Effect of platelet-rich fibrin on pain and edema after third molar extraction

Abstract

Introduction: Third molar extraction causes intense acute inflammation, pain, and edema. PlateletRich Fibrin (PRF) has emerged as na autologous biological therapy to modulate this inflammation
and reduce the use of medications; however, its clinical effectiveness remains debated in the scientific
literature. Objective: To critically analyze the literature in order to determine the effectiveness of
PRF in reducing pain and facial edema after third molar extraction. Data source: This is a systematic
review conducted according to PRISMA 2020 guidelines. The PubMed database was used to search
for clinical trials in humans published in the last five years, in English or Portuguese, applying the
PICO strategy. Data synthesis: The application of PRF and its variants (such as i-PRF and L-PRF)
significantly reduces early postoperative pain and the consumption of rescue analgesics. Regarding
edema, the results are conflicting; however, more precise methods (3D facial scanning) show that
volumetric reduction with PRF does not reach statistical significance compared to the control group
during the inflammatory peak. Additionally, accelerated epithelialization and improved periodontal
protection of the adjacent second molar were observed. Conclusions: The routine clinical use of PRF
is valuable and justified as na excellent adjuvant for pain control, reduction of pharmacological
dependence, and acceleration of tissue repair. However, its effect on edema is modest. The surgeon
should evaluate whether the benefits outweigh the additional clinical time and costs for each patient.