Effects of platelet-rich fibrin and piezosurgery on impacted mandibular third molar surgery outcomes

Lokman Onur Uyanık, Kani Bilginaylar, İlker Etikan, Lokman Onur Uyanık, Kani Bilginaylar, İlker Etikan

Abstract

Introduction: The aim of this study was the comparision of postoperative outcomes in impacted mandibular third molars that were treated using either platelet-rich fibrin (PRF), a combination of PRF and piezosurgery, or conventional rotatory osteotomy.

Patient and methods: The study included 20 patients; 40 extractions of impacted mandibular third molars were performed. Patients were divided into two main groups. In group A (n = 20), traditional surgery was performed on one side (Group 1, n = 10); traditional surgery was performed, and PRF was administered to the extracted socket on the other side of same patient (Group 2, n = 10). In group B (n = 20), on one side, piezosurgery was used for osteotomy, and PRF was administered (Group 3, n = 10); on the other side of same patient, traditional surgery was performed (Group 4, n = 10). Parameters assessed at baseline for each patient included pain, the number of analgesics taken, trismus, and cheek swelling. These variables were also assessed on postoperative days 1, 2, 3, and 7.

Results: Statistical analysis revealed a significant reduction in postoperative pain (sum of 1(st), 2(nd), 3(rd) and 7(th) days) and trismus (on postoperative day 1) in group 2 (traditional surgery + PRF group), and in postoperative pain, the number of analgesics taken (sum of 1(st), 2(nd),3(rd) and 7(th) days) and trismus (on postoperative day 1) in group 3 (piezosurgery + PRF group) compared to groups 1 and 4 (traditional surgery groups), (p ≤ 0.05). However, swelling on postoperative days 1, 3, and 7 did not differ among the groups (p > 0.05). Only difference was on second day between groups 1-4 and 2-4 (p ≤ 0.05).

Conclusions: The results of our study have shown that the use of PRF with traditional surgery and PRF combined with piezosurgery significantly reduced pain during the postoperative period. In addition, PRF in combination with piezosurgery significantly decreased the number of analgesics taken. Both operations also significantly decreased trismus 24 h after the surgery. As a result of this study, PRF and combination use of PRF and piezosurgery have positive effects in reducing postoperative outcomes after impacted third molar surgery.

