Effects of platelet-rich fibrin on outcomes following mandibular third molar removal: a randomized controlled clinical trial

Abstract

Surgical removal of mandibular third molars is a routine procedure in oral and maxillofacial surgery, often followed by pain, swelling, trismus, and alveolar osteitis (AO), affecting patient comfort and daily function. Platelet-rich fibrin (PRF) is an autologous biomaterial that promotes healing through the gradual release of cytokines and growth factors. This prospective, randomized, controlled, and patient-blinded study investigated whether PRF applied to the extraction socket reduces postoperative symptoms and complications. Ninety patients scheduled for mandibular third molar removal were randomized to receive PRF or no adjunct treatment prior to wound closure. Seventy-five patients completed follow-up and were included in the analysis. Postoperative outcomes including AO, infection, pain, trismus, analgesic use, and sick leave were recorded over 10 days. The incidence of AO was lower in the PRF group (3.0%) compared to the control group (11.9%), although the difference was not statistically significant. PRF treatment significantly reduced postoperative pain during the first six days. These findings suggest that while PRF may not significantly reduce AO incidence, it can contribute to improved patient comfort and recovery by decreasing early postoperative pain.