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Do blood concentrates influence inflammatory signs and symptoms after mandibular third molar surgery? A systematic review and network meta-analysis of randomized clinical trials

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Abstract

Objectives

To investigate, through a network meta-analysis, the effectiveness of blood concentrates in reducing pain perception, trismus, and edema after mandibular third molar extraction.

Materials and methods

An electronic search was performed in nine databases to locate randomized clinical trials comparing blood concentrate use after mandibular third molar extraction. Two authors selected and extracted the data independently. The individual risk of bias in the studies was assessed with the RoB v2.0 tool. A network meta-analysis compared postoperative pain and trismus scores after applying different blood concentrates, using the mean difference (MD) as an effect estimate. The GRADE approach assessed the certainty of evidence.

Results

Thirty-one randomized clinical trials were included in the review and 18 in the meta-analysis. Leukocyte- and platelet-rich fibrin (L-PRF) was the most used blood concentrate, followed by platelet-rich plasma (PRP). The network meta-analysis, depending on the analyzed period, evaluated up to 1240 surgeries. Among the analyzed blood concentrates, advanced platelet-rich fibrin (A-PRF) performed better among the analyzed blood concentrates, decreasing postoperative pain in 1, 2, 3, and 7 days and reducing trismus up to the inflammatory peak compared to blood clots. Only two studies had a low risk of bias.

Conclusions

Based on very low certainty of evidence, using concentrates seemed efficient compared to blood clots in reducing pain and trismus after mandibular third molar surgeries. A-PRF decreased postoperative pain throughout the evaluated time and trismus during the acute inflammatory peak.

Clinical relevance

A-PRF after mandibular third molar extractions performed better among the analyzed blood concentrates and seemed efficient in improving postoperative quality by decreasing inflammatory signs and symptoms.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Duarte-Rodrigues L, Miranda EFP, Souza TO, de Paiva HN, Falci SGM, Galvão EL (2018) Third molar removal and its impact on quality of life: systematic review and meta-analysis. Qual Life Res 27:2477–2489. https://doi.org/10.1007/s11136-018-1889-1

    Article  PubMed  Google Scholar 

  2. Bailey E, Kashbour W, Shah N, Worthington HV, Renton TF, Coulthard P (2020) Surgical techniques for the removal of mandibular wisdom teeth. Cochrane Database Syst Rev 7:CD004345. https://doi.org/10.1002/14651858.CD004345.pub3

    Article  PubMed  Google Scholar 

  3. Albuquerque AFM, Fonteles CSR, do Val DR, Chaves HV, Bezerra MM, KMA P, de Barros Silva PG, de Lima BB, ECS S, Ribeiro TR, FWG C (2017) Effect of pre-emptive analgesia on clinical parameters and tissue levels of TNF-α and IL-1β in third molar surgery: a triple-blind, randomized, placebo-controlled study. Int J Oral Maxillofac Surg 46:1615–1625. https://doi.org/10.1016/j.ijom.2017.05.007

    Article  PubMed  Google Scholar 

  4. Costa FWG, Soares ECS, Esses DFS, deB SPG, Bezerra TP, Scarparo HC, Ribeiro TR, CSR F (2015) A split-mouth, randomized, triple-blind, placebo-controlled study to analyze the pre-emptive effect of etoricoxib 120 mg on inflammatory events following removal of unerupted mandibular third molars. Int J Oral Maxillofac Surg 44:1166–1174. https://doi.org/10.1016/j.ijom.2015.06.012

    Article  PubMed  Google Scholar 

  5. Silva PUJ, Meneses-Santos D, Vieira WDA, Ramacciato JC, Silva RPD, Silva MCPD, Rode SDM, Paranhos LR (2021) Preemptive use of intravenous ibuprofen to reduce postoperative pain after lower third molar surgery: a systematic review of randomized controlled trials. Clinics (Sao Paulo) 76:e2780. https://doi.org/10.6061/clinics/2021/e2780

    Article  PubMed  Google Scholar 

  6. Jaroń A, Preuss O, Grzywacz E, Trybek G (2021) The impact of using kinesio tape on non-infectious complications after impacted mandibular third molar surgery. Int J Environ Res Public Health 18:E399. https://doi.org/10.3390/ijerph18020399

    Article  Google Scholar 

  7. Landim FS, Laureano Filho JR, Nascimento J, do Egito Vasconcelos BC (2020) Effectiveness of nicotine patch for the control of pain, oedema, and trismus following third molar surgery: a randomized clinical trial. Int J Oral Maxillofac Surg 49:1508–1517. https://doi.org/10.1016/j.ijom.2019.08.013

