Effectiveness of Concentrated Growth Factor on Improving Postoperative Comfort in Patients Undergoing Coronectomy for Impacted Lower Third Molars: A Double-Blinded Split-Mouth Randomized Controlled Clinical Study

Abstract

Background

Following coronectomy, pain and edema are adverse side effects. Concentrated growth factor (CGF) is recognized for its potential to enhance wound healing, reduce inflammation and may help to improve postoperative comfort following coronectomy.

Purpose

The study purpose was to measure and compare postoperative pain and edema between CGF and control treatments in patients undergoing bilateral coronectomies.

Study Design, Setting, and Sample

In this split-mouth, double-blind, randomized controlled study conducted at Ege University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery in Izmir, Turkey, patients aged 18 to 65 years at risk of mandibular nerve injury underwent bilateral coronectomy. Patients over 65 years of age or those with systemic conditions contraindicating surgery were excluded. Patients and the researcher responsible for data collection and analysis were blinded to the intervention.

Independent Variable

The independent variable was wound management. Within subjects, the treatment sides were randomly assigned to CGF treatment or control.

Main Outcome Variable

The outcome variable was postoperative comfort measured using pain and edema. Pain was measured using the visual analog scale for 7 days after surgery. Edema was quantified in millimeters in 3 planes preoperatively and on postoperative days 2 and 7.

Covariates

Age, sex, and depth of impaction were covariates.

Analyses

The conformity of edema measurements to normal distribution was assessed with the Shapiro-Wilk test, analysis of variance for repeated measures and Bonferroni correction, and supported by paired two-sample t test (significant interaction); since pain levels did not fit the normal distribution (ordinal scale), the nonparametric Brunner and Langer model (LD-F2) and Benjamini-Hochberg procedure were used. Statistical significance was defined as (P < .01).

Results

The sample included 35 subjects, comprising 12 (34.3%) males and 23 (65.7%) females, with a mean age of 32.7 ± 11.42 (standard deviation). Visual analog scale scores were significantly lower on the CGF side for the first 6 days (P < .001) but not on day 7 (P = .6). Postoperative second day edema was statistically significantly lower in the 2 planes on the CGF side (P < .001, P = .007, P = .8) but not on day 7 in any plane (P = .5, P = .8, P = .1).

Conclusions and Relevance

Our study shows that CGF enhances postoperative comfort by minimizing pain and edema. Additional interventions may be necessary for patients undergoing coronectomy due to the potential for significant postoperative discomfort.