Effects of Platelet Concentrates on Palatal Wound Healing
Condition: Wound Heal; Platelets; Defect; Periodontal Inflammation; Gingival Recession
MeSH terms: Gingival Recession; Inflammation; Wounds and Injuries
Study type: Interventional

Summary: 
      Platelet concentrates used in palatal wound healing have been reported to accelerate wound
      healing and reduce postoperative patient discomfort. The use of elet platelet rich fibrin
      '(PRF) in the palatal donor site after FGG surgery has been shown to provide significant
      benefits in terms of wound healing parameters and postoperative comfort. In a study using a
      platelet rich plasma (PRP) with a different platelet concentration, PRP was found to
      accelerate wound healing and shorten the healing time. In another study using
      titanium-prepared platelet rich fibrin (T-PRF) for palatal wound healing, it accelerated the
      wound healing process and reached the initial level of soft tissue thickness in the donor
      region at the end of 6 months. In the literature, there are few studies using platelet
      concentrates in palatal wound healing and only some concentrates (PRP, PRF, T-PRF) are used.
      The aim of this study is to compare the effects of injectable platelet rich fibrin (i-PRF),
      which are autologous fibrin glue (AFG) and injectable platelet concentrates, on palatal wound
      healing. The findings obtained from this study will contribute to the literature in
      determining the product and method that will provide optimal postoperative patient comfort
      and wound healing.
    

Detailed description: 
      Attached gingiva plays an important role in maintaining periodontal health. In the presence
      of inadequate attached gingiva, periodontal tissue inflammation, root sensitivity, root
      caries and gingival recessions are caused due to mucogingival stress in the related area and
      oral hygiene which is not provided adequately. In such cases, inadequate attached gingival
      width should be increased with mucogingival periodontal plastic surgery.

      Free gingival graft (FGG) is accepted as the most commonly used mucogingival procedure in
      increasing the attached gingival, because of its predictable surgical outcome, simple
      technique and its application in large areas of operation. In the free gingival graft
      operation, the recipient bed is prepared in the area with insufficient attached gingiva. Free
      gingival grafts containing epithelial and connective tissue from the donor area are applied
      to this recipient bed in appropriate dimensions . Palatal region is the most preferred donor
      site in terms of anatomical advantage, ideal tissue thickness and wide keratinized band
      removal. The secondary wound in the donor site after FGG heals in 2-4 weeks and may cause
      problems that affect patient comfort such as paresthesia, herpetic lesion, mucocele, bleeding
      and pain in the postoperative period. Different products such as hemostatic agents, low-dose
      laser treatments, herbal products, ozonated oil, antibacterial / antiseptic agents, bioactive
      materials and platelet concentrates have been tested to accelerate wound healing and prevent
      these problems. Studies on the determination of the product and method that provide optimal
      postoperative patient comfort and wound healing from such products, whose effects on wound
      healing are known, are ongoing.

      Platelet concentrates used in palatal wound healing have been reported to accelerate wound
      healing and reduce postoperative patient discomfort. The use of elet platelet rich fibrin
      '(PRF) in the palatal donor site after FGG surgery has been shown to provide significant
      benefits in terms of wound healing parameters and postoperative comfort. In a study using a
      platelet rich plasma (PRP) with a different platelet concentration, PRP was found to
      accelerate wound healing and shorten the healing time. In another study using
      titanium-prepared platelet rich fibrin (T-PRF) for palatal wound healing, it accelerated the
      wound healing process and reached the initial level of soft tissue thickness in the donor
      region at the end of 6 months. In the literature, there are few studies using platelet
      concentrates in palatal wound healing and only some concentrates (PRP, PRF, T-PRF) are used.
      The aim of this study is to compare the effects of injectable platelet rich fibrin (i-PRF),
      which are autologous fibrin glue (AFG) and injectable platelet concentrates, on palatal wound
      healing. The findings obtained from this study will contribute to the literature in
      determining the product and method that will provide optimal postoperative patient comfort
      and wound healing.

      In this randomized, controlled clinical study, 36 patients in need of FGG were divided into
      three groups. AFG (n=12) or i-PRF (n=12) was applied to donor sites and compared to control
      group (n=12). Wound healing with H2O2 test, VAS, MMS scale and LTH index were evaluated on
      the 3rd, 7th, 14th day and 1st month. The bleeding status was evaluated on 3rd and 7th days.
      Palatal tissue thickness was measured at baseline, 1st month and 3rd month.

      AFG and i-PRF have positive effects on the healing process by accelerating wound healing and
      reducing postoperative morbidity.
    

Intervention name(s): AFG application on palatinal wound healing; i-PRF application on palatinal wound healing; control
Intervention type(s): Biological; Biological; Other
Intervention description(s): 9 ml venous blood collected from the patient was transferred to the tube without any anticoagulants. In the protocol, venous blood collected in the tube was centrifuged for 2 minutes at 2700 rpm (approximately 692 g) in a special centrifuge (Medifuge, Silfradent, Italy) to obtain two layers: the lower layer of red blood cells and the upper layer of AFG. The AFG at the top of the tube was collected by means of an injector and transferred to the metal godet. It was held for 15-20 minutes for polymerization. After polymerization occurred, the polymerized AFG in the metal gum was applied to the wound surface in the donor site . No suture or tissue glue was used. Adhesive properties of AFG were utilized.; 10 ml venous blood collected from the patient was transferred to the tube without any anticoagulants. Based on G force, collected venous blood were centrifuged at 2300 rpm (about 241 g) in a centrifuge (PC-O2, Process for PRF, Nice, France) for 3 minutes to obtain two layers: The two layers are the lower layer of red blood cells and the upper layer of i-PRF. The i-PRF at the top of the tube was collected with a syringe and transferred to the metal godet. It was held for 20-25 minutes for polymerization. After the polymerization, the polymerized i-PRF was applied to the wound surface in the donor site. No suture or tissue glue was used. Adhesive properties of AFG were utilized.; no application
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This study was designed as a randomized, controlled clinical trial. Three groups were randomly assigned as one control and two test groups. A total of 36 patients (12 patients in each group) were included in the study. In the control group, only moist sterile tamponade was applied following graft removal to the palatinal donor area. In the test groups, polymerized AFG or polymerized i-PRF were applied to the donor area. After these procedures, donor palate was closed with sterile aluminum foil and periodontal pat in all 3 groups.
Masking: Double (Participant, Investigator)
Primary purpose: Supportive Care