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Comparison of the effects of injectable platelet-rich fibrin and autologous fibrin glue applications on palatal wound healing: a randomized controlled clinical trial

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Abstract

Objective

The aim of this study was to compare the effects of AFG and i-PRF on palatal wound healing and postoperative discomfort.

Materials and methods

Thirty-six patients in need of FGG were divided into three groups. AFG (n = 12) or i-PRF (n = 12) was applied and compared with control group (n = 12). Wound healing with H2O2 test, VAS, MSS, and LTH index were evaluated on the 3rd,7th, and 14th days and 1st month. The bleeding status was evaluated on the 3rd and 7th days. Palatal tissue thickness was measured at baseline, 1st month, and 3rd month.

Results

Epithelialization was higher in the test groups on the 14th day than the control group (p < 0.05). MSS scores at the 14th day and 1st month were lower in the AFG group than the control and the i-PRF group (p < 0.05). In the AFG group, LTH levels at the 3rd,7th, and 14th days and 1 month were higher than control and i-PRF groups (p < 0.05). VAS scores of the AFG group were lower than the control and i-PRF groups at the 7th day (p < 0.05). Bleeding was lower in the test groups than in the control group (p < 0.05). There was no difference between the groups in terms of tissue thickness (p > 0.05).

Conclusion

AFG and i-PRF have positive effects on the healing process by accelerating wound healing and reducing postoperative morbidity. Therewithal, AFG has superior properties in wound healing compared with i-PRF.

Clinical relevance

Patient discomfort and pain feeling have a great effect on patient’s tendency to surgery and platelet concentrates such as AFG and i-PRF overcome these problems and contribute to patient’s quality of life.

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References

  1. Wennstrom J, Pini-Prato G (2003) Mucogingival therapy-periodontal plastic surgery. In: Lindhe J, Karring T, Lang N (eds) Clinical periodontlogy and implant dentistry, 4th edn. Blackwell Munksgaard, Oxford, pp 588–592

    Google Scholar 

  2. Almeida AL, Esper LA, Sbrana MC, Ribeiro IW, Kaizer RO (2009) Utilization of low-intensity laser during healing of free gingival grafts. Photomed Laser Surg 27(4):561–564

    Article  Google Scholar 

  3. Wang H-L, Bunyaratavej P, Labadie M, Shyr Y, MacNeil RL (2001) Comparison of 2 clinical techniques for treatment of gingival recession. J Periodontol 72(10):1301–1311

    Article  Google Scholar 

  4. Samani MK, Saberi BV, Tabatabaei SA, Moghadam MG (2017) The clinical evaluation of platelet-rich plasma on free gingival graft’s donor site wound healing. Eur J Dent 11(4):447–454

    Article  Google Scholar 

  5. Kozlovsky A, Artzi Z, Hirshberg A, Israeli-Tobias C, Reich L (2007) Effect of local antimicrobial agents on excisional palatal wound healing: a clinical and histomorphometric study in rats. J Clin Periodontol 34(2):164–171

    Article  Google Scholar 

  6. Firat ET, Dag A, Gunay A, Kaya B, Karadede MI, Ersoz Kanay B, Ketani A, Evliyaoglu O, Uysal E (2014) The effect of low-level laser therapy on the healing of hard palate mucosa and the oxidative stress status of rats. J Oral Pathol Med 43(2):103–110. https://doi.org/10.1111/jop.12106

    Article  PubMed  Google Scholar 

  7. Femminella B, Iaconi MC, Di Tullio M, Romano L, Sinjari B, D'Arcangelo C, De Ninis P, Paolantonio M (2016) Clinical comparison of platelet-rich fibrin and a gelatin sponge in the management of palatal wounds after epithelialized free gingival graft harvest: a randomized clinical trial. J Periodontol 87(2):103–113. https://doi.org/10.1902/jop.2015.150198

    Article  PubMed  Google Scholar 

  8. Ustaoğlu G, Ercan E, Tunali M (2016) The role of titanium-prepared platelet-rich fibrin in palatal mucosal wound healing and histoconduction. Acta Odontol Scand 74(7):558–564

    Article  Google Scholar 

  9. Kim S, Tramontina V, Papalexiou V, Luczsyzyn S, De Lima A, Do Prado A (2012) Bismuth subgallate as a topical haemostatic agent at the palatal wounds: a histologic study in dogs. Int J Oral Maxillofac Surg 41(2):239–243

