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Journal of Indian Society of Periodontology logoLink to Journal of Indian Society of Periodontology
. 2014 Nov-Dec;18(6):684–685. doi: 10.4103/0972-124X.147397

Author's reply: Platelet-rich fibrin as an adjunct to palatal wound healing after harvesting a free gingival graft: A case series

Kulkarni Mihir Raghavendra 1, Thomas Betsy Sara 1,, Varghese J Mariam 1, Giliyar Subraya Bhat 1
PMCID: PMC4296449  PMID: 25624621

Sir,

In response to the letter written with reference to our article,[1] we would like to make the following comments:

  • We sincerely thank the reader for raising valid points about the present article. The astute observations have helped us critically analyse our work and have helped identify the important considerations for any future work on this topic

  • The authors acknowledge the priority of Jain et al.[2] and Aravindaksha et al.[3] in reporting the use of platelet-rich fibrin (PRF) to augment palatal wound healing

  • Yet we would like to note that this case series is the first PubMed indexed publication to report the use of PRF as a palatal wound dressing for free gingival graft wounds to the best of our knowledge

  • The first case treated by us dates back to February, 2012 at which point, the above mentioned studies[2,3] had not been published. The decision to use PRF as a palatal dressing was based on our own clinical judgement

  • The authors of the present case series have suggested the term “bio-active dressing” for the PRF as it may partly integrate with the host tissue rather than merely behaving like a bandage

  • The method used for assessment of wound healing in the present study was similar to that by Del Pizzo et al.[4] There is a controversy on the effects of hydrogen peroxide on healing wounds according to various studies; some of which have been reviewed by Wasserbauer et al.[5] Changes in the rate of wound healing due to the frequent application of H2O2 could have been a confounding factor leading to a significant bias in the results of this study

  • Nevertheless, in the present case series, the authors have made an attempt to objectively assess the patient morbidity by using the Wong Baker Faces Scale

  • We would like to note that at the 21 day visit, the sites where PRF had not been used did show complete wound closure. This point had not been mentioned in the article

  • A more frequent recall would surely have given a better picture but would also have led to issues of patient compliance

  • This case series reports 10 consecutive cases treated using PRF which is substantially more than the other similar publications.[2,3]

We hope we have clarified the pertinent points raised by our reader.

Thank you,

Yours Sincerely

The Authors

REFERENCES

  • 1.Kulkarni MR, Thomas BS, Varghese JM, Bhat GS. Platelet-rich fibrin as an adjunct to palatal wound healing after harvesting a free gingival graft: A case series. J Indian Soc Periodontol. 2014;18:399–402. doi: 10.4103/0972-124X.134591. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Jain V, Triveni MG, Kumar AB, Mehta DS. Role of platelet-rich-fibrin in enhancing palatal wound healing after free graft. Contemp Clin Dent. 2012;3:S240–3. doi: 10.4103/0976-237X.101105. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.Aravindaksha SP, Batra P, Sood V, Kumar A, Gupta G. Use of platelet rich fibrin (PRF) membrane as palatal bandage. Clin Adv Periodontics. 2014;4:246–250. DOI: 10.1902/cap.2013.130011. [Google Scholar]
  • 4.Del Pizzo M, Modica F, Bethaz N, Priotto P, Romagnoli R. The connective tissue graft: A comparative clinical evaluation of wound healing at the palatal donor site. A preliminary study. J Clin Periodontol. 2002;29:848–54. doi: 10.1034/j.1600-051x.2002.290910.x. [DOI] [PubMed] [Google Scholar]
  • 5.Wasserbauer S, Perez-Meza D, Chao R. Hydrogen peroxide and wound healing: A theoretical and practical review for hair transplant surgeons. Dermatol Surg. 2008;34:745–50. doi: 10.1111/j.1524-4725.2008.34141.x. [DOI] [PubMed] [Google Scholar]

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