Effect of Platelet-Rich Fibrin Application on Non-Infectious Complications after Surgical Extraction of Impacted Mandibular Third Molars

Abstract

Due to the frequent development of non-infectious complications after surgical removal of the third lower impacted tooth, many techniques are used to reduce their severity. Among them is the technique of applying platelet-rich fibrin to the post-extraction alveolus. The study included 90 consecutively enrolled patients. Eligible patients were randomly assigned to two groups: patients with and without platelet-rich fibrin introduced into the postoperative alveolus. Pain, swelling, trismus, and temperature were evaluated after the procedure. Pain intensity was significantly higher in the control group than in the study group at 6 h, 1, and 3 days after surgery. PRF application did not significantly affect the intensity of swelling. Body temperature was significantly higher in the control group than the study group on day two after surgery. The trismus was significantly higher in the control group than in the study group at one, two, and seven days after surgery. Application of the PRF allows for a faster and less traumatic treatment process. It will enable for speedier recovery and return to active life and professional duties.

The Growth Factors in Advanced Platelet-Rich Fibrin (A-PRF) Reduce Postoperative Complications after Mandibular Third Molar Odontectomy

“…In the studies conducted by Kumar et al [ 35 ], trismus showed a lower intensity in the group of patients in whom the alveoli were supplied with PRF in the 1st day after the surgery. Trybek et al [ 4 ] also showed better mouth opening the in group with PRF. In the study by Asutay et al [ 41 ] the effect of PRF application on the trismus was not confirmed.…”

“…The study by Dar et al [ 36 ] showed a lower severity of pain in the group of patients in whom the alveolus was supplemented with PRF after tooth extraction, except the 14th day, when there was no significant difference. In a study by Trybek et al [ 4 ], assessing pain using the NRS scale (numerical rating scale), it was shown that after the surgery, the severity of pain was lower in the group of patients with PRF sockets filling. Ozgul et al [ 37 ] performed simultaneous extraction of both completely impacted third molars in the mandible, with similar difficulty of the procedure, by supplementing one alveolus, using PRF membrane.…”

“…The studies showed a lower severity of edema at each of the follow-up visits in the group of patients whose alveolus was supplemented with PRF after tooth extraction, except the 14th day, when there was no significant difference [ 36 ]. Trybek et al [ 4 ] showed no relationship between edema and PRF application to the socket. Zahid and Nadershah [ 38 ] performed simultaneous extraction of both completely impacted third molars in the mandible, with similar difficulty of the procedure, by supplementing one of the alveoli using an A-PRF membrane.…”

“…These symptoms can be observed particularly frequently as a consequence of surgical removal of mandibular third molars—a procedure considered to be the one of the most difficult and time-consuming among all oral surgery procedures. At the same time, it constitutes one of the most frequently performed procedures within this specialty [ 1 , 2 , 3 , 4 ]. The factors that determine the difficulty of the surgical procedure of avulsion of the third molar are depth and space available for removal of the impacted mandibular third molar, the angulation of the tooth, root spacing, size of the bone septum, presence or absence of a dilated tooth follicle, periodontal space, bone density, and the relation to the inferior alveolar nerve.…”

Comparative Study between the Combination of Dexamethasone and Bupivacaine for Third Molar Surgery Postoperative Pain: A Triple-Blind, Randomized Clinical Trial

“…A combination of analgesics can have a “sparing effect” such that a lower dose of the drugs can relieve pain with fewer side effects. As many nociception pathways exist in the human body, a combination of medications is recommended by the World Health Organization (WHO) [ 25 ]. NSAIDs (nonsteroidal anti-inflammatory drugs) have been shown to be effective in managing postoperative dental pain.…”