Healing of Mandibular Third Molar Extraction Sockets Using Platelet Concentrates and Photobiomodulation

NCT07324213 | Completed

• 1 other identifier: KB7052019-UMW
• Study Type: interventional
• Target: 122
• Locations: 1 country
• Sites: 1

Brief Summary

Surgical removal of impacted mandibular third molars is a common procedure that may be associated with postoperative pain, swelling, limited mouth opening, and delayed bone healing. Various regenerative techniques are used to improve healing outcomes after tooth extraction. This study evaluated whether autologous platelet concentrates (advanced platelet-rich fibrin \[A-PRF+\] and concentrated growth factors \[CGF\]) and photobiomodulation using low-level laser therapy can improve healing after mandibular third molar extraction. Participants requiring surgical removal of a mandibular third molar were randomly assigned to one of six treatment groups. Depending on the group, patients received standard wound closure alone, photobiomodulation, placement of autologous platelet concentrates into the extraction socket, or a combination of platelet concentrates and photobiomodulation. Postoperative pain, swelling, mouth opening, and early wound healing were assessed during the first postoperative week. Bone regeneration within the extraction socket was evaluated using radiological imaging several months after surgery. All procedures used in this study are commonly applied in clinical practice and are considered safe. The results of this study may help identify the most effective approach to improve healing and reduce postoperative discomfort following mandibular third molar extraction.

Conditions

Impacted Mandibular Third Molar; Alveolar Bone Loss; Impacted Mandibular Third Molar Extraction

Keywords

Mandibular third molar extraction,; Platelet-rich fibrin,; Concentrated growth factors,; Fractal dimension analysis; Low-level laser therapy,; Photobiomodulation,; Bone regeneration,

Outcome Measures

Primary Outcomes (2)

• Postoperative Pain Intensity

  Postoperative pain intensity was assessed using a visual analogue scale (VAS) ranging from 1 to 10, where 1 indicates no pain and 10 indicates the worst pain imaginable.

  1 day, 3 days, and 7 days after surgery

• Alveolar Bone Regeneration

  Bone regeneration within the post-extraction socket assessed using cone-beam computed tomography-based fractal dimension analysis.

  4 months after surgery

Secondary Outcomes (3)

• Postoperative Swelling

  1 day, 3 days, and 7 days after surgery

• Postoperative Trismus

  1 day, 3 days, and 7 days after surgery

• Early Wound Healing

  7 days after surgery

Study Arms (6)

Control - Standard Extraction

OTHER

Participants underwent surgical extraction of an impacted mandibular third molar followed by standard primary wound closure without the use of platelet concentrates or photobiomodulation.

Procedure: Mandibular Third Molar Extraction With Primary Wound Closure

Photobiomodulation

OTHER

Participants underwent surgical extraction of an impacted mandibular third molar followed by primary wound closure and photobiomodulation using low-level laser therapy applied immediately after surgery and during follow-up visits.

Procedure: Mandibular Third Molar Extraction With Primary Wound Closure; Other: Photobiomodulation

A-PRF+

OTHER

Participants underwent surgical extraction of an impacted mandibular third molar followed by placement of autologous advanced platelet-rich fibrin (A-PRF+) into the extraction socket prior to primary wound closure.

Procedure: Mandibular Third Molar Extraction With Primary Wound Closure; Biological: Autologous Platelet Concentrates

CGF

OTHER

Participants underwent surgical extraction of an impacted mandibular third molar followed by placement of autologous concentrated growth factors (CGF) into the extraction socket prior to primary wound closure.

Procedure: Mandibular Third Molar Extraction With Primary Wound Closure; Biological: Autologous Platelet Concentrates

A-PRF+ Plus Photobiomodulation

OTHER

Participants underwent surgical extraction of an impacted mandibular third molar followed by placement of autologous advanced platelet-rich fibrin (A-PRF+) into the extraction socket and adjunctive photobiomodulation using low-level laser therapy.

Procedure: Mandibular Third Molar Extraction With Primary Wound Closure; Biological: Autologous Platelet Concentrates; Other: Photobiomodulation

CGF Plus Photobiomodulation

OTHER

Participants underwent surgical extraction of an impacted mandibular third molar followed by placement of autologous concentrated growth factors (CGF) into the extraction socket and adjunctive photobiomodulation using low-level laser therapy.

Procedure: Mandibular Third Molar Extraction With Primary Wound Closure; Biological: Autologous Platelet Concentrates; Other: Photobiomodulation

Interventions

Mandibular Third Molar Extraction With Primary Wound Closure PROCEDURE

Surgical extraction of a partially or fully impacted mandibular third molar performed under standardized clinical conditions, followed by primary wound closure with sutures. This procedure was applied in all study arms.

A-PRF+; A-PRF+ Plus Photobiomodulation; CGF; CGF Plus Photobiomodulation; Control - Standard Extraction; Photobiomodulation

Autologous Platelet Concentrates BIOLOGICAL

Autologous platelet concentrates prepared from the participant's peripheral blood and placed into the extraction socket prior to primary wound closure. Advanced platelet-rich fibrin (A-PRF+) and concentrated growth factors (CGF) were obtained using standardized centrifugation protocols and used according to the allocated study arm.

Also known as: Advanced Platelet-Rich Fibrin (A-PRF+), Concentrated Growth Factors (CGF)

A-PRF+; A-PRF+ Plus Photobiomodulation; CGF; CGF Plus Photobiomodulation

Photobiomodulation OTHER

Adjunctive photobiomodulation performed using low-level laser therapy applied to the extraction site. The intervention was delivered immediately after surgery and during follow-up visits according to the study protocol.

A-PRF+ Plus Photobiomodulation; CGF Plus Photobiomodulation; Photobiomodulation

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Adults aged 18 to 40 years.
• Indication for surgical extraction of a partially or fully impacted mandibular third molar.
• Generally healthy individuals without systemic diseases.
• Ability to provide written informed consent.
• Willingness to attend scheduled follow-up visits.

You may not qualify if:

• Presence of systemic diseases or metabolic disorders.
• Pregnancy or breastfeeding.
• Smoking.
• Recent antibiotic therapy.
• Poor oral hygiene.
• Exceptionally difficult tooth position.
• Surgical procedure exceeding the expected duration.
• Inability to achieve primary wound closure.
• Failure to comply with follow-up visits.

Sponsors & Collaborators

• Medical Innovation Center Wroclaw: lead
• Wrocław Medical University: collaborator

Study Sites (1)

Medyczne Centrum Innowacji Wrocław Sp. z o.o.

Wroclaw, Poland

Location

MeSH Terms

Conditions

Alveolar Bone Loss

Interventions

Low-Level Light Therapy

Condition Hierarchy (Ancestors)

Bone Resorption; Bone Diseases; Musculoskeletal Diseases; Periodontal Atrophy; Periodontal Diseases; Mouth Diseases; Stomatognathic Diseases

Intervention Hierarchy (Ancestors)

Laser Therapy; Therapeutics; Phototherapy

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Participants were not informed about the type of regenerative intervention applied. Due to the nature of the surgical procedures, care providers and investigators were not masked.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor, PhD, DSc (Med.), Specialist in Oral Surgery

Model Details: Participants were randomly assigned to one of six parallel intervention groups and received only the intervention allocated to their study arm.

Study Record Dates

• First Submitted: December 23, 2025
• First Posted: January 7, 2026
• Study Start: January 2, 2020
• Primary Completion: December 20, 2023
• Study Completion: December 20, 2024
• Last Updated: January 21, 2026

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

PL (1)