CLINICAL APPLICATION OF AUTOLOGOUSPLATELET RICH PLASMA (P.R.P.) IN THEEXTRACTION OF THIRD IMPACTEDMANDIBULAR MOLAR

The impacted third molar surgery has various limits; one of these limit is the type of surgery applied, often demolitive for the patientswith long term consequeses in the post-op period. Aim of our study is to get a better healing of soft and hard tissues with theapplications of PRP in this type of surgery. 5 patients were included in the study with these requests: the impacted or semiimpacted third molar were on both side; the acceptance of PRP tecnique on one side (considered as the case) the extraction ofthe other impacted molar as the controll side to our case; both teeth were extracted on the same day, both sockets were closedby hermetically suturing the flap; on one socket it has been inserted the platelet gel on the other side nothing. Pre operativemesurements were: 1. probing depth of both the seventh (3.7-4.7); 2. ortopantomography (OPT). Post operative measurementsincluded: 1. probing depth two months after surgery; 2. OPT at one weeek, one month, two month.One week after surgery patiens were aked about the post-op through a questionary on the course of the week, in specific theywere asked to assess a score from one to three on swelling and pain of the two side. One week after a clinician who was out of thestudy (not the surgeon) evaluated the eventual bacterial sovrainfections, the dehicence of the flaps, the eventual collateral effectsgiven by the application of PRP giving a score from one to three to the type of healing. Periodontal healing was evaluated on bothside after 2 months after surgery in all the cases treated the initial P.D. was 2-3mms on both sides. It showed an improvement inthe sites treated with P.R.P. Swelling (perceived by the patients during the course of the fist week) was not reduced by theapplication of PRP gel, while there has been a reduction in the pain in comparison with the control side reffered by the patients.Clinical evaluation realized a week after the extractions showed a better healing on the PRP side vs the controll side (total score12 vs 8) where three patients from five realized a primary closure with no bacterial sovrainfection or dehiscence of the flap vs oneprimary closure on the controll side. Bone healing measured by digital OPT did not show a real improvement on PRP side after twomonths in the cases analyzed