Korean J Orthod.  2024 Sep;54(5):303-315. 10.4041/kjod23.112.

Effectiveness of autologous leukocyte–platelet-rich fibrin on the rate of maxillary canine retraction, rotation, pain, and soft tissue healing: A split-mouth randomized controlled trial

• Satapathy SK
• Das SK
• Barik AK
• Mohanty D
• Rath SK
• Mishra M

• KMID: 2559819
• DOI: http://doi.org/10.4041/kjod23.112

Abstract

Objective
To assess the effectiveness of leukocyte–platelet-rich fibrin (L-PRF) compared with conventional treatment on canine retraction, rotation, pain, and soft tissue healing.
Methods
Sixteen adult patients aged 18–25 years (10 females, and 6 males; mean age 22.25 ± 2.26 years) with Class I bimaxillary protrusion and Class II div 1 malocclusion participated in this single-center, split-mouth randomized controlled trial at the Orthodontics Department of a single hospital in SCB Dental College and Hospital, Cuttack, India. Randomization was performed using a computer-assisted function with a 1:1 allocation ratio. The intervention included the placement of L-PRF on the experimental side and follow-up for 90 days. The primary outcome measures were canine retraction, rotation, pain, and soft tissue healing. The range of tooth movement was evaluated at 15-day intervals: 0th day (T0), 15th day (T1), 30th day (T2), 45th day (T3), 60th day (T4), 75th day (T5), and 90th day (T6). Canine rotation was assessed at T0 and T6, and pain and soft tissue healing were evaluated on the 3rd, 7th, and 15th days of the treatment.
Results
Cumulatively, the L-PRF group demonstrated a significantly greater tooth movement as compared to conventional treatment group (P < 0.001). Overall, canine retraction was 1.5 times greater on the L-PRF side than on the control side. Canine rotation showed no significant relationship, whereas pain and soft tissue healing were significantly better on the L-PRF side than on the control side.
Conclusions
Local administration of L-PRF amplifies canine retraction while improving pain and soft tissue repair. 

Keyword

Leukocyte–platelet-rich fibrin; Orthodontic tooth movement

Figure

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  Figure 1 Distribution of malocclusion among the 16 study participants.

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  Figure 2 Patient selection and leukocyte–platelet-rich fibrin allocation (Consolidated Standards of Reporting Trials diagram).16

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  Figure 3 Intraoral and radiographic views of a guiding template for the safe placement of micro-implant.

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  Figure 4 Preparation and placement of leukocyte–platelet-rich fibrin (L-PRF). A, Drawing of venous blood. B, Three layers of the venous blood post centrifugation. C, Dissected section of L-PRF. D, Placement of L-PRF in the extraction socket.

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  Figure 5 Measurement of canine distalization/retraction using a digital Vernier caliper (the distance between the distal aspect of the maxillary canine bracket and the mesial aspect of the molar tube slot). A, Measurement in the maxillary right quadrant. B, Measurement in the maxillary left quadrant.

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  Figure 6 Measurement of canine rotation. A, Occlusogram showing the angle between the mid-palatal raphe and a line joining the mesial and distal contact points canine on day 0. B, Occlusogram showing the angle between the mid-palatal raphe and a line joining the mesial and distal contact points of the canine after 3 months of retraction.

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  Figure 7 Intraoral images of canine retraction after 30 days of canine retraction. A, The extraction space of the maxillary right quadrant denotes the control side, and the maxillary left denotes the experimental side with leukocyte–platelet-rich fibrin (L-PRF). B, Maxillary right quadrant without L-PRF. The red arrow shows less distalization on the control side. C, Frontal view of both arches in occlusion. D, Maxillary left quadrant with L-PRF. The red arrow shows more distalization on the L-PRF side than on the control side.

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  Figure 8 Intraoral images of soft tissue healing after 7 days of leukocyte–platelet-rich fibrin (L-PRF) placement. A, Extraction space of the maxillary right quadrant denotes the control side, and the maxillary left indicates the experimental side with L-PRF. The red arrow shows better soft tissue healing on left side of maxillary arch with L-PRF placement. B, Maxillary right quadrant without L-PRF. The red arrow shows less healing on the control side. The red arrow indicates right side extraction socket without L-PRF, i.e., control side with less soft tissue healing. C, Frontal view of both arches in occlusion. D, Maxillary left quadrant with L-PRF. The red arrow shows better healing on the L-PRF side than on the control side.

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  Figure 9 Enhanced image of Figure 8A showing superior soft tissue healing. The red arrow denotes better soft tissue healing in the maxillary left quadrant with the leukocyte–platelet-rich fibrin side compared with that on the control side.

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