Abstract
BackgroundThe present study investigated and evaluated the efficacy and safety of platelet-rich fibrin (PRF) in patients during bilateral mandibular third molars extraction by systematic review and meta-analysis.MethodsThe PubMed, Embase, and Cochrane library databases were retrieved, and the effect of PRF on the healing process of the alveolar socket after surgical extraction of the mandibular third molars was evaluated by meta-analysis. The postoperative pain, swelling, trismus, osteoblastic activity, and soft tissue healing were assessed, and the incidence of alveolar osteitis, weighted mean difference (WMD)/standard mean difference (SMD), the risk ratio (RR), and the 95% confidence interval (CI) were calculated.ResultsThe current results showed that the local application of PRF during lower third molar extraction prevented postoperative complications. Subsequently, the pain (SMD = − 0.53, 95% CI: − 1.02–-0.05, Pheterogeneity = 0.001, I2 = 75.7%) and swelling (WMD = − 0.55, 95% CI: − 1.08–-0.01, Pheterogeneity = 0.573, I2 = 0) were relieved and the incidence of alveolar osteitis was reduced (RR = 0.35, 95% CI: 0.16–0.75, Pheterogeneity = 0.597, I2 = 0%). However, no significant difference was observed in trismus, osteoblastic activity, and soft tissue healing between the PRF and non-PRF groups.ConclusionThe current study confirms that PRF only reduces some of the postoperative complications but does not prevent all the postoperative complications. PRF significantly relieved the pain and swelling and reduced the incidence of alveolar osteitis after the extraction of an impacted lower third molar.
Highlights
The present study investigated and evaluated the efficacy and safety of platelet-rich fibrin (PRF) in patients during bilateral mandibular third molars extraction by systematic review and meta-analysis
The current results showed a beneficial effect of PRF in relieving pain and swelling and reducing the incidence of alveolar osteitis after the extraction of an impacted lower third molar
As a reservoir of platelets, cytokines, leukocytes, and immune cells, PRF allows a sustained release of cytokines such as Vascular endothelial growth factor (VEGF), PDGF, Transforming growth factor (TGF), and epidermal growth factor (EGF) that play a key role in vascular and tissue healing and scarring [11, 13, 14]
Summary
The present study investigated and evaluated the efficacy and safety of platelet-rich fibrin (PRF) in patients during bilateral mandibular third molars extraction by systematic review and meta-analysis. After the impacted third molars are removed in the early postoperative stage, patients usually present complications such as pain, swelling, and trismus [2, 3]. These inflammatory complications are crucial for patients and surgeons in order to develop the customized strategy for reducing the risk of complications and improving postoperative healing [4]. The PRF originates from the slow, gradual polymerization occurring during centrifugation [15] This is the second generation of immune platelet concentrate, collected as single fiber membrane protein components of the blood sample.
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