Skip to main content
Erschienen in: Clinical Oral Investigations 9/2018

09.03.2018 | Original Article

Effect of platelet-rich fibrin palatal bandage on pain scores and wound healing after free gingival graft: a randomized controlled clinical trial

verfasst von: Maha A. Bahammam

Erschienen in: Clinical Oral Investigations | Ausgabe 9/2018

Einloggen, um Zugang zu erhalten

Abstract

Objective

This prospective randomized clinical trial was conducted to determine whether the application of a platelet-rich fibrin (PRF) palatal bandage after harvesting free gingival grafts (FGG) would improve healing of donor sites and decrease pain scores and patient discomfort.

Materials and methods

Twenty-four patients received FGG to augment keratinized tissue dimensions. The application of a PRF bandage was decided randomly (n = 12 in each group). Patients reported their pain levels for the first 7 days of healing using the visual analog scale (VAS), 101-point numerical rating scale (NRS-101), and 4-point verbal rating scale (VRS-4). The patients’ pre-operative anxiety levels were measured using three anxiety scales. The healing of the donor sites was evaluated and compared to preoperative records. Data were assessed and recorded before surgery and at 1, 2, 3, 4, and 8 weeks postoperatively.

Results

Dental anxiety and state-trait anxiety were evaluated at baseline and correlated to the postoperative pain scores. There were no significant differences in anxiety levels between the two groups; yet, they could potentially influence the outcome of any surgery and were included as covariates. The patients in the PRF group reported significantly lower pain scores and their pain levels returned to baseline levels earlier, compared to the control group.

Conclusions

PRF palatal bandages significantly reduced postoperative pain and discomfort and facilitated wound healing after harvesting FGG.

