Comparative Effects of CGF and PRP in Impacted Third Molar Surgery

Evaluation of the Effects of Platelet-rich Plasma and Concentrated Growth Factor on Postoperative Pain, Swelling, and Alveolar Osteitis After Mandibular Third Molar Surgery: a Randomized Controlled Clinical Trial

This study evaluates the effects of two different blood products obtained from the patient's own blood (Concentrated Growth Factor [CGF] and Platelet-Rich Plasma [PRP]) on healing after wisdom tooth extraction. The aim is to determine whether applying these materials to the extraction area reduces postoperative pain, facial swelling, and the risk of dry socket compared to standard healing.

This prospective, randomized, controlled clinical trial compares the efficacy of autologous platelet concentrates in reducing postoperative sequelae following the surgical extraction of impacted mandibular third molars.

A total of 42 patients were randomly assigned to one of three groups:

Control Group: Standard surgical extraction without additional biomaterials.

CGF Group: Standard extraction followed by the placement of a CGF clot into the extraction socket.

PRP Group: Standard extraction followed by submucosal injection of PRP.

The primary outcome measured is postoperative pain (Visual Analog Scale) on postoperative days 1, 3, and 7. The secondary outcomes include facial swelling (linear measurements) on postoperative days 1, 3, and 7, and the incidence of alveolar osteitis (dry socket).

Inclusion Criteria:

• Patients aged between 18 and 50 years.
• Systemically healthy individuals classified as American Society of Anesthesiologists (ASA) Class I or Class II.
• Presence of impacted mandibular third molars (teeth 38 and 48 according to Fédération Dentaire Internationale (FDI) notation).
• Mesioangular impaction with bone retention according to Winter's classification.
• Class II relationship to the ramus according to the Pell and Gregory classification.
• Level B or Level C depth of impaction according to the Pell and Gregory classification.

Exclusion Criteria:

• Patients younger than 18 years.
• Habitual smoking or alcohol consumption.
• Presence of coagulation (bleeding) disorders.
• Systemic diseases affecting wound healing or use of medications that compromise healing.
• Pregnancy or lactation.
• Presence of active pericoronitis associated with the tooth.
• Presence of pathological lesions (cysts or tumors) associated with the impacted tooth.
• Uncontrolled periodontal disease in the oral cavity.
• Known allergy to any medications used in the study protocol.
• Inability to comply with follow-up visits.