    Article  PubMed  Google Scholar 

  8. Sáez-Alcaide L-M, Molinero-Mourelle P, González-Serrano J, Rubio-Alonso L, Bornstein M-M, López-Quiles J (2020) Efficacy of a topical gel containing chitosan, chlorhexidine, allantoin and dexpanthenol for pain and inflammation control after third molar surgery: A randomized and placebo-controlled clinical trial. Med Oral Patol Oral Cir Bucal 25:e644–e651. https://doi.org/10.4317/medoral.23661

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kaplan V, Hasanoglu Erbasar GN, Cigerim L, Altay Turgut H, Cerit A (2021) Effect of St. John’s wort oil and olive oil on the postoperative complications after third molar surgery: randomized, double-blind clinical trial. Clin Oral Investig 25:2429–2438. https://doi.org/10.1007/s00784-020-03639-0

    Article  PubMed  Google Scholar 

  10. Quesada-Bravo FJ, García-Carricondo AR, Espín-Gálvez F, Fernández-Sánchez C, Fernández-Ginés D, Requena-Mullor MDM, Alarcón-Rodríguez R (2021) Comparative study between the combination of dexamethasone and bupivacaine for third molar surgery postoperative pain: a triple-blind, randomized clinical trial. J Clin Med 10:5081. https://doi.org/10.3390/jcm10215081

    Article  PubMed  PubMed Central  Google Scholar 

  11. Al-Hamed FS, Tawfik MA-M, Abdelfadil E, Al-Saleh MAQ (2017) Efficacy of platelet-rich fibrin after mandibular third molar extraction: a systematic review and meta-analysis. J Oral Maxillofac Surg 75:1124–1135. https://doi.org/10.1016/j.joms.2017.01.022

    Article  PubMed  Google Scholar 

  12. Canellas JVDS, Ritto FG, Medeiros PJD (2017) Evaluation of postoperative complications after mandibular third molar surgery with the use of platelet-rich fibrin: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 46:1138–1146. https://doi.org/10.1016/j.ijom.2017.04.006

    Article  PubMed  Google Scholar 

  13. Zhu J, Zhang S, Yuan X, He T, Liu H, Wang J, Xu B (2021) Effect of platelet-rich fibrin on the control of alveolar osteitis, pain, trismus, soft tissue healing, and swelling following mandibular third molar surgery: an updated systematic review and meta-analysis. Int J Oral Maxillofac Surg 50:398–406. https://doi.org/10.1016/j.ijom.2020.08.014

    Article  PubMed  Google Scholar 

  14. Mihaylova Z, Mitev V, Stanimirov P, Isaeva A, Gateva N, Ishkitiev N (2017) Use of platelet concentrates in oral and maxillofacial surgery: an overview. Acta Odontol Scand 75:1–11. https://doi.org/10.1080/00016357.2016.1236985

    Article  PubMed  Google Scholar 

  15. Choukroun J, Ghanaati S (2018) 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 44:87–95. https://doi.org/10.1007/s00068-017-0767-9

    Article  PubMed  Google Scholar 

  16. 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 I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101:e37–e44. https://doi.org/10.1016/j.tripleo.2005.07.008

    Article  PubMed  Google Scholar 

  17. 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–e55. https://doi.org/10.1016/j.tripleo.2005.07.010

    Article  PubMed  Google Scholar 

  18. 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 II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101:e45–e50. https://doi.org/10.1016/j.tripleo.2005.07.009

    Article  PubMed  Google Scholar 

  19. Choukroun J, Diss A, Simonpieri A, Girard M-O, Schoeffler C, Dohan SL, Dohan AJJ, 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 Endod 101:e56–e60. https://doi.org/10.1016/j.tripleo.2005.07.011

    Article  PubMed  Google Scholar 

  20. Choukroun J, Ghanaati S (2017) Introducing the low-speed centrifugation concept. In: Platelet rich fibrin in regenerative dentistry: biological background and clinical indications. John Wiley & Sons, Ltd, pp 33–46

    Chapter  Google Scholar 

  21. Sato A, Kawabata H, Aizawa H, Tsujino T, Isobe K, Watanabe T, Kitamura Y, Miron RJ, Kawase T (2020) Distribution and quantification of activated platelets in platelet-rich fibrin matrices. Platelets 1–6. https://doi.org/10.1080/09537104.2020.1856359

