Abstract
This study assessed the effects of leukocyte-platelet-rich fibrin (L–PRF) on soft tissue healing and the correlation with the local concentration of growth factors (GF) and cytokines in the dental socket of lower third molars. Forty lower-third molars (20 participants) were included in this randomized, double-blinded, split-mouth study. After extractions, randomized sides received alveolar filling with L–PRF on one side and a natural blood clot on the other side. The pain was assessed for up to seven days and soft tissue healing (Landry index) for 14 days post-extraction. Swabs were collected from the surgical sites for GF and cytokine assessment by flow luminometry. Participants reported lower postoperative pain on the sides grafted with L–PRF, which also presented increased tissue healing scores (p < 0.05). There were increased levels of all GFs and several cytokines at the L–PRF site at day one, while vascular endothelial growth factor (VEGF), IL–10, and IL1–RA remained higher throughout for seven days (p < 0.05). VEGF concentration at L–PRF sites correlated positively with the participants’ blood platelet content (ρ = 0.769). PDGF correlated negatively with pain experience on days 2 and 3, and positively with soft tissue healing scores, while FGFb presented a weak correlation with a reduction of pain on day 3. The use of L–PRF improves the soft tissue healing process and decreases postoperative pain after the third molar extractions, which correlates with an increase in the local concentration of growth factors such as PDGF and FGFb.
Highlights
Lower third molar tooth extraction is one of the most common surgeries performed by dental surgeons in the daily clinic
The present study aimed to evaluate the tissue repair and postoperative pain in lower third molar extraction sockets treated with leukocyte-platelet-rich fibrin (L–PRF), assessing the correlation between these outcomes and the presence of growth factors and cytokines quantified at the surface of the surgical site by using a swab extraction method
The purpose of the present study was to assess the effects of L–PRF on the healing process of the lower third molars extraction socket and its relationship with the local concentration of growth factors and cytokines
Summary
Lower third molar tooth extraction is one of the most common surgeries performed by dental surgeons in the daily clinic. Different strategies have been developed to reduce the risk of these complications and improve tissue healing. One of the current strategies is the implantation of the leukocyte-platelet-rich fibrin (L–PRF) immediately after tooth extraction. Prior studies have demonstrated the effectiveness of this autologous biomaterial in reducing postoperative complications in third molars [4,5]. This second-generation autologous blood-derived biomaterial contains a dense fibrin mesh with increased contents of platelets and leukocytes, as well as increased concentrations of essential growth factors and cytokines that will assist in tissue repair, especially concerning soft tissue healing [6,7].
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