Influence of leukocyte- and platelet-rich fibrin (L-PRF) on the outcomes of impacted mandibular third molar removal surgery: A split-mouth randomized clinical trial

Quintessence Int. 2018;49(5):377-388. doi: 10.3290/j.qi.a40113.

Abstract

Objectives: The purpose of this study was to evaluate the influence of leukocyte- and platelet-rich fibrin (L-PRF) on impacted mandibular third molar (IMTM) extraction wound healing, patient postoperative discomfort, and incidence of alveolar osteitis.

Method and materials: Thirty-four patients (20 female, 14 male) who met the inclusion criteria for this split-mouth randomized clinical trial were enrolled and 30 patients completed the study. Patients were randomized and underwent bilateral IMTM surgical extractions. Following extraction, one socket randomly received L-PRF, and the other socket served as a regular blood clot control. Postoperatively, the soft tissue healing index (HI), pain according to visual analog scale (VAS), facial swelling using a horizontal and vertical guide, and incidence of alveolar osteitis were evaluated 1, 3, 7, and 14 days after surgery.

Results: Sites treated with L-PRF resulted in improved HI (P = .001) and lower pain VAS scores (P = .001) in the first postoperative week. Significant reduction of facial swelling was recorded on first (P = .035) and third (P = .023) postoperative days in L-PRF sites versus controls, ceasing to nonsignificant difference at day 7 (P = .224). None of the L-PRF sites and four control sites were affected by alveolar osteitis (P = .001).

Conclusion: Within the limitations of this split-mouth study, L-PRF improved soft tissue healing and reduced postoperative pain, swelling, and incidence of alveolar osteitis after IMTM surgical extractions.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Dry Socket / prevention & control
  • Edema / prevention & control
  • Female
  • Humans
  • Male
  • Molar, Third / surgery*
  • Pain Measurement
  • Pain, Postoperative / prevention & control
  • Platelet-Rich Fibrin / physiology*
  • Prospective Studies
  • Tooth Extraction / methods
  • Tooth, Impacted / surgery*
  • Treatment Outcome
  • Wound Healing / physiology*
  • Young Adult