Comparison of Dentine Graft and Plasma Rich Fibrin in Bony Defects Following Extraction of Impacted Mandibular Third Molars: Protocol for a Split-mouth Study

Abstract

Introduction: Third molar extraction is a common surgical procedure that can have unintended consequences, such as periodontal disease that results in bone loss on the distal part of the second molar. By halting the atrophy of the alveolar ridge, socket and ridge preservation procedures enable restorations that are both functional and aesthetically acceptable. Maintaining the volume of the alveolar socket after tooth extraction is the primary objective of alveolar management, as it prevents substantial resorption and facilitates socket repair. Numerous methods have been reported on socket healing following tooth extractions. Grafting materials may promote healing of the post-extraction socket in three separate ways: osteogenesis, osteoinduction and osteoconduction. Need for the Study: This study is necessary because managing bony defects after the extraction of impacted mandibular third molars is critically dependent on successful interventions. Third molars that are impacted often need to be surgically removed, resulting in bony defects that require proper regeneration for the best possible outcome after surgery. An important consideration in this process is the selection of grafting materials. It is imperative to comprehend the relative effectiveness of dentine graft and Platelet-rich Fibrin (PRF) to assist clinicians in deciding the best treatment option. Both PRF and dentine graft have shown promise in fostering bone regeneration; however, to develop evidence-based guidelines for clinical practice, a direct comparison using a rigorous split-mouth study is essential. Aim: To compare and evaluate outcomes of dentine graft against PRF in postoperative impacted mandibular third molar bony defects. Materials and Methods: A prospective randomised splitmouth study will be conducted in the Department of Oral and Maxillofacial Surgery at Sharad Pawar Dental College, DMIHER, Sawangi, Wardha, Maharastra, India from April 2023 to January 2025. After the extraction of the 3rd molar, the patient will be instructed to bite on a sterile swab while waiting for the biomaterials to be ready. Following the examination of the extraction socket, the particulate dentine graft and liquid PRF preparation will be made and then placed in the extraction socket. The patient will then be instructed to use chlorhexidine mouth rinse (0.2%) twice a day in place of mechanical plaque management in the treated region for one week, as part of the postoperative regimen. Postoperative pain, wound healing, bone regeneration, and complications, if any will be assessed at a specified interval. Fisher’s-exact test will be used for statistical analysis, and the level of significance will be set at p<0.05.