Related Experiment Video
Updated: Jun 30, 2025
Preparation, Procedures and Evaluation of Platelet-Rich Plasma Injection in the Treatment of Knee Osteoarthritis
Published on: January 4, 2019
Do Platelet-Rich Concentrates Improve the Adverse Sequelae of Impacted Mandibular Third Molar Removal?
Amir Yari1, Paniz Fasih2, Nader Ghotbi3
1Assistant Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Kashan University of Medical Sciences, Kashan, Iran.
Background:
Several measures have been implemented to minimize the side effects of impacted third molar (M3) removal including the use of platelet-rich fibrin (PRF).
Purpose:
This study compared the effects of three modifications of PRF (leukocyte-PRF [L-PRF], advanced-PRF [A-PRF], and advanced-PRF plus [A-PRF +]) on the side effects of impacted M3 removal.
Study Design, Setting, And Sample:
This double-blinded randomized controlled trial was conducted at the Oral Surgery Department of Kashan University between September 2022 and May 2023 on patients undergoing mandibular impacted M3 removal. Exclusion criteria were age over 30, local inflammation and infection, medication usage, and systemic disease.
Independent Variable:
The independent variable was the PRF product grouped into four categories (control, L-PRF, A-PRF, and A-PRF+). Study subjects were randomly distributed among the four groups.
Main Outcome Variable(S):
The main outcome variables were postoperative sequelae including measures of soft tissue healing, pain, analgesic use, alveolar osteitis, trismus, and swelling. Subjects were assessed at baseline and on days 1, 2, 3, and 7 postsurgery.
Covariates:
Age, sex, duration of surgery, and side of surgery were the covariates.
Analyses:
Changes at different time points were analyzed using repeated measures analysis of variance. Pairwise comparisons were performed if significant. P values ≤.05 were considered statistically significant.
Results:
The sample consisted of 64 subjects (16 per group). All three modifications of PRF yielded significantly better soft tissue healing index than the control group on days 2, 3, 7, and 14 postoperatively (P > .05). A-PRF and A-PRF + had significantly better healing index than L-PRF on the third day (P = .02, P = .01). All the study groups significantly reduced visual analog scale pain score than the control group on days 1, 2, and 3. A-PRF and A-PRF + had significantly lower visual analog scale scores than L-PRF on the second day (P = .003, P = .02). No significant difference was found in maximum mouth opening during follow-up sessions (P = .2). Study groups had less facial swelling on days 2 and 3 than the control group (P < .05).
Conclusion And Relevance:
L-PRF, A-PRF, and A-PRF + can improve postoperative outcomes after M3 removal but may not impact trismus. A-PRF and A-PRF + may be more effective than L-PRF in promoting soft tissue healing and reducing pain. A-PRF and A-PRF + have comparable results.
Insights
Platelet-rich fibrin (PRF) modifications, including leukocyte-PRF (L-PRF), advanced-PRF (A-PRF), and A-PRF plus (A-PRF+), significantly improve healing and reduce pain after impacted third molar removal compared to no PRF. A-PRF and A-PRF+ showed superior results over L-PRF.
Area of Science:
- Oral Surgery
- Regenerative Medicine
- Biomaterials
Background:
- Minimizing side effects of impacted third molar (M3) removal is crucial.
- Platelet-rich fibrin (PRF) is a biomaterial used to aid healing.
- Investigating advanced PRF formulations may offer improved outcomes.
Purpose of the Study:
- To compare the efficacy of three PRF modifications: leukocyte-PRF (L-PRF), advanced-PRF (A-PRF), and A-PRF plus (A-PRF+).
- To evaluate their impact on postoperative sequelae following impacted M3 removal.
- To determine if advanced PRF formulations offer superior benefits over L-PRF.
Main Methods:
- A double-blinded randomized controlled trial involving 64 patients undergoing mandibular M3 removal.
- Four groups were established: control, L-PRF, A-PRF, and A-PRF+.
- Postoperative outcomes including soft tissue healing, pain, swelling, and trismus were assessed.
Main Results:
- All PRF groups demonstrated significantly better soft tissue healing and reduced pain scores compared to the control group.
- A-PRF and A-PRF+ showed superior soft tissue healing and pain reduction compared to L-PRF on specific days.
- Reduced facial swelling was observed in all PRF groups compared to the control.
Conclusions:
- L-PRF, A-PRF, and A-PRF+ enhance postoperative recovery after M3 extraction.
- A-PRF and A-PRF+ appear more effective than L-PRF for soft tissue healing and pain management.
- These advanced PRF formulations offer comparable and potentially superior results in managing M3 removal complications.
Related Concept Videos
01:22Formation of the Platelet Plug
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
01:16Clot Retraction and Fibrinolysis