Clinical and Molecular Impact of Advanced Platelet-Rich Fibrin on Pain, Swelling, and Distal Periodontal Status of Mandibular Second Molars After Mandibular Third-Molar Extraction

<i>Background and Objectives</i>: This study aimed to evaluate the role of A-PRF (advanced platelet-rich fibrin) in the enhancement of wound healing and protecting the periodontal health of mandibular second molars after the extraction of mandibular third molars. Additionally, the study...

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Main Authors: Ada Stefanescu, Irina-Georgeta Sufaru, Iulia Chiscop, Fabian Cezar Lupu, Cristian Martu, Bogdan Oprisan, Kamel Earar
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/60/12/2062
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author Ada Stefanescu
Irina-Georgeta Sufaru
Iulia Chiscop
Fabian Cezar Lupu
Cristian Martu
Bogdan Oprisan
Kamel Earar
author_facet Ada Stefanescu
Irina-Georgeta Sufaru
Iulia Chiscop
Fabian Cezar Lupu
Cristian Martu
Bogdan Oprisan
Kamel Earar
author_sort Ada Stefanescu
collection DOAJ
description <i>Background and Objectives</i>: This study aimed to evaluate the role of A-PRF (advanced platelet-rich fibrin) in the enhancement of wound healing and protecting the periodontal health of mandibular second molars after the extraction of mandibular third molars. Additionally, the study assessed the levels of pro-inflammatory cytokines in the gingival crevicular fluid (GCF) of mandibular second molars as markers of inflammation. <i>Materials and Methods</i>: Twenty-five systemically healthy adult patients with bilateral removal of impacted mandibular third molars were included. Each patient received A-PRF in one extraction site, while the contralateral site served as a control. Periodontal parameters of the adjacent second molar, including probing depth (PD) and clinical attachment level (CAL), were measured in distal–vestibular (DV) and distal–lingual (DL) sites. Pain, swelling, and overall healing were subjectively evaluated. Levels of tumor necrosis factor-alpha (TNF-α), interleukin 1 beta (IL-1β), and interleukin 6 (IL-6) in the GCF were analyzed. Evaluations occurred at baseline and three months post-surgery. <i>Results</i>: A-PRF significantly improved PD (from 4.69 ± 0.61 mm to 3.85 ± 0.34 mm in DV, and from 4.71 ± 0.65 mm to 3.79 ± 0.27 mm in DL, respectively) and CAL (from 2.41 ± 0.25 mm to 1.82 ± 0.21 mm in DV, and from 2.40 ± 0.36 mm to 1.75 ± 0.19 mm in DL, respectively) of the adjacent second molar, compared to control sites, three months post-surgery. Pain and swelling scores were notably lower on the 7th postoperative day in the A-PRF group. A-PRF also reduced pro-inflammatory cytokines in GCF, significantly more than in control sites, at three months post-surgery. <i>Conclusions</i>: A-PRF enhances the periodontal and inflammatory status of adjacent teeth and wound healing after the extraction of mandibular third molars.
