Title |
Platelet Rich Fibrin Wound Dressing Decreases Post-Operative Pain |
Clinical Question |
In patients undergoing a free gingival graft procedure with the palate as the donor site, would use of a platelet rich fibrin (PRF) wound dressing as compared to no wound dressing result in decreased post-operative pain? |
Clinical Bottom Line |
For patients undergoing a free gingival graft procedure with the palate as the donor site, the use of platelet rich fibrin wound dressing compared to no wound dressing results in decreased post-operative pain. Additional clinical evidence especially systematic reviews are needed to validate the clinical findings. |
Best Evidence |
|
PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
29524029 | Bahammam/2018 | 24 patients who received a free gingival graft | Randomized Controlled Trial | Key results | Patients treated with PRF wound dressings compared to those without had decreased postoperative pain, lower visual analog scale scores with lower peak pain levels at 4 hours post-operatively (2.10 vs 5.46), and lower NRS-101 score (numerical rating scale to rate pain 0 [no pain] to 100 [worst pain]) peak pain levels at 4 hours post-operatively (18.58 vs 53.75). | 28817141 | Ozcan/2017 | 125 patients who underwent free gingival graft | Randomized Controlled Trial | Key results | The use of PRF on palatal wound healing showed improved wound healing (P=0.0001) compared to the use of butyl-cyanocacrylate and wet gauze compression. Groups with PRF had less pain perception during the first 5 days (P<0.05). | 26313017 | Femminella/2016 | 40 patients treated with de-epithelized free gingival graft | Randomized Controlled Trial | Key results | Patients treated with the PRF membrane reported less discomfort and changes in feeding habits (P≤0.02) and took lower doses of analgesics (P=0.02). Faster palatal wound epithelization was shown in patients treated with PRF (P<0.001) | |
Evidence Search |
"Free"[All Fields] AND ("gingiva"[MeSH Terms] OR "gingiva"[All Fields] OR "gingival"[All Fields] OR "gingivally"[All Fields] OR "gingivals"[All Fields] OR "gingivitis"[MeSH Terms] OR "gingivitis"[All Fields] OR "gingivitides"[All Fields]) AND ("graft s"[All Fields] OR "grafted"[All Fields] OR "graftings"[All Fields] OR "transplantation"[MeSH Subheading] OR "transplantation"[All Fields] OR "grafting"[All Fields] OR "transplantation"[MeSH Terms] OR "grafts"[All Fields] OR "transplants"[MeSH Terms] OR "transplants"[All Fields] OR "graft"[All Fields]) AND ("platelet rich fibrin"[MeSH Terms] OR ("platelet rich"[All Fields] AND "fibrin"[All Fields]) OR "platelet rich fibrin"[All Fields] OR ("platelet"[All Fields] AND "rich"[All Fields] AND "fibrin"[All Fields]) OR "platelet rich fibrin"[All Fields]) |
Comments on
The Evidence |
Validity: Bahammam's controlled trial used an adequate randomized design and frequent follow-up data collection to conclude that PRF decreases post-operative pain. Baseline pain levels were taken prior to the procedure as a comparison following the surgery and examiners were blinded. However, re-epithelialization and thickness of the donor site were not evaluated which may affect the level of pain. Ozcan performed adequate randomization based on a computer generated randomization table. Blinding and examiner calibration was performed. Femminella standardized defects by only including Miller class 1 or 2 recession defects. Patients were evaluated frequently at 1, 2, 3, and 4 weeks after surgery. More studies a need to be done so a higher level of evidence can be evaluated for this topic.
Perspective: Based on these randomized control trials, patients overall tend to have less discomfort post-operatively when a PRF membrane is placed over the palatal site.
|
Applicability |
The randomized controlled trials included patients with little or no keratinized tissue undergoing a free gingival graft using the palate as the donor site. The cost of obtaining PRF is minimal for the practice, as it is the patient’s own blood, but a patient fee is associated with its use. |
Specialty |
(General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics) |
Keywords |
Platelet Rich Fibrin, pain, free gingival graft
|
ID# |
3434 |
Date of submission |
12/03/2020 |
E-mail |
shelbourn@uthscsa.edu |
Author |
Julia Shelbourn, DMD |
Co-author(s) |
Brett Jessen, DDS |
Co-author(s) e-mail |
jessen@livemail.uthscsa.edu |
Faculty mentor |
Brian Mealey, DDS, MS |
Faculty mentor e-mail |
mealey@uthscsa.edu |
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Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
None available | |
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
None available | |