Ávila-Oliver C, Veloso V, Laissle G, Rojas A-M, Verdugo-Paiva F, Ramos-Rojas J
Escuela de Odontología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián 8420000, Bellavista 7, Recoleta, Santiago, Chile
Med Oral Patol Oral Cir Bucal. 2025 May 1;30(3):e345-e353. doi: 10.4317/medoral.26801.
This systematic review aims to provide an updated summary of the available evidence on the role of platelet-rich fibrin (PRF) in the treatment of alveolar osteitis.
Searches were conducted in several electronic databases, including PubMed, EBSCO, Cochrane Central Register of Controlled Trials (CENTRAL) LILACS and ClinicalTrials.gov. No date or language restrictions were applied. Two reviewers independently evaluated eligible studies according to predefined criteria and extracted data using a standardized form. Meta-analyses were performed to estimate results and the certainty of evidence, using the GRADE approach, was assessed.
The search strategy yielded 1.706 references. Finally, 4 randomized trials were included and assessed quantitatively. Overall, the risk of bias was low for 75% of the domains reviewed across studies. The studies included a total of 179 patients, where the intervention group received PRF, and the control group received several treatment alternatives, including iodoform gauze, zinc oxide eugenol, and saline solution. Results showed that the use of PRF may decrease pain severity measured on day 3 (MD -1.66, CI 95%, -4.11 to 0.78) and on day 7 (MD -1.57, CI 95%, -4.00 to 0.88), and improves alveolar socket healing (SMD 2.25; 95% CI 1.70 to 2.80; p<0.00001; I2=12%).
The results of this study demonstrate that PRF improves alveolar healing, reduces analgesic use in patients, and likely increases overall clinical efficacy, making it a valuable alternative in the treatment of alveolar osteitis. Despite these findings, this review also showed a great degree of uncertainty on the impact of PRF on pain severity associated with alveolar osteitis. Although these results are promising, further randomized clinical trials with standardized methodologies must be performed to validate these findings.
本系统评价旨在提供关于富血小板纤维蛋白（PRF）在治疗干槽症中作用的现有证据的最新总结。
在多个电子数据库中进行检索，包括PubMed、EBSCO、Cochrane对照试验中心注册库（CENTRAL）、拉丁美洲及加勒比地区卫生科学数据库（LILACS）和ClinicalTrials.gov。未设置日期或语言限制。两名评价者根据预定义标准独立评估符合条件的研究，并使用标准化表格提取数据。采用GRADE方法进行荟萃分析以估计结果，并评估证据的确定性。
检索策略共获得1706篇参考文献。最终，纳入4项随机试验并进行定量评估。总体而言，各研究中75%的评价领域偏倚风险较低。这些研究共纳入179例患者，干预组接受PRF治疗，对照组接受多种治疗方法，包括碘仿纱条、氧化锌丁香油和生理盐水。结果显示，使用PRF可能会降低第3天（MD -1.66，95%CI，-4.11至0.78）和第7天（MD -1.57，95%CI，-4.00至0.88）测量的疼痛严重程度，并改善牙槽窝愈合（SMD 2.25；95%CI 1.70至2.80；p<0.00001；I²=12%）。
本研究结果表明，PRF可改善牙槽愈合，减少患者的镇痛药物使用，并可能提高总体临床疗效，使其成为治疗干槽症的一种有价值的替代方法。尽管有这些发现，但本综述也显示，PRF对与干槽症相关的疼痛严重程度的影响存在很大不确定性。虽然这些结果很有前景，但必须进行更多采用标准化方法的随机临床试验来验证这些发现。
