EFFECT OF AUTOLOGOUS PLATELET RICH FIBRIN ON OSSEOUS REGENERATION IN SURGICALLY TREATED IMPACTED MANDIBULAR 3RD MOLARS: A COMPARATIVE STUDY

Abstract

Objective: To determine the efficacy of PRF in promoting osteosynthesis in extraction sockets and reducing post-op pain following surgical removal of mandibular 3^rd molars.

Background: The extraction sockets heal by secondary intention. To speed up this healing process and to reduce postoperative complications, different strategies are employed after wisdom tooth removal.

Methodology: A comparative study was conducted in OMFS department of PIMS from February till November 2025 after having received ethical approval. A sample size of 60 was calculated using the WHO sample size calculator. Either gender of age 18 years and above who needed mandibular third molar extraction was included in the study. The selected patients were split into two groups, namely test group (A) and control group (B). Patients of the test group (group A) received PRF while patients of the control group (group B) were treated without PRF application after surgical extraction of mandibular 3^rd molars. These patients were assessed for osseous regeneration and pain status at multiple time points. The osseous regeneration was assessed through grayscale histogram on OPG using ImageJ software at immediate post-operative period, 3^rd and 5^th post-operative months. The pain status was evaluated at 48hrs, 72hrs and 1 week post-operatively using the Visual Analog Scale (VAS). Data was analyzed through SPSS V27.0. Quantitative variables were calculated through mean and standard deviation while qualitative variables were calculated through frequency and percentages.

Results: To assess the effect of PRF on bone healing/osseous regeneration, immediate post-operative greyscale values on OPG were recorded and compared with values at 3^rd and 5^th post-operative months between test group (group A) and control group (group B). No statistically significant difference was noted between the two groups in this study in terms of osseous regeneration, indicating that healing parameters improved in both groups overtime regardless of PRF application. Similarly, pre-operative and post-operative pain levels were compared between test group (group A) and control group (group B) during 1^st post-operative week. A statistically significant pain reduction was observed in test group (group A) who received PRF following wisdom tooth removal, particularly at 72hrs and onwards till the 7^th post-operative day. P-value of less than 0.05 was considered significant.

Conclusion: After surgical removal of impacted mandibular 3^rd molars, application of autologous PRF lessens early post-operative discomfort. However, the radiographic effect of autologous PRF on bone healing was not found to be statistically significant between the two groups in this study. These results are in line with recent research that demonstrates better post-operative pain recovery but inconsistent effects on bone repair