Advanced Platelet-Rich Fibrin as a Therapeutic Option in the Treatment of Dry Socket: Literature Review and Case Series

Gaetano Marenzi,Gilberto Sammartino,Mauro Mariniello,Alessandro Espedito Di Lauro,Roberta Gasparro,Claudia Capone

doi:10.3390/app11209474

Gaetano Marenzi, Gilberto Sammartino + Show 4 more

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https://doi.org/10.3390/app11209474

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Journal: Applied sciences	Publication Date: Oct 12, 2021
License type: CC BY 4.0

Affiliation: University of Naples Federico II

Abstract

Alveolar osteitis (AO) is one of the complications that occur after tooth extraction. The aim of this study has been to evaluate the efficacy of Advanced Platelet-rich Fibrin (A-PRF) in the management of pain and the acceleration of wound healing in the treatment of AO. Consecutive patients who were diagnosed with AO, recruited from patients referred to the Oral Surgery Department of the University of Naples Federico II, were enrolled. After local anesthesia, the dry socket was curetted and irrigated with saline. The Platelet-rich Fibrin (PRF) clot was placed in the socket and then covered with an A-PRF membrane. Clinical parameters, such as the degree of pain and rate of granulation tissue (GT) formation, were measured before treatment and after 1, 3, 7, 14, and 21 days. The Friedman test for dependent samples was used to detect the treatment and time effect. Four patients with established AO were included. On all the examination days, the post-operative recovery was uneventful. The pain scores progressively reduced, from an average of 8.5 before treatment to 0.25 on the third day, and the GT formation improved over time. The use of A-PRF in the treatment of AO significantly reduced the pain level and enhanced the wound-healing process.

Highlights

Alveolar osteitis (AO), originally described by Crawford in 1896, is one of the complications that occur after tooth extraction [1]
The underlying etiology remains unclear, dry socket is related to an alteration in the formation of the blood clot
According to Birn [10], dry sockets show increased fibrinolytic activity and activation of plasminogen in the plasmin resulting in an early dissolution of the blood clot, which leaves the bony wall exposed to the oral cavity

Summary

Introduction

Alveolar osteitis (AO), originally described by Crawford in 1896, is one of the complications that occur after tooth extraction [1]. It is accompanied by a partially or totally disintegrated blood clot resulting in the exposure of the alveolar socket walls, associated with acute and intense pain, without any sign of inflammation or infection and with or without halitosis [2,3]. AO is still poorly understood and different factors have been reported as being predisposing factors for the development of dry socket, relating either to the patient, such as age, gender, smoking habit, or the use of oral contraceptives, or to a traumatic surgical extraction or previous infection [6,7,8]. According to Birn [10], dry sockets show increased fibrinolytic activity and activation of plasminogen in the plasmin resulting in an early dissolution of the blood clot, which leaves the bony wall exposed to the oral cavity

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