Application of platelet-rich fibrin on mandibular third molar extraction: systematic review and Meta-analysis

doi:10.7518/hxkq.2021.05.017

Abstract

Abstract: Objective

This study aims to analyze the effectiveness of platelet-rich fibrin (PRF) in mandibular third molar extraction and provide suggestions for alleviating postoperative complications.

Methods

Pubmed, EMBASE, Web of Science, and SinoMed were searched electronically on February 2020. Randomized controlled trials focusing on PRF usage in mandibular third molar extraction were included. Reviewers assessed the risk of bias in the included literature and extracted data independently using the criteria recommended by the Cochrane Collaboration. Meta-analysis was performed using RevMan 5.3 and STATA 13.0.

Results

Twenty-one studies were included, comprising 991 patients who had mandibular third molar extraction. The topical application of PRF effectively reduced pain after extraction [MD=-12.06, 95%CI (-21.42, -2.71), P=0.01], attenuated post-extraction swelling [MD=-1.42, 95%CI (-2.41, -0.44), P=0.005], and promoted soft tissue hea-ling [MD=0.66, 95%CI (0.34, 0.99), P<0.000 1]. PRF significantly reduced trismus and alveolar osteitis (P<0.05). However, data could not prove whether PRF has any significant positive effect on bone healing compared with the control group (P>0.05).

Conclusion

Limited clinical evidence indicates that applying PRF after mandibular third molar extraction could reduce pain, swelling, trismus and the occurrence of dry socket and promote soft tissue healing. However, the effect of PRF on bone healing requires further large-scale randomized controlled trials and unified measurement criteria.

Key words: platelet-rich fibrin, mandibular third molar extraction, Meta-analysis, systematic review

CLC Number:

R 782.11

Bao Mingzhe, Liu Wei, Yu Shurong, Men Yi, Han Bo, Li Chunjie. Application of platelet-rich fibrin on mandibular third molar extraction: systematic review and Meta-analysis[J]. West China Journal of Stomatology, 2021, 39(5): 605-611.

Figures/Tables 10

Fig 1

Tab 1

The characteristics of the included study

作者	国籍	研究设计	平均年龄/岁	M/F	参与人数	PRF组	对照组	手术次数	骨移除	PRF制备	联合干预
Dar等^[8]	印度	RCT（sm）	23.6（18~50）	13∶17	30	30	30	2	Yes	10 mL，3 000 r·min^-1，12 min	ATB-NSAID
Jeyaraj等^[9]	印度	RCT（pa）	>18	NR	60	30	30	1	Yes	10 mL，2 700 r·min^-1，12 min	ATB-NSAID
Kapse等^[10]	印度	RCT（sm）	18~40	13∶17	30	30	30	2	Yes	10 mL，2 700 r·min^-1，12 min	NR
Revathy等^[11]	印度	RCT（sm）	18~35	15∶10	25	25	25	1	No	15 mL，3 000 r·min^-1，10 min	ATB-NSAID
王敏等^[12]	中国	RCT（pa）	21.4（18~25）	34∶46	80	40	40	1	No	NR	NR
Eshghpour等^[13]	爱尔兰	RCT（sm）	24（18~35）	99∶142	241	118	118	1	Yes	10 mL，3 000 r·min^-1，10 min	ATB-NSAID
Güls?en等^[14]	土耳其	RCT（sm）	20.03（17~27）	21∶9	30	30	30	1	Yes	10 mL，3 000 r·min^-1，10 min	ATB-NSAID
Unsal等^[15]	土耳其	RCT（sm）	23.96（15~43）	17∶33	50	50	50	2	Yes	10 mL，3 000 r·min^-1，10 min	ATB-NSAID
Varghese等^[16]	印度	RCT（sm）	18~35	-	30	30	30	1	Yes	5~10 mL，3 000 r·min^-1，10 min	NR
Al-Hamed等^[17]	埃及	RCT（pa）	25.24（18-48）	13∶34	47	25	25	1	Yes	5 mL，3 000 r·min^-1，10 min	ATB-NSAID
Bilginaylar^[18]	塞浦路斯	RCT（pa）	18~31	22∶37	59	40	40	1	Yes	10 mL，3 000 r·min^-1，10 min	ATB-NSAID
Doiphode等^[19]	印度	RCT（pa）	18~30	-	30	15	15	1	NR	5 mL，3 000 r·min^-1，10 min	NR
Dutta等^[20]	印度	RCT（pa）	27（17~36）	13∶27	40	10	10	1	No	5 mL，2 000 r·min^-1，15 min	NR
Kumar等^[21]	印度	RCT（sm）	18~40	-	34	34	34	NR	Yes	NR	ATB-NSAID
Baslarli等^[22]	土耳其	RCT（sm）	23.9（19~34）	7∶13	20	20	20	1	No	9 mL，3 000 r·min^-1，10 min	ATB-NSAID
Uyanik等^[23]	塞浦路斯	RCT（sm）	22.5（19~31）	10∶10	20	20	20	2	Yes	10 mL，3 000 r·min^-1，10 min	ATB-NSAID
Kumar等^[24]	印度	RCT（pa）	26.1（19~35）	-	31	16	15	2	Yes	5 mL，3 000 r·min^-1，10 min	ATB-NSAID
Ozgul等^[25]	土耳其	RCT（sm）	NR	23∶33	56	56	56	1	No	10 mL，3 000 r·min^-1，10 min	ATB-NSAID
Eshghpour等^[26]	爱尔兰	RCT（sm）	25.1（18~35）	33∶45	78	78	78	1	Yes	10 mL，3 000 r·min^-1，10 min	ATB-NSAID
Singh等^[27]	土耳其	RCT（sm）	32（18~50）	10∶10	20	20	20	1	NR	5~10 mL，3 000 r·min^-1，10 min	NR
Gürbürzer等^[28]	土耳其	RCT（sm）	24.9（NR）	7∶7	14	14	14	1	No	10 mL，2 030 r·min^-1，10 min	ATB-NSAID

Tab 1

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