ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
View the CAT printer-friendly / share this CAT
spacer
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 (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 29524029Bahammam/201824 patients who received a free gingival graftRandomized Controlled Trial
Key resultsPatients 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).
#2) 28817141Ozcan/2017125 patients who underwent free gingival graftRandomized Controlled Trial
Key resultsThe 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).
#3) 26313017Femminella/201640 patients treated with de-epithelized free gingival graftRandomized Controlled Trial
Key resultsPatients 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/Discipline (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics)
Keywords Platelet Rich Fibrin, pain, free gingival graft
ID# 3434
Date of submission: 12/03/2020spacer
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/Co-author Brian Mealey, DDS, MS
Faculty mentor/Co-author e-mail mealey@uthscsa.edu
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?)
post a rationale
None available
spacer
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)
post a comment
None available
spacer

Return to Found CATs list