Patient perceptions of recovery following surgical removal of an impacted mandibular third molar and application of advanced platelet-rich fibrin: a prospective randomized controlled clinical trial

The objective was to assess patient perceptions of recovery following surgical removal of mandibular third molar (SRM3) with application of advanced platelet-rich fibrin (A-PRF) (test) compared with SRM3 and no extraction socket intervention (control). Predictors of impaired convalescence were analysed. Eighty patients were randomly allocated (1:1) to test or control. A compulsory analgesic regimen was applied and the pain intensity before and after analgesic intake was recorded in a pain diary. Preoperative patient parameters, questionnaire results (OHIP-14, MDAS, SF-36, PASS-20), and the DMFT index were correlated with the numbers of days with pain and of sick leave. Postoperative assessments of the effects on work attendance, social and physical activities, sleep, speech, diet, and quality of life, as well as satisfaction with the treatment, were conducted after 30 days. The application of A-PRF within the extraction socket was not associated with a significant reduction in pain or in the number of days with pain (mean 8.7 vs 10.2 without A-PRF) or on sick leave (mean 1.3 vs 1.6 without A-PRF) (all P > 0.05). No significant difference was found for any of the outcomes. Preoperative employment status (employed) and the SF-36 'physical function' domain score were found to be predictors of impaired convalescence. Routine application of A-PRF following SRM3 is, therefore, not recommended.