Impact of platelet-rich fibrin on mandibular third molar surgery recovery: a systematic review and meta-analysis

BMC Oral Health. 2019 Jul 25;19(1):163. doi: 10.1186/s12903-019-0824-3.


Background: The present study investigated and evaluated the efficacy and safety of platelet-rich fibrin (PRF) in patients during bilateral mandibular third molars extraction by systematic review and meta-analysis.

Methods: The PubMed, Embase, and Cochrane library databases were retrieved, and the effect of PRF on the healing process of the alveolar socket after surgical extraction of the mandibular third molars was evaluated by meta-analysis. The postoperative pain, swelling, trismus, osteoblastic activity, and soft tissue healing were assessed, and the incidence of alveolar osteitis, weighted mean difference (WMD)/standard mean difference (SMD), the risk ratio (RR), and the 95% confidence interval (CI) were calculated.

Results: The current results showed that the local application of PRF during lower third molar extraction prevented postoperative complications. Subsequently, the pain (SMD = - 0.53, 95% CI: - 1.02--0.05, Pheterogeneity = 0.001, I2 = 75.7%) and swelling (WMD = - 0.55, 95% CI: - 1.08--0.01, Pheterogeneity = 0.573, I2 = 0) were relieved and the incidence of alveolar osteitis was reduced (RR = 0.35, 95% CI: 0.16-0.75, Pheterogeneity = 0.597, I2 = 0%). However, no significant difference was observed in trismus, osteoblastic activity, and soft tissue healing between the PRF and non-PRF groups.

Conclusion: The current study confirms that PRF only reduces some of the postoperative complications but does not prevent all the postoperative complications. PRF significantly relieved the pain and swelling and reduced the incidence of alveolar osteitis after the extraction of an impacted lower third molar.

Keywords: Mandibular third molars; Meta-analysis; Platelet-rich fibrin; Systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Dry Socket / epidemiology
  • Female
  • Humans
  • Male
  • Molar, Third / surgery*
  • Platelet-Rich Fibrin*
  • Postoperative Complications / prevention & control*
  • Tooth Extraction / methods*
  • Tooth Socket / physiology*
  • Tooth, Impacted / surgery*
  • Treatment Outcome
  • Wound Healing / physiology*