Efficacy of Platelet-Rich Fibrin (PRF) Following Mandibular Third Molar Extraction: A systematic Review and Meta-Analysis

Abstract Purpose To assess the effect of platelet-rich fibrin (PRF) on the healing process of the alveolar socket following surgical extraction of the mandibular third molars. Materials and Methods PubMed, Cochrane Central Register of Controlled Trials, Scopus, and relevant journals were searched using a combination of specific keywords ( Platelet-rich fibrin, oral surgery, and third molar ). The final search was conducted on November 2, 2015. Randomized controlled clinical trials (RCTs) and controlled clinical trials aimed at comparing the effect of PRF versus natural healing after extracting mandibular third molars were included. Results Five randomized controlled trials and one controlled clinical trial were included. There were 335 extractions (168 tests and 167 controls) in 183 participants. A considerable heterogeneity in study characteristics, outcome variables, and estimated scales was observed. Positive results were generally recorded for pain, trismus, swelling, periodontal pocket depth, soft tissue healing, and incidence of localized osteitis but not in all studies. However, no meta-analysis could be conducted for such variables due to the different scales of measurements used. The qualitative and meta-analysis results showed no significant improvement in bone healing with PRF-treated sockets compared to the naturally healing sockets. Conclusions Within the limitations of the available evidence, PRF seems to have no beneficial role on bone healing following extraction of the mandibular third molars. Future standardized RCTs are required to estimate the effect of PRF in socket regeneration.