Non-Cochrane · intervention · PM41398928
Efficacy and Safety of Regenerative Periodontal Therapy on Recovery After Surgical Removal of Impacted Third Molars: A Systematic Review and Meta-Analysis.
Ou Xueping, Ma Shaofei · Oral diseases · 2026 · PubMed · doi:10.1111/odi.70150
Findings
Population Patients undergoing surgical removal of impacted third molars
17 findings
| Regenerative periodontal therapy (any modality) | Conventional treatment or spontaneous healing | Adverse events | OR 0.64 [0.34, 1.19] Moderate Downgraded: inconsistency, publication bias 22 studies |
| Regenerative periodontal therapy (any modality) | Conventional treatment or spontaneous healing | Probing depth (PD) reduction | MD 1.13 [0.48, 1.79] Moderate Downgraded: inconsistency 15 studies |
| Regenerative periodontal therapy (any modality) | Conventional treatment or spontaneous healing | Alveolar bone level (ABL) gain | MD 1.31 [0.62, 2.01] Moderate Downgraded: inconsistency 8 studies |
| Regenerative periodontal therapy (any modality) | Conventional treatment or spontaneous healing | Clinical attachment level (CAL) gain | MD 1.69 [1.13, 2.25] Moderate Downgraded: inconsistency 11 studies |
| Guided tissue regeneration (GTR) | Conventional treatment or spontaneous healing | Alveolar bone level (ABL) gain GTR | MD 1.13 [0.21, 2.06] GRADE not reported 5 studies |
| Guided tissue regeneration (GTR) | Conventional treatment or spontaneous healing | Clinical attachment level (CAL) gain GTR | MD 1.61 [0.45, 2.78] GRADE not reported 4 studies |
| Guided tissue regeneration (GTR) | Conventional treatment or spontaneous healing | Adverse events GTR | OR 0.92 [0.33, 2.63] GRADE not reported 11 studies |
| Guided tissue regeneration (GTR) | Conventional treatment or spontaneous healing | Probing depth (PD) reduction GTR | MD 1.22 [0.18, 2.26] GRADE not reported 7 studies |
| Guided bone regeneration (GBR) | Conventional treatment or spontaneous healing | Clinical attachment level (CAL) gain GBR | MD 2.19 [1.31, 3.07] GRADE not reported 2 studies |
| Guided bone regeneration (GBR) | Conventional treatment or spontaneous healing | Probing depth (PD) reduction GBR | MD 1.5 [1.02, 1.98] GRADE not reported 1 study |
| Guided bone regeneration (GBR) | Conventional treatment or spontaneous healing | Alveolar bone level (ABL) gain GBR | MD 2.4 [2.17, 2.63] GRADE not reported 1 study |
| Osseous grafting | Conventional treatment or spontaneous healing | Alveolar bone level (ABL) gain Osseous grafting | MD 1.07 [-0.72, 2.87] GRADE not reported 2 studies |
| Osseous grafting | Conventional treatment or spontaneous healing | Clinical attachment level (CAL) gain Osseous grafting | MD 0.89 [0.19, 1.6] GRADE not reported 2 studies |
| Osseous grafting | Conventional treatment or spontaneous healing | Adverse events Osseous grafting | OR 6.87 [1.13, 41.64] GRADE not reported 3 studies |
| Platelet-rich preparations (PRP) | Conventional treatment or spontaneous healing | Probing depth (PD) reduction PRP | MD 0.99 [-0.01, 1.99] GRADE not reported 7 studies |
| Platelet-rich preparations (PRP) | Conventional treatment or spontaneous healing | Adverse events PRP | OR 0.31 [0.18, 0.55] GRADE not reported 8 studies |
| Platelet-rich preparations (PRP) | Conventional treatment or spontaneous healing | Clinical attachment level (CAL) gain PRP | MD 1.65 [-0.44, 3.73] GRADE not reported 3 studies |
Included primary studies 32
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Asutay 2017 An evaluation of effects of platelet-rich-fibrin on postoperative morbidities after lower third molar surgery. PMID:29378982 | 2017 | 1 other review | Adverse events | not extracted yet |
| Daugela 2018 Influence of leukocyte- and platelet-rich fibrin (L-PRF) on the outcomes of impacted mandibular third molar removal surgery: A split-mouth… PMID:29629438 | 2018 | 1 other review | Adverse events | not extracted yet |
| Elayah 2022 Effect of concentrated growth factor (CGF) on postoperative sequel of completely impacted lower third molar extraction: a randomized… PMID:36042448 | 2022 | 1 other review | Adverse events | not extracted yet |
| Eshghpour 2014 Effect of platelet-rich fibrin on frequency of alveolar osteitis following mandibular third molar surgery: a double-blinded randomized… PMID:25037182 | 2014 | 1 other review | Adverse events | not extracted yet |
| Fang 2022 Efficacy and Safety of Concentrated Growth Factor Fibrin on the Extraction of Mandibular Third Molars: A Prospective, Randomized,… PMID:34801470 | 2022 | 1 other review | Adverse events | not extracted yet |
| Iqbal 2023 Assessment of Dry Socket after Mandibular Third Molar Surgery Using Platelet-Rich Fibrin - A Prospective Clinical Study. PMID:37190682 | 2023 | 1 other review | Adverse events | not extracted yet |
| Ozveri Koyuncu 2020 Effect of concentrated growth factor (CGF) on short-term clinical outcomes after partially impacted mandibular third molar surgery: A… PMID:31299343 | 2020 | 1 other review | Adverse events | not extracted yet |
| Unsal 2018 Evaluation of the Effect of Platelet-Rich Fibrin on the Alveolar Osteitis Incidence and Periodontal Probing Depth after Extracting… PMID:29465055 | 2018 | 1 other review | Adverse events | not extracted yet |
| Aimetti 2007 Clinical and radiographic evaluation of the effects of guided tissue regeneration using resorbable membranes after extraction of impacted… PMID:17370662 | 2007 | this