    Article  Google Scholar 

  10. Patel PV, Kumar S, Vidya G, Patel A, Holmes JC, Kumar V (2012) Cytological assessment of healing palatal donor site wounds and grafted gingival wounds after application of ozonated oil: an eighteen-month randomized controlled clinical trial. Acta Cytol 56(3):277–284

    Article  Google Scholar 

  11. Thoma DS, Sancho-Puchades M, Ettlin DA, Hämmerle CH, Jung RE (2012) Impact of a collagen matrix on early healing, aesthetics and patient morbidity in oral mucosal wounds–a randomized study in humans. J Clin Periodontol 39(2):157–165

    Article  Google Scholar 

  12. Ozcan M, Ucak O, Alkaya B, Keceli S, Seydaoglu G, Haytac MC (2017) Effects of platelet-rich fibrin on palatal wound healing after free gingival graft harvesting: a comparative randomized controlled clinical trial. Int J Periodontics Restorative Dent 37(5):e270–e278. https://doi.org/10.11607/prd.3226

    Article  PubMed  Google Scholar 

  13. Keceli HG, Aylikci BU, Koseoglu S, Dolgun A (2015) Evaluation of palatal donor site haemostasis and wound healing after free gingival graft surgery. J Clin Periodontol 42(6):582–589

    Article  Google Scholar 

  14. Ghanaati S, Mourão CF, Adam EH, Sader R, Zadeh HH, Al-Maawi S (2019) The role of centrifugation process in the preparation of therapeutic blood concentrates: standardization of the protocols to improve reproducibility. Int J Growth Factors Stem Cells Dent 2:41–44

    Article  Google Scholar 

  15. Sohn D-S, Huang B, Kim J, Park WE, Park CC (2015) Utilization of autologous concentrated growth factors (CGF) enriched bone graft matrix (sticky bone) and CGF-enriched fibrin membrane in implant dentistry. Jr Implant Adv Cli Dent 7:11–29

    Google Scholar 

  16. Wend S, Kubesch A, Orlowska A, Al-Maawi S, Zender N, Dias A, Miron RJ, Sader R, Booms P, Kirkpatrick CJ (2017) Reduction of the relative centrifugal force influences cell number and growth factor release within injectable PRF-based matrices. J Mater Sci Mater Med 28(12):188

  17. Crichton N (2001) Visual analogue scale (VAS). J Clin Nurs 10(5):706–706

    Google Scholar 

  18. Silva CO, Ribeiro ÉDP, Sallum AW, Tatakis DN (2010) Free gingival grafts: graft shrinkage and donor-site healing in smokers and non-smokers. J Periodontol 81(5):692–701

    Article  Google Scholar 

  19. Landry RG, Turnbull RS, Howley T (1988) Effectiveness of benzydamine HCI in the treatment of periodontal post-surgical patients. Res Clinic Forums 10:105–118

    Google Scholar 

  20. Pippi R (2017) Post-surgical clinical monitoring of soft tissue wound healing in periodontal and implant surgery. Int J Med Sci 14(8):721–728

    Article  Google Scholar 

  21. Beausang E, Floyd H, Dunn KW, Orton CI, Ferguson MW (1998) A new quantitative scale for clinical scar assessment. Plast Reconstr Surg 102(6):1954–1961

    Article  Google Scholar 

  22. Sanz M, Simion M, Abbas F, Aroca S, Artzi Z, Burkhardt R, Cortellini P, Demirel K, Monnet Corti V, Ortiz-Vigon A (2014) Surgical techniques on periodontal plastic surgery and soft tissue regeneration: consensus report of Group 3 of the 10th European Workshop on Periodontology. J Clin Periodontol 41:S92–S97

    Article  Google Scholar 

  23. Brasher WJ, Rees TD, Boyce WA (1975) Complications of free grafts of masticatory mucosa. J Periodontol 46(3):133–138

    Article  Google Scholar 

  24. Verma UP, Yadav RK, Dixit M, Gupta A (2017) Platelet-rich fibrin: a paradigm in periodontal therapy–A systematic review. J Int Soc Prev Community Dent 7(5):227–233

    PubMed  PubMed Central  Google Scholar 

  25. Miron RJ, Fujioka-Kobayashi M, Hernandez M, Kandalam U, Zhang Y, Ghanaati S, Choukroun J (2017) Injectable platelet rich fibrin (i-PRF): opportunities in regenerative dentistry? Clin Oral Investig 21(8):2619–2627. https://doi.org/10.1007/s00784-017-2063-9

    Article  PubMed  Google Scholar 

  26. Wang X, Zhang Y, Choukroun J, Ghanaati S, Miron RJ (2017) Behavior of gingival fibroblasts on titanium implant surfaces in combination with either injectable-PRF or PRP. Int J Mol Sci 18(2):331

