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  3. Investigating the effect of platelet-enriched fibrin (PRF) on reducing periodontal problems after mandibular impacted wisdom teeth surgery.

Investigating the effect of platelet-enriched fibrin (PRF) on reducing periodontal problems after mandibular impacted wisdom teeth surgery.

Number of pages: 86 File Format: word File Code: 32031
Year: 2006 University Degree: Master's degree Category: Medical Sciences
Tags/Keywords: Dental surgery - Enriched fibrin - Oral surgeries - Periodontal pocket - Platelet enriched with fibrin - Second molar tooth - The third molar of the mandible - Third molar tooth - Wisdom teeth surgery
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  • Summary of Investigating the effect of platelet-enriched fibrin (PRF) on reducing periodontal problems after mandibular impacted wisdom teeth surgery.

    Dissertation for general doctor degree in dentistry

    Abstract

    Introduction: One of the common problems after the surgery of the impacted third molar tooth is the development of periodontal problems, which occurs in the form of pocket formation in the distal second molar tooth, loss of connections and lack of adequate bone formation. To solve this problem, various methods such as using demineralized bone and PRP have been proposed. PRF is the second generation of platelet concentration techniques, which has a higher concentration of growth factors than PRP due to the lack of use of anticoagulants and gelling agents in their production. This study was conducted with the aim of investigating the effect of PRF on periodontal problems after impacted third molar surgery.

    Methodology: 36 candidates for bilateral mandibular impacted third molar surgery were selected. For each patient, one side was randomly selected as the intervention side and the other side was considered as control. PRF was placed on the intervention side after cleaning the tooth cavity. Periodontal indices including pocket depth (distobuccal, middistal and distolingual second molar), gingival index and periodontal index were measured before and 12 weeks after surgery. Finally, in order to compare the periodontal indices between the intervention and control groups, the data were subjected to statistical analysis.

    Results: All three periodontal indices measured in this study before the operation between the control and intervention groups had no statistically significant difference. The gingival index and periodontal index did not have a statistically significant difference after the operation, but the depth of the pocket after the operation in the intervention group was significantly lower than the control group.

    Conclusion: The results of our study showed that the use of PRF can be a suitable method to prevent pocket formation and periodontal problems of the distal second molar after the removal of the hidden mesiangular molars of the mandible. .

    Key words: periodontal pocket, fibrin-enriched platelet, mandibular impacted third molar

    (1-1) Preface

    Third molars are the last erupted teeth in the dental arch, so they are more likely to be impacted than all other teeth (1) Many genetic and environmental factors They play a role in this impingement (2) Third molar impingement causes a range of complications such as pericoronitis, root resorption of adjacent teeth, cystic and neoplastic changes and even disorders of the TMJ joint (2 and 3), so removing the third molar is one of the most common oral surgeries. Extraction of the mandibular third molar is one of the most challenging oral surgeries for many clinicians, and one of the most important complications of this surgery is the increased risk of spreading the distal periodontal defect of the second molar after the extraction of the third molars. Age, inclination of the third molar teeth, wide contact area, visible plaque in the distal second molar and dilated follicle of the third molar are among these risk factors that have been mentioned in the studies so far (1.5) Removing the hidden mesiangular third molars causes multiple periodontal lesions in the distal root of the third molar (6-8). The second one exists and has a higher prevalence (10, 9). The mesiangularity of the tooth is one of the most destructive positions of the mandibular third molar because it causes periodontal defects and periodontal pockets in the distal second molar (11). Various methods have been proposed to solve this complication. One of these methods is the use of demineralized bones in the cavity of surgical teeth (12), although in some studies this method has been effective in reducing problems, but due to the high cost, it cannot be used in the clinic. Using concentrated platelets like PRP is another one of these methods. PRP is a suspension of concentrated autologous platelets in plasma (13-15). Platelets are a rich source of growth factors such as PDGF and TGF?1,2. Platelets can be concentrated by separating them by centrifugation (15-17). When PRP is mixed with calcium chloride and thrombin, the cytokines in the platelets are released.PRP gel also contains a high concentration of fibrinogen, as a result, it provides the possibility of blood clotting and then the regeneration of bone defects in the very first stages. Soft tissue repair is also accelerated as a result of using PRP by increasing collagen content, angiogenesis, and initial wound resistance (13). The growth factors in PRP regulate key cellular processes such as chemotaxis, cell differentiation, and metabolism. PRF is the second generation of platelet concentration technologies, which due to the absence of anticoagulants and gelling agents in their production has a higher concentration of cytokines and growth factors than PRP (18) PRP is an uncontrollable mixture and its effect is short-term because the high amount of thrombin used in its preparation accelerates the polymerization of this substance (19) since the polymerization of PRF occurs during centrifugation, the release of cytokines It happens at a lower speed and in this sense it is more controllable and more efficient. Unlike the production of PRP, whose production process takes time, PRF can be easily prepared before the operation, and to prepare it, only a patient's blood sample and a PC-02 centrifuge are needed. The present study was conducted with the aim of investigating the effect of PRF on periodontal problems after impacted third molar surgery. the second molar adjacent to the extracted third molar. Different methods such as application of demineralized bone or PRP suggested for this issue. PRF is the second generation of platelet concentrate containing more autologous growth factors than PRP. The aim of this study is to evaluate the effect of PRF on periodontal problems at distal root of the second molar after extraction of impacted mandibular third molar.

    Method: 36 volunteers for extraction of bilateral mesioangular mandibular third molar selected for this study. For each patient randomly one side considered as experimental side and after extraction of third molar the remaining socket filled with PRF. All operations performed by one person. Periodontal indices include pocket depth (at distobuccal, middistal and distolingual of second molar), gingival index and periodontal index before and 12 weeks after surgery were measured by one examiner.

    Results: Data analysis showed that all periodontal indices used in this study were not different before surgery. Gingival and periodontal index also were not different after operation between two groups, but pocket depth in control sides was significantly more than experimental sides.

  • Contents & References of Investigating the effect of platelet-enriched fibrin (PRF) on reducing periodontal problems after mandibular impacted wisdom teeth surgery.

    List:

    (1) First chapter: 3

    (1-1) Preface 4

    (1-2) General.. 7

    (1-2-1) Fibrin technologies. An overview of the studies conducted. 27 (2) Second chapter: Materials and methods. 40 (3) Third chapter: Findings. 51 (4) Fourth chapter: Discussion and conclusion. 56 (5) Fifth chapter: References. Pericoronitis: its nature and etiology. J Am Dent Assoc 1971; 83: 1074

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Investigating the effect of platelet-enriched fibrin (PRF) on reducing periodontal problems after mandibular impacted wisdom teeth surgery.
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