Efficacy of Platelet Rich Plasma (PRP) on Mouth Opening and Pain After Surgical Extraction of Mandibular Third Molars.

Overview

Wisdom tooth extraction is the most common surgical procedure being carried out in oral surgical departments. The complications carried by post operative period include pain and trismus and may affect patient's quality of life.

PRP is an autologous concentrate of platelet in plasma and accelerate healing by production of growth factors. PRP is prepared from patient's own blood and later packed with gel sponge (Spongistone) in the experimental group immediately after surgical extraction of mandibular third molar teeth, followed by suture placement to close the surgical site.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: May 14, 2016

Detailed Description

Wisdom tooth extraction is the most common surgical procedure being carried out in oral surgical departments. The complications carried by post operative period includes pain, swelling, trismus , along with disturbance in post extraction wound healing which may significantly affect patient's quality of life.

PRP is an autologous concentrate of platelet suspended in plasma and accelerate healing by production of various growth factors. PRP is prepared from patient's own blood and later packed with gel sponge (Spongistone) in the experimental group immediately after surgical extraction of mandibular third molar teeth, followed by suture placement to close the surgical site. PRP speeds up healing by concentration of growth factors which can lessen the inflammation and decreases trismus and pain.

Interventions

  • Procedure: Platelet Rich Plasma (PRP)
    • PRP was prepared by withdrawing 8-10 ml of patients own blood (IV from antecubiodal area and collected in a vacuum tube coated with anticoagulant (Na citrate). For activation 1 ml of calcium chloride was added to Platelet Rich Plasma. This layer of approximately 2 ml of PRP was then taken into the residual bone cavity along with gel sponge to stimulate regeneration in wound healing after surgical extraction of mandibular third molar tooth followed by sutures
  • Procedure: Surgical Extraction
    • Surgical extraction procedure under Local anesthesia on dental chair, followed by spongstone (gel sponge) and suture placement.

Arms, Groups and Cohorts

  • Active Comparator: Control Group
  • Experimental: Study Group

Clinical Trial Outcome Measures

Primary Measures

  • Visual Analogue Scale (VAS)
    • Time Frame: 1 day
    • Visual Analogue Scale (VAS) used to quantify pain
  • Visual Analogue Scale (VAS)
    • Time Frame: 3rd post op day
    • Visual Analogue Scale (VAS) used to quantify pain
  • Visual Analogue Scale (VAS)
    • Time Frame: 7th post op day
    • Visual Analogue Scale (VAS) used to quantify pain
  • Trismus
    • Time Frame: 1 day
    • Trismus was quantified/measured using Vernier Calliper.
  • Trismus
    • Time Frame: 3rd post op day
    • Trismus was quantified/measured using Vernier Calliper.
  • Trismus
    • Time Frame: 7th post op day
    • Trismus was quantified/measured using Vernier Calliper.

Participating in This Clinical Trial

Inclusion Criteria

1. Age between 18-45 iyears

2. Either gender

3. Patients requiring extraction of mandibular 3rd molars

4. ASA grade1

5. Nonsmokers & non alcoholics

6. Not allergic to any medicines

7. No pain before the extraction procedure

8. No trismus, i.e. normal mouth opening before the extraction procedure

Exclusion Criteria

a) Systemic diseases b) Compromised immune system c) Platelet count less than 1.5 lacs/cmm d) Allergy to drugs e) Patients not willing to participate in the study f) Pregnant females/Lactating mothers g) Presence of pericoronitis, periapical infection or any associated lesion.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 45 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Foundation University Islamabad
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Maidah Hanif, BDS, FCPS, Principal Investigator, Foundation University College of Dentistry
    • Muhammad Azhar Sheikh, BDS, MSc, FFD, Study Chair, Foundation University College of Dentistry

References

Ogundipe OK, Ugboko VI, Owotade FJ. Can autologous platelet-rich plasma gel enhance healing after surgical extraction of mandibular third molars? J Oral Maxillofac Surg. 2011 Sep;69(9):2305-10. doi: 10.1016/j.joms.2011.02.014. Epub 2011 May 7.

CĂ©lio-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 Jan;70(1):19-24. doi: 10.1016/j.joms.2011.03.028. Epub 2011 Jul 20.

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