Clinical and Biochemical Evaluation of The Use of Alb-PRF Versus L-PRF in Mandibular Third Molar Extractions: a Split-Mouth Randomized Clinical Trial

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Abstract
Objective This study compares the performance of L-PRF and a new activated plasma albumin gel, Alb-PRF. Materials and Methods In a controlled, split-mouth study involving ten volunteers, twenty extracted molars were treated with either Alb-PRF (Group 1) or L-PRF (Group 2). Post-extraction, pain, trismus (jaw muscle spasm), infection presence, and swelling were evaluated after one and seven days using the Visual Analogue Scale (VAS) for pain, a trismus measurement method, and Gabka and Matsumura's swelling analysis method. Infection presence was based on any detected suppuration. The concentrations of different analytes in the surgical sites were also examined. The data were statistically analyzed with significance defined at p < 0.05 (t-test). Results No significant difference was noted between the groups for pain and trismus, but Alb-PRF showed a significant reduction in swelling on day seven. Interleukin-1 beta (IL-1b) was significantly different between groups. The Alb-PRF group showed lower levels of proinflammatory cytokines (GM-CSF, IL-1b, IL-6, IFNy, IL-8, IL-15, RANTES, and MIP-1a) after seven days, with only higher expressions of MIP-1b, IL-1b, and MCP-1 found in the L-PRF group. Conclusion Differences were observed in the release of analytes between L-PRF and Alb-PRF, with Alb-PRF significantly reducing edema after seven days. Clinical Relevance: In the first clinical trial using denatured albumin combined with PRF, the results showed that Alb-PRF had better outcomes in reducing swelling and improving post-operative recovery compared to L-PRF. This makes it a promising alternative for dental procedures that require invasive methods.

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