Clinical relevance

The study provided evaluation of patient-centered outcomes, which is timely, significant, and could benefit both periodontists and patients.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Del Pizzo M, Modica F, Bethaz N, Priotto P, Romagnoli R (2002) The connective tissue graft: a comparative clinical evaluation of wound healing at the palatal donor site. J Clin Periodontol 29:848–854CrossRef Del Pizzo M, Modica F, Bethaz N, Priotto P, Romagnoli R (2002) The connective tissue graft: a comparative clinical evaluation of wound healing at the palatal donor site. J Clin Periodontol 29:848–854CrossRef
2.
Zurück zum Zitat Wessel JR, Tatakis DN (2008) Patient outcomes following subepithelial connective tissue graft and free gingival graft procedures. J Periodontol 79:425–430CrossRef Wessel JR, Tatakis DN (2008) Patient outcomes following subepithelial connective tissue graft and free gingival graft procedures. J Periodontol 79:425–430CrossRef
3.
Zurück zum Zitat Silva CO, Ribeiro EDP, Sallum AW, Tatakis DN (2010) Free gingival grafts: graft shrinkage and donor-site healing in smokers and non-smokers. J Periodontol 81:692–701CrossRef Silva CO, Ribeiro EDP, Sallum AW, Tatakis DN (2010) Free gingival grafts: graft shrinkage and donor-site healing in smokers and non-smokers. J Periodontol 81:692–701CrossRef
4.
Zurück zum Zitat Tomar N, Singh R, Jain G, Kaushik M, Dureja D (2016) Enhancement of healing of donor hard palate site using platelet-rich fibrin. J Curr Res Sci Med 2:132CrossRef Tomar N, Singh R, Jain G, Kaushik M, Dureja D (2016) Enhancement of healing of donor hard palate site using platelet-rich fibrin. J Curr Res Sci Med 2:132CrossRef
5.
Zurück zum Zitat Choukroun J, Adda F, Schoeffer C, Vervelle A (2001) PRF: an opportunity in perio-implantology (in French). Implantodontie 42:55–62 Choukroun J, Adda F, Schoeffer C, Vervelle A (2001) PRF: an opportunity in perio-implantology (in French). Implantodontie 42:55–62
6.
Zurück zum Zitat Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, Dohan AJ, Mouhyi J, Dohan DM (2006) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 101:e56–e60CrossRef Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, Dohan AJ, Mouhyi J, Dohan DM (2006) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 101:e56–e60CrossRef
7.
Zurück zum Zitat Dohan Ehrenfest DM, Del Corso M, Diss A, Mouhyi J, Charrier JB (2010) Three-dimensional architecture and cell composition of a Choukroun’s platelet-rich fibrin clot and membrane. J Periodontol 81:546–555CrossRef Dohan Ehrenfest DM, Del Corso M, Diss A, Mouhyi J, Charrier JB (2010) Three-dimensional architecture and cell composition of a Choukroun’s platelet-rich fibrin clot and membrane. J Periodontol 81:546–555CrossRef
8.
Zurück zum Zitat Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B (2006) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 101:e45-e50 Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B (2006) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 101:e45-e50
9.
Zurück zum Zitat Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJJ, Mouhyi J, Gogly B (2006) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part III: leucocyte activation: a new feature for platelet concentrates? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101:e51–e55CrossRef Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJJ, Mouhyi J, Gogly B (2006) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part III: leucocyte activation: a new feature for platelet concentrates? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101:e51–e55CrossRef
10.
Zurück zum Zitat Dohan Ehrenfest DM, de Peppo P, Doglioli, Sammartino G (2009) Slow release of growth factors and thrombospondin-1 in Choukroun’s platelet-rich fibrin (PRF): a gold standard to achieve for all surgical platelet concentrates technologies. Growth Factors 27:63–69CrossRef Dohan Ehrenfest DM, de Peppo P, Doglioli, Sammartino G (2009) Slow release of growth factors and thrombospondin-1 in Choukroun’s platelet-rich fibrin (PRF): a gold standard to achieve for all surgical platelet concentrates technologies. Growth Factors 27:63–69CrossRef
11.
Zurück zum Zitat Gamal AY, Abdel Ghaffar KA, Alghezwy OA (2016) Crevicular fluid growth factors release profile following the use of platelet-rich fibrin and plasma rich growth factors in treating periodontal intrabony defects: a randomized clinical trial. J Periodontol 87:654–662CrossRef Gamal AY, Abdel Ghaffar KA, Alghezwy OA (2016) Crevicular fluid growth factors release profile following the use of platelet-rich fibrin and plasma rich growth factors in treating periodontal intrabony defects: a randomized clinical trial. J Periodontol 87:654–662CrossRef
12.
Zurück zum Zitat Jain V, Triveni MG, Kumar AT, Mehta DS (2012) Role of platelet-rich-fibrin in enhancing palatal wound healing after free graft. Contemp Clin Dent 3:S240CrossRef Jain V, Triveni MG, Kumar AT, Mehta DS (2012) Role of platelet-rich-fibrin in enhancing palatal wound healing after free graft. Contemp Clin Dent 3:S240CrossRef
13.
