OPTIMIZATION OF POSTEXTRACTION WOUND HEALING AND REGENERATION OF BONE DEFECTS OF THE JAWS USING AUTOLOGOUS BLOOD CONCENTRATES
DOI:
https://doi.org/10.32782/2786-7684/2026-2-4Keywords:
tooth extraction, molar, jaw bone defect, wound healing, retention, dystopia, A-PRF, osteoregenerationAbstract
Introduction. Tooth extraction, especially atypical removal of impacted and dystopic lower third molars, remains one of the most common surgical interventions in oral surgery. Despite the improvement of surgical protocols, the frequency of postoperative complications, such as dry sockets, edema, pain syndrome, and the formation of a persistent bone defect of the jaws in the area of the distal surface of the second molar, remains high. Purpose of the study. To improve the effectiveness of surgical treatment of patients with retention and dystopia of the lower third molars by using the technique of filling the post-extraction socket with platelet-rich fibrin (A-PRF). A randomized controlled clinical trial was conducted involving 80 patients (aged 18–35) with a diagnosis of retention and dystopia of the lower third molars. Patients were divided into two groups of 40 people: the main group, in which the socket was filled with A-PRF membranes after tooth extraction, and the control group, in which healing occurred under a blood clot. The results were evaluated according to clinical (pain according to VAS, swelling, epithelialization) and radiological (CBCT after 6 months to assess the density of the regenerated bone) parameters. Patients in the main group had a significant decrease in pain syndrome on the 3rd day after surgery (p≤0.05) and accelerated wound epithelialization. Analysis of CPCT data after 6 months showed that the density of newly formed bone tissue in the main group was 35% higher compared to the control group. A significant decrease in the depth of periodontal pockets in the area of the second molars was also noted in the group using A-PRF. Conclusion. The use of the A-PRF technique in the operation of atypical removal of the lower third molar allows for significant improvement in the clinical course of the postoperative period, accelerates the healing of the soft tissue wound and ensures high-quality regeneration of the jawbone defect.
References
Monaco G, Gatto MRA, Pelliccioni GA. Incidence of Delayed Infections after Lower Third Molar Extraction. Int J Environ Res Public Health. 2022;19(7):4028. doi: 10.3390/ijerph19074028.
Suzuki S, Ohta Y, Ogawa H, Kamijo H, Sugihara N. Tooth Extraction, Dental Visits, and Glucose Levels: a Retrospective Study. Bull Tokyo Dent Coll. 2025;66(4):135–143. doi: 10.2209/tdcpublication.2025-0005.
Ariizumi D, Sakamoto T, Yamamoto M, Nishii Y. External Root Resorption of Second Molars Due to Impacted Mandibular Third Molars during Orthodontic Retention. Bull Tokyo Dent Coll. 2022;63(3):129–138. doi: 10.2209/tdcpublication.2021-0044.
Lokes KP, Karasiunok AY, Smaglyuk LV, Voloshyna LI, Voronkova HV, Rezvina K Yu. Operatsiya vydalennya zuba yak skladova ortodontychnoho likuvannya [Tooth extraction operation as a component of orthodontical treatment]. Ukrainian Dental Almanac. 2024;2:32–35. doi: 10.31718/2409-0255.2.2024.06. [in Ukrainian].
Lokes KP, Avetikov HD, Ivanytska OS, Steblovskyi DV, Skikevych MG, Ivanytskyi IO, Avetikov DS. Analysis of methods of prevention of intra-and postoperative complications during tooth extraction. World of Medicine and Biology. 2024;2(88):231-236. doi: 10.26724/2079-8334-2024-2-88-231-236.
Camps-Font O, Sábado-Bundó H, Toledano-Serrabona J, Valmaseda-de-la-Rosa N, Figueiredo R, Valmaseda-Castellón E. Antibiotic prophylaxis in the prevention of dry socket and surgical site infection after lower third molar extraction: a network meta-analysis. Int J Oral Maxillofac Surg. 2024;53(1):57-67. doi: 10.1016/j.ijom.2023.08.001.
Lu Z, Bingquan H, Jun T, Fei G. Effectiveness of concentrated growth factor and laser therapy on wound healing, inferior alveolar nerve injury and periodontal bone defects post-mandibular impacted wisdom tooth extraction: A randomized clinical trial. Int Wound J. 2024;21(1):e14651. doi: 10.1111/iwj.14651.
Kolesnichenko MO, Savchenko DV, Savchenko VV, Ivaniuk OS, Zhyvotovskyi IV, Yacenko PI, Lokes KP. Dynamics of changes in biochemical markers of blood serum after removal of mandibular molars and augmentation of the alveolar process. World of Medicine and Biology. 2023;1(83):96–99. doi: 10.26724/2079-8334-2023-1-83-96-99.
Avetikov HD, Lokes KP. Dynamika klinichnykh pokaznykiv zahoyennya postekstraktsiynoyi rany pislya vydalennya mezialʹno nakhylenykh retenovanykh nyzhnikh tretikh molyariv [Dynamics of clinical indicators of healing post-extraction wounds after removal of mesially inclined impacted lower third molars]. Actual Problems of the Modern Medicine: Bulletin of Ukrainian Medical Stomatological Academy. 2024; 24(4):133–137. doi: 10.31718/2077–1096.24.4.133. [in Ukrainian].
Tanan Karaca G, Duygu G, Er N, Ozgun E. Comparative Investigation of Anti-Inflammatory Effect of Platelet-Rich Fibrin after Mandibular Wisdom Tooth Surgery: A Randomized Controlled Study. J Clin Med. 2023;12(13):4250. doi: 10.3390/jcm12134250.
Santos KK, Lages FS, Maciel CAB, Glória JCR, Douglas-de-Oliveira DW. Prevalence of Mandibular Third Molars According to the Pell & Gregory and Winter Classifications. J Maxillofac Oral Surg. 2022;21(2):627-633. doi: 10.1007/s12663-020-01473-1.
Miyazaki R, Sukegawa S, Nakagawa K, Nakai F, Nakai Y, Ishihama T, Miyake M. Risk Factors for Delayed-Onset Infection after Mandibular Wisdom Tooth Extractions. Healthcare (Basel). 2023;11(6):871. doi: 10.3390/healthcare11060871.
Avetikov DS, Lokes KP, Ischenko VV. Zminy mineralnoho komponentu nyzhnoschelepovoyi kistky v dynamici reparatyvnoho osteohenezu za umov khronichnoyi nitratnoyi intoksykatsiyi [Changes in the mineral component of the mandibular cyst in the dynamics of reparative osteogenesis under conditions of chronic nitrate intoxication]. Bulletin of problems in biology and medicine. 2014;1:37-9. [in Ukrainian].
Bhati B, Kukreja P, Kumar S, Rathi VC, Singh K, Bansal S. Piezosurgery versus Rotatory Osteotomy in Mandibular Impacted Third Molar Extraction. Ann Maxillofac Surg. 2017;7(1):5–10. doi: 10.4103/ams.ams_38_16.
Avetikov HD, Lokes KP. Vplyv metodyky provedennya operatsiyi atypovoho vydalennya nyzhnʹoho tretʹoho molyaru na dynamiku klinichnykh pokaznykiv [Іmpact of surgical technique for atypical mandibular third molar removal on clinical parameter dynamics]. Actual Problems of Modern Medicine. 2025;25,4(92):103–106. doi: 10.31718/2077-1096.25.103. [in Ukrainian].
