Effect of Leucocyte and Platelet Rich Fibrin (L-PRF) in Postoperative Sequelae of Impacted Mandibular Third Molar Surgery- A Split Mouth Randomized Controlled Trial

Objectives: The surgical removal of impacted mandibular third molars is one of the most common procedures in oral surgery, and also one of the most feared inciting procedures among patients due to the postoperative sequelae. Leukocyte and platelet rich fibrin (L-PRF) is an autologous biomaterial enmeshed with platelets, leukocytes and cytokines. The aim of this study is to assess the effect of placing platelet rich fibrin on post-operative healing and complications after impacted mandibular third molar removal.Materials and Methods: This study is a split mouth randomized controlled trial. 25 patients with the same type of mandibular third molar impaction bilaterally were chosen for the study. Venous blood obtained from the patient and centrifuged at 2800 rpm for 12 minutes to obtain L-PRF. In the Case group the Socket was filled with L-PRF; and in the Control group the Socket was filled with standard blood clot. Post-operative swelling and pain score (VAS) assessed on the 1st, 3rd and 7th pos-operative days. Soft tissue healing index assessed on the 7th postoperative day. Post-operative complications, if any were noted. Statistical test -Mann-Whitney U test and Wilcoxon signed rank test were performed using SPSS version 20.0.Results: L-PRF treated sites showed improved Healing Index (p<0.05) and reduced pain VAS scores (p<0.05) when compared to the control site. The post-operative swelling showed statistically significant reduction in the case group for the 1st and 3rd days (p<0.05). Only one L-PRF site and five control sites were affected with alveolar osteitis.Conclusion: Within the limitations of this study, L-PRF exhibits the potential of improving the soft tissue healing and reducing the post-operative pain, swelling and incidence of alveolar osteitis following mandibular third molar removal.