Zurück zum Zitat Sclafani AP (2009) Applications of platelet-rich fibrin matrix in facial plastic surgery. Facial Plastic Surgery 25:270–276CrossRef Sclafani AP (2009) Applications of platelet-rich fibrin matrix in facial plastic surgery. Facial Plastic Surgery 25:270–276CrossRef
14.
Zurück zum Zitat Mazor Z, Horowitz RA, Del Corso M, Prasad HS, Rohrer MD, Dohan Ehrenfest DM (2009) Sinus floor augmentation with simultaneous implant placement using Choukroun’s platelet-rich fibrin as the sole grafting material: a radiologic and histologic study at 6 months. J Periodontol 80:2056–2064CrossRef Mazor Z, Horowitz RA, Del Corso M, Prasad HS, Rohrer MD, Dohan Ehrenfest DM (2009) Sinus floor augmentation with simultaneous implant placement using Choukroun’s platelet-rich fibrin as the sole grafting material: a radiologic and histologic study at 6 months. J Periodontol 80:2056–2064CrossRef
15.
Zurück zum Zitat Aroca S, Keglevich T, Barbieri B, Gera I, Etienne D (2009) Clinical evaluation of a modified coronally advanced flap alone or in combination with a platelet-rich fibrin membrane for the treatment of adjacent multiple gingival recessions: a 6-month study. J Periodontol 80:244–252CrossRef Aroca S, Keglevich T, Barbieri B, Gera I, Etienne D (2009) Clinical evaluation of a modified coronally advanced flap alone or in combination with a platelet-rich fibrin membrane for the treatment of adjacent multiple gingival recessions: a 6-month study. J Periodontol 80:244–252CrossRef
16.
Zurück zum Zitat Ghanaati S, Booms P, Orlowska A (2014) Advanced platelet-rich fibrin: a new concept for cell-based tissue engineering by means of inflammatory cells. J Oral Implantol 40:679–689CrossRef Ghanaati S, Booms P, Orlowska A (2014) Advanced platelet-rich fibrin: a new concept for cell-based tissue engineering by means of inflammatory cells. J Oral Implantol 40:679–689CrossRef
17.
Zurück zum Zitat Schulz KF, Altman Moher DG (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. PLoS Med 7:e1000251CrossRef Schulz KF, Altman Moher DG (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. PLoS Med 7:e1000251CrossRef
19.
Zurück zum Zitat Bahammam MA (2016) Validity and reliability of an Arabic version of the state-trait anxiety inventory in a Saudi dental setting. Saudi Med J 37:668–674CrossRef Bahammam MA (2016) Validity and reliability of an Arabic version of the state-trait anxiety inventory in a Saudi dental setting. Saudi Med J 37:668–674CrossRef
20.
Zurück zum Zitat Spielberger CD, Gorsuch RL, Lushene RE (1970) Manual for the state-trait anxiety inventory Spielberger CD, Gorsuch RL, Lushene RE (1970) Manual for the state-trait anxiety inventory
21.
Zurück zum Zitat Bahammam MA, Hassan MH (2014) Validity and reliability of an Arabic version of the modified dental anxiety scale in Saudi adults. Saudi Med J 35:1384–1389PubMedPubMedCentral Bahammam MA, Hassan MH (2014) Validity and reliability of an Arabic version of the modified dental anxiety scale in Saudi adults. Saudi Med J 35:1384–1389PubMedPubMedCentral
22.
Zurück zum Zitat Humphris Morrison GMT, Lindsay SJ (1995) The modified dental anxiety scale: validation and United Kingdom norms. Community Dent Health 12:143–150PubMed Humphris Morrison GMT, Lindsay SJ (1995) The modified dental anxiety scale: validation and United Kingdom norms. Community Dent Health 12:143–150PubMed
23.
Zurück zum Zitat Sullivan HC (1968) Free autogenous gingival grafts. I. Principles of successful grafting. Periodontics 6:121–129PubMed Sullivan HC (1968) Free autogenous gingival grafts. I. Principles of successful grafting. Periodontics 6:121–129PubMed
24.
Zurück zum Zitat Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B (2006) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 101:e37–e44CrossRef Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B (2006) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 101:e37–e44CrossRef
25.
Zurück zum Zitat Houde RW (1982) Methods for measuring clinical pain in humans. Acta Anaesthesiol Scand 74:25–29CrossRef Houde RW (1982) Methods for measuring clinical pain in humans. Acta Anaesthesiol Scand 74:25–29CrossRef
26.
Zurück zum Zitat Jensen MP, Karoly P, Braver S (1986) The measurement of clinical pain intensity: a comparison of six methods. Pain 27:117–126CrossRef Jensen MP, Karoly P, Braver S (1986) The measurement of clinical pain intensity: a comparison of six methods. Pain 27:117–126CrossRef
27.
Zurück zum Zitat Dohan Ehrenfest DM, Rasmusson L, Albrektsson T (2009) Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol 27:158–167CrossRef Dohan Ehrenfest DM, Rasmusson L, Albrektsson T (2009) Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol 27:158–167CrossRef
28.
Zurück zum Zitat Chang YC, Zhao JH (2011) Effects of platelet-rich fibrin on human periodontal ligament fibroblasts and application for periodontal infrabony defects. Aust Dent J 56:365–371CrossRef Chang YC, Zhao JH (2011) Effects of platelet-rich fibrin on human periodontal ligament fibroblasts and application for periodontal infrabony defects. Aust Dent J 56:365–371CrossRef
29.