  22. Ghanaati S, Booms P, Orlowska A, Kubesch A, Lorenz J, Rutkowski J, Landes C, Sader R, Kirkpatrick C, Choukroun J (2014) Advanced platelet-rich fibrin: a new concept for cell-based tissue engineering by means of inflammatory cells. J Oral Implantol 40:679–689. https://doi.org/10.1563/aaid-joi-D-14-00138

    Article  PubMed  Google Scholar 

  23. Bai M-Y, Wang C-W, Wang J-Y, Lin M-F, Chan WP (2017) Three-dimensional structure and cytokine distribution of platelet-rich fibrin. Clinics (Sao Paulo) 72:116–124. https://doi.org/10.6061/clinics/2017(02)09

    Article  PubMed  Google Scholar 

  24. Yanmin Z (2017) Biological additives and platelet concentrates for tissue engineering on regenerative dentistry: basic science and concise review. Asian J Pharm (AJP): Free full text articles from Asian J Pharm 11. https://doi.org/10.22377/ajp.v11i04.1621

  25. Mudalal M, Sun X, Li X, Zhou Y (2019) The evaluation of leukocyte-platelet rich fibrin as an antiinflammatory autologous biological additive: a novel in vitro study. Saudi Med J 40:657–669. https://doi.org/10.15537/smj.2019.7.24302

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kargarpour Z, Nasirzade J, Strauss FJ, Di Summa F, Hasannia S, Müller H-D, Gruber R (2020) Platelet-rich fibrin suppresses in vitro osteoclastogenesis. J Periodontol 91:413–421. https://doi.org/10.1002/JPER.19-0109

    Article  PubMed  Google Scholar 

  27. Zhang J, Yin C, Zhao Q, Zhao Z, Wang J, Miron RJ, Zhang Y (2020) Anti-inflammation effects of injectable platelet-rich fibrin via macrophages and dendritic cells. J Biomed Mater Res A 108:61–68. https://doi.org/10.1002/jbm.a.36792

    Article  PubMed  Google Scholar 

  28. Wang Z, Mudalal M, Sun Y, Liu Y, Wang J, Wang Y, Sun X, Zhou Y (2020) The effects of leukocyte-platelet rich fibrin (L-PRF) on suppression of the expressions of the pro-inflammatory cytokines, and proliferation of Schwann cell, and neurotrophic factors. Sci Rep 10:2421. https://doi.org/10.1038/s41598-020-59319-2

    Article  PubMed  PubMed Central  Google Scholar 

  29. Bao M, Du G, Zhang Y, Ma P, Cao Y, Li C (2021) Application of platelet-rich fibrin derivatives for mandibular third molar extraction related post-operative sequelae: a systematic review and network meta-analysis. J Oral Maxillofac Surg S0278-2391(21):00661–00663. https://doi.org/10.1016/j.joms.2021.07.006

    Article  Google Scholar 

  30. Barona-Dorado C, González-Regueiro I, Martín-Ares M, Arias-Irimia O, Martínez-González J-M (2014) Efficacy of platelet-rich plasma applied to post-extraction retained lower third molar alveoli. A systematic review. Med Oral Patol Oral Cir Bucal 19:e142–e148. https://doi.org/10.4317/medoral.19444

    Article  PubMed  Google Scholar 

  31. Vitenson J, Starch-Jensen T, Bruun NH, Larsen MK (2022) The use of advanced platelet-rich fibrin after surgical removal of mandibular third molars: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 51:962–974. https://doi.org/10.1016/j.ijom.2021.11.014

    Article  PubMed  Google Scholar 

  32. Xiang X, Shi P, Zhang P, Shen J, Kang J (2019) Impact of platelet-rich fibrin on mandibular third molar surgery recovery: a systematic review and meta-analysis. BMC Oral Health 19:163. https://doi.org/10.1186/s12903-019-0824-3

    Article  PubMed  PubMed Central  Google Scholar 

  33. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA, PRISMA-P Group (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 4:1. https://doi.org/10.1186/2046-4053-4-1

    Article  PubMed  PubMed Central  Google Scholar 

  34. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev 10:89. https://doi.org/10.1186/s13643-021-01626-4

    Article  PubMed  PubMed Central  Google Scholar 

  35. Hutton B, Salanti G, Caldwell DM, Chaimani A, Schmid CH, Cameron C, Ioannidis JPA, Straus S, Thorlund K, Jansen JP, Mulrow C, Catalá-López F, Gøtzsche PC, Dickersin K, Boutron I, Altman DG, Moher D (2015) The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med 162:777–784. https://doi.org/10.7326/M14-2385

