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. 2019 Oct-Dec;9(4):336-339.
doi: 10.1016/j.jobcr.2019.07.003. Epub 2019 Aug 18.

Efficacy of Platelet Rich Fibrin versus chitosan as a hemostatic agent following dental extraction in patients on antiplatelet therapy

Sourav Sarkar  1 , N T Prashanth  1 , E S Shobha  1 , Vinod Rangan  1 , G Nikhila  1
Affiliations

Efficacy of Platelet Rich Fibrin versus chitosan as a hemostatic agent following dental extraction in patients on antiplatelet therapy

Sourav Sarkar et al. J Oral Biol Craniofac Res. 2019 Oct-Dec.

Abstract

Objectives: The aim of this study is to compare the effectiveness of Platelet Rich Fibrin gel and Chitosan gel dressing in providing hemostasis in patients receiving Oral Antiplatelet Therapy and also to evaluate their surgical healing outcome following dental extractions.

Methodology: A total of 60 patients under Oral Antiplatelet Therapy indicated for tooth extraction were included for treatment in the study without altering the oral antiplatelet regimens. Patients were allocated equally in two groups; Group A: where PRF gel was packed into the extraction socket, while Group B: Chitosan hydrogel was packed. Timing of hemostasis was noted for each patient of both the groups. Patients were examined for any pain/secondary bleeding/healing/soft tissue dehiscence/alveolar osteitis in the extraction site on first, third and seventh post-operative days.

Results: All extraction sockets with Platelet-rich fibrin achieved hemostasis in 2.64 min and sockets with Chitosan hydrogel achieved hemostasis in 1.182 min (p < 0.001). Post-operative pain in Group A sites (3.2, 1.4, 0.37 on 1st, 3rd & 7th day respectively) was significantly lower than the control sites (3.4, 1.67, 0.53 on 1st, 3rd & 7th day respectively) p-value 0.001, 0.001 respectively.

Conclusion: In this study, Chitosan hydrogel dressing thus proved to be a superior hemostatic agent compared to PRF gel, that significantly shortens the clotting time following dental extraction in patients under antiplatelet therapy. But, PRF gel has superior wound healing properties than Chitosan with less postoperative pain following minor oral surgical procedures under local anesthesia.

Keywords: Antiplatelet therapy; Chitosan; Extractions; Hemostasis; PRF.

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Figures

Fig. 1
Fig. 1
a) Platelet Rich Fibrin matrix present in the middle layer b) Fibrin clot 2mm below lower dividing line of the middle fraction is PRF c) Lyophilized chitosan hydrogel.
Fig. 2
Fig. 2
Procedure in Group A patient- a) 24 indicated for extraction. b) Immediate post extraction. c) Socket with PRF gel. d) 1st post-op day. e) 3rd post-op.
Fig. 3
Fig. 3
Procedure in Group B patient a) 46 indicated for extraction b) Immediate post extraction c) Socket with Chitosan hydrogel. d) 1st post-op day. e) 3rd post op day.
Fig. 4
Fig. 4
Correlation of Hemorrhage time in subjects of Group A and Group B.
Fig. 5
Fig. 5
Correlation of Mean Pain Score in subjects of Group A and Group B on 1st, 3rd and 7th postoperative day.
See this image and copyright information in PMC

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