Use of leukocyte and platelet-rich fibrin (L-PRF) in periodontally accelerated osteogenic orthodontics (PAOO): clinical effects on edema and pain
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Muñoz, Francisco; Jiménez, Constanza; Espinoza, Daniela; Vervelle, Alain; Beugnet, Jacques; Haidar, Ziyad
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Aquest document és un/a article, creat/da en: 2016
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Background: Demand for shorter treatment time is common in orthodontic patients. Periodontally Accelerated
Osteogenic Orthodontics (PAOO) is a somewhat new surgical procedure which allows faster tooth movement via
combining orthodontic forces with corticotomy and grafting of alveolar bone plates. Leukocyte and Platelet-Rich
Fibrin (L-PRF) possess hard- and soft-tissue healing properties. Further, evidence of pain-inhibitory and anti-
inflammatory potential is growing. Therefore, this study explores the feasibility, intra- and post-operative effects of
using L-PRF in PAOO in terms of post-operative pain, inflammation, infection and post-orthodontic stability.
Material and Methods: A pilot prospective observational study involving a cohort of 11 patients was carried out.
A Wilcko’s modified PAOO technique with L-PRF (incorporated into the graft and as covering membrane) was
performed with informed consent. Post-surgical pain, inflammation and infection were recorded for 10 days post-
operatively, while the overall orthodontic treatment and post-treatment stability were followed up to 2 years.
Results: Accelerated wound healing with no signs of infection or adverse reactions was evident. Post-surgical
pain was either “mild” (45.5%) or “moderate” (54.5%). Immediate post-surgical inflammation was either “mild”
(89.9%) or “moderate” (9.1%). Resolution began on day 4 where most patients experienced either “mild” or no inflammation (72.7% and 9.1%, respectively). Complete resolution was achieved in all patients by day 8. The average
orthodontic treatment time was 9.3 months. All cases were deemed stable for 2 years.
Conclusions: L-PRF is simple and safe to use in PAOO. Combination with traditional bone grafts potentially accelerates wound healing and reduces post-surgical pain, inflammation, infection without interfering with tooth movement
and/or post-orthodontic stability, over a 2 years period; thus alleviating the need for analgesics and anti-inflammatory
medications.
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