The Effect of Platelet-Rich Fibrin in Preventing Inferior Alveolar Nerve Paresthesia After Mandibular Third Molar Surgery: A Randomized Clinical Trial.

Abstract

Objectives: Platelet-rich fibrin (PRF), an autologous biomaterial, has been increasingly utilized to mitigate postoperative pain, edema, and alveolar osteitis, while promoting both soft and hard tissue regeneration during the surgical extraction of third molars. The present study aimed to compare the incidence of postoperative paresthesia in patients undergoing impacted third molar surgery with PRF application versus those treated without PRF.

Materials and methods: A double-blinded randomized clinical trial was conducted involving patients scheduled for surgical extraction of impacted third molars. Cone-beam computed tomography was utilized preoperatively to confirm the anatomical relationship between the inferior alveolar nerve canal and the tooth roots. Patients were randomly allocated into two groups: the intervention group received PRF placement within the extraction socket, whereas the control group received no adjunctive material. The incidence of postoperative paresthesia was evaluated on the seventh day following surgery using the light-touch sensory test.

Statistical analysis: Normality was assessed via the Kolmogorov-Smirnov test, and group comparisons were conducted using the Mann-Whitney U-test, Pearson's chi-square test, or Fisher's exact test (α = 0.05).

Results: A total of 100 participants were enrolled in the study, comprising 67 females and 33 males, with a mean age of 23.78 ± 3.49 years. There were no statistically significant differences in age or sex distribution between the PRF and control groups (p = 0.464 and p = 0.832, respectively). Postoperative paresthesia was observed in 8% and 2% of patients in the control and PRF groups, respectively; however, this difference did not reach statistical significance (p = 0.117).

Conclusion: The findings of this study indicate that PRF did not significantly reduce the incidence of paresthesia following mandibular third molar extraction. Nonetheless, the results underscore the importance of further research to elucidate PRF's potential role in neurosensory recovery and postoperative outcomes.