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Meta-Analysis
. 2019 Jul 25;19(1):163.
doi: 10.1186/s12903-019-0824-3.

Impact of platelet-rich fibrin on mandibular third molar surgery recovery: a systematic review and meta-analysis

Xu Xiang  1 , Ping Shi  1 , Ping Zhang  1 , Jun Shen  1 , Jian Kang  2
Affiliations
Meta-Analysis

Impact of platelet-rich fibrin on mandibular third molar surgery recovery: a systematic review and meta-analysis

Xu Xiang et al. BMC Oral Health. .

Abstract

Background: The present study investigated and evaluated the efficacy and safety of platelet-rich fibrin (PRF) in patients during bilateral mandibular third molars extraction by systematic review and meta-analysis.

Methods: The PubMed, Embase, and Cochrane library databases were retrieved, and the effect of PRF on the healing process of the alveolar socket after surgical extraction of the mandibular third molars was evaluated by meta-analysis. The postoperative pain, swelling, trismus, osteoblastic activity, and soft tissue healing were assessed, and the incidence of alveolar osteitis, weighted mean difference (WMD)/standard mean difference (SMD), the risk ratio (RR), and the 95% confidence interval (CI) were calculated.

Results: The current results showed that the local application of PRF during lower third molar extraction prevented postoperative complications. Subsequently, the pain (SMD = - 0.53, 95% CI: - 1.02--0.05, Pheterogeneity = 0.001, I2 = 75.7%) and swelling (WMD = - 0.55, 95% CI: - 1.08--0.01, Pheterogeneity = 0.573, I2 = 0) were relieved and the incidence of alveolar osteitis was reduced (RR = 0.35, 95% CI: 0.16-0.75, Pheterogeneity = 0.597, I2 = 0%). However, no significant difference was observed in trismus, osteoblastic activity, and soft tissue healing between the PRF and non-PRF groups.

Conclusion: The current study confirms that PRF only reduces some of the postoperative complications but does not prevent all the postoperative complications. PRF significantly relieved the pain and swelling and reduced the incidence of alveolar osteitis after the extraction of an impacted lower third molar.

Keywords: Mandibular third molars; Meta-analysis; Platelet-rich fibrin; Systematic review.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Schematic representation of the identification of the studies
Fig. 2
Fig. 2
Risk of bias assessment for the randomized trials included in the meta-analysis. a Risk of bias summary; b Risk of bias graph. Symbols. (+): low risk of bias; (?): unclear risk of bias; (−): high risk of bias
Fig. 3
Fig. 3
Forest plots showing the effect of PRF vs. control after mandibular third molar surgery. a Pain; b Swelling; c Trismus; d Alveolar osteitis; e Osteoblastic activity; f Soft tissue healing
Fig. 4
Fig. 4
Sensitivity analysis of the effect of PRF vs. control after mandibular third molar surgery. a Pain; b Swelling; c Trismus
Fig. 5
Fig. 5
Funnel plot for publication bias test. Each point represented an independent study for the indicated association. a Trismus; b Alveolar osteitis
See this image and copyright information in PMC

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