Pain and quality of life after endodontic surgery with or without advanced platelet-rich fibrin membrane application: a randomized clinical trial.

Abstract

Clinical evidence of the autologous platelet concentrates effects on the patient-reported outcome measures (PROMs) after endodontic surgery is still limited. To investigate the effect of the advanced platelet-rich fibrin (A-PRF+) membrane application upon patient postoperative pain, and quality of life in endodontic surgery. A two-parallel-arm randomized clinical trial was made comparing endodontic surgery with or without A-PRF+ as adjunctive treatment. Fifty individuals comprehending 50 apical lesions (second premolar to the second premolar) of upper maxilla were included. Pain perception and quality of life (functional limitations and other symptoms) were assessed 1week after surgery using a visual analog scale and a Likert scale-based questionnaire. Descriptive analysis was done using χ2 and t test. Binary logistic regression, ANOVA-type statistic, and GEE analysis were used for inferential analysis. Pain perception was mild in both groups [A-PRF+ 12.7 ± 8.5] versus [no A-PRF+ 20.7 ± 16.3]; it proved less variable during the first 4days in test group, showing lower extreme pain values (p = 0.096). Analgesic use was similar in both groups. Controls reported significantly worse sleep and speech functions (p < 0.05). Bleeding and bad taste/breath were the most discriminative symptoms. Postoperative pain perception was mild in endodontic surgery of the upper anterior maxilla. Differences in pain perception were not statistically significant. The use of A-PRF+ afforded less variable pain perception than in the controls. Altered quality of life parameters were more prevalent in the control group and prove significant for speech and sleep functions. Patient-related outcomes are of utmost importance in clinical practice. The use of A-PRF+ provides an affordable and safe alternative to improve postoperative quality of life in endodontic surgery.