    Article  PubMed  Google Scholar 

  36. Aromataris E, Munn Z (2020) JBI manual for evidence synthesis. JBI

    Google Scholar 

  37. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A (2016) Rayyan—a web and mobile app for systematic reviews. Syst Rev 5:210. https://doi.org/10.1186/s13643-016-0384-4

    Article  PubMed  PubMed Central  Google Scholar 

  38. Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, Cates CJ, Cheng H-Y, Corbett MS, Eldridge SM, Emberson JR, Hernán MA, Hopewell S, Hróbjartsson A, Junqueira DR, Jüni P, Kirkham JJ, Lasserson T, Li T et al (2019) RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 366:l4898. https://doi.org/10.1136/bmj.l4898

    Article  PubMed  Google Scholar 

  39. Dias S, Ades AE, Welton NJ, Jansen JP, Sutton AJ (2018) Network meta-analysis for comparative effectiveness research. Hoboken, New Jersey: John Wiley & Sons Ltd

  40. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188. https://doi.org/10.1016/0197-2456(86)90046-2

    Article  PubMed  Google Scholar 

  41. Bhujbal R, Veerabhadrappa SK, Yadav S, Chappi M, Patil V (2020) Evaluation of platelet-rich fibrin and platelet-rich plasma in impacted mandibular third molar extraction socket healing and bone regeneration: a split-mouth comparative study. Eur J Gen Dent 9:96–102

    Article  Google Scholar 

  42. Bilginaylar K, Uyanik LO (2016) Evaluation of the effects of platelet-rich fibrin and piezosurgery on outcomes after removal of impacted mandibular third molars. Br J Oral Maxillofac Surg 54:629–633. https://doi.org/10.1016/j.bjoms.2016.03.016

    Article  PubMed  Google Scholar 

  43. Gandevivala A, Sangle A, Shah D, Tejnani A, Sayyed A, Khutwad G, Patel AA (2017) Autologous platelet-rich plasma after third molar surgery. Ann Maxillofac Surg 7:245–249. https://doi.org/10.4103/ams.ams_108_16

    Article  PubMed  PubMed Central  Google Scholar 

  44. Sweeting MJ, Sutton AJ, Lambert PC (2004) What to add to nothing? Use and avoidance of continuity corrections in meta-analysis of sparse data. Stat Med 23:1351–1375. https://doi.org/10.1002/sim.1761

    Article  PubMed  Google Scholar 

  45. Wei J-J, Lin E-X, Shi J-D, Yang K, Hu Z-L, Zeng X-T, Tong T-J (2021) Meta-analysis with zero-event studies: a comparative study with application to COVID-19 data. Mil Med Res 8:41. https://doi.org/10.1186/s40779-021-00331-6

    Article  PubMed  PubMed Central  Google Scholar 

  46. Brignardello-Petersen R, Bonner A, Alexander PE, Siemieniuk RA, Furukawa TA, Rochwerg B, Hazlewood GS, Alhazzani W, Mustafa RA, Murad MH, Puhan MA, Schünemann HJ, Guyatt GH, GRADE Working Group (2018) Advances in the GRADE approach to rate the certainty in estimates from a network meta-analysis. J Clin Epidemiol 93:36–44. https://doi.org/10.1016/j.jclinepi.2017.10.005

    Article  PubMed  Google Scholar 

  47. Puhan MA, Schünemann HJ, Murad MH, Li T, Brignardello-Petersen R, Singh JA, Kessels AG, Guyatt GH, GRADE Working Group (2014) A GRADE Working Group approach for rating the quality of treatment effect estimates from network meta-analysis. BMJ 349:g5630. https://doi.org/10.1136/bmj.g5630

    Article  PubMed  Google Scholar 

  48. Asutay F, Yolcu Ü, Geçör O, Acar AH, Öztürk SA, Malkoç S (2017) An evaluation of effects of platelet-rich-fibrin on postoperative morbidities after lower third molar surgery. Niger J Clin Pract 20:1531–1536. https://doi.org/10.4103/1119-3077.181400

    Article  PubMed  Google Scholar 

  49. Bhujbal R, Malik NA, Kumar N, Suresh KV, Parkar MI, Jeevan MB (2018) Comparative evaluation of platelet rich plasma in socket healing and bone regeneration after surgical removal of impacted mandibular third molars. J Dent Res Dent Clin Dent Prospects 12:153–158. https://doi.org/10.15171/joddd.2018.024

