Autologous Platelet Gel After Surgical Removal of Mandibular Third Molar: A Comparative Study
Background: Recent studies revealed the usage of platelet-rich plasma in oral and maxillofacial surgery to enhance coagulation and wound healing process due to their growth factors that can promote the complete healing. The Hypothesis of this study is that autologous platelet-rich plasma gel (Platelet gel) can be used to promote wound healing process after surgical removal of impacted mandibular third molars tooth comparing to control side.
Methods: 30 patients 18-25 years old, are in good status and scheduled for surgical removal of bilateral impact mandibular third molars that were in the inclusion criteria. One mandibular third molar was simple randomized chosen as experimental group and the other one would be in control group. Both groups were operated at the same visit by using bone removal and tooth division technique. After the operation, autologous platelet gel was inserted in the experimental socket and sutured while the control site was sutured. Every patient was followed up at 7 days, 1 month and 3 months after operation. The collected data included probing depths, facial edema and bone density using the ImageJ® program to analyze films. All data were processed using ANOVA statistics method.
Results: We found the probing depths of experimental group at before and 3 months after operation were significantly different (p<0.05). Bone density from radiographic films at before and 3 months after operation in the experimental group was significantly different (p<0.05). While facial edema showed no significant difference between groups (p>0.05).
Conclusion: Autologous platelet gel can significantly improve wound healing process after surgical removal of impacted mandibular third molars (p<0.05).
1. Schropp L, Wenzel A, Kostopoulos L, Karring T. Bone healing and soft tissue contour changes followingsingle-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restorative Dent 2003; 23: 313- 323.
2. Everts PA. et al. Platelet-Rich Plasma and Platelet Gel: A Review. J Extra-Corporeal Tech 2006; 38: 174-187.
3. Marx, R.E. Platelet-Rich plasma: Evidence to Support Its Use. J Oral Maxillofacial Surg 2004; 62: 489-496.
4. Beanes SR, Dang C, Soo C, et al. Skin repair and scar formation: The central role of TGF-beta. Expert Rev Mol Med 2003; 5:1-22.
5. Schmidt MB, Chen EH, Lynch SE. A review of the effects of insulinlike growth factor and platelet derived growth factor on in vivo cartilagehealing and repair. Osteoarthritis Cartilage 2006; 14:403-412.
6. Canalis E, Varghese S, McCarthy TL, et al. Role of platelet derived growth factor in bone cell function. Growth Regul 1992; 2:151-155.
7. Caplan AI, Correa D. PDGF in bone formation and regeneration: New insights into a novel mechanism involving MSCs. J Orthop Res 2011; 29:1795-1803.
8. Douglas HE. TGF-β1 in wound healing: A review. J Wound Care 2010; 19: 403-406.
9. Yang EY, Moses HL. Transforming growth factor beta 1-induced changes in cell migration, proliferation, and angiogenesis in the chicken chorioallantoic membrane. J Cell Biol 1990; 111:731-741.
10. Zhao L, Jiang S, Hantash BM. Transforming growth factor beta1 induces osteogenic differentiation of murine bone marrow stromal cells. Tissue Eng Part A 2010; 16:725-733.
11. Bikle DD, Harris J, Halloran BP, et al. Expression of the genes for insulin-like growth factors and their receptors in bone during skeletal growth. Am J Physiol 1994; 267:E278-E286.
12. Meinel L, Zoidis E, Zapf J, et al. Localized insulin-like growth factor I delivery to enhance new bone formation. Bone 2003; 33:660-672.
13. Heron-Milhavet L, Mamaeva D, LeRoith D, et al. Impaired muscle regeneration and myoblast differentiation in mice with a muscle-specificKO of IGF-IR. J Cell Physiol 2010; 225:1-6.
14. Nakamura T. Structure and function of hepatocyte growth factor. Prog Growth Factor Res 1991; 3:67-85.
15. Bao P, Kodra A, Tomic-Canic M, et al. The role of vascular endothelial growth factor in wound healing. J Surg Res 2009; 153:347-358.
16. Ferrara N, Gerber HP. The role of vascular endothelial growth factor in angiogenesis. Acta Haematol 2001; 106:148-156.
17. Carpenter G, Cohen S. Epidermal growth factor. J Biol Chem 1990; 265:7709-7712.
18. Kurten RC, Chowdhury P, Sanders RC Jr, et al. Coordinating epidermal growth factor-induced motility promotes efficient wound closure. Am J Physiol Cell Physiol 2005; 288:C109-C121.
19. Berlanga-Acosta J, Gavilondo-Cowley J, López-Saura P, et al. Epidermal growth factor in clinical practice—A review of its biological actions, clinical indications and safety implications. Int Wound J 2009; 6:331-346.
20. Klagsbrun M. The fibroblast growth factor family: Structural and biological properties. Prog Growth Factor Res 1989; 1:207-235.
21. Tabata Y, Yamada K, Hong L, et al. Skull bone regeneration in primates in response to basic fibroblast growth factor. J Neurosurg 1999; 91:851-856.
22. Chang J, Most D, Thunder R, et al. Molecular studies in flexor tendon wound healing: The role of basic fibroblast growth factor gene expression. J Hand Surg Am 1998; 23:1052-1058.
23. Shirakata Y, Taniyama K, Yoshimoto T, et al. Regenerative effect of basic fibroblast growth factor on periodontal healing in two-wall intrabony defects in dogs. J Clin Periodontol 2010; 37:374-381.
24. Sonnleitner D, huemer P, Sullivan DY. A simplified technique for producing platelet-rich plasma and platelet concentrate for intraoral bone grafting techniques: A technical note. Int J Oral Maxillofac Implants 2000; 15:879.
25. Kaul R, Godhi S, Singh A. Autologous platelet rich plasma after third molar surgery: a comparative study. J Maxillofac Oral Surg 2012; 11(2): 200-205.
26. Ogundipe O, Ugboko V, Owotade F. Can Autologous Platelet-Rich Plasma Gel Enhance Healing After Surgical Extraction of Mandibular Third Molars? J Oral Maxillofac Surg 2011; 69: 2305- 2310.
27. Sammartino G, Tia M, Marenzi G, et al. Use of autologous PRP in periodontal defect treatment after extraction of impacted mandibular third molars. J Maxillofac and Oral Surg 2012; 32: 235.
28. Simon D,Manuel S,Geetha V, Naik BR. Potential for osseous regeneration of platelet-rich plasma--a comparative study in mandibular third molar sockets. Indian J Dent Res. 2005; Jan-Mar; 16(1):18.
29. Célio-Mariano R, de Melo WM, Carneiro-Avelino C. Comparative radiographic evaluation of alveolar bone healing associated with autologous platelet-rich plasma after impacted mandibular third molar surgery. J Oral Maxillofac Surg 2012; 70: 19-24.