J Korean Assoc Oral Maxillofac Surg.  2022 Dec;48(6):371-381. 10.5125/jkaoms.2022.48.6.371.

Does platelet-rich fibrin increase bone regeneration in mandibular third molar extraction sockets?

• Njokanma AR
• Fatusi OA
• Ogundipe OK
• Arije OO
• Akomolafe AG
• Kuye OF

• KMID: 2537563
• DOI: http://doi.org/10.5125/jkaoms.2022.48.6.371

Abstract

Objectives
This study determined the effect of platelet-rich fibrin (PRF) on extraction socket bone regeneration and assessed the patterns and determinants of bone regeneration after the surgical extraction of impacted mandibular third molars.
Materials and Methods
This prospective study randomly allocated 90 patients into two treatment groups: A PRF group (intervention group) and a non-PRF group (control group). After surgical extractions, the PRF group had PRF placed in the extraction socket and the socket was sutured, while the socket was only sutured in the non-PRF group. At postoperative weeks 1, 4, 8, and 12, periapical radiographs were obtained and HLImage software was used to determine the region of newly formed bone (RNFB) and the pattern of bone formation. The determinants of bone regeneration were assessed. Statistical significance was set at P<0.05.
Results
The percentage RNFB (RNFB%) was not significantly higher in the PRF group when compared with the non-PRF group at postoperative weeks 1, 4, 8, and 12 (P=0.188, 0.155, 0.132, and 0.219, respectively). Within the non-PRF group, the middle third consistently exhibited the highest bone formation while the least amount of bone formation was consistently observed in the cervical third. In the PRF group, the middle third had the highest bone formation, while bone formation at the apical third was smaller compared to the cervical third at the 8th week with this difference widening at the 12th week. The sex of the patient, type of impaction, and duration of surgery was significantly associated with percentage bone formation (P=0.041, 0.043, and 0.018, respectively).
Conclusion
Placement of PRF in extraction sockets increased socket bone regeneration. However, this finding was not statistically significant. The patient’s sex, type of impaction, and duration of surgery significantly influenced the percentage of bone formation.

Keyword

Platelet-rich fibrin; Bone regeneration; Third molar

Figure

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  Fig. 1 Platelet-rich fibrin prepared after the centrifugation of 10 mL of autologous whole blood at 3,000 rpm for 10 minutes.

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  Fig. 2 Platelet-rich fibrin (PRF) inserted into the extraction socket of a participant in the PRF group.

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  Fig. 3 Assessment of radiographic density of newly formed bone in the extraction socket using the HLImage++ software (ver. PCM: 18.0.3.q; Western Vision Software). The background area (BA), natural bone area (NBA), and the region of newly formed bone (RNFB) in the cervical, middle and apical thirds of the extraction socket are shown.

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  Fig. 4 Flow chart of participants in the platelet-rich fibrin (PRF) and non-PRF groups. (POW: postoperative week)

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  Fig. 5 Plot of linear prediction of bone formation following one-way MANOVA (multivariate ANOVA) of percentage bone formation on x-ray at cervical, middle, and apical portions of the tooth across postoperative follow-up measurement at weeks 1, 4, 8, and 12 for platelet-rich fibrin (PRF) and non-PRF groups. (POW: postoperative week)

Reference

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