Adjunctive Use of Plasma Rich in Growth Factors for Improving Alveolar Socket Healing: A Systematic Review

Purpose: The purpose of this study was to determine if the adjunctive use of plasma rich in growth factors in post-extraction sites could be beneficial in terms of hard/soft tissue healing and patient’s comfort. Materials and Methods: An electronic search was performed on MEDLINE, EMBASE, Scopus, and CENTRAL. Only controlled clinical trials or randomized clinical trials that used plasma rich in growth factors in the test group were included. The primary outcomes were: pain assessment, complications and adverse events; secondary outcomes were hard tissue healing, bone remodelling, soft tissue healing. Results: Eight comparative studies (5 RCTs) were included. Four studies had a split-mouth design. 614 teeth were extracted in 338 patients. Only qualitative analysis could be done. Postoperative pain and the incidence of complications like alveolar osteitis was consistently lower in the test group. Hard tissue healing, evaluated by clinical, radiographic, histological and histomorphometric technique showed results significantly better for the test group in almost all studies. Better epithelization, keratinized tissue thickness and healing score were also reported. Conclusion: Plasma rich in growth factors may bring advantages in some relevant clinical and radiographic outcomes following tooth extraction, such as bone density and soft tissue healing. It could also represent a useful tool for reducing adverse events, complications and patients’ discomfort, however still not quantifiable.