Effectiveness of Concentrated Growth Factors in Reducing Postoperative Sequelae and Enhancing Healing Outcomes After Third Molar Extraction: A Systematic Review

Abstract

Background

Concentrated growth factors (CGFs) are autologous biomaterials with notable regenerative potential, particularly relevant in oral surgical applications. Optimizing postoperative recovery after third molar extraction is a clinically significant concern.

Purpose

This systematic review evaluates the effectiveness of CGFs in reducing postoperative sequelae and complications and in improving healing after third molar extraction in healthy adults. The primary outcomes assessed were pain and analgesic use, swelling, hemostasis, trismus, infection and dry socket, inferior alveolar nerve injury and paresthesia, fever, patient-reported outcomes, and satisfaction. Secondary outcomes included surgical duration, overall healing time, soft tissue recovery, radiographic bone fill, and periodontal parameters.

Study Selection

A comprehensive literature search was conducted across 11 databases up to April 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD420251031885). Clinical studies involving healthy adults undergoing third molar extraction with or without CGF application were considered eligible based on population, intervention, comparison, outcomes, and study design framework. Of the 380 studies initially identified, 11 studies (2.9%) met eligibility; all were randomized clinical trials. Study quality was assessed using a modified Cochrane tool.

Results

Among the 11 included randomized clinical trials, 5 were rated as having unclear risk of bias, while the remainder demonstrated low risk, supporting the reliability of the findings. Due to high heterogeneity in study designs, methodologies, and outcomes, quantitative synthesis was not feasible. Pain improved in 6 of 8 (75%) studies, swelling in 4 of 7 (57%), and trismus in 2 of 4 (50%). Analgesic consumption decreased in 2 of 2 (100%) studies. Dry socket incidence was reduced in 1 of 3 (33%) of studies, while 2 showed no or nonsignificant differences. Soft-tissue healing improved in 2 of 2 studies, radiographic bone outcomes in 4 of 5 (80%), and periodontal parameters in 4 of 4 studies. Patient-reported outcomes improved in at least 1 domain in 2 of 2 studies.

Conclusions and Relevance

Within the limits of the current evidence, CGF appears to reduce postoperative pain and analgesic use, enhance soft-tissue healing, and show potential benefits in radiographic bone fill and periodontal outcomes distal to the second molar after third molar surgery. Its effects on swelling, trismus, and alveolar osteitis remain uncertain. Further well-designed, large-scale trials are needed to confirm these findings and clarify the role of CGF in routine practice. Registration: PROSPERO registration number: CRD420251031885.