Evaluation of the postoperative effects of H-PRF (Horizontal platelet rich fibrin) after impacted third molar extraction: A randomized controlled clinical study

Aim: In our study, we evaluated the effects of platelet concentrates on wound healing and regenerative effects, and evaluated the postoperative complications that may be seen in patients after mandibular impacted third molar tooth extraction using Horizontal Platelet Rich Fibrin (H-PRF) and Leukocyte and Platelet Rich Fibrin (L-PRF) materials. It was aimed to examine its effects on quality of life. Materials and Methods: Patients between the ages of 18 and 40 were included in our study. Impacted third molars with soft tissue retention were studied, and a total of 75 patients were included. 75 patients were divided into three groups and the patients included in the groups were assigned to groups with 25 patients in each group using the sealed envelope randomization method. Groups; The study group was named H-PRF, the comparison group was named L-PRF and the control group. Routinely performed surgical procedures were performed by the same surgeon. After tooth extraction, PRF materials obtained from the patients were placed in the extraction sockets of the patients and postoperative follow-ups were performed. In the control group, no platelet concentrate was applied after routine extraction of impacted teeth. Changes in the patients' postoperative pain, edema, mouth opening limitation, soft tissue healing and quality of life were evaluated on the 2nd and 7th days. Results: When the findings were evaluated, it was seen that the amount of edema in the groups in which PRF was placed was statistically less in the swelling measurements made on the 2nd and 7th postoperative days. No statistically significant difference was observed between L-PRF and H-PRF. When postoperative trismus was compared, it was determined that there was no statistically significant difference between the groups. In the evaluation of pain levels, less pain values were observed in the L-PRF group compared to the other groups, but no statistically significant difference was observed between the 6th hour pain values according to the groups. Pain values were found to be less in the H-PRF and L-PRF groups compared to the control group on the 1st day, 2nd day, 3rd day, 5th day and 6th day, but no statistically significant difference was obtained. According to the groups, postoperative analgesic consumption on the 2nd and 3rd days was found to be less in the L-PRF group than in the H-PRF group, but no statistically significant difference was obtained. No statistical difference was found between the groups in analgesic consumption on other days. It was observed that the PRF groups were significantly more successful than the control group on the 7th postoperative day in soft tissue healing. Conclusion: In our results, we observed that H-PRF is superior to L-PRF, especially in reducing postoperative edema. However, we observed that L-PRF was more successful at certain times compared to H-PRF, especially in pain scores and frequency of taking painkillers. Both L-PRF and H-PRF were found to be successful in soft tissue healing. Key Words: Impacted 3rd Molar, H-PRF application, regenerative treatment, postoperative complication