Evaluation of the effects of injectable platelet-rich fibrin (i-PRF) application on wound healing and post-operational complications after impacted mandibular third molar extraction

Objective: The aim of our study is to evaluate the effect of Injectiable Platelet-Rich Fibrin (i-PRF) on postoperative complications such as pain, swelling, alveolar osteitis, trismus, soft tissue healing, analgesic drug usage, and patients' quality of life after mandibular impacted third molar extraction, considering the positive effects of platelet concentrations on revascularization and wound healing. Materials and Methods: A total of 60 patients aged between 18 and 31, with positions classified as mesioangular according to the Winter classification, Class II according to the Pell & Gregory classification, and Position B, were included in the study. These patients were randomly assigned to three groups, with 20 patients in each group, using a closed envelope randomization method. Following routine surgical protocol, local i-PRF was applied in addition to standard impacted tooth surgery in the i-PRF group. In the i-PRF&spongostane group, i-PRF soaked in spongostane was applied locally along with standard impacted tooth surgery. In the control group, no platelet concentrate was applied after the standard extraction of impacted teeth. Changes in postoperative pain, swelling, trismus, distal periodontal pocket depth of the second molar tooth, alveolar osteitis, soft tissue healing, and quality of life were evaluated during follow-up visits. Results: When postoperative findings were evaluated, it was seen that the pain level of the i-PRF&SPNG group was higher at the 12th and 24th hour postoperatively than the other two groups, and on the 5th day, the pain level of the i-PRF group was less than the i-PRF&SPNG group. Additionally, it was determined that the amount of analgesic used on the 2nd day in the i-PRF&SPNG group was higher than in the i-PRF group (p<0.05). When postoperative edema and trismus were compared, it was seen that there was no statistical difference between the groups. When the distal periodontal pocket of the second molar tooth and the quality of life scales were evaluated, no significant difference was observed between the groups. In our study, alveolar osteitis was observed in only one patient. Although it was observed in the control group, no statistically vii significant difference was found. When we evaluated it in terms of soft tissue healing, it was concluded that the i-PRF group was significantly more successful than the control group on the 7th and 21st days (p<0.05). Conclusion: According to the results of the study, it has been determined that i-PRF contributes positively to soft tissue healing. However, an adverse effect of spongostane on postoperative pain has been observed. To reach more comprehensive conclusions on this matter, further studies with larger patient groups are needed. Keywords: i-PRF, Mandibular third molar, Postoperative complications Spongostane