To investigate the effect of plasma rich in growth factors (PRGF) on healing and quality of life following mandibular third molar removal

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O'Sullivan, Laura
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University College Cork
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Objectives: To investigate the effect of plasma rich in growth factors (PRGF) on clinician-reported and patient-reported outcomes following surgical removal of a unilateral impacted mandibular third molar. Materials and Methods: Ethical approval to conduct this prospective, double-blind randomised controlled trial (RCT) was granted by the local Clinical Research Ethics Committee. Seventy-four patients requiring surgical removal of a single impacted mandibular third molar (M3M) under local anaesthesia were recruited to participate. A blood sample was obtained immediately pre-operatively (T0) for all participants irrespective of study arm allocation, and PRGF prepared according to the product protocol. Patients allocated to the treatment arm received PRGF clot in the third molar socket after tooth removal. All patients received a telephone call 3 days postoperatively (T1), and were asked to return to the clinic for review 7 days postoperatively (T2). Primary outcome measures were NRS (numeric rating scale) pain score, OHIP-14 (Oral Health Impact Profile-14) and PoSSe (Postoperative Symptom Severity) scale data. Secondary outcome measures such as mouth opening (MIO), dry socket, socket healing and analgesia consumption were also explored. Statistical analysis was performed using IBM SPSS® 25.0 software and Stata® 15.1. ANCOVA was used for analysis of NRS, OHIP-14 and PoSSe total scores and MIO outcomes. Categorical variables were analysed using the Chi square test. Results: The mean age of participants was 28.1years (range 19-39, SD 5.8) with females accounting for 77% of the study population. NRS scores were higher in the PRGF group at T1 (4.1±2.4) demonstrating borderline significance (p=0.06) with no significant difference at T2. No significant differences were observed in PoSSe subscales between groups overall, with the exception of the ‘interference with daily activities’ subscale at T1, with PRGF patients scoring on average 1.2units higher (p=0.02). OHIP-14 outcomes revealed patients in the PRGF group were 25% more likely to experience discomfort on eating at T1 (p=0.02) with no significant difference between groups at T2. Reduced MIO was observed at T2 in control (35.7±8.2) and PRGF groups (35.4±8.5), but was not significant (p=0.67). The incidence of dry socket was not significant between groups (p=0.3). Socket healing, graded using a modified Landry et al healing index, did not vary significantly between groups: control 4.0±1.2, PRGF 3.6±1.2, nor did analgesia consumption. Conclusion: The results of this study did not demonstrate any significant difference in clinical or quality of life outcomes in patients following adjunctive use of PRGF in mandibular third molar sockets.
Third molar , Quality of life , Plasma rich in growth factors , Wisdom teeth
O'Sullivan, L. 2021. To investigate the effect of plasma rich in growth factors (PRGF) on healing and quality of life following mandibular third molar removal. PhD Thesis, University College Cork.
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