Zurück zum Zitat Naik B, Karunakar P, Jayadev M, Marshal VR (2013) Role of platelet rich fibrin in wound healing: a critical review. J Conserv Dent 16:284–293CrossRef Naik B, Karunakar P, Jayadev M, Marshal VR (2013) Role of platelet rich fibrin in wound healing: a critical review. J Conserv Dent 16:284–293CrossRef
30.
Zurück zum Zitat Del Corso M, Vervelle A, Simonpieri A et al (2012) Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 1: periodontal and dentoalveolar surgery. Curr Pharm Biotechnol 13:1207–1230CrossRef Del Corso M, Vervelle A, Simonpieri A et al (2012) Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 1: periodontal and dentoalveolar surgery. Curr Pharm Biotechnol 13:1207–1230CrossRef
31.
Zurück zum Zitat He L, Lin Y, Hu X, Zhang Y, Wu H A comparative study of platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) on the effect of proliferation and differentiation of rat osteoblasts in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:707–713CrossRef He L, Lin Y, Hu X, Zhang Y, Wu H A comparative study of platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) on the effect of proliferation and differentiation of rat osteoblasts in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:707–713CrossRef
32.
Zurück zum Zitat Soileau KM, Brannon RB (2006) A histologic evaluation of various stages of palatal healing following subepithelial connective tissue grafting procedures: a comparison of eight cases. J Periodontol 77:1267–1273CrossRef Soileau KM, Brannon RB (2006) A histologic evaluation of various stages of palatal healing following subepithelial connective tissue grafting procedures: a comparison of eight cases. J Periodontol 77:1267–1273CrossRef
33.
Zurück zum Zitat Yen CA, Griffin TJ, Cheung WS, Chen J (2007) Effects of platelet concentrate on palatal wound healing after connective tissue graft harvesting. J Periodontol 78:601–610CrossRef Yen CA, Griffin TJ, Cheung WS, Chen J (2007) Effects of platelet concentrate on palatal wound healing after connective tissue graft harvesting. J Periodontol 78:601–610CrossRef
34.
Zurück zum Zitat Farnoush A (1978) Techniques for the protection and coverage of the donor sites in free soft tissue grafts. J Periodontol 49:403–405CrossRef Farnoush A (1978) Techniques for the protection and coverage of the donor sites in free soft tissue grafts. J Periodontol 49:403–405CrossRef
35.
Zurück zum Zitat Bahammam MA, Linjawi AI (2014) Knowledge, attitude, and barriers towards the use of evidence based practice among senior dental and medical students in western Saudi Arabia. Saudi Med J 35:1250–1256PubMedPubMedCentral Bahammam MA, Linjawi AI (2014) Knowledge, attitude, and barriers towards the use of evidence based practice among senior dental and medical students in western Saudi Arabia. Saudi Med J 35:1250–1256PubMedPubMedCentral
36.
Zurück zum Zitat Malvania EA, Ajithkrishnan CG (2011) Prevalence and socio-demographic correlates of dental anxiety among a group of adult patients attending a dental institution in Vadodara city, Gujarat, India. Indian J Dent Res 22:179–180CrossRef Malvania EA, Ajithkrishnan CG (2011) Prevalence and socio-demographic correlates of dental anxiety among a group of adult patients attending a dental institution in Vadodara city, Gujarat, India. Indian J Dent Res 22:179–180CrossRef
37.
Zurück zum Zitat Anilkumar K, Geetha A, Umasudhakar TR, Vijayalakshmi R, Pameela E (2009) Platelet-rich-fibrin: a novel root coverage approach. J Indian Soc Periodontol 13:50–54CrossRef Anilkumar K, Geetha A, Umasudhakar TR, Vijayalakshmi R, Pameela E (2009) Platelet-rich-fibrin: a novel root coverage approach. J Indian Soc Periodontol 13:50–54CrossRef
38.
Zurück zum Zitat Femminella B, Iaconi MC, Di Tullio 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 87:103–113CrossRef Femminella B, Iaconi MC, Di Tullio 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 87:103–113CrossRef
39.
Zurück zum Zitat Choukroun J, Ghanaati S (2017) Reduction of relative centrifugation force within injectable platelet-rich-fibrin (PRF) concentrates advances patients’ own inflammatory cells, platelets and growth factors: the first introduction to the low speed centrifugation concept. Eur J Trauma Emerg Surg Choukroun J, Ghanaati S (2017) Reduction of relative centrifugation force within injectable platelet-rich-fibrin (PRF) concentrates advances patients’ own inflammatory cells, platelets and growth factors: the first introduction to the low speed centrifugation concept. Eur J Trauma Emerg Surg
Metadaten
Titel
Effect of platelet-rich fibrin palatal bandage on pain scores and wound healing after free gingival graft: a randomized controlled clinical trial
verfasst von
Maha A. Bahammam
Publikationsdatum
09.03.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Oral Investigations / Ausgabe 9/2018
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-018-2397-y

Weitere Artikel der Ausgabe 9/2018

Clinical Oral Investigations 9/2018 Zur Ausgabe

Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Zahnmedizin und bleiben Sie gut informiert – ganz bequem per eMail.