This randomized controlled clinical trial evaluated the effects of advanced platelet-rich fibrin (A-PRF) and hyaluronic acid (HA) on healing after surgical removal of impacted mandibular third molars. Participants were assigned to one of three groups: A-PRF applied to the extraction socket, HA applied to the extraction socket, or a control group receiving no additional biomaterial. Postoperative pain, facial swelling, and maximum mouth opening were assessed during the first postoperative week. Radiographic bone healing was evaluated using fractal dimension and mean gray value measurements on panoramic radiographs obtained on postoperative days 7 and 90. The study aimed to determine whether A-PRF or HA could improve postoperative clinical recovery and radiographic bone healing compared with standard treatment alone.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
47
Advanced platelet-rich fibrin (A-PRF) was prepared from autologous venous blood by centrifugation at 1500 rpm for 14 minutes. The resulting A-PRF membrane was placed into the extraction socket immediately after surgical removal of the impacted mandibular third molar.
One milliliter of 0.8% sodium hyaluronate gel was applied directly into the extraction socket immediately after surgical removal of the impacted mandibular third molar.
Inonu University Faculty of Dentistry
Malatya, Battalgazi, Turkey (Türkiye)
Fractal Dimension of the Extraction Socket
Fractal dimension (FD) was used to evaluate the trabecular bone pattern within the extraction socket on digital panoramic radiographs. A standardized 32 × 32-pixel region of interest was selected at the center of the extraction socket, and FD was calculated using the box-counting method in ImageJ.
Time frame: Postoperative days 7 and 90
Mean Radiographic Gray Value
Mean radiographic gray value was measured within a standardized 32 × 32-pixel region of interest located at the center of the extraction socket on digital panoramic radiographs using ImageJ software.
Time frame: Postoperative days 7 and 90
Postoperative Pain
Postoperative pain intensity was assessed using a visual analog scale (VAS).
Time frame: Postoperative days 1, 3, and 7
Postoperative Facial Swelling
Facial swelling was assessed using standardized facial measurements obtained between predefined anatomical landmarks before surgery and during postoperative follow-up.
Time frame: Baseline and postoperative days 1, 3, and 7
Maximum Mouth Opening
Maximum mouth opening was measured in millimeters as the maximum interincisal distance.
Time frame: Baseline and postoperative days 1, 3, and 7
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