Adjunctive Use of Plasma Rich in Growth Factors for Improving Alveolar Socket Healing: A Systematic Review

Abstract

Purpose: The purpose of this study was to determine whether the adjunctive use of plasma rich in growth factors in postextraction sites could be beneficial in terms of hard- and soft-tissue healing and patients' comfort.

Materials and methods: An electronic search was performed on MEDLINE, EMBASE, Scopus, and CENTRAL. Only controlled clinical trials or randomized clinical trials that used plasma rich in growth factors in the test group were included. The primary outcomes were pain assessment, complications, and adverse events. Secondary outcomes were hard-tissue healing, bone remodeling, and soft-tissue healing.

Results: Eight comparative studies (5 randomized clinical trials) were included. Four studies had a split-mouth design. Six hundred fourteen teeth were extracted in 338 patients. Only qualitative analysis could be performed. Postoperative pain and the incidence of complications such as alveolar osteitis were consistently lower in the test group. Hard-tissue healing, evaluated by clinical, radiographic, histologic, and histomorphometric techniques, showed significantly better results for the test group in almost all studies. Better epithelialization, keratinized tissue thickness, and healing score were also reported.

Conclusion: Plasma rich in growth factors may bring advantages in some relevant clinical and radiographic outcomes, such as bone density and soft-tissue healing, after tooth extraction. It could also represent a useful tool for reducing adverse events, complications, and patients' discomfort, although it is still not quantifiable.

Keywords: Platelet rich in growth factors; Postextraction healing; Systematic review.