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Quintessence International



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Quintessence Int 49 (2018), No. 5     6. Apr. 2018
Quintessence Int 49 (2018), No. 5  (06.04.2018)

Page 377-388, doi:10.3290/j.qi.a40113, PubMed:29629438

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
Daugela, Povilas / Grimuta, Vaidas / Sakavicius, Dalius / Jonaitis, Juozas / Juodzbalys, Gintaras
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.

Keywords: impacted tooth, pain, platelet-rich fibrin, third molar, tooth extraction, wound healing