Evaluation of the Effect of Platelet Rich Fibrin on Bone Healing After Surgical Removal of Impacted Mandibular Third Molar

Abstract

Introduction: Following the extraction of impacted mandibular third molars, there is a risk for developing new, or having persistent osseous periodontal defects on the distal aspects of the adjacent second molars. Objectives: To evaluate the effect of platelet rich fibrin (PRF) on bone healing distal to the second molar following removal of impacted mandibular third molar. Materials and methods: This was a parallel, controlled and randomized clinical trial. Twenty patients aged between 20-30 years, who have mesioangular position B impacted mandibular third molar indicated for surgical removal were selected for this study. Ten patients were taken for the study group, where PRF was applied in the extraction socket of the mandibular third molar and 10 patients for the control group, where the extraction sockets were sutured without receiving PRF. The patients were evaluated clinically for pain, edema and trismus on the second, fourth and seventh day post-operatively and radiographically on the first, second and third month post-operatively. Standardized periapical x-ray films were taken for each patient preoperatively and on the first, second and third postoperative months. Image-J Processing Program was used for the assessment of new bone formation at the distal surface of the second molar. Results: There was less pain and trismus in the study group than in the control group but the difference among them was not statistically significant (p > 0.05). Edema was significantly lower in the study group than in the control group in the second and fourth postoperative days. There was significantly more bone density and higher bone level in the study group than in the control group on the second and third postoperative months (p < 0.05). Conclusion: It is clear that PRF is biocompatible and can improve both soft tissue healing and bone regeneration after surgical removal of impacted mandibular third molar.