Long-Term Socket Healing After Mandibular Third-Molar Extraction: Fractal Analysis and Clinical Parameters Comparing H-Prf and L-Prf

Nursena Ünlü Kuzu; Esengül Şen

doi:10.7126/cumudj.1819822

EN TR

Long-Term Socket Healing After Mandibular Third-Molar Extraction: Fractal Analysis and Clinical Parameters Comparing H-Prf and L-Prf

Abstract

Objectives: To compare horizontal platelet-rich fibrin (H-PRF) and leukocyte-rich PRF (L-PRF) with no-PRF on long-term socket bone structure and periodontal parameters 12–18 months after impacted mandibular third-molar extraction. Materials and Methods: This retrospective follow-up analyzed a previously randomized three-arm clinical cohort (n=45; 15 per group). Panoramic radiographs obtained 12–18 months post-extraction were assessed by fractal analysis at the extraction site. Periodontal probing depths at six sites around the adjacent second molar and buccal keratinized tissue width were recorded with a UNC-15 probe. Group differences were evaluated at α=0.05. Results: Mean fractal dimension (FD) differed among groups (H-PRF 1.32±0.05; L-PRF 1.28±0.04; Control 1.26±0.06; overall p=0.005). H-PRF showed higher FD than Control (mean difference 0.062; 95% CI 0.018–0.105; p=0.004), whereas H-PRF vs L-PRF was not significant (p=0.101) and L-PRF vs Control was not significant (p=0.396). Keratinized tissue width tended to be greater with H-PRF (1.70±1.10 mm) than Control (0.84±1.00 mm) without significance (p=0.093). Site-specific probing depths showed no between-group differences (lowest p=0.051). Intra-examiner reliability for measures was good-to-excellent (ICC=0.895; p<0.001). Conclusion: At 12–18 months, H-PRF yielded a higher socket FD than no-PRF, while differences versus L-PRF were not significant. Periodontal indices at the adjacent second molar were broadly comparable across groups.

Keywords

Supporting Institution

Tokat Gaziosmanpaşa University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery.

Project Number

none/no funfing

Ethical Statement

At its meeting dated 16.09.2025, our Ethics Committee reviewed your study titled “Long-Term Effects of Platelet-Rich Fibrin Applications in Mandibular Third-Molar Extraction Sockets: A Retrospective Study with Fractal Analysis and Clinical Parameters,” registered under number 25-MOBAEK-317, by considering its justification, objectives, approach, and methods, and found it appropriate. It was decided that there is no ethical or scientific objection to conducting the study at the center specified in the application file.

Thanks

The authors thank all participants and the clinical staff for their cooperation. No specific funding was received.

GÖMÜLÜ MANDİBULAR ÜÇÜNCÜ MOLAR ÇEKİMİ SONRASINDA UZUN DÖNEM SOKET İYİLEŞMESİ: H-PRF İLE L-PRF’NİN FRAKTAL ANALİZ VE KLİNİK GÖSTERGELER AÇISINDAN KARŞILAŞTIRILMASI

Abstract

Amaç: Gömülü mandibular üçüncü molar çekiminden 12–18 ay sonra yatay trombositten zengin fibrin (H-PRF) ile lökositten zengin PRF (L-PRF) uygulamalarını, PRF uygulanmayan kontrolle karşılaştırarak soket kemik yapısı ve periodontal parametreleri değerlendirmek. Gereç ve Yöntemler: Bu retrospektif takiple, daha önceden yapılmış olan üç kollu klinik prospektif bir kohort çalışmasının (n=45; her grupta 15) verilerini analiz ettik. Çekimden 12–18 ay sonra alınan panoramik radyograflarda, çekim bölgesinde fraktal analiz yapıldı. Komşu ikinci moların çevresindeki altı noktada periodontal sondalama derinlikleri ve bukkal keratinize doku genişliği UNC-15 sonda ile ölçüldü. Grup farkları α=0.05 düzeyinde değerlendirildi. Bulgular: Ortalama fraktal boyut (FB) gruplar arasında farklıydı (H-PRF 1,32±0,05; L-PRF 1,28±0,04; Kontrol 1,26±0,06; genel p=0,005). H-PRF, kontrole göre daha yüksek FB gösterdi (ort. fark 0,062; %95 GA 0,018–0,105; p=0,004); H-PRF ile L-PRF arasındaki fark anlamlı değildi (p=0,101) ve L-PRF ile kontrol arasındaki fark da anlamlı değildi (p=0,396). Keratinize doku genişliği H-PRF’de (1,70±1,10 mm) kontrole (0,84±1,00 mm) göre daha fazla olma eğilimindeydi ancak anlamlı değildi (p=0,093). Bölge-bazlı sondalama derinlikleri gruplar arasında farklılık göstermedi (en düşük p=0,051). Ölçümlerde gözlemci-içi güvenirlik iyi ile mükemmel arasındaydı (ICC=0.895; p<0.001). Sonuçlar: 12–18 ayda, H-PRF uygulaması PRF uygulanmayan kontrole kıyasla istatistiksel olarak daha yüksek FB ile ilişkiliydi; L-PRF’ye karşı fark ise anlamlı değildi. Komşu ikinci molardaki periodontal indeksler genel olarak gruplar arasında benzerlik göstermiştir.

