Evaluation of treatment outcome after impacted mandibular third molar surgery with the use of autologous platelet-rich fibrin: a randomized controlled clinical study

J Oral Maxillofac Surg. 2015 Jun;73(6):1042-9. doi: 10.1016/j.joms.2014.11.013. Epub 2014 Dec 13.

Abstract

Purpose: To assess the effect of platelet-rich fibrin (PRF) on postoperative pain, swelling, trismus, periodontal healing on the distal aspect of the second molar, and progress of bone regeneration in mandibular third molar extraction sockets.

Materials and methods: Over a 2-year period, 31 patients (mean age, 26.1 yr) who required surgical extraction of a single impacted third molar and met the inclusion criteria were recruited. After surgical extraction of the third molar, only primary closure was performed in the control group, whereas PRF was placed in the socket followed by primary closure in the case group (16 patients). The outcome variables were pain, swelling, maximum mouth opening, periodontal pocket depth, and bone formation, with a follow-up period of 3 months. Quantitative data are presented as mean. Statistical significance was inferred at a P value less than .05.

Results: Pain (P = .017), swelling (P = .022), and interincisal distance (P = .040) were less in the case group compared with the control group on the first postoperative day. Periodontal pocket depth decreased at 3 months postoperatively in the case (P < .001) and control (P = .014) groups, and this decrease was statistically significant. Bone density scores at 3 months postoperatively were higher in the case group than in the control group, but this difference was not statistically important.

Conclusions: The application of PRF lessens the severity of immediate postoperative sequelae, decreases preoperative pocket depth, and hastens bone formation.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Autografts / physiology*
  • Blood Platelets / physiology*
  • Bone Density / drug effects
  • Bone Regeneration / drug effects
  • Edema / etiology
  • Female
  • Fibrin / therapeutic use*
  • Follow-Up Studies
  • Humans
  • Male
  • Mandible / surgery
  • Molar / pathology
  • Molar, Third / surgery*
  • Osteogenesis / drug effects
  • Pain, Postoperative / etiology
  • Periodontal Pocket / etiology
  • Postoperative Complications
  • Tooth Extraction / methods*
  • Tooth Socket / drug effects
  • Tooth, Impacted / surgery*
  • Treatment Outcome
  • Trismus / etiology

Substances

  • Fibrin