Role of platelet-rich fibrin in soft and hard tissue healing after impacted third molar surgery: A triple-blind split-mouth randomized controlled clinical trial.

Background: Platelet-rich fibrin (PRF) enhances tissue healing by releasing essential growth factors. Surgical extraction of deeply impacted mandibular third molars poses a common challenge, often leading to significant defects at the distal root of the second molar. This study explored the role of PRF in soft and hard tissue healing after surgical extraction.

Methods: This triple-blind, split-mouth, randomized controlled trial involved patients with bilateral impacted mandibular third molars. Single-stage surgical extraction was performed, and PRF was applied at one site while the other served as the control. Plaque index (PI), sulcus bleeding index (SBI), clinical attachment levels (CALs), postoperative pain, edema, tenderness, sensitivity, and bone level were assessed on day 1, day 3, first week, and first, third, and sixth months.

Results: Sixty-four (34 males and 30 females) patients were found eligible for assessment. The test group exhibited a significant decrease in mean pain scores compared to controls (P<0.001), notably resolving by one month. Edema scores were significantly lower in the test group at all intervals up to one month (P=0.045). Tenderness showed a significant difference at one week (P=0.001), resolving by three months. No significant hard tissue changes were noted (P=0.825).

Conclusion: Significant benefits over postoperative pain, bleeding, tenderness, and initial sensitivity underscored the importance of PRF in soft tissue healing following impacted mandibular third molar extraction. However, no improvement in bone height outlined its limited potential in hard tissue regeneration over exposed root surfaces of the mandibular second molar.