Platelet-Rich Fibrin as an Antibiotic Delivery Vehicle in Mandibular Third Molar Surgery

August 18, 2026 updated by: Amerigo Giudice

Effects of Antibiotic-Prepared Platelet-Rich Fibrin on Postoperative Recovery After Mandibular Third Molar Surgery: A Randomized Split-Mouth Clinical Trial

The present study aims to evaluate the effect of platelet-rich fibrin (PRF) used as a local antibiotic delivery vehicle on postoperative outcomes, including facial swelling, trismus, and pain, following mandibular third molar surgery in a randomized split-mouth clinical trial.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

31

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 Locations

  • Italy
    • cz
      • Catanzaro, cz, Italy, 88100
        • Magna Graecia University of Catanzaro

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

Yes

Description

Inclusion Criteria:

  • Healthy patients (ASA I) according to the American Society of Anesthesiologists classification.
  • Age 18-32 years.
  • Ability to provide written informed consent.
  • Bilateral mandibular third molars requiring extraction for prophylactic, therapeutic, or strategic reasons.
  • Complete root development of mandibular third molars (Shumaker Stage H).
  • Availability of diagnostic-quality CBCT scans with adequate field of view (17 × 20).
  • Mandibular third molars classified as having conventional or moderate surgical difficulty according to Juodzbalys and Daugela classification.

Exclusion Criteria:

  • Known allergy to corticosteroids.
  • Immunosuppression or immunocompromised conditions.
  • Acute infection at the mandibular third molar extraction sites.
  • Current or previous intravenous amino-bisphosphonate therapy.
  • Psychiatric disorders.
  • Thrombocytopenia (platelet count <40,000/µL), thrombocytosis, or other coagulation disorders.
  • Severe hepatic cirrhosis, advanced chronic renal failure, or uncontrolled -diabetes mellitus.
  • Pregnancy or breastfeeding.
  • Requirement for additional regenerative procedures (e.g., bone grafting).
  • Localized facial malformations involving the cheek region.

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: Treatment
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Test Group - Antibiotic and PRF
Participants will receive platelet-rich fibrin prepared with the addition of antibiotic prior to centrifugation. The antibiotic-enriched PRF clot will be placed into the mandibular third molar extraction socket to provide local antibiotic delivery at the surgical site.
Biological: Antibiotic-enriched Platelet-Rich Fibrin (PRF)
Platelet-rich fibrin prepared with the addition of antibiotic prior to centrifugation and applied into the mandibular third molar extraction socket to provide local antibiotic delivery.
Active Comparator: Control Group - PRF only
Participants will receive standard platelet-rich fibrin prepared without antibiotic addition. The PRF clot will be placed into the mandibular third molar extraction socket according to the same surgical protocol.
Biological: Platelet-Rich Fibrin (PRF)
Standard platelet-rich fibrin prepared without antibiotic addition and applied into the mandibular third molar extraction socket.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Incidence of postoperative infection
Time Frame: Up to 7 days after surgery
Occurrence of postoperative infection following mandibular third molar surgery, assessed through clinical examination based on the presence of signs and symptoms of infection (e.g., purulent discharge, erythema, fever, or need for additional antibiotic therapy).
Up to 7 days after surgery
Facial swelling quantitative analysis - volumetric differences
Time Frame: Change from baseline (before surgery) at 2 day after surgery and at 7 days after surgery
To compare postoperative facial swelling between treatment groups using quantitative three-dimensional analysis based on volumetric differences. Facial volume changes will be measured in cubic centimeters (cm³) through three-dimensional facial scan superimposition.
Change from baseline (before surgery) at 2 day after surgery and at 7 days after surgery
Facial swelling quantitative analysis - linear differences
Time Frame: Change from baseline (before surgery) at 2 day after surgery and at 7 days after surgery
To compare postoperative facial swelling between treatment groups using quantitative three-dimensional analysis based on linear measurements. Facial changes will be assessed by evaluating linear differences (mm) between preoperative and postoperative three-dimensional facial scans.
Change from baseline (before surgery) at 2 day after surgery and at 7 days after surgery
Facial swelling qualitative analysis
Time Frame: Change from baseline (before surgery) at 2 day after surgery and at 7 days after surgery
Change in facial volume from baseline, assessed by three-dimensional facial scan superimposition and expressed as colorimetric variation between the preoperative and postoperative scans.
Change from baseline (before surgery) at 2 day after surgery and at 7 days after surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Trismus analysis
Time Frame: Change from baseline (before surgery) at 2 day after surgery and at 7 days after surgery
To compare postoperative limitation of mouth opening between treatment groups following mandibular third molar surgery. Trismus will be assessed by measuring maximum mouth opening (MMO) in millimeters (mm).
Change from baseline (before surgery) at 2 day after surgery and at 7 days after surgery
Pain analysis with Visual analogue scale (VAS)
Time Frame: Change from baseline (before surgery) at 2 day after surgery and at 7 days after surgery
To compare postoperative pain intensity between treatment groups following mandibular third molar surgery. Pain will be assessed using a Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (worst possible pain).
Change from baseline (before surgery) at 2 day after surgery and at 7 days after surgery

Collaborators and Investigators

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

Sponsor

Amerigo Giudice

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 (Actual)

November 1, 2025

Primary Completion (Estimated)

September 1, 2026

Study Completion (Estimated)

November 20, 2026

Study Registration Dates

First Submitted

August 10, 2026

First Submitted That Met QC Criteria

August 10, 2026

First Posted (Actual)

August 14, 2026

Study Record Updates

Last Update Posted (Actual)

August 20, 2026

Last Update Submitted That Met QC Criteria

August 18, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 23/2023

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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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