Effects of concentrated growth factor and platelet-rich plasma on postoperative pain and edema following impacted mandibular third molar surgery: a randomized controlled clinical trial

BACKGROUND: The aim of this study was to evaluate the effects of concentrated growth factor (CGF) and platelet-rich plasma (PRP) on postoperative pain and edema following impacted mandibular third molar surgery, and to investigate postoperative complications. METHODS: This prospective, randomized controlled clinical trial included a total of 42 patients divided into three groups: control, CGF, and PRP (n = 14 per group). Pain was evaluated using a 10-cm Visual Analog Scale (VAS), and edema was assessed using standard linear facial measurements on postoperative days 1, 3, and 7. Changes over time and differences between groups were analyzed using Generalized Estimating Equations (GEE). RESULTS: According to the GEE analysis, both CGF and PRP applications demonstrated a statistically significant reduction in facial edema (tragus-pogonion) compared to the control group; however, the absolute reduction was minimal (0.2-0.5 mm) and likely of limited clinical significance. These applications appear to be effective in edema control following mandibular third molar surgery (CGF: B=-1.056, 95% CI [-1.835, -0.276], p = 0.008; PRP: B=-1.002, 95% CI [-1.750, -0.254], p = 0.009). However, the clinical magnitude of the differences between the groups remained limited. Although pain scores were lower in the CGF group, they did not show a statistically significant difference between the groups. The healing process was completed uneventfully in all groups, and no alveolar osteitis or serious postoperative complications were observed in any patient during the study. CONCLUSIONS: While CGF and PRP applications provided a statistically significant reduction in facial edema following impacted tooth surgery, the minimal magnitude of this reduction suggests it is unlikely to meaningfully improve the patient's postoperative quality of life. Furthermore, their effects on postoperative pain and complications did not offer an additional clinical advantage compared to a standard and atraumatic surgical procedure. Therefore, case-based evaluation is recommended rather than the routine use of these biomaterials. TRIAL REGISTRATION: This study was registered retrospectively at ClinicalTrials.gov under the number NCT07320170 on January 06, 2026. Although patient recruitment and data collection began prior to registration due to an initial oversight, the study protocol, including primary and secondary outcome variables and the statistical analysis plan, was established before recruitment commenced, and no changes were made following data collection.