Ways to optimize well healing after complex removal of lower third teeth

Surgical removal of impacted or dystopic lower third molars is accompanied by damage to bone tissue and the mucous membrane, which can lead to pain, swelling, trismus, alveolitis, infectious complications, and delayed healing in the postoperative period. The choice of local and regenerative agents is complicated by the heterogeneity of the available data. The aim of the review was to compare methods for optimizing socket repair after complex removal, taking into account the strength of the evidence, clinical applicability, and limitations. Publications from 2010–2026, published in Elibrary and CyberLeninka, were analysed; an international search was carried out in PubMed/Medline, Cochrane Library and Web of Science. Antiseptic prevention of alveolitis and autologous platelet preparations were the most convincingly confirmed. Collagen-based materials can reduce early pain, but their effect on osteogenesis and the prevention of alveolitis is inconsistent. Platelet-rich fibrin is associated with a reduced incidence of alveolitis and pain in the early stages, although data on the recovery of soft tissues and bone are contradictory, and the quality of systematic reviews varies. Photobiomodulation, growth factor concentrates, hyaluronate, and bone-grafting materials can be used as supplements, but they require comparable studies with standardized criteria. There is no sufficient basis to claim that any single or combined method, including the combination of a collagen carrier with an antibacterial agent or plasma technologies, is universally superior; the treatment strategy should be determined by the therapeutic objective and the individual risk of complications.