Injectable Platelet-Rich Fibrin Improves Healing After mandibular impacted third molar surgery: Study

A new research published in the journal of BMC Oral Health showed that the use of injectable platelet-rich fibrin (iPRF) may improve early soft tissue healing (STH), reduce postoperative pain (PAP), and support favorable clinical attachment level (CAL) changes after mandibular impacted third molar (MITM) extraction.

Mandibular impacted third molar extraction (lower wisdom tooth removal) is one of the most frequently performed oral surgeries worldwide. Although generally safe, patients often experience postoperative pain, swelling, delayed healing, and periodontal complications affecting the neighboring second molar.

Injectable platelet-rich fibrin is an autologous blood-derived biomaterial rich in platelets, growth factors, leukocytes, and fibrin proteins believed to promote tissue regeneration and wound healing. Since it is produced from the patient’s own blood without chemical additives, iPRF has gained growing interest in oral surgery and regenerative dentistry. Thus, this trial was set to determine whether irrigation with injectable platelet-rich fibrin could improve healing outcomes when compared with standard saline irrigation.

The study enrolled 32 patients with bilateral impacted lower wisdom teeth, allowing each participant to serve as their own control. One extraction site was randomly assigned to receive iPRF irrigation, while the opposite side received saline irrigation.

This research assessed healing at multiple postoperative stages using the Inflammatory-Proliferative-Remodeling (IPR) scale. Additional outcomes included wound epithelialization, postoperative pain levels, and periodontal measurements around the adjacent second molar.

The findings showed that patients treated with iPRF experienced significantly better early soft tissue healing during both the inflammatory and proliferative phases when compared to the control sites. The patients in the iPRF group also reported lower average postoperative pain during the first three days after surgery, which suggests that the biologic therapy may help reduce early surgical discomfort.

Both treatment groups demonstrated reductions in probing pocket depth over 6 weeks, but only the iPRF-treated sites showed significant improvement in clinical attachment level (CAL). Further analysis revealed that the iPRF group achieved significantly greater gains in clinical attachment when compared to saline-treated sites, despite having worse baseline periodontal measurements before surgery.

The regenerative effects of iPRF may stem from its ability to release growth factors gradually over time, by supporting angiogenesis, collagen synthesis, tissue remodeling, and inflammatory regulation during healing. Larger trials with longer observation periods will be needed to confirm whether the benefits persist over time and translate into clinically significant long-term periodontal protection.

Source:

Çiftçi Şişman, A., Özsağir, Z. B., Öke, M., Duru, A., & Mollaalioğlu, İ. (2026). Injectable platelet-rich fibrin (iPRF) and postoperative outcomes in mandibular impacted third molar surgery: a split-mouth randomized controlled trial. BMC Oral Health. https://doi.org/10.1186/s12903-026-08593-z