Is Platelet-rich Fibrin Effective in Preserving the Alveolar Ridge?
Researchers conducted a systematic review evaluating the potential of platelet-rich fibrin (PRF) to preserve the alveolar ridge. PRF, the second generation of platelet concentrates, is used in many areas of dentistry but its effectiveness in preserving the alveolar ridge remains controversial.
In a recent article published in the September 2019 edition of the Journal of the American Dental Association (JADA), the authors concluded that “Given the potential value of PRF, consideration should be given to PRF after tooth extraction.” However, they also cautioned that “more high-quality trials are necessary to evaluate the exact role of PRF.”
Therefore, the authors suggest the use of PRF in alveolar ridge preservation as a treatment modality for patients.
About platelet-Rich Fibrin (PRF)
Platelet-rich fibrin is defined as “an autogenous matrix derived from the concentration of the patient’s blood platelets. A simplified chairside procedure results in the production of a fibrin membrane that is capable of stimulating the release of many important growth factors involved during wound healing processes that take place after surgery.”
More specifically, according to the study’s authors, “PRF contains a 3-dimensional fibrin network in which platelets and leucocytes are connected and many growth factors and cytokines, such as platelet-derived growth factor, transforming growth factor, vascular endothelial growth factor, and insulin like growth factor, are released slowly for seven(7) through 14 days. These properties of PRF tend to accelerate soft tissue healing by stimulating several biological functions, such as chemotaxis, angiogenesis, proliferation, differentiation, and modulation.”
The authors concluded that the systematic review did not yield definitive answers to the question of how effective PRF is in the preservation of the alveolar ridge. In fact, based on the qualitative analysis, there is only limited evidence that PRF may play a positive role in reducing postoperative pain during the first week and reducing ridge dimension changes at six (6) months after tooth extraction.
Most of the variables were assessed only in two (2) randomized control trial (RCT) studies; therefore, results should be interpreted with caution due to the small number of the eligible trials.
Additionally, the authors highlighted that socket healing is complicated by many factors, such as indication for tooth extraction and smoking, which can influence ridge resorption and limit the results of the trials.
According to the authors’, PRF may be associated with smaller mesial bone height changes and more bone fill after tooth extraction.However, the evidence remains insufficient to draw conclusions on whether PRF can bring benefit on hard- and soft-tissue healing because of the small number of RCTs included and the high risk of bias in most of the trials.
Learn more about this systematic review, view it by accessing the article via The Journal of the American Dental Association.
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