    Article  Google Scholar 

  27. Dohan Ehrenfest DM, Bielecki T, Jimbo R, Barbé G, Del Corso M, Inchingolo F, Sammartino G (2012) Do the fibrin architecture and leukocyte content influence the growth factor release of platelet concentrates? An evidence-based answer comparing a pure platelet-rich plasma (P-PRP) gel and a leukocyte- and platelet-rich fibrin (L-PRF). Curr Pharm Biotechnol 13(7):1145–1152

    Article  Google Scholar 

  28. Aravindaksha SP, Batra P, Sood V, Kumar A, Gupta G (2014) Use of platelet-rich fibrin membrane as a palatal bandage. Clin Adv Periodontics 4(4):246–250

    Article  Google Scholar 

  29. Reddy S, Prasad MG, Singh S, Krishnanand P, Bhowmik N, Ashwini N (2015) Enhancing palatal wound healing by using platelet rich fibrin membrane as fibrin bandage. Int J Appl Dent Sci 1(4):02–04

    Google Scholar 

  30. Kulkarni MR, Thomas BS, Varghese JM, Bhat GS (2014) Platelet-rich fibrin as an adjunct to palatal wound healing after harvesting a free gingival graft: a case series. J Indian Soc Periodontol 18(3):399–402. https://doi.org/10.4103/0972-124x.134591

    Article  PubMed  PubMed Central  Google Scholar 

  31. Yen CA, Griffin TJ, Cheung WS, Chen J (2007) Effects of platelet concentrate on palatal wound healing after connective tissue graft harvesting. J Periodontol 78(4):601–610

    Article  Google Scholar 

  32. Zucchelli G, Mele M, Stefanini M, Mazzotti C, Marzadori M, Montebugnoli L, De Sanctis M (2010) Patient morbidity and root coverage outcome after subepithelial connective tissue and de-epithelialized grafts: a comparative randomized-controlled clinical trial. J Clin Periodontol 37(8):728–738

    PubMed  Google Scholar 

  33. Keskiner I, Aydogdu A, Balli U, Kaleli AE (2016) Quantitative changes in palatal donor site thickness after free gingival graft harvesting: a pilot study. J Clin Periodontol 43(11):976–984

    Article  Google Scholar 

  34. Sousa F, Machado V, Botelho J, Proença L, Mendes JJ, Alves R (2020) Effect of A-PRF application on palatal wound healing after free gingival graft harvesting: a prospective randomized study. Eur J Dent 14(1):63–69

    Article  Google Scholar 

  35. Shayesteh YS, Eshghyar N, Moslemi N, Dehghan MM, Motahhary P, Ghobadi Z, Golestan B (2012) The effect of platelet-rich plasma on healing of palatal donor site following connective tissue harvesting: a pilot study in dogs. Clin Implant Dent Relat Res 14(3):428–433. https://doi.org/10.1111/j.1708-8208.2009.00263.x

    Article  PubMed  Google Scholar 

  36. Varela HA, Souza JCM, Nascimento RM, Araújo RF Jr, Vasconcelos RC, Cavalcante RS, Guedes PM, Araújo AA (2019) Injectable platelet rich fibrin: cell content, morphological, and protein characterization. Clin Oral Investig 23(3):1309–1318. https://doi.org/10.1007/s00784-018-2555-2

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors thank statistician Ebru Osmanoğlu Akyol (Varyans Statistics, Istanbul) for the help in statistical analysis.

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Authors and Affiliations

  1. Batman Oral and Dental Health Center, Batman, Turkey

    Mehmet Kızıltoprak

  2. Department of Periodontology, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey

    Mustafa Özay Uslu

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  1. Mehmet Kızıltoprak
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Correspondence to Mustafa Özay Uslu.

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The authors declare that they have no conflict of interest.

Ethical approval and data protection

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board of Malatya Clinical Research Ethics Committee (Protocol No: 2018/46) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was registered at www.clinicaltrials.gov with the registration number NCT04097509. Informed consent was obtained from all participants individual included in the study.

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Informed consent was obtained from all participants individual included in the study.

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Kızıltoprak, M., Uslu, M.Ö. Comparison of the effects of injectable platelet-rich fibrin and autologous fibrin glue applications on palatal wound healing: a randomized controlled clinical trial. Clin Oral Invest 24, 4549–4561 (2020). https://doi.org/10.1007/s00784-020-03320-6

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  • DOI: https://doi.org/10.1007/s00784-020-03320-6

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