    Article  PubMed  PubMed Central  Google Scholar 

  50. Caymaz MG, Uyanik LO (2019) Comparison of the effect of advanced platelet-rich fibrin and leukocyte- and platelet-rich fibrin on outcomes after removal of impacted mandibular third molar: a randomized split-mouth study. Niger J Clin Pract 22:546–552. https://doi.org/10.4103/njcp.njcp_473_18

    Article  PubMed  Google Scholar 

  51. da Silva MT, de Almeida Barros Mourão CF, Mello-Machado RC, Montemezzi P, de Lima Barbosa R, Sartoretto SC, PEC L, Javid K, Kawase T, Alves GG, Calasans-Maia MD (2021) Effects of leukocyte-platelet-rich fibrin (L–PRF) on pain, soft tissue healing, growth factors, and cytokines after third molar extraction: a randomized, split-mouth, double-blinded clinical trial. Appl Sci 11:1666. https://doi.org/10.3390/app11041666

    Article  Google Scholar 

  52. Dar MM, Shah AA, Najar AL, Younis M, Kapoor M, Dar JI (2018) Healing potential of platelet rich fibrin in impacted mandibular third molar extraction sockets. Ann Maxillofac Surg 8:206–213. https://doi.org/10.4103/ams.ams_181_18

    Article  PubMed  PubMed Central  Google Scholar 

  53. Daugela P, Grimuta V, Sakavicius D, Jonaitis J, Juodzbalys G (2018) Influence of leukocyte- and platelet-rich fibrin (L-PRF) on the outcomes of impacted mandibular third molar removal surgery: a split-mouth randomized clinical trial. Quintessence Int 49:377–388. https://doi.org/10.3290/j.qi.a40113

    Article  PubMed  Google Scholar 

  54. Gülşen U, Şentürk MF (2017) Effect of platelet rich fibrin on edema and pain following third molar surgery: a split mouth control study. BMC Oral Health 17:79. https://doi.org/10.1186/s12903-017-0371-8

    Article  PubMed  PubMed Central  Google Scholar 

  55. Gupta N, Agarwal S (2021) Advanced-PRF: clinical evaluation in impacted mandibular third molar sockets. J Stomatol Oral Maxillofac Surg 122:43–49. https://doi.org/10.1016/j.jormas.2020.04.008

    Article  PubMed  Google Scholar 

  56. Kapse S, Surana S, Satish M, Hussain SE, Vyas S, Thakur D (2019) Autologous platelet-rich fibrin: can it secure a better healing? Oral Surg Oral Med Oral Pathol Oral Radiol 127:8–18. https://doi.org/10.1016/j.oooo.2018.08.010

    Article  PubMed  Google Scholar 

  57. Kumar A, Singh G, Gaur A, Kumar S, Numan M, Jacob G, Kiran K (2020) Role of platelet-rich plasma in the healing of impacted third molar socket: a comparative study on central India population. J Contemp Dent Pract 21:986–991

    Article  PubMed  Google Scholar 

  58. Kumar YR, Mohanty S, Verma M, Kaur RR, Bhatia P, Kumar VR, Chaudhary Z (2016) Platelet-rich fibrin: the benefits. Br J Oral Maxillofac Surg 54:57–61

    Article  PubMed  Google Scholar 

  59. Miyamoto H, Nakamura T, Takashima H, Mizutani T, Morita M, Hirose M, Kurata M, Maeda M, Aoki N, Kato S, Shibuya Y (2020) Investigation of the analgesic effect of platelet-rich fibrin on postoperative pain after mandibular impacted wisdom tooth extraction. J Oral Maxillofac Surg Med Pathol 32:237–240. https://doi.org/10.1016/j.ajoms.2020.03.001

    Article  Google Scholar 

  60. Ozgul O, Senses F, Er N, Tekin U, Tuz HH, Alkan A, Kocyigit ID, Atil F (2015) Efficacy of platelet rich fibrin in the reduction of the pain and swelling after impacted third molar surgery: randomized multicenter split-mouth clinical trial. Head Face Med 11:37. https://doi.org/10.1186/s13005-015-0094-5

