The Effect of Platelet Rich Fibrin On Sensitivity and Periodontal Pockets Distal to Second Molar After Surgical Extraction of Impacted Third Molar

January 11, 2026 updated by: Muhammad Umar Hayat, University of Health Sciences Lahore

" The Effect of Platelet Rich Fibrin On Sensitivity and Periodontal Pockets Distal to Second Molar After Surgical Extraction of Impacted Third Molar "

Surgical extraction of impacted third molar is the most common surgical procedure performed in oral and maxillofacial surgery. The immediate post operative complications after 3rd molar surgery are pain, swelling and trismus while delayed post operative complications are mostly seen on the distal surface of second molar due to distal bone loss which include prolonged sensitivity due to increased periodontal pocket depth, gingival recession and root exposure.

When PRF clot is given in wound, it causes alterations of the cellular ratios in the wound blood clot, leading to replacement of blood cells with Platelets and growth factors stimulating all phases of healing which will improve the immidiate and delayed post operative complications The purpose of present study is to compare the clinical outcomes in the treatment of senstivity and periodontal pockets at the distal aspect of second molar following surgical extraction of impacted third molar using PRF or Blood clot alone.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Impacted third molars distal to second molar are the cause of distal attachment loss leading to degradation of the interdental bone. This causes formation of periodontal pocket which leads to pericoronitis and further infection. If there is minimum or no distance between second and third molar, the loss of interdental bone leads to periodonto-pathogenic bacterial aggression. Partially impacted third molars are the active source of bacterial entry into the distal area of the second molar because of food retention and poor oral hygiene.

PRF is the second generation autologous platelet concentrate that is obtained from patient's own blood in simple and cost effective manner. PRF contains platelets, cytokines, leucocytes and circulating stem cells that are embedded in a heterogeneous fibrin matrix. These unique elements in PRF make it a good biomaterial that improves healing. The slow release of cytokines-vascular endothelial growth factor, transforming growth factor, Epidermal growth factor and platelet-derived growth factor-are the main components which play an important role in neo-angiogenesis and tissue repair which makes this particular material useful.

Platelet-Rich Fibrin (PRF), has potential to enhance soft and hard tissue healing However, the evidence surrounding its effectiveness in reduction of sensitivity and periodontal pockets remains inconclusive. Previous studies evaluating the use of PRF have reported contradictory results. While some have demonstrated a significant reduction in periodontal pocket depth and improved healing when PRF is applied to the extraction socket, others have found little to no difference when compared to surgical extraction without PRF placement. This inconsistency highlights the need for further investigation to clarify PRF's role in postoperative outcomes, particularly in relation to periodontal health distal to the second molar. In addition, many of the available studies on PRF in third molar extraction are limited by small sample sizes which reduces the statistical power and generalizability of their findings. Contradiction in their results are most probably due to small sample size Therefore study with larger sample size is required to validate previous results and offer more conclusive evidence Furthermore, there is a notable lack of research focusing on postoperative tooth sensitivity, which is a common patient complaint following third molar extraction. Existing literature has predominantly emphasized parameters such as pain, swelling, and periodontal pocket depth, while the effect of PRF on sensitivity remains largely unexplored. This represents a significant gap in research and patient-centered outcomes.

By assessing periodontal pocket depth, clinical attachment loss and sensitivity distal to the second molar with larger sample size, this study aims to offer a more integrated evaluation of PRF's effectiveness in third molar surgery

Study Type

Interventional

Enrollment (Estimated)

56

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • Allama Iqbal Medical College/ Jinnah Hospital
        • Contact:
          • Allama Iqbal Medical College (AIMC)
          • Phone Number: +92-42-9923144 +92-42-99231480
          • Email: Info@aimc.edu.pk

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Impacted third molar (as per Operational Definition) with fully erupted second molars bilaterally.
  • Impacted Third molar with Class 2 and Level B according to Pell and Gregory's classification (Annexure B) with mesioangular or horizontal angulation of impaction
  • Periodontal pocket depth > 4mm and Clinical attachment loss > 1mm at distal side of second molar
  • Age 18-40 years, both genders.
  • Patients who give informed consent.

Exclusion Criteria:

  • Any Systemic Disease i.e. Uncontrolled Diabetes mellitus, Uncontrolled hypertension, Ischemic heart disease, bleeding disorders, Autoimmune diseases or immunocompromised patients
  • Decayed or recommended for extraction second molars on either side.
  • Allergic to Amoxicillin to standardize Antibiotic therapy protocol.
  • Untreated periodontal condition.
  • Inability to follow up.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Case Group
PRF placement in extraction socket
Other: Platelet rich fibrin
After surgical extraction of impacted mandibular 3rd molar PRF will be placed in extraction socket
Other Names:
  • PRF
No Intervention: Control Group
Surgical extraction without using PRF

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Periodontal Pocket Depth
Time Frame: From Enrollment to end of treatment at 03 months
Periodontal pocket depth will be measured as a distance between gingival margin and base of the periodontal pocket in millimeters by Williams periodontal probe .
From Enrollment to end of treatment at 03 months
Senstivity
Time Frame: from Enrollment to end of treatment at 03 months
Response of patient elicited by painful stimulus i.e Tactile stimulus which is characteristically of short duration will be measured by Tactile method i.e. scratching the distal surface of second molar at cemento-enamel junction with dental explorer on Numeric scale with values from 0 to 10, 0 being the least/no sensitivity and 10 being the worst
from Enrollment to end of treatment at 03 months
Clinical attachment loss
Time Frame: From Enrollment to end of treatment at 03 months
Clinical attachment loss will be measured as a distance between cemento-enamel junction of second molar to the base of periodontal pocket in millimeters by williams periodontal probe
From Enrollment to end of treatment at 03 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Health Sciences Lahore

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

February 1, 2026

Primary Completion (Estimated)

July 1, 2027

Study Completion (Estimated)

February 1, 2028

Study Registration Dates

First Submitted

January 11, 2026

First Submitted That Met QC Criteria

January 11, 2026

First Posted (Actual)

January 20, 2026

Study Record Updates

Last Update Posted (Actual)

January 20, 2026

Last Update Submitted That Met QC Criteria

January 11, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • ERB167/2/02-07-2024/S1 ERB

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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