The efficacy of platelet-rich fibrin (PRF) on healing following surgical removal of third molar teeth
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Date
2021
Authors
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Journal ISSN
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Publisher
University of the Western Cape
Abstract
Aim: A clinical trial to determine the post-operative outcomes of a PRF-treated socket versus a conventionally treated socket following surgical removal of third molar teeth. Introduction: Third molar surgery is a procedure many have to endure and which often results in prolonged healing time with consequential absence from work and school. This has motivated clinicians to seek methods to enhance the healing process and in effect, reduce the healing time. Research on the use of PRF in enhancing wound healing in maxillofacial and oral surgery have shown varying results. Therefore, this study was conceived to ascertain the effect PRF has on the post-operative sequelae of third molar teeth. Materials and Methods: This was a split mouth, prospective, single blinded, randomized control trial. The study sample was made up of 26 patients (N=26) who met the inclusion criteria. Four of the patients experienced neurosensory fallout of an associated nerve and were subsequently excluded from the sample. This resulted in the total sample size of twenty-two patients (n=22). Symmetrically impacted maxillary and mandibular third molars were removed under general anaesthesia. Patients were treated in a within subject design: when one side of a patient was treated with PRF, the other side was conventionally treated and acted as a control. The allocation of the side treated with PRF was 'random'. Patients were followed-up on Day 2 and Day 7, respectively. Pain scores were recorded on a visual analogue scale (VAS) using 0 to 10 pain score. Swelling, wound dehiscence, development of alveolar osteitis, wound infection and post-operative bleeding were compared between the intervention and control side. Results: Twenty-two patients (females = 13 and males = nine) between the age of 16 and 31 years met the inclusion criteria. Pain experienced between the PRF and control side on Day 2 and Day 7 were not shown to be statistically significant. The reduction in pain was significant. between Day 2 and Day 7 but not between the treatment modalities. Swelling was lower on the PRF side but this was not significant compared to the control side. There was a significant reduction in swelling over time (between Day 2 and Day 7) but not between the treatment modalities. No impact was shown of PRF on wound dehiscence, infection, alveolar osteitis and bleeding. Conclusion: Overall, this study showed no reduction in post-operative pain and swelling following placement of PRF in the sockets of third molar teeth. It also showed no effect on the incidence of wound dehiscence, infection, alveolar osteitis and bleeding, following PRF treated third molar sockets. The small sample size could be the limiting factor to reflect the true value of PRF as an intervention. However, further investigation with larger sample sizes, more meticulous measuring tools as well as longer follow-up periods are needed to assess the true effect PRF has on enhancing post-operative healing in third molar surgery
Description
Magister Chirurgiae Dentium (MChD)
Keywords
Third molar, Wisdom tooth, Impacted third molar, Platelet-rich fibrin, Platelet concentrates