Soft tissue healing and bony regeneration of impacted mandibular third molar extraction sockets, following postoperative incorporation of platelet-rich fibrin

Priya Esther Jeyaraj, Ashish Chakranarayan

Annals of Maxillofacial Surgery 2018 8(1):10-18

Introduction: Surgical removal of impacted mandibular third molars is one of the most commonly performed dentoalveolar surgeries by dental surgeons around the globe. It is known to be associated with clinically significant postoperative morbidity including swelling, pain, trismus, fever, and infection. In addition, the residual bony defect takes 7 months to 1 year to gradually fill with bone and to reossify. Aims and Objective: (1) To carry out a prospective study to evaluate differences in soft tissue healing and bony regeneration of impacted mandibular third molar extraction sites, with and without the incorporation of autologous platelet-rich fibrin (PRF) within the surgical wounds. (2) To also compare the incidence of short- and long-term posttreatment complications in both cases. Materials and Methods: Sixty patients were randomly inducted into two groups, consisting of 30 patients each. The first group, which served as the study group, consisted of patients in whom fresh autologous PRF were placed within the extraction site immediately following the surgical removal of the impacted mandibular third molar, before suturing of the mucoperiosteal flap. The second group, which served as the control froup, included those patients in whom the mucoperiosteal flaps were closed without incorporation of PRF within site.Both groups were evaluated and compared for postoperative pain, swelling, trismus, soft tissue healing, as well as bone fill of the extraction socket. Results: It was found that the study group in which autologous PRF had been incorporated into the operative site exhibited quick and complication-free soft tissue healing as well as a much quicker reossification and bone fill of the extraction socket, as compared to the control group in which no PRF was used. Conclusion: Incorporation of PRF within extraction sockets of impacted third molars proved to be beneficial for patients, yielding a quicker postoperative recovery with fewer complications such as postoperative swelling and edema, pain, and trismus; better overall postoperative results in terms of faster soft tissue healing as well as an earlier bony regeneration.

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