Comparison of bone repair of advanced platelet-rich fibrin (A-PRF) and leukocyte- and platelet-rich fibrin (L-PRF) following the extraction of impacted third molars: a randomized clinical trial.
6 affiliations
- 1Department of Anesthesiology and Oral and Maxillofacial Surgery, Santo Agostinho University Center, Teresina, Piauí, Brazil.
- 2Clinical and Preventive Dentistry Department, Oral Radiology Sector, Federal University of Pernambuco, Recife, Pernambuco, Brazil.
- 3Department of Oral and Maxillofacial Surgery, Coordinator of Postgraduate Program in Oral and Maxillofacial Surgery, Oswaldo Cruz University Hospital, University of Pernambuco, Recife, Pernambuco, Brazil.
- 4OMS resident, Department of Oral and Maxillofacial Surgery, Oswaldo Cruz University Hospital, University of Pernambuco, Recife, Pernambuco, Brazil.
- 5Chair of Department of Oral and Maxillofacial Surgery, Coordinator of Postgraduate Program in Oral and Maxillofacial Surgery, Oswaldo Cruz University Hospital, University of Pernambuco, Recife, Pernambuco, Brazil.
- 6Department of Oral and Maxillofacial Surgery, Federal University of Pernambuco, Oswaldo Cruz University Hospital, R. Arnóbio Marquês, 310 - Santo Amaro, Recife, Pernambuco, 50100-130, Brazil. [email protected].
Abstract
Purpose
To compare the effects of leukocyte- and platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF) on bone healing and postoperative outcomes following impacted third molar extraction (ITME).Methods
A randomized, double-blind, split-mouth clinical trial was conducted in patients undergoing bilateral ITME. One extraction socket received L-PRF and the contralateral socket received A-PRF. The primary outcome was bone volume at the extraction socket, assessed by cone-beam computed tomography (CBCT), as a measure of bone healing. Secondary outcomes included trabecular thickness, trabecular spacing, soft tissue healing assessed using the modified Landry healing index, postoperative pain assessed using a visual analog scale (VAS), and facial swelling. Statistical significance was set at p < 0.05.Results
Thirty-five patients were included in the final analysis. No significant differences were observed in bone volume between the L-PRF (21.04 ± 7.46) and A-PRF (21.43 ± 7.65) groups (p = 0.802). Trabecular thickness was significantly greater in the A-PRF group (p = 0.012), whereas trabecular spacing did not differ between groups. An exploratory time-specific comparison showed lower pain scores in the L-PRF group at 8 h postoperatively (p = 0.046), although no significant overall treatment effect was observed for postoperative pain. No significant differences were identified regarding facial swelling or soft tissue healing.Conclusion
Within the limitations of this randomized clinical trial, L-PRF and A-PRF demonstrated comparable effects on bone healing and postoperative clinical outcomes following impacted third molar extraction. Trial registration Brazilian registry of clinical trials [ReBEC] number: RBR-10vc6r63.
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BibTeX
@article{rodrigues2026comparison,
title = {{Comparison of bone repair of advanced platelet-rich fibrin (A-PRF) and leukocyte- and platelet-rich fibrin (L-PRF) following the extraction of impacted third molars: a randomized clinical trial.}},
author = {Ewerton Rodrigues and Andrea Pontual and Carlos Lago and Ariana Loureiro and Priscilla Pinto and Belmiro Vasconcelos},
journal = {Oral and maxillofacial surgery},
year = {2026},
month = oct,
doi = {10.1007/s10006-026-01641-6},
url = {https://europepmc.org/article/MED/42955100},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparison of bone repair of advanced platelet-rich fibrin (A-PRF) and leukocyte- and platelet-rich fibrin (L-PRF) following the extraction of impacted third molars: a randomized clinical trial.
AU - Ewerton Rodrigues
AU - Andrea Pontual
AU - Carlos Lago
AU - Ariana Loureiro
AU - Priscilla Pinto
AU - Belmiro Vasconcelos
PY - 2026
DA - 2026/10/29
JO - Oral and maxillofacial surgery
DO - 10.1007/s10006-026-01641-6
UR - https://europepmc.org/article/MED/42955100
AB - Purpose To compare the effects of leukocyte- and platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF) on bone healing and postoperative outcomes following impacted third molar extraction (ITME).Methods A randomized, double-blind, split-mouth clinical trial was conducted in patients undergoing bilateral ITME. One extraction socket received L-PRF and the contralateral socket received A-PRF. The primary outcome was bone volume at the extraction socket, assessed by cone-beam computed tomography (CBCT), as a measure of bone healing. Secondary outcomes included trabecular thickness, trabecular spacing, soft tissue healing assessed using the modified Landry healing index, postoperative pain assessed using a visual analog scale (VAS), and facial swelling. Statistical significance was set at p < 0.05.Results Thirty-five patients were included in the final analysis. No significant differences were observed in bone volume between the L-PRF (21.04 ± 7.46) and A-PRF (21.43 ± 7.65) groups (p = 0.802). Trabecular thickness was significantly greater in the A-PRF group (p = 0.012), whereas trabecular spacing did not differ between groups. An exploratory time-specific comparison showed lower pain scores in the L-PRF group at 8 h postoperatively (p = 0.046), although no significant overall treatment effect was observed for postoperative pain. No significant differences were identified regarding facial swelling or soft tissue healing.Conclusion Within the limitations of this randomized clinical trial, L-PRF and A-PRF demonstrated comparable effects on bone healing and postoperative clinical outcomes following impacted third molar extraction. Trial registration Brazilian registry of clinical trials [ReBEC] number: RBR-10vc6r63.
SN - 1865-1550
SN - 1865-1569
ER -