tissue alternatives to free gingival graft: a systematic review and meta-analysis. J Evid Based Dent Pract 2017; 17 (04) 370-380.e3
    CrossrefPubMedGoogle Scholar
  • 2 Silva CO, Ribeiro EdelP, Sallum AW, Tatakis DN. Free gingival grafts: graft shrinkage and donor-site healing in smokers and non-smokers. J Periodontol 2010; 81 (05) 692-701
    CrossrefPubMedGoogle Scholar
  • 3 Bennani V, Ibrahim H, Al-Harthi L, Lyons KM. The periodontal restorative interface: esthetic considerations. Periodontol 2000 2017; 74 (01) 74-101
    CrossrefPubMedGoogle Scholar
  • 4 Bahammam MA. Effect of platelet-rich fibrin palatal bandage on pain scores and wound healing after free gingival graft: a randomized controlled clinical trial. Clin Oral Investig 2018; 22 (09) 3179-3188
    CrossrefPubMedGoogle Scholar
  • 5 Dohan DM, Choukroun J, Diss A. et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part III: leucocyte activation: a new feature for platelet concentrates?. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101 (03) e51-e55
    CrossrefPubMedGoogle Scholar
  • 6 Caruana A, Savina D, Macedo JP, Soares SC. From platelet-rich plasma to advanced platelet-rich fibrin: biological achievements and clinical advances in modern surgery. Eur J Dent 2019; 13 (02) 280-286
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 7 Dohan Ehrenfest DM, Del Corso M, Diss A, Mouhyi J, Charrier J-B. Three-dimensional architecture and cell composition of a Choukroun’s platelet-rich fibrin clot and membrane. J Periodontol 2010; 81 (04) 546-555
    CrossrefPubMedGoogle Scholar
  • 8 Theys T, Van Hoylandt A, Broeckx CE. et al. Plasma-rich fibrin in neurosurgery: a feasibility study. Acta Neurochir (Wien) 2018; 160 (08) 1497-1503
    CrossrefPubMedGoogle Scholar
  • 9 Castro AB, Meschi N, Temmerman A. et al. Regenerative potential of leucocyte- and platelet-rich fibrin. Part A: intra-bony defects, furcation defects and periodontal plastic surgery. A systematic review and meta-analysis. J Clin Periodontol 2017; 44 (01) 67-82
    CrossrefPubMedGoogle Scholar
  • 10 Castro AB, Meschi N, Temmerman A. et al. Regenerative potential of leucocyte- and platelet-rich fibrin. Part B: sinus floor elevation, alveolar ridge preservation and implant therapy. A systematic review. J Clin Periodontol 2017; 44 (02) 225-234
    CrossrefPubMedGoogle Scholar
  • 11 Fredes F, Pinto J, Pinto N. et al. Potential effect of leukocyte-platelet-rich fibrin in bone healing of skull base: a pilot study. Int J Otolaryngol 2017; 2017: 1231870
    PubMedGoogle Scholar
  • 12 Ding H, Yuan JQ, Zhou JH. et al. Systematic review and meta-analysis of application of fibrin sealant after liver resection. Curr Med Res Opin 2013; 29 (04) 387-394
    CrossrefPubMedGoogle Scholar
  • 13 Agarwal SK, Jhingran R, Bains VK, Srivastava R, Madan R, Rizvi I. Patient-centered evaluation of microsurgical management of gingival recession using coronally advanced flap with platelet-rich fibrin or amnion membrane: A comparative analysis. Eur J Dent 2016; 10 (01) 121-133
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 14 Sharma A, Aggarwal N, Rastogi S, Choudhury R, Tripathi S. Effectiveness of platelet-rich fibrin in the management of pain and delayed wound healing associated with established alveolar osteitis (dry socket).. Eur J Dent 2017; 11 (04) 508-513
