Surgical removal of impacted mandibular third molars is often followed by postoperative sequelae like pain, swelling, trismus, etc. This systematic review explored the benefits of applying different autologous platelet concentrates (APCs) in the extraction socket of third molars. For this systematic review, PubMed, EMBASE, Web of Science, and Scopus have been utilized, initially yielding 544 papers. The search was narrowed to randomized controlled trials (RCTs, n = 59) published before 2024, all comparing the outcome of applying APCs in the extraction socket of surgically removed impacted mandibular third molars with unassisted healing (blood clot). Most RCTs primarily assessed the impact of APCs on postoperative sequelae. Some RCTs looked at soft‐ and hard‐tissue healing. Eleven studies used PRP, three PRGF, and 45 L‐PRF. A detailed analysis revealed a large heterogeneity between studies rendering a meta‐analysis impossible. Moreover, the risk of bias was considered high. In the majority of RCTs, the application of an APC resulted in statistically significant reductions of postoperative sequelae (lower pain intensity, lower consumption of analgesics, less postoperative edema, and a lower incidence of trismus and alveolar osteitis), as well as a faster soft tissue healing, and qualitatively and quantitatively better bone healing. A minority of studies reported significant differences in periodontal parameters distally from the second molar.

中文翻译：

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第三磨牙拔除后自体血小板浓缩物：系统评价


手术拔除下颌阻生第三磨牙通常会出现术后后遗症，如疼痛、肿胀、牙关紧闭等。本系统综述探讨了在第三磨牙拔牙槽中应用不同自体血小板浓缩物（APC）的好处。本次系统综述使用了 PubMed、EMBASE、Web of Science 和 Scopus，最初产生了 544 篇论文。搜索范围缩小到 2024 年之前发表的随机对照试验 (RCT，n = 59)，所有试验都比较了在手术切除的下颌阻生第三磨牙的拔牙槽中应用 APC 与独立愈合（血凝块）的结果。大多数随机对照试验主要评估 APC 对术后后遗症的影响。一些随机对照试验着眼于软组织和硬组织的愈合。 11 项研究使用了 PRP、3 项 PRGF 和 45 项 L-PRF。详细的分析显示研究之间存在很大的异质性，使得荟萃分析变得不可能。此外，偏倚风险被认为很高。在大多数随机对照试验中，APC 的应用在统计上显着减少了术后后遗症（疼痛强度降低、镇痛药用量减少、术后水肿减少、牙关紧闭和牙槽骨炎发生率降低），以及更快的软恢复。组织愈合，以及质量和数量上更好的骨愈合。少数研究报告第二磨牙远端牙周参数存在显着差异。