Postoperative effects of dexamethasone-enriched platelet-rich fibrin in mandibular third molar surgery: A randomized split-mouth study

Background: The extraction of third molars often results in postoperative inflammation, characterized by pain, swelling, and trismus, which can significantly impact patients’ daily functioning and comfort. Aim: This research sought to investigate whether platelet-rich fibrin (PRF) prepared from blood enriched with dexamethasone could improve postoperative outcomes. Materials and Methods: This single-center, randomized, controlled, split-mouth clinical trial included 16 individuals presenting with bilaterally impacted mandibular third molars. In each patient, one extraction socket was treated with conventional PRF, whereas the opposite socket received PRF derived from dexamethasone-supplemented blood. Pain intensity, measured through Visual Analog Scale (VAS), along with analgesic use, was assessed at 24, 48, and 72 h postoperatively. Edema and trismus were evaluated on postoperative days 1, 3, and 7. Data were processed using SPSS version 22.0. Depending on variable distribution, either the independent samples t -test or the Mann–Whitney U- test was applied, with significance set at P < 0.05. Results: The test group showed significantly reduced cumulative VAS pain scores at 24, 48, and 72 h (24 h: P =0.001, 48 h: P =0.002, 72 h: P =0.006) and lower analgesic consumption at 48 h ( P = 0.017) compared to the control group. No statistically significant differences were detected in trismus (T0: P =0.545, T1: P =0.543, T2: P =0.918, T3: P =0.963) or edema measurements (T0: P =0.985, T1: P =0.392, T2: P =0.428, T3: P =0.747). Conclusion: Incorporating dexamethasone into PRF appears to enhance postoperative pain management and reduce analgesic requirements more effectively than standard PRF.