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 15 Abirami T, Subramanian S, Prakash PSG, Victor DJ, Devapriya AM. Comparison of connective tissue graft and platelet rich fibrin as matrices in a novel papillary augmentation access: a randomized controlled clinical trial. Eur J Dent 2019; 13 (04) 607-612
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 16 Ghanaati S, Booms P, Orlowska A. et al. Advanced platelet-rich fibrin: a new concept for cell-based tissue engineering by means of inflammatory cells. J Oral Implantol 2014; 40 (06) 679-689
    CrossrefPubMedGoogle Scholar
  • 17 Masuki H, Okudera T, Watanebe T. et al. Growth factor and pro-inflammatory cytokine contents in platelet-rich plasma (PRP), plasma rich in growth factors (PRGF), advanced platelet-rich fibrin (A-PRF), and concentrated growth factors (CGF).. Int J Implant Dent 2016; 2 (01) 19
    CrossrefPubMedGoogle Scholar
  • 18 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. J Periodontol 2017; 88 (01) 112-121
    CrossrefPubMedGoogle Scholar
  • 19 Miron RJ, Chai J, Zheng S, Feng M, Sculean A, Zhang Y. A novel method for evaluating and quantifying cell types in platelet rich fibrin and an introduction to horizontal centrifugation. J Biomed Mater Res A 2019; 107 (10) 2257-2271
    CrossrefPubMedGoogle Scholar
  • 20 Femminella B, Iaconi MC, Di Tullio M. et al. Clinical comparison of platelet-rich fibrin and a gelatin sponge in the management of palatal wounds after epithelialized free gingival graft harvest: a randomized clinical trial. J Periodontol 2016; 87 (02) 103-113
    CrossrefPubMedGoogle Scholar
  • 21 Ozcan M, Ucak O, Alkaya B, Keceli S, Seydaoglu G, Haytac MC. Effects of platelet-rich fibrin on palatal wound healing after free gingival graft harvesting: a comparative randomized controlled clinical trial. Int J Periodontics Restorative Dent 2017; 37 (05) e270-e278
    CrossrefPubMedGoogle Scholar
  • 22 Clark D, Rajendran Y, Paydar S. et al. Advanced platelet-rich fibrin and freeze-dried bone allograft for ridge preservation: A randomized controlled clinical trial. J Periodontol 2018; 89 (04) 379-387
    CrossrefPubMedGoogle Scholar
  • 23 Soto-Peñaloza D, Peñarrocha-Diago M, Cervera-Ballester J, Peñarrocha-Diago M, Tarazona-Alvarez B, Peñarrocha-Oltra D. Pain and quality of life after endodontic surgery with or without advanced platelet-rich fibrin membrane application: a randomized clinical trial. Clin Oral Investig 2019; DOI: 10.1007/s00784-019-03033-5.
    CrossrefPubMedGoogle Scholar
  • 24 Zuhr O, Bäumer D, Hürzeler M. The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution. J Clin Periodontol 2014; 41 (Suppl. 15) S123-S142
    CrossrefPubMedGoogle Scholar
  • 25 Kulkarni MR, Thomas BS, Varghese JM, Bhat GS. Platelet-rich fibrin as an adjunct to palatal wound healing after harvesting a free gingival graft: a case series. J Indian Soc Periodontol 2014; 18 (03) 399-402
    CrossrefPubMedGoogle Scholar
  • 26 Ustaoğlu G, Ercan E, Tunali M. The role of titanium-prepared platelet-rich fibrin in palatal mucosal wound healing and histoconduction. Acta Odontol Scand 2016; 74 (07) 558-564
    CrossrefPubMedGoogle Scholar
  • 27 Wyrębek B, Górski B, Górska R. Patient morbidity at the palatal donor site depending on gingival graft dimension. Dent Med Probl 2018; 55 (02) 153-159
    CrossrefPubMedGoogle Scholar
  • 28 Watanabe T, Isobe K, Suzuki T. et al. An evaluation of the accuracy of the subtraction method used for determining platelet counts in advanced platelet-rich fibrin and concentrated growth factor preparations. Dent J (Basel) 2017; 5 (01) 7
    CrossrefPubMedGoogle Scholar