The Effectiveness of Autologous Platelet-Rich Fibrin (PRF) in Enhancing Nerve Regeneration Following Mandibular Third Molar Surgery: A Meta-Analysis of Randomized Controlled Trials
DOI:
https://doi.org/10.54361/LJMR.19.2.35Keywords:
Platelet-Rich Fibrin (PRF), Nerve Regeneration, Mandibular Third Molar Surgery, Inferior Alveolar Nerve, Neurosensory Disturbance, Meta-Analysis Randomized Controlled Trials (RCTsAbstract
Background: Mandibular third molar surgery can lead to neurosensory disturbances due to potential damage to the inferior alveolar nerve. Platelet-rich fibrin (PRF), an autologous blood-derived biomaterial, has been proposed as a potential adjunct to enhance nerve regeneration and improve clinical outcomes following these procedures. Objective: This meta-analysis aimed to evaluate the effectiveness of autologous PRF in enhancing nerve regeneration following mandibular third molar surgery based on available randomized controlled trials. Material and Methods: A comprehensive search was conducted across multiple databases, including PubMed, Cochrane Library, Web of Science, and Embase for randomized controlled trials evaluating PRF application after mandibular third molar surgery. Studies were assessed for quality using the Cochrane risk-of-bias tool. Data on nerve regeneration outcomes and related clinical parameters were extracted and analyzed. Results: Four studies met the inclusion criteria, with only one study directly measuring nerve regeneration outcomes. This study demonstrated significant improvement in the brush directional stroke discrimination test (BDSD) in the PRF group (p < 0.001), though no significant differences were observed in two-point discrimination (TPD) and self-reported neurosensory disturbance (SR-NSD). The other studies focused on related clinical outcomes, including pain, swelling, trismus, and bone healing, consistently showing the benefits of PRF application. Meta-analysis of pain reduction showed a standardized mean difference of -0.74 (95% CI: -0.97 to -0.52) favoring PRF. Conclusions: While limited evidence suggests PRF may enhance nerve regeneration following mandibular procedures, more research specifically focused on neurosensory outcomes after third molar surgery is needed. PRF consistently demonstrates benefits for pain reduction, swelling control, and improved healing, making it a promising adjunctive treatment. Future studies should incorporate standardized neurosensory testing to better evaluate PRF's impact on nerve regeneration.
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Copyright (c) 2025 Taher Hamed Mahmud Al Khfif, Haytham, A. K. Matougs, Ahmed s Mikael, Rabab R.Elhassi, Aseel. k .sharif (Author); Rasha j Abraheem (Translator)
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