Efficacy of Autologous Leucocyte-Platelet-rich Fibrin (L-PRF) versus Hydroxyapatite as a Graft Material for Socket Healing after Surgical Extraction of Impacted Mandibular Third Molars: A Comparative Clinical and Radiographic study

Abstract

OBJECTIVE: The purpose of this study was to compare the efficacy of Leucocyte -platelet‑rich fibrin (L-PRF), and hydroxyapatite (HA) for reduction of pain and swelling, the incidence of dry socket, soft tissue healing, and bone regeneration after surgical removal of impacted mandibular third molar in human patients.Patients and Methods: Thirty-six patients (20 males and 16 females) requiring extraction of mandibular third molars were randomly grouped as L-PRF, HA, and Control‑treated. All the procedures were done on an outpatient basis without any complication such as lip numbness. The patients were assessed for postoperative pain, swelling and maximal inter-incisal distance on the 1st, 3rd and 7th postoperative days. Exposed bony socket wall (dry socket), as well as soft tissue healing (healthy granulation tissue Formation), were also assessed at 1st, 3rd, 7th and 14th day of postoperative periods depending on the standard methods. Assessment of daily and total analgesics consumption was done and Radiological assessment of the extraction site was done at 2 and 6 months interval. Results: Pain, swelling, interincisal distance, and soft tissue healing had statistically significant more improvement for L-PRF group compared to HA and control groups. Radiographic assessment showed comparatively lesser bone density values in PRF and control sites at 2 and 6 months than HA site. Conclusion: Our study showed that L-PRF is better graft materials than HA regarding pain, swelling, dry socket, and soft tissue healing post‑L-PRF placement in the extraction socket. Bone regeneration is induced quickly by HA as compared to PRF. However, study with a wide scale of clinical cases is very much essential to be more decisive regarding the efficacy of the graft materials.