Effect of horizontal and extended platelet-rich fibrin on soft tissue healing and outcomes after impacted mandibular third molar extraction: a controlled trial.

Postoperative sequelae such as pain, swelling, and trismus are common following mandibular third molar surgery. This single-blind controlled trial was performed to evaluate the effects of two newer platelet-rich fibrin (PRF) formulations, horizontal PRF (H-PRF) and extended PRF (E-PRF/albumin-PRF), on soft tissue healing and postoperative complications. Sixty-seven ASA class 1 patients aged 16-30 years were assigned to the H-PRF, E-PRF, or control (natural coagulum) group, with 60 completing the study. The primary outcome was soft tissue healing, while secondary outcomes included pain, analgesic use, swelling, trismus, alveolar osteitis, and infection. The PRF formulations did not significantly improve soft tissue healing during the first postoperative week (day 3: P = 0.64; day 7: P = 0.22). On day 7, the H-PRF group showed a significantly reduced trismus when compared to the control group (P = 0.017). No significant differences were observed in terms of pain, swelling, or analgesic consumption (all P > 0.05). A significantly reduced trismus observed with H-PRF suggests potential clinical benefits; however, further studies with larger samples are needed to confirm these findings and their clinical relevance.