Postoperative effects of horizontal platelet-rich fibrin after impacted third molar extraction: a randomized controlled trial.

This double-blind randomized controlled trial was performed to evaluate the effects of horizontal platelet-rich fibrin (H-PRF) and leukocyte-platelet-rich fibrin (L-PRF) on postoperative outcomes after mandibular third molar extraction. Seventy-five patients (25 per group) were allocated to H-PRF, L-PRF, or control (no PRF). Pain was assessed on postoperative days 1-7, while swelling, trismus, and soft tissue healing were assessed on days 2 and 7. Quality of life (QoL) was assessed by questionnaire on day 4, and patients recorded the duration of QoL impacts during the first postoperative week, which was reviewed on day 7. Swelling was significantly lower in the H-PRF group compared with control group (-5.18 mm, 95% confidence interval -8.67 to -1.69 mm on day 2; -4.70 mm, 95% confidence interval -8.16 to -1.24 mm on day 7). Both PRF groups demonstrated improved soft tissue healing on day 7 (P = 0.009). No significant differences were observed in pain, trismus, analgesic use, or QoL scores. H-PRF may reduce postoperative oedema, and both PRF formulations may enhance early healing; however, larger trials are required to confirm these findings.