Autologous platelet concentrates after third molar extraction: A systematic review

Area of Science:

• Oral and Maxillofacial Surgery
• Regenerative Medicine
• Biomaterials

Background:

• Surgical extraction of impacted mandibular third molars frequently leads to pain, swelling, and trismus.
• Autologous platelet concentrates (APCs) are being investigated to mitigate these postoperative complications.

Purpose of the Study:

• To systematically review the efficacy of different autologous platelet concentrates (APCs) in managing postoperative sequelae and promoting healing after impacted mandibular third molar extraction.

Main Methods:

• A systematic review of randomized controlled trials (RCTs) published before 2024 was conducted using PubMed, EMBASE, Web of Science, and Scopus.
• Fifty-nine RCTs were included, comparing APC application in extraction sockets versus unassisted healing.
• Studies assessed postoperative sequelae, soft and hard tissue healing, and periodontal parameters.

Main Results:

• The majority of RCTs reported statistically significant reductions in postoperative sequelae, including pain, edema, trismus, and alveolar osteitis.
• APCs demonstrated faster soft tissue healing and improved bone healing (qualitative and quantitative).
• A minority of studies noted significant differences in periodontal parameters.

Conclusions:

• Autologous platelet concentrates show promise in reducing postoperative complications and enhancing healing following impacted mandibular third molar surgery.
• Despite promising results, high heterogeneity and risk of bias across studies necessitate cautious interpretation and further high-quality research.