Effectiveness of Platelet-Rich Fibrin (PRF) in Post-Extraction Socket Healing Among Diabetic and Non-Diabetic Patients
Main Article Content
Abstract
Introduction: Tooth extraction poses an increased risk of delayed healing in diabetic patients due to impaired cellular repair and compromised immune responses. Platelet-Rich Fibrin (PRF), a second-generation platelet concentrate, has emerged as a promising biomaterial for enhancing postoperative healing. This study aimed to evaluate and compare the effectiveness of PRF in promoting post-extraction socket healing in controlled diabetic and non-diabetic patients.
Materials and Methods: This 12-month prospective comparative study was conducted from August 2022 to August 2023 at the Department of Oral and Maxillofacial Surgery, Fatima Jinnah Dental College (DUHS), Karachi. A total of 93 patients undergoing single-tooth extraction were enrolled and divided into two groups: Group A (n = 46, controlled type 2 diabetics, HbA1c < 8%) and Group B (n = 47, non-diabetic individuals). PRF was prepared from autologous blood and placed into extraction sockets following atraumatic extraction under local anesthesia. Standardized postoperative care was provided to all patients. Clinical follow-up was conducted on days 3, 7, and 21, and at 1, 3, 6, 9, and 12 months. Pain was assessed using the Visual Analogue Scale (VAS); soft tissue healing was scored via the Landry, Turnbull, and Howley Index; and bone regeneration was evaluated using a radiographic numeric density scale. Postoperative complications, including infections, were also recorded. Statistical analysis was conducted using SPSS version 26, with p < 0.05 considered statistically significant.
Results: Non-diabetic patients demonstrated significantly lower pain scores (p < 0.001) and superior soft tissue healing by day 21 (p = 0.002). The incidence of postoperative infection was higher in diabetic patients (13.0%) compared to non-diabetics (2.1%) (p = 0.045). Radiographic bone density scores were significantly lower in diabetic patients at 3, 6, and 12 months (p < 0.001). By the 12-month mark, 93.6% of non-diabetic patients achieved complete socket healing compared to 65.2% of diabetic patients (p < 0.001).
Conclusion: The application of PRF significantly enhanced post-extraction healing in both diabetic and non-diabetic patients. However, healing outcomes—including pain reduction, soft tissue regeneration, and bone density—were markedly superior in non-diabetic individuals. These findings underscore the positive role of PRF in clinical socket healing and the need for tailored strategies to improve outcomes in diabetic populations.
Downloads
Article Details
Section
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
References
Akhtar N, Virk ST, Zubair A, Mehboob S. Precision Medicine Approaches in Diabetes Management: Targeting Individualized Pathways. Innovative Research in Applied, Biological and Chemical Sciences. 2024 Jul 2;2(1):5-12.
Yang S, Li Y, Liu C, Wu Y, Wan Z, Shen D. Pathogenesis and treatment of wound healing in patients with diabetes after tooth extraction. Frontiers in Endocrinology. 2022 Sep 23;13:949535.
Radović K, Brković B, Roganović J, Ilić J, Milić Lemić A, Jovanović B. Salivary VEGF and post-extraction wound healing in type 2 diabetic immediate denture wearers. Acta Odontologica Scandinavica. 2022 Jan 2;80(1):9-14.
La Rosa GR, Marcianò A, Priolo CY, Peditto M, Pedullà E, Bianchi A. Effectiveness of the platelet-rich fibrin in the control of pain associated with alveolar osteitis: a scoping review. Clinical Oral Investigations. 2023 Jul;27(7):3321-30.
Mlhem G, Murad R, Nattouf A. Evaluation of Pentoxifylline efficacy in Socket healing in Type-2 Diabetic adult males. Research Journal of Pharmacy and Technology. 2022 Jun 1;15(6):2552-8.
Farmani AR, Nekoofar MH, Ebrahimi Barough S, Azami M, Rezaei N, Najafipour S, Ai J. Application of platelet rich fibrin in tissue engineering: focus on bone regeneration. Platelets. 2021 Feb 17;32(2):183-8.
Iqbal MA, Mim MH, Shahabuddin NB. Platelet-rich fibrin to manage different periodontal defects combine with Flap surgery and other uses in dentistry. A descriptive review. Update Dental College Journal. 2021 Oct 10;11(2):43-51.
Shaaban Metwally AA, Fahmy AM, El Khourazaty NS. Effects of the platelet-rich fibrin (PRF) on bone density in immediate implant placement and loading in esthetic zone (a randomized clinical trial). Egyptian Dental Journal. 2021 Jan 1;67(1-January (Fixed Prosthodontics, Removable Prosthodontics and Dental Materials)):669-77.
Tatsis D, Vasalou V, Kotidis E, Anestiadou E, Grivas I, Cheva A, Koliakos G, Venetis G, Pramateftakis MG, Ouzounidis N, Angelopoulos S. The combined use of platelet-rich plasma and adipose-derived mesenchymal stem cells promotes healing. a review of experimental models and future perspectives. Biomolecules. 2021 Sep 24;11(10):1403.
Kamal A, Salman B, Razak NH, Al Qabbani A, Samsudin AR. Research Article The Efficacy of Concentrated Growth Factor in the Healing of Alveolar Osteitis: A Clinical Study.
Aljofi FE, Alesawy A, Alzaben B, Alshaikh M, Alotaibi N, Aldulaijan HA, Alshehri S, Aljoghaiman E, Al-Dulaijan YA, AlSharief M. Impact of metformin on periodontal and peri-implant soft and hard tissue. International Journal of Environmental Research and Public Health. 2023 Jan 8;20(2):1095.
Epstein JB, Arany PR, Yost SE, Yuan Y. Medication-related osteonecrosis of the jaw: successful medical management of complex maxillary alveolus with sinus involvement. Case Reports in Oncology. 2023 Dec 20;16(1):412-28.
Djais AI, Mappangara S, Gani A, Mansyur SR, Fatah NA. The Utilization Of Milk Fish Scales Chitosan For Bone And Soft Tissue Regeneration After Tooth Extraction: A Literature Review. Journal of Pharmaceutical Negative Results. 2023 Feb 1;14.
Sano T, Kuraji R, Miyashita Y, Yano K, Kawanabe D, Numabe Y. Biomaterials for alveolar ridge preservation as a preoperative procedure for implant treatment: history and current evidence. Bioengineering. 2023 Nov 30;10(12):1376.
Gurbanov S, Plugmann P. Immediate implant placement in fresh extraction sites in the maxillary esthetic zone: a case series with 2-years' follow-up. European Review for Medical & Pharmacological Sciences. 2023 Oct 1;27(19).
Montemurro N, Pierozzi E, Inchingolo AM, Pahwa B, De Carlo A, Palermo A, Scarola R, Dipalma G, Corsalini M, Inchingolo AD, Inchingolo F. New biograft solution, growth factors and bone regenerative approaches in neurosurgery, dentistry, and orthopedics: a review. European Review for Medical & Pharmacological Sciences. 2023 Aug 15;27(16).
Poorni S, Srinivasan MR. Delegate Abstracts.
Tukan LE. Pengaruh Aplikasi Gel Metformin 1% Dan Xenograft Terhadap Pembentukan Woven Bone Pada Tindakan Socket Preservation= The Effect Of 1% Metformin Gel And Xenograft Application On Woven Bone Formation In Socket Preservation Actions (Doctoral dissertation, Universitas Hasanuddin).
Cantuña Flores MI. Efectividad del plasma rico en plaquetas en la cicatrización de heridas postexodoncia (Bachelor's thesis, Universidad Nocional de Chimborazo).