A randomized comparative prospective study of platelet-rich plasma, platelet-rich fibrin, and hydroxyapatite as a graft material for mandibular third molar extraction socket healing

Abstract

Aim:The purpose of this study was to compare the efficacy of platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and hydroxyapatite (HA) for reduction of pain and swelling, absence of dry socket, soft tissue healing, and bone regeneration after mandibular third molar extraction in human patients.Materials and Methods:Forty patients requiring extraction of mandibular third molars were randomly grouped as control, PRP, PRF, and HA-treated. The patients were assessed for postoperative pain, swelling, dry socket, and soft tissue healing on the 3rd, 7th, and 14th day of postoperative periods depending on the standard methods. Radiological assessment of the extraction site was done at 1, 2, and 6 months interval to compare the change in bone density in the sockets in control and treated patients.Results:Pain and swelling were less on PRP and PRF site when compared to HA and control site. PRP and PRF site showed better soft tissue healing when compared to HA and control site. Radiographic assessment showed comparatively lesser bone density values in PRP, PRF, and control site at 1, 2, and 6 months than HA site.Conclusion:Our study showed that PRP and PRF are better graft materials than HA regarding pain, swelling, dry socket, and soft tissue healing. Bone regeneration is induced promptly by HA as compared to other graft materials. However, a more elaborate study with a larger number of clinical cases is very much essential to be more conclusive regarding the efficacy of the graft materials.

Impact of platelet-rich fibrin on mandibular third molar surgery recovery: a systematic review and meta-analysis

“…The remaining 18 full-text articles were assessed for potential eligibility, of which, 4 were excluded for comparing the PRF with other interventions, 3 were without usable data, and 1 was a case-control study. Finally, a total of 10 studies [19–21, 28–34] fulfilled the inclusion and exclusion criteria in this systematic review and meta-analysis (Fig. 1).…”

“…Postoperative pain : The 6 studies [19–21, 32–34] that provided the outcomes regarding the postoperative pain in patients, who received PRF and control treatments, were included in the meta-analysis. A significant difference was observed in the postoperative pain on the third day (SMD = − 0.53, 95% CI: − 1.02 to − 0.05, P heterogeneity = 0.001, I 2 = 75.7%) between the two groups (Fig.…”

“…This outcome was reported in 2 trials [19, 20]. A significant heterogeneity occurred between the two studies as evaluated by the random effects model.…”

“…These meta-analyses were followed by several RCTs on the same topic; however, the findings were controversial and no updated meta-analysis is yet available. Herein, we identified the eligible studies [19–21] and performed a detailed analysis at different time points. The present systematic review and meta-analysis investigated and assessed whether PRF was effective and safe for patients during the extraction of bilateral mandibular third molars.…”

Molecular and Cellular Aspects of Socket Healing in the Absence and Presence of Graft Materials and Autologous Platelet Concentrates: a Focused Review

“…This contributes toward the prevention of bacterial contamination within the surgical site in addition to platelet antimicrobial peptides (platelet factor 4, RANTES, connective tissue activating peptide 3, platelet basic protein, thymosin β-4, fibrinopeptide B, and fibrinopeptide A), which were shown to be potent against Escherichia coli and Staphylococcus aureus, and other pathogenic bacteria [105]. Leukocyte containing APCs were found to significantly reduce infection-related complications and the incidence of alveolar osteitis after mandibular third molar surgical extractions [89,106,107].…”