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Randomized Controlled Trial
. 2024 Oct 29;28(11):615.
doi: 10.1007/s00784-024-06002-9.

Effectiveness of platelet-rich fibrin in third molar extractions: a randomized controlled split-mouth study

Katharina Zwittnig  1 , Barbara Kirnbauer  1 , Astrid Truschnegg  1 , Norbert Jakse  1 , Axel Wolf  2 , Alwin Sokolowski  3 , Irene Mischak  1 , Michael Payer  4
Affiliations
Randomized Controlled Trial

Effectiveness of platelet-rich fibrin in third molar extractions: a randomized controlled split-mouth study

Katharina Zwittnig et al. Clin Oral Investig. .

Abstract

Objectives: To date, studies have only investigated the use of platelet-rich fibrin (PRF) after removal of third molars from the mandible or maxilla. Removal of the upper and lower third molars is typically combined into one session per side; therefore, this study aimed to investigate influence on PRF.

Materials and methods: This prospective, single-blinded, randomized controlled, clinical trial (split-mouth design) included 25 patients. After third molar removal, the test group's sockets were treated with solid PRF clots, whereas the control group's sockets were conventionally treated. The primary outcome was swelling, which was measured digitally and analogously. Secondary outcomes included trismus, pus, hematoma, and clinical attachment loss (CAL) of the second molars on days 1, 3, 7, and 14. Patient-centered outcome measures and the consumption of painkillers and antibiotics were recorded on days 0-7. The t-test for paired samples, Wilcoxon test, and Chi-Square test were used for statistical analyses.

Results: Swelling was significantly lower on day 14 in the test group (p < 0.05). No statistically significant differences were observed in pain, trismus, and CAL. In the test group, the number of painkillers taken and the number of days of intake were significantly lower (p < 0.05).

Conclusions: PRF caused a reduction of painkiller consumption and in the days painkillers were needed. PRF significantly considerably reduced swelling after 14 days. Owing to the lack of differences in other parameters, the integration of PRF application into routine wisdom tooth removal is critical.

Clinical relevance: PRF affects the long-term outcomes of third molar removal by reducing swelling and reducing as well as shortening painkiller consumption.

Trial registration: clinicaltrials.gov (NCT05089812).

Keywords: Oral surgery; Platelet-rich-fibrin; Regenerative therapy; Third molar surgery.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
CONSORT flow chart showing information about enrollment (34 patients were assessed for eligibility and met the inclusion criteria, 5 were excluded owing to loss of interest), randomization (29 patients were randomized), allocation and interventions (as 2 participants lost the will to continue, 27 patients underwent the second surgery), and analysis (owing to the loss of follow-up [n = 1] and undergoing test treatment twice [n = 1]; 25 patients were analyzed)
Fig. 2
Fig. 2
Influence of gender on analogue swelling measurement (grey: conventional treatment, black: PRF treatment)
Fig. 3
Fig. 3
Pus was recognized more frequently in the control group (conventional treatment; gray) than the test group (PRF application; black) (Wilcoxon test)
Fig. 4
Fig. 4
Appearance of the hematoma in the control group (conventional treatment; gray) vs. test group (PRF application; black)
Fig. 5
Fig. 5
General linear model with repeated measurements comparing effect of PRF in upper vs. lower jaw (grey: control group, black: test group)
Fig. 6
Fig. 6
Subjective swelling evaluated using a numeric rating scale comparing the control group (C; gray) with the test group (T; black) postoperatively from day 0 (day of surgery) until day 14. (t-test for paired samples)
Fig. 7
Fig. 7
VAS of pain evaluated in the 1st week and on day 14: control group (C; gray) vs. test group (T; black). Lower pain levels were observed in the test group (PRF) at all time points
See this image and copyright information in PMC

References

    1. Bailey E, Kashbour W, Shah N, Worthington HV, Renton TF, Coulthard P (2020) Surgical techniques for the removal of mandibular wisdom teeth. Cochrane Database Syst Rev 7(7):CD004345 - PMC - PubMed
    1. Sifuentes-Cervantes JS, Carrillo-Morales F, Castro-Nunez J, Cunningham LL, Van Sickels JE (2021) Third molar surgery: past, present, and the future. Oral Surg Oral Med Oral Pathol Oral Radiol 132(5):523–531 - PubMed
    1. Winter G, seAMBC (1926) St. Louis (MO). Impacted mandibular third molar. American Medical Book Company, St. Louis (MO);, St. Louis (MO), p 835
    1. Cho H, Lynham AJ, Hsu E (2017) Postoperative interventions to reduce inflammatory complications after third molar surgery: review of the current evidence. Aust Dent J 62(4):412–419 - PubMed
    1. Shahram Ghanaati 1 CH-V (2018) Sarah Al-Maawi 1, Jonas Lorenz 1, Richard J Miron 2, Katja Nelson 3, Frank Schwarz 4, Joseph Choukroun 5, Robert Sader 1. Fifteen years of platelet Rich Fibrin in Dentistry and Oromaxillofacial surgery: how high is the level of scientific evidence? - PubMed. J Oral Implantol. 44(6) - PubMed

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