    Article  PubMed  PubMed Central  Google Scholar 

  61. Özveri Koyuncu B, Işık G, Özden Yüce M, Günbay S, Günbay T (2020) Effect of concentrated growth factor (CGF) on short-term clinical outcomes after partially impacted mandibular third molar surgery: a split-mouth randomized clinical study. J Stomatol Oral Maxillofac Surg 121:118–123. https://doi.org/10.1016/j.jormas.2019.07.002

    Article  PubMed  Google Scholar 

  62. Ritto FG, Pimentel T, Canellas JVS, Junger B, Cruz M, Medeiros PJ (2019) Randomized double-blind clinical trial evaluation of bone healing after third molar surgery with the use of leukocyte- and platelet-rich fibrin. Int J Oral Maxillofac Surg 48:1088–1093. https://doi.org/10.1016/j.ijom.2019.01.020

    Article  PubMed  Google Scholar 

  63. Sybil D, Sawai M, Faisal M, Singh S, Jain V (2020) Platelet-rich fibrin for hard- and soft-tissue healing in mandibular third molar extraction socket. Ann Maxillofac Surg 10:102–107. https://doi.org/10.4103/ams.ams_228_19

    Article  PubMed  PubMed Central  Google Scholar 

  64. Uyanık LO, Bilginaylar K, Etikan İ (2015) Effects of platelet-rich fibrin and piezosurgery on impacted mandibular third molar surgery outcomes. Head Face Med 11:25. https://doi.org/10.1186/s13005-015-0081-x

    Article  PubMed  PubMed Central  Google Scholar 

  65. Zahid TM, Nadershah M (2019) Effect of advanced platelet-rich fibrin on wound healing after third molar extraction: a split-mouth randomized double-blind study. J Contemp Dent Pract 20:1164–1170

    Article  PubMed  Google Scholar 

  66. Riaz R, Radhakrishnan M, Perumal J (2022) Comparative study of the efficacy of advanced platelet-rich fibrin and standard platelet-rich fibrin in mandibular third molar surgery. J Pharm Bioallied Sci 14:S781–S787. https://doi.org/10.4103/jpbs.jpbs_157_22

    Article  PubMed  PubMed Central  Google Scholar 

  67. Elayah SA, Liang X, Sakran KA, Xie L, Younis H, Alajami AE, Tu J, Na S (2022) Effect of concentrated growth factor (CGF) on postoperative sequel of completely impacted lower third molar extraction: a randomized controlled clinical study. BMC Oral Health 22:368. https://doi.org/10.1186/s12903-022-02408-7

    Article  PubMed  PubMed Central  Google Scholar 

  68. Kumar N, Prasad K, Ramanujam L, Ranganath K, Dexith J, Chauhan A (2015) Evaluation of treatment outcome after impacted mandibular third molar surgery with the use of autologous platelet-rich fibrin: a randomized controlled clinical study. J Oral Maxillofac Surg 73:1042–1049. https://doi.org/10.1016/j.joms.2014.11.013

    Article  PubMed  Google Scholar 

  69. Dutta SR, Passi D, Singh P, Sharma S, Singh M, Srivastava D (2016) A randomized comparative prospective study of platelet-rich plasma, platelet-rich fibrin, and hydroxyapatite as a graft material for mandibular third molar extraction socket healing. Natl J Maxillofac Surg 7:45–51. https://doi.org/10.4103/0975-5950.196124

    Article  PubMed  PubMed Central  Google Scholar 

  70. Afat İM, Akdoğan ET, Gönül O (2018) Effects of leukocyte- and platelet-rich fibrin alone and combined with hyaluronic acid on pain, edema, and trismus after surgical extraction of impacted mandibular third molars. J Oral Maxillofac Surg 76:926–932. https://doi.org/10.1016/j.joms.2017.12.005

    Article  PubMed  Google Scholar 

  71. Jeyaraj PE, Chakranarayan A (2018) Soft tissue healing and bony regeneration of impacted mandibular third molar extraction sockets, following postoperative incorporation of platelet-rich fibrin. Ann Maxillofac Surg 8:10–18. https://doi.org/10.4103/ams.ams_185_17

    Article  PubMed  PubMed Central  Google Scholar 

  72. Nourwali I (2021) The effects of platelet-rich fibrin on post-surgical complications following removal of impacted wisdom teeth: a pilot study. J Taibah Univ Med Sci 16:521–528. https://doi.org/10.1016/j.jtumed.2021.02.004

