 PICOS criteria 
malocclusion, bleeding, normodivergent, angulation, pain, orthodontic tooth, platelet disorders, orthodontic
PLATELET DISORDERS, BLEEDING, ROOT RESORPTION, PLAQUE

» Population: Class II division 1 or Class I bimaxillary
protrusion patients requiring fixed mechanotherapy with first
premolar extractions.» Intervention: L-PRF plugs on the experimental side. » Comparison: Control side with no L-PRF plug placement. » Outcome: Primary outcome: Assessment of canine movement rate.
Secondary outcome: rate of molar movement, assessment of canine
angulation, root resorption, and pain perception. Study design: Randomized controlled trial. The inclusion criteria were as follows: Subjects with Class II division 1
malocclusion or Class I bimaxillary protrusion, with relatively well-aligned
arches, normodivergent growth pattern (FMA = 25 ± 5°), postpubertal as
assessed by CVMI stage > 5, requiring therapeutic bilateral first
premolar extractions with subsequent retraction of the canine, healthy oral
and systemic conditions (probing depth <3 mm, plaque index <1 mm, no
bleeding on probing), and no previous history of orthodontic treatment.
Patients taking medications that could interfere with orthodontic tooth
movement (NSAIDs, cortisone, hormones, anticoagulants), smoking, pregnancy,
restorations, or endodontic treatments on maxillary canines, and patients
with platelet disorders were excluded from the study.