References

    1. Mantovani E, Arduino PG, Schierano G, Ferrero L, Gallesio G, Mozzati M, et al. A split-mouth randomized clinical trial to evaluate the performance of piezosurgery compared with traditional technique in lower wisdom tooth removal. J Oral Maxillofac Surg. 2014;72(10):1890–1897. doi: 10.1016/j.joms.2014.05.002.
    1. Lee CT, Zhang S, Leung YY, Li SK, Tsang CC, Chu CH. Patients’ satisfaction and prevalence of complications on surgical extraction of third molar. Patient Prefer Adherence. 2015;10(9):257–263.
    1. Gelesko S, Long L, Faulk J, Philips C, Dicus C, White RP. Cryotherapy and topical minocycline as adjunctive measures to control pain after third molar surgery: an exploratory study. J Oral Maxillofac Surg. 2011;69:e324–e332. doi: 10.1016/j.joms.2011.03.059.
    1. Osunde OD, Adebola RA, Omeje UK. Management of inflammatory complications in third molar surgery: a review of the literature. Afr Health Sci. 2011;11(3):530–7.
    1. Ogundipe OK, Ugboko VI, Owotade FJ. Can autologous platelet-rich plasma gel enhance healing after surgical extraction of mandibular third molars? J Oral Maxillofac Surg. 2011;69:2305–2310. doi: 10.1016/j.joms.2011.02.014.
    1. Laureano Filho JR, De Oliveira e Silva ED, Batista CI, Gouveia FM. The influence of cryotherapy on swelling, pain and trismus after third-molar extraction. J Am Dent Assoc. 2005;136(6):774–778. doi: 10.14219/jada.archive.2005.0261.
    1. Olurotimi AO, Gbotolorun OM, Ibikunle AA, Emeka CI, Arotiba GT, Akinwande JA. A comparative clinical evaluation of the effects of preoperative and postoperative antimicrobial therapy on postoperative sequelae after ımpacted mandibular third molar extraction. J Oral Maxillofac Res. 2014;5(2):e2.
    1. Barone A, Marconcini S, Giacomelli L, Rispoli L, Calvo JL, Covani U. A randomized clinical evaluation of ultrasound bone surgery versus traditional rotary ınstruments in lower third molar extraction. J Oral Maxillofac Surg. 2010;68:330–336. doi: 10.1016/j.joms.2009.03.053.
    1. Koyuncu BO, Zeytinoğlu M, Tetik A, Gomel MM. Effect of tube drainage compared with conventional suturing on postoperative discomfort after extraction of impacted mandibular third molars. Br J Oral Maxillofac Surg. 2015;53(1):63–67. doi: 10.1016/j.bjoms.2014.09.021.
    1. Sandhu A, Sandhu S, Kaur T. Comparision of two different flap design in the surgical removal of bilateral impacted mandibular third molars. Int J Oral Maxillofac Surg. 2010;39:1091–1096. doi: 10.1016/j.ijom.2010.07.003.
    1. Forouzanfar T, Sabelis A, Ausems S, Baart JA, van der Waal I. Effect of ice compression on pain after mandibular third molar surgery: a single-blind, randomized controlled trial. Int J Oral Maxillofac Surg. 2008;37:824–830. doi: 10.1016/j.ijom.2008.05.011.
    1. Bamgbose BO, Akinwande JA, Adeyemo WL, Ladeinde AL, Arotiba GT, Ogunlewe MO. Effects of co-administered dexamethasone and diclofenac potassium on pain, swelling and trismus following third molar surgery. Head Face Med. 2005;1:11. doi: 10.1186/1746-160X-1-11.
    1. Pouchain EC, Costa FWG, Bezerra TP, Soares ECS. Comparative efficacy of nimesulide and ketoprofen on inflammatory events in third molar surgery: a split-mouth, prospective, randomized,double-blind study. Int J Oral Maxillofac Surg. 2015; doi:10.1016/ijoms.2014.10.026.
    1. Romeo U, Libotte F, Palaia G, Tenore G, Galanakis A, Annibali S. Is Er:YAG laser vs conventional rotary osteotomy better in the post operative period for lower third molar surgery? Randomized split mouth clinical study. Oral Maxillofac Surg. 2015;73(2):211–218. doi: 10.1016/j.joms.2014.08.013.
    1. Mozzati M, Gallesio G, Russo A, Staiti G, Mortellaro C. Third-molar extraction with ultrasound bone surgery: a case–control study. J Craniofac Surg. 2014;25:856–859. doi: 10.1097/SCS.0000000000000825.
    1. Rullo R, Addabbo F, Papaccio G, D’Aquino R, Festa VM. Piezoelectric device vs. conventional rotative instruments in impacted third molar surgery: relationships between surgical difficulty and postoperative pain with histological evaluations. J Craniofac Surg. 2013;41:e33–e38. doi: 10.1016/j.jcms.2012.07.007.
    1. Ruga E, Gallesio C, Boffano P. Platelet-rich fibrin and piezoelectric surgery: a safe technique for prevention of periodontal complications in third molar surgery. J Craniofac Surg. 2011;22(5):1951–1955. doi: 10.1097/SCS.0b013e31822ea76b.
    1. Sivolella S, Berengo M, Bressan E, Di Fiore A, Stellini E. Osteotomy for lower third molar germectomy: randomized prospective crossover clinical study comparing piezosurgery and conventional rotatory osteotomy. J Oral Maxillofac Surg. 2011;69:e15–e23. doi: 10.1016/j.joms.2010.12.036.
    1. Singh A, Kohli M, Gupta N. Platelet rich fibrin: a novel approach for osseous regeneration. J Maxillofac Oral Surg. 2012;11(4):430–434. doi: 10.1007/s12663-012-0351-0.
    1. Hoaglin DR, Lines GK. Prevention of localized osteitis in mandibular third-molar sites using platelet-rich fibrin. Int J Dent. 2013;2013:1–4. doi: 10.1155/2013/875380.
    1. Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, Dohan AJJ, Mouhyi J, Dohan DM. Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part IV: Clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:E56–E60. doi: 10.1016/j.tripleo.2005.07.011.
    1. Fragiskos FD. Oral Surgery. Verlag Berlin Heidelberg: Springer; 2007. p. 126.
    1. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJJ, Mouhyi J, et al. Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part I: Technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:E37–44. doi: 10.1016/j.tripleo.2005.07.008.
    1. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJJ, Mouhyi J, et al. Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part II: Platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:E45–50. doi: 10.1016/j.tripleo.2005.07.009.
    1. Üstün Y, Erdoğan Ö, Esen E, Karsli ED. Comparison of the effects of 2 doses of methylprednisolone on pain, swelling, and trismus after third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96:535–9. doi: 10.1016/S1079-2104(03)00464-5.
    1. Schultze-Mosgau S, Schmelzeısen R, Frölich JC, Schmele H. Use of Ibuprofen and methylprednisolone for the prevention of pain and swelling after removal of impacted third molars. J Oral Maxillofac Surg. 1995;53:2–7. doi: 10.1016/0278-2391(95)90486-7.
    1. Goyal M, Marya K, Jhamb A, Chawla S, Sonoo PR, Singh V, et al. Comparative evaluation of surgical outcome after removal of impacted mandibular third molars using a Piezotome or a conventional handpiece: a prospective study. Br J Oral Maxillofac Surg. 2011;50(6):556–61. doi: 10.1016/j.bjoms.2011.10.010.
    1. Kumar N, Prasad K, Lalitha RM, Ramanujam L, K R, Dexith J, Chauhan A. Evaluation of treatment outcome after impacted mandibular third molar surgery with the use of autologous platelet rich fibrin: a randomized controlled clinical study. J Oral Maxillofac Surg. 2014; doi:10.1016/j.joms.2014.11.013.
    1. Simonpieri A, Del Corso M, Sammartino G, Dohan DM. The relevance of Choukroun’s platelet-rich fibrin and metronidazole during complex maxillary rehabilitations using bone allograft. Part I: a new grafting protocol. Implant Dent. 2009;18:102–111. doi: 10.1097/ID.0b013e318198cf00.
    1. Chignon Sicard B, Georgiou CA, Fontas E, David S, Dumas P, Ihrai T, et al. Efficacy of leukocyte- and platelet-rich fibrin in wound healing: a randomized controlled clinical trial. Plast Reconstr Surg. 2012;130(6):819e–829e. doi: 10.1097/PRS.0b013e31826d1711.
    1. Kim JH, Lee DW, Ryu DM. Effect of platelet-rich fibrin on pain and swelling after surgical extraction of third molars. J Tissue Eng Regen Med. 2011;8(2):80–86.

Source: PubMed

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