Long-term Assessment of Oral Health-Related Quality of Life Following Surgical Removal of Mandibular Third Molar with Advanced Platelet-rich Fibrin: a Single-blinded Randomized Controlled Trial

Objectives: The aim of this single-blinded randomized controlled trial was to test the hypothesis of no difference in long-term oral health-related quality of life following surgical removal of an impacted mandibular third molar with advanced platelet-rich fibrin (test) compared with natural socket healing (control). Material and Methods: Eighty patients were randomly allocated to test or control. Patient demographic, mouth opening, wound heling, and neurosensory function were assessed at enrolment (T0), 10 days (T1), 30 days (T2), and one-year (T3) after surgery. Oral health-related quality of life (OHRQoL) was evaluated by OHIP-14 and SF-36 questionnaires. Results: There was no statistically significant difference between test and control in patient demographic, mouth opening, and wound heling at T0-T3, as well as oral health impact profile-14 (OHIP-14) at T1, T2, and T3 (P = 0.35; P = 0.086; P = 0.19), or SF-36 at T3 (P = 0.85). OHIP-14 score was significantly higher at T1 compared with T0 in test and control (P < 0.001), indicating impaired OHRQoL immediately after surgical removal of an impacted mandibular third molar, whereas OHIP-14 score was significant lower in test and control at T3 compared with T0 (P < 0.001), indicating improved long-term OHRQoL. SF-36 score was significantly higher at T3 compared with T0 in control (P = 0.009), indicating improved OHRQoL, while test revealed no significant difference (P = 0.79). Conclusions: This study demonstrates that surgical removal of an impacted mandibular third molar is associated with long-term improvement in oral health-related quality of life. However, application of advanced platelet-rich fibrin in the extraction socket does not have a beneficial effect on oral health-related quality of life compared with natural socket healing.