    Article  PubMed  PubMed Central  Google Scholar 

  73. Trybek G, Rydlińska J, Aniko-Włodarczyk M, Jaroń A (2021) Effect of platelet-rich fibrin application on non-infectious complications after surgical extraction of impacted mandibular third molars. Int J Environ Res Public Health 18:8249. https://doi.org/10.3390/ijerph18168249

    Article  PubMed  PubMed Central  Google Scholar 

  74. Osagie O, Saheeb BD, Egbor EP (2022) Evaluation of the efficacy of platelet-rich plasma versus platelet-rich fibrin in alleviating postoperative inflammatory morbidities after lower third molar surgery: a double-blind randomized study. West Afr J Med 39:343–349

    PubMed  Google Scholar 

  75. Ogundipe OK, Ugboko VI, Owotade FJ (2011) Can autologous platelet-rich plasma gel enhance healing after surgical extraction of mandibular third molars? J Oral Maxillofac Surg 69:2305–2310. https://doi.org/10.1016/j.joms.2011.02.014

    Article  PubMed  Google Scholar 

  76. Aftab A, Joshi UKM, Patil SKG, Hussain E, Bhatnagar S (2020) Efficacy of autologous platelet rich plasma gel in soft and hard tissue healing after surgical extraction of impacted mandibular third molar - a prospective study. J Oral Maxillofac Surg Med Pathol 32:241–246. https://doi.org/10.1016/j.ajoms.2020.03.008

    Article  Google Scholar 

  77. Hanif M, Sheikh MA (2021) Efficacy of platelet rich plasma (PRP) on mouth opening and pain after surgical extraction of mandibular third molars. J Oral Med Oral Surg 27:9. https://doi.org/10.1051/mbcb/2020045

    Article  Google Scholar 

  78. Torul D, Omezli MM, Kahveci K (2020) Evaluation of the effects of concentrated growth factors or advanced platelet rich-fibrin on postoperative pain, edema, and trismus following lower third molar removal: a randomized controlled clinical trial. J Stomatol Oral Maxillofac Surg 121:646–651. https://doi.org/10.1016/j.jormas.2020.02.004

    Article  PubMed  Google Scholar 

  79. Fang D, Li D, Li C, Yang W, Xiao F, Long Z (2022) Efficacy and safety of concentrated growth factor fibrin on the extraction of mandibular third molars: a prospective, randomized, double-blind controlled clinical study. J Oral Maxillofac Surg 80:700–708. https://doi.org/10.1016/j.joms.2021.10.005

    Article  PubMed  Google Scholar 

  80. Kobayashi E, Flückiger L, Fujioka-Kobayashi M, Sawada K, Sculean A, Schaller B, Miron R (2016) Comparative release of growth factors from PRP, PRF, and advanced-PRF. Clin Oral Investig 20:1–8. https://doi.org/10.1007/s00784-016-1719-1

    Article  Google Scholar 

  81. Everts P, Onishi K, Jayaram P, Lana JF, Mautner K (2020) Platelet-rich plasma: new performance understandings and therapeutic considerations in 2020. Int J Mol Sci 21:7794. https://doi.org/10.3390/ijms21207794

    Article  PubMed  PubMed Central  Google Scholar 

  82. Kuffler DP (2018) Variables affecting the potential efficacy of PRP in providing chronic pain relief. J Pain Res 12:109–116. https://doi.org/10.2147/JPR.S190065

    Article  PubMed  PubMed Central  Google Scholar 

  83. Bielecki T, Dohan Ehrenfest DM (2012) Platelet-rich plasma (PRP) and Platelet-Rich Fibrin (PRF): surgical adjuvants, preparations for in situ regenerative medicine and tools for tissue engineering. Curr Pharm Biotechnol 13:1121–1130. https://doi.org/10.2174/138920112800624292

    Article  PubMed  Google Scholar 

  84. Wang X, Fok MR, Pelekos G, Jin L, Tonetti MS (2022) In vitro and ex vivo kinetic release profile of growth factors and cytokines from leucocyte- and platelet-rich fibrin (L-PRF) preparations. Cells 11:2089. https://doi.org/10.3390/cells11132089

    Article  PubMed  PubMed Central  Google Scholar 

  85. Castro AB, Herrero ER, Slomka V, Pinto N, Teughels W, Quirynen M (2019) Antimicrobial capacity of leucocyte- and platelet rich fibrin against periodontal pathogens. Sci Rep 9:8188. https://doi.org/10.1038/s41598-019-44755-6