Keywords

Supporting Institution

Tokat Gaziosmanpaşa Üniversitesi,Diş Hekimliği Fakültesi,Ağız, Diş ve Çene Cerrahisi bölümü

Project Number

none/no funfing

Ethical Statement

Etik Kurulumuzun 16.09.2025 tarihli toplantısında görüşülen 25-MOBAEK-317 kayıt numaralı "Mandibular Üçüncü Molar Çekim Soketlerinde Trombositten Zengin Fibrin Uygulamalarının Uzun Dönem Etkileri: Fraktal Analiz ve Klinik Parametrelerle Retrospektif Çalışma" başlıklı çalışmanız gerekçe, amaç, yaklaşım ve yöntemleri dikkate alınarak incelenmiş ve uygun bulunmuş olup, çalışmanın başvuru dosyasında belirtilen merkezde gerçekleştirilmesinde etik ve bilimsel sakınca bulunmadığına karar verilmiştir.

Thanks

Yazarlar, tüm katılımcılara ve klinik ekibine iş birlikleri için teşekkür eder. Çalışma için özel bir fon alınmamıştır.

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Details

Primary Language

English

Subjects

Oral and Maxillofacial Surgery

Journal Section

Research Article

Authors

Nursena Ünlü Kuzu ^*
0009-0004-7565-5885
Türkiye

Esengül Şen
0000-0001-9273-0235
Türkiye

Publication Date

July 1, 2026

Submission Date

November 8, 2025

Acceptance Date

February 23, 2026

Published in Issue

Year 2026 Volume: 29 Number: 2

DOI

https://doi.org/10.7126/cumudj.1819822

IZ

https://izlik.org/JA66UP42YZ

Cite

RIS / Bibtex

APA

Ünlü Kuzu, N., & Şen, E. (2026). Long-Term Socket Healing After Mandibular Third-Molar Extraction: Fractal Analysis and Clinical Parameters Comparing H-Prf and L-Prf. Cumhuriyet Dental Journal, 29(2), 280-286. https://doi.org/10.7126/cumudj.1819822

AMA

1.Ünlü Kuzu N, Şen E. Long-Term Socket Healing After Mandibular Third-Molar Extraction: Fractal Analysis and Clinical Parameters Comparing H-Prf and L-Prf. Cumhuriyet Dent J. 2026;29(2):280-286. doi:10.7126/cumudj.1819822

Chicago

Ünlü Kuzu, Nursena, and Esengül Şen. 2026. “Long-Term Socket Healing After Mandibular Third-Molar Extraction: Fractal Analysis and Clinical Parameters Comparing H-Prf and L-Prf”. Cumhuriyet Dental Journal 29 (2): 280-86. https://doi.org/10.7126/cumudj.1819822.

EndNote

Ünlü Kuzu N, Şen E (July 1, 2026) Long-Term Socket Healing After Mandibular Third-Molar Extraction: Fractal Analysis and Clinical Parameters Comparing H-Prf and L-Prf. Cumhuriyet Dental Journal 29 2 280–286.

IEEE

[1]N. Ünlü Kuzu and E. Şen, “Long-Term Socket Healing After Mandibular Third-Molar Extraction: Fractal Analysis and Clinical Parameters Comparing H-Prf and L-Prf”, Cumhuriyet Dent J, vol. 29, no. 2, pp. 280–286, July 2026, doi: 10.7126/cumudj.1819822.

ISNAD

Ünlü Kuzu, Nursena - Şen, Esengül. “Long-Term Socket Healing After Mandibular Third-Molar Extraction: Fractal Analysis and Clinical Parameters Comparing H-Prf and L-Prf”. Cumhuriyet Dental Journal 29/2 (July 1, 2026): 280-286. https://doi.org/10.7126/cumudj.1819822.

JAMA

1.Ünlü Kuzu N, Şen E. Long-Term Socket Healing After Mandibular Third-Molar Extraction: Fractal Analysis and Clinical Parameters Comparing H-Prf and L-Prf. Cumhuriyet Dent J. 2026;29:280–286.

MLA

Ünlü Kuzu, Nursena, and Esengül Şen. “Long-Term Socket Healing After Mandibular Third-Molar Extraction: Fractal Analysis and Clinical Parameters Comparing H-Prf and L-Prf”. Cumhuriyet Dental Journal, vol. 29, no. 2, July 2026, pp. 280-6, doi:10.7126/cumudj.1819822.

Vancouver

1.Nursena Ünlü Kuzu, Esengül Şen. Long-Term Socket Healing After Mandibular Third-Molar Extraction: Fractal Analysis and Clinical Parameters Comparing H-Prf and L-Prf. Cumhuriyet Dent J. 2026 Jul. 1;29(2):280-6. doi:10.7126/cumudj.1819822