Efficacy of platelet-rich fibrin on pain, edema, and healing in mandibular third molar surgery: A split-mouth randomized study

Abstract

Context: The postoperative sequelae after third molar surgery include pain, swelling and trismus, distal bone loss along with prolonged sensitivity due to root exposure or increased probing depth. Platelet rich fibrin (PRF) appears to accelerate physiologic healing due to the development of effective neovascularization, accelerated wound closing with fast cicatricial tissue remodelling and reduced incidence of infectious events. The mechanism of action of PRF on pain and edema is not fully understood and it is possible that this effect could be a reflection of better and faster healing of the socket.Aim: The aim is to assess the influence of PRF on pain, edema, and wound healing of the socket after surgical extraction of mandibular third molars.Settings and Design: This randomized controlled study was conducted on 60 patients with bilateral impacted mandibular third molars, reporting to the Department of Oral and Maxillofacial Surgery, Army Dental Centre (Research and Referral).Subjects and Methods: Surgical removal of the impacted mandibular molars of both sides was planned with a gap of 4 weeks between the two sides and appointments were given accordingly. Study side-Surgical extraction followed by placement of PRF in socket and closure and control side-Surgical extraction followed by closure.Statistical Analysis: Preoperative and postoperative measurement of visual analog scale scores for pain, edema, interincisal opening, and gray level histogram values of orthopantomograph was subjected to statistical analysis. The normality of data was analyzed using the Kolmogorov–Smirnov test. The Mann–Whitney U and Wilcoxon Signed-Rank tests were used to check mean differences.Results: We observed a reduction in pain and swelling with improvement in interincisal and greater reduction in pocket depth distal to the second molar on the PRF side. Soft-tissue healing index scores and gray level histogram values for the study side were higher compared to the control side.Conclusions: Further clinical studies to evaluate and assess the applications of PRF in maxillofacial surgery are needed.