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spelling doaj-art-ce5a4cf87d0640b896121be33436744d2025-08-20T02:43:20ZengMDPI AGMedicina1010-660X1648-91442024-12-016012206210.3390/medicina60122062Clinical and Molecular Impact of Advanced Platelet-Rich Fibrin on Pain, Swelling, and Distal Periodontal Status of Mandibular Second Molars After Mandibular Third-Molar ExtractionAda Stefanescu0Irina-Georgeta Sufaru1Iulia Chiscop2Fabian Cezar Lupu3Cristian Martu4Bogdan Oprisan5Kamel Earar6Faculty of Dental Medicine, “Dunarea de Jos” University, Al. I. Cuza Street 35, 800216 Galati, RomaniaFaculty of Dental Medicine, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street 16, 700115 Iasi, RomaniaFaculty of Dental Medicine, “Dunarea de Jos” University, Al. I. Cuza Street 35, 800216 Galati, RomaniaMechanical Engineering, Mechatronics and Robotics Department, “Gheorghe Asachi” Technical University of Iasi, 700050 Iasi, RomaniaFaculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street 16, 700115 Iasi, RomaniaFaculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street 16, 700115 Iasi, RomaniaFaculty of Dental Medicine, “Dunarea de Jos” University, Al. I. Cuza Street 35, 800216 Galati, Romania<i>Background and Objectives</i>: This study aimed to evaluate the role of A-PRF (advanced platelet-rich fibrin) in the enhancement of wound healing and protecting the periodontal health of mandibular second molars after the extraction of mandibular third molars. Additionally, the study assessed the levels of pro-inflammatory cytokines in the gingival crevicular fluid (GCF) of mandibular second molars as markers of inflammation. <i>Materials and Methods</i>: Twenty-five systemically healthy adult patients with bilateral removal of impacted mandibular third molars were included. Each patient received A-PRF in one extraction site, while the contralateral site served as a control. Periodontal parameters of the adjacent second molar, including probing depth (PD) and clinical attachment level (CAL), were measured in distal–vestibular (DV) and distal–lingual (DL) sites. Pain, swelling, and overall healing were subjectively evaluated. Levels of tumor necrosis factor-alpha (TNF-α), interleukin 1 beta (IL-1β), and interleukin 6 (IL-6) in the GCF were analyzed. Evaluations occurred at baseline and three months post-surgery. <i>Results</i>: A-PRF significantly improved PD (from 4.69 ± 0.61 mm to 3.85 ± 0.34 mm in DV, and from 4.71 ± 0.65 mm to 3.79 ± 0.27 mm in DL, respectively) and CAL (from 2.41 ± 0.25 mm to 1.82 ± 0.21 mm in DV, and from 2.40 ± 0.36 mm to 1.75 ± 0.19 mm in DL, respectively) of the adjacent second molar, compared to control sites, three months post-surgery. Pain and swelling scores were notably lower on the 7th postoperative day in the A-PRF group. A-PRF also reduced pro-inflammatory cytokines in GCF, significantly more than in control sites, at three months post-surgery. <i>Conclusions</i>: A-PRF enhances the periodontal and inflammatory status of adjacent teeth and wound healing after the extraction of mandibular third molars.https://www.mdpi.com/1648-9144/60/12/2062A-PRFclinical parameterscytokinesoral surgerypaintumefaction
spellingShingle Ada Stefanescu
Irina-Georgeta Sufaru
Iulia Chiscop
Fabian Cezar Lupu
Cristian Martu
Bogdan Oprisan
Kamel Earar
Clinical and Molecular Impact of Advanced Platelet-Rich Fibrin on Pain, Swelling, and Distal Periodontal Status of Mandibular Second Molars After Mandibular Third-Molar Extraction
Medicina
A-PRF
clinical parameters
cytokines
oral surgery
pain
tumefaction
title Clinical and Molecular Impact of Advanced Platelet-Rich Fibrin on Pain, Swelling, and Distal Periodontal Status of Mandibular Second Molars After Mandibular Third-Molar Extraction
title_full Clinical and Molecular Impact of Advanced Platelet-Rich Fibrin on Pain, Swelling, and Distal Periodontal Status of Mandibular Second Molars After Mandibular Third-Molar Extraction
title_fullStr Clinical and Molecular Impact of Advanced Platelet-Rich Fibrin on Pain, Swelling, and Distal Periodontal Status of Mandibular Second Molars After Mandibular Third-Molar Extraction
title_full_unstemmed Clinical and Molecular Impact of Advanced Platelet-Rich Fibrin on Pain, Swelling, and Distal Periodontal Status of Mandibular Second Molars After Mandibular Third-Molar Extraction
title_short Clinical and Molecular Impact of Advanced Platelet-Rich Fibrin on Pain, Swelling, and Distal Periodontal Status of Mandibular Second Molars After Mandibular Third-Molar Extraction
title_sort clinical and molecular impact of advanced platelet rich fibrin on pain swelling and distal periodontal status of mandibular second molars after mandibular third molar extraction
topic A-PRF
clinical parameters
cytokines
oral surgery
pain
tumefaction
url https://www.mdpi.com/1648-9144/60/12/2062
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