Prevention of Mandibular Third Molar Extraction- Associated Periodontal Defects Using Platelet-Rich Fibrin
Condition: Periodontal; Lesion; Periodontal Pocket; Molar, Third
MeSH terms: Periodontal Pocket
Study type: Interventional

Summary: 
      The extraction of deep impacted mandibular third molar may cause periodontal defects at the
      distal root of the second molar. The aim of this study was to evaluate the ability of
      platelet-rich fibrin (PRF) in preventing periodontal complications at the distal root of the
      second molar adjacent to the extracted third molar.
    

Detailed description: 
      Eighteen young patients with bilateral impacted mandibular third molars will be selected. All
      36 cases of impactions will be selected for a split mouth study and randomly treated by using
      2 different therapeutic approaches, thereby yielding 2 different study groups, each of which
      is composed of 18 cases: in one side the post-extraction socket is left healing
      spontaneously, on the other side the socket is filled with PRF.

      CAL at the distal surface of the lower second molar is chosen as primary outcome.

      Criteria will be the presence of a pocket distal to the mandibular second molar with a
      probing depth >7 mm and a probing clinical attachment level >6mm.

      This study was designed as a single-blind research since subjects will be unaware of their
      treatment allocation. A software will be used to produce a random sequence of 18 integer
      numbers without duplicates generated from atmospheric noise and concealed in closed envelopes
      by one of the investigators. At the time of the patient's first surgery, the envelope will be
      opened and patient allocated either to group 1 (PRF on the right side, spontaneous healing on
      the left side), for allocation numbers 1-9, or group 2 (spontaneous healing on the right
      side, PRF on the left side), for allocation numbers 10-18.

      One clinician, not involved in patient treatment and not aware of what therapeutic approach
      used for the different sites of treatment, will perform all clinical measurements (PD, CAL,
      gingival recession, plaque index and gingival bleeding index) before and after 12 and 18
      weeks of surgery.

      Clinical and radiographical measurements will be recorded at 12 and 18 weeks after the
      surgery. The Student t test will be used to compare the differences between the 2 groups.
    

Intervention name(s): extraction of mandibular third molar
Intervention type(s): Procedure
Intervention description(s): After loco-regional anesthesia was administered, a full-thickness mucoperiosteal flap was raised. The flap incision was extended from the vestibular side of the retromolar trigon to the second molar, corresponding to its distolingual cusp. The incision continued intrasulcular at the second molar and proceeded with a release incision distally to the papilla between the first and second molars, on a 45° angle. An osteotomy using a Lindemann burr under constant irrigation, followed by an odontotomy using a diamond burr was performed, if necessary
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: Molar, Third; Platelet-Rich Fibrin