Effect of CGF on Frequency of Alveolar Osteitis Following Partially Erupted Mandibular Third Molar Surgery
Condition: Alveolar Osteitis; Impacted Tooth
MeSH terms: Osteitis; Tooth, Impacted; Dry Socket
Study type: Interventional

Summary: 
      The aim of this prospective study was to assess the effectiveness of concentrated growth
      factors (CGFs) in preventing the development of alveolar osteitis (AO) after the extraction
      of partially-erupted mandibular third molars.

      This study was designed as a randomized controlled clinical trial. In each case, one socket
      received CGFs and the other served as a control. The predictor variable was the CGFs
      application and the sides were categorized as 'CGFs' and 'non-CGFs'. The outcome variable was
      the development of AO during the first postoperative week. Also, demographic variable
      included age and gender was noted.
    

Detailed description: 
      The investigators designed and implemented a randomized single-blind clinical
      trial.Randomization was performed by simple coin toss to select the side of CGFs fibrin gel
      placement before the commencement of third molar surgery. In this way, the sides in each
      patient were randomly divided into 2 study groups:

      Group I (test) - with CGFs placed in the extraction socket Group II (control) - without CGFs
      placement All operations were performed under local anesthesia by the same surgeon. An
      envelope flap was raised to provide access. Bone removal was done with the help of stainless
      steel burs. Constant irrigation with saline was used while removing bone to prevent thermal
      necrosis. Third molar was luxated with the help of straight elevator and then extracted with
      the help of third molar forceps. After extraction, any remains of the dental follicle were
      removed and the extraction sockets were irrigated with 60 mL of sterile saline. To prevent
      the flap laceration, bone contouring was also performed under sterile saline irrigation. CGFs
      fibrin gel was then randomly placed into one socket and the opposite side was considered as
      the control. Finally, wound closure was completed with silk suture.

      The primary outcome variable was AO, classified as present or absent.It is characterized by
      postoperative pain in and around the extraction side, which increases in severity within
      first week after the extraction, accompanied by a partially or totally disintegrated blood
      clot within the alveolar socket, with or without halitosis. Other defining symptoms that have
      been reported in the literature are radiating pain towards the temporal region and ear,
      inflamed gingival margin, ipsilateral regional lymphadenopathy and, less commonly, low-grade
      fever.
    

Intervention name(s): Concentrated Growth Factor (Test group); Non-Concentrated Growth Factor (Control group)
Intervention type(s): Procedure; Procedure
Intervention description(s): The patients' blood was collected in 9 ml glass tubes and immediately centrifuged to prevent coagulation in special centrifuge device. The CGF program was set up as follows: accelerated for 30 seconds so as to reach 2700 rpm, rotated for 2 minutes, then reduced to 2400 rpm, then rotated again for 4 minutes and accelerated to 2700 rpm, rotated for 4 minutes, then accelerated to 3000 rpm for 3 minutes, and decelerated for 36 seconds to stop. The middle layer in the tube was separated by the ''Buffy coat'' containing the CGFs fibrin gel using forceps and scissor. Then, this fibrin gel was inserted in the extraction cavity.; Third molar extraction was performed under local anesthesia. Following the extraction, the socket was sutured and natural healing process was observed. This side was considered as a control group.
Intervention MeSH terms: Mitogens
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Third molar surgery; Alveolar osteitis; Platelet concentrates