Wound Healing and Bone Regeneration in Postextraction Sockets with and without Platelet-rich Fibrin.

CONTEXT AND AIM: In today's world of advanced dentistry, there are various aspects of restorative, esthetic, and surgical processes. Healing of an extraction socket comprises of bone as well as soft-tissue remodeling with maximum dimensional changes occurring during the first 3 months. Platelet-rich fibrin (PRF) was first developed in France as a therapeutic alternative to platelet-rich plasma to overcome many of its limitations. The present study was planned to evaluate and compare wound healing and bone regeneration in extraction sockets with and without PRF. MATERIALS AND METHODS: The present study was carried out on 30 patients selected from the outpatient department over a period of 2½ years starting from May 2013 undergoing extraction of maxillary or mandibular teeth simultaneously to conduct a split-mouth study. The research protocol was approved by the Institutional Ethics Committee governing the use of human subjects in clinical experimentation. STATISTICAL ANALYSIS USED: Descriptive and analytical statistics were calculated using Statistical Package for Social Sciences version 19. Chi-square test was used to assess wound healing score in the two groups while paired t-test was used to compare the bone density in the socket and periapical regions at different time intervals, and unpaired t-test was used for the intergroup comparisons. P < 0.05 was considered to be significant while P < 0.001 was considered highly significant. RESULTS: Patients in PRF group had better healing index when compared to without PRF group. Use of PRF showed a comparable increase in bone density too. CONCLUSION: An appreciable wound healing and bone regeneration was seen in the experimental group when compared to the control sites where no PRF was used substantiating the use of PRF as an inexpensive autologous material for socket preservation and future rehabilitation. The present study, also, showed that minimal operator expertise was required to conduct the procedure of PRF preparation and grafting when compared to bone harvesting from distant sites. The shorter duration between extractions and further rehabilitation obviates the need for a second procedure.

Malignant conversion of oral submucous fibrosis in surgically treated case.

Oral submucous fibrosis (OSMF) is an insidious chronic disease affecting any part of the oral cavity and sometimes the pharynx with epithelial atrophy leading to stiffness of the oral mucosa, causing trismus and inability to eat. However a more serious complication of this disease is the risk of the development of oral carcinoma. We reported the histopathologically proven case of OSMF with initial interincisal mouth opening 2mm which was treated surgically with nasolabial flap technique but failed to follow up and could not do active mouth opening exercises. Malignant conversion of OSMF was seen in this case. This is required to assess the progress and evaluate any malignant transformation at the earliest. So, the importance of active co-operation and frequent follow up cannot be overemphasized. The purpose of this study is to emphasize the importance of regular follow up and frequent biopsies to facilitate oral examination and to check any malignant conversion after the surgery.