Pain and quality of life after endodontic surgery with or without advanced platelet-rich fibrin membrane application: a randomized clinical trial
Abstract
Background
Clinical
evidence of the autologous platelet concentrates effects on the
patient-reported outcome measures (PROMs) after endodontic surgery is
still limited.
Objectives
To
investigate the effect of the advanced platelet-rich fibrin (A-PRF+)
membrane application upon patient postoperative pain, and quality of
life in endodontic surgery.
Materials and methods
A
two-parallel-arm randomized clinical trial was made comparing
endodontic surgery with or without A-PRF+ as adjunctive treatment. Fifty
individuals comprehending 50 apical lesions (second premolar to the
second premolar) of upper maxilla were included. Pain perception and
quality of life (functional limitations and other symptoms) were
assessed 1 week after surgery using a visual analog scale and a Likert
scale-based questionnaire. Descriptive analysis was done using χ2 and t test. Binary logistic regression, ANOVA-type statistic, and GEE analysis were used for inferential analysis.
Results
Pain
perception was mild in both groups [A-PRF+ 12.7 ± 8.5] versus [no
A-PRF+ 20.7 ± 16.3]; it proved less variable during the first 4 days in
test group, showing lower extreme pain values (p = 0.096). Analgesic use was similar in both groups. Controls reported significantly worse sleep and speech functions (p < 0.05). Bleeding and bad taste/breath were the most discriminative symptoms.
Conclusions
Postoperative
pain perception was mild in endodontic surgery of the upper anterior
maxilla. Differences in pain perception were not statistically
significant. The use of A-PRF+ afforded less variable pain perception
than in the controls. Altered quality of life parameters were more
prevalent in the control group and prove significant for speech and
sleep functions.
Clinical relevance
Patient-related
outcomes are of utmost importance in clinical practice. The use of
A-PRF+ provides an affordable and safe alternative to improve
postoperative quality of life in endodontic surgery.
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