Effects of platelet-rich fibrin on postoperative pain, trismus, and swelling after impacted mandibular third molar surgery in smokers and nonsmokers: an exploratory prospective clinical study
Journal of Cranio-Maxillofacial Surgery, cilt.54, sa.12, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 54 Sayı: 12
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.jcms.2026.109934
- Dergi Adı: Journal of Cranio-Maxillofacial Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Anahtar Kelimeler: Mandibular third molar, Platelet-rich fibrin, Postoperative pain, Smoking, Swelling, Trismus
- Ankara Üniversitesi Adresli: Evet
Özet
Mandibular third molar surgery is commonly associated with postoperative pain, swelling, and trismus. Platelet-rich fibrin (PRF) has been proposed as a biological adjunct to improve postoperative healing; however, its effectiveness in smokers remains unclear. This prospectively conducted randomized split-mouth clinical study evaluated the effect of PRF placed in the extraction socket on postoperative pain, swelling, and trismus after mandibular third molar surgery in 30 patients (15 smokers and 15 nonsmokers). The trial was retrospectively registered at ClinicalTrials.gov (NCT07604584). The included patients had bilaterally impacted mandibular third molars classified as Class I, Position C (Pell and Gregory) and Class II difficulty (Parant). Bilateral extractions were performed at least 2 weeks apart. PRF was placed in one extraction socket, while the contralateral site served as the control. Postoperative pain was assessed using a 10-cm visual analog scale (VAS) on days 1, 2, 3, and 7. Swelling was evaluated using linear facial measurements between anatomical landmarks, and trismus was assessed by measuring maximum interincisal distance. Statistical analyses were performed using SPSS with a significance level of p < 0.05. No significant differences were found between PRF-treated and control sites regarding postoperative pain, swelling, trismus, or analgesic consumption at any time point in either smokers or nonsmokers ( p > 0.05). Postoperative outcomes also did not differ significantly between smokers and nonsmokers regardless of PRF application. PRF did not significantly reduce postoperative pain, swelling, or trismus after mandibular third molar surgery. However, given the limited statistical power to detect small-to-moderate PRF × smoking interaction effects, the absence of statistically significant differences should not be interpreted as evidence of equivalence between smokers and nonsmokers or between PRF-treated and control conditions.