    Article  PubMed  PubMed Central  Google Scholar 

  86. JVDS C, PJD M, CMDS F, Fischer RG, Ritto FG (2019) Platelet-rich fibrin in oral surgical procedures: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 48:395–414. https://doi.org/10.1016/j.ijom.2018.07.007

    Article  Google Scholar 

  87. Miron R, Choukroun J, Ghanaati S (2018) Controversies related to scientific report describing g-forces from studies on platelet-rich fibrin: necessity for standardization of relative centrifugal force values. Int J Growth Factors Stem Cells Dent 1:80. https://doi.org/10.4103/GFSC.GFSC_23_18

    Article  Google Scholar 

  88. Miron RJ, Choukroun J, Ghanaati S (2019) Reply from authors: RE: Optimized platelet-rich fibrin with the low-speed concept: growth factor release, biocompatibility, and cellular response: necessity for standardization of relative centrifugal force values in studies on platelet-rich fibrin. J Periodontol 90:122–125. https://doi.org/10.1002/JPER.18-0329

    Article  PubMed  Google Scholar 

  89. Cuschieri S (2019) The CONSORT statement. Saudi J Anaesth 13:S27–S30. https://doi.org/10.4103/sja.SJA_559_18

    Article  PubMed  PubMed Central  Google Scholar 

  90. Lambert J (2011) Statistics in brief: how to assess bias in clinical studies? Clin Orthop Relat Res 469:1794–1796. https://doi.org/10.1007/s11999-010-1538-7

    Article  PubMed  Google Scholar 

  91. Al-Moraissi EA, Elmansi YA, Al-Sharaee YA, Alrmali AE, Alkhutari AS (2016) Does the piezoelectric surgical technique produce fewer postoperative sequelae after lower third molar surgery than conventional rotary instruments? A systematic review and meta analysis. Int J Oral Maxillofac Surg 45:383–391. https://doi.org/10.1016/j.ijom.2015.10.005

    Article  PubMed  Google Scholar 

  92. Yamada S-I, Hasegawa T, Yoshimura N, Hakoyama Y, Nitta T, Hirahara N, Miyamoto H, Yoshimura H, Ueda N, Yamamura Y, Okuyama H, Takizawa A, Nakanishi Y, Iwata E, Akita D, Itoh R, Kubo K, Kondo S, Hata H et al (2022) Prevalence of and risk factors for postoperative complications after lower third molar extraction: a multicenter prospective observational study in Japan. Medicine (Baltimore) 101:e29989. https://doi.org/10.1097/MD.0000000000029989

    Article  PubMed  Google Scholar 

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Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior — Brazil (CAPES) — Finance Code 001. We are also thankful for the support of Conselho Nacional de Desenvolvimento Científico e Tecnológico — Brazil (CNPq) and of Fundação de Amparo à Pesquisa do Estado de Minas Gerais — Brazil (FAPEMIG).

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Authors and Affiliations

  1. Postgraduate Program in Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil

    Marcelo Dias Moreira de Assis Costa & Vinícius Lima de Almeida

  2. Division of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Campus Umuarama, Av. Pará, 1720, Bloco 2G, sala 1, ZIP code, Uberlândia, Minas Gerais, 38405-320, Brazil

    Luiz Renato Paranhos

  3. Division of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil

    Leandro Machado Oliveira

  4. Department of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, State University of Campinas, Piracicaba, São Paulo, Brazil

    Walbert de Andrade Vieira

  5. Department of Cell Biology, Histology, and Embryology, Biomedical Science Institute, Federal University of Uberlândia, Uberlândia, Brazil

    Paula Dechichi

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  1. Marcelo Dias Moreira de Assis Costa
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  2. Luiz Renato Paranhos
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  3. Vinícius Lima de Almeida
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  4. Leandro Machado Oliveira
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  5. Walbert de Andrade Vieira
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  6. Paula Dechichi
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Marcelo Dias Moreira de Assis Costa, Luiz Renato Paranhos, Vinícius Lima de Almeida, Leandro Machado Oliveira, Walbert de Andrade Vieira, and Paula Dechichi. The first draft of the manuscript was written by Marcelo Dias Moreira de Assis Costa, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Luiz Renato Paranhos.

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Costa, M.D.M.d.A., Paranhos, L.R., de Almeida, V.L. et al. Do blood concentrates influence inflammatory signs and symptoms after mandibular third molar surgery? A systematic review and network meta-analysis of randomized clinical trials. Clin Oral Invest 27, 7045–7078 (2023). https://doi.org/10.1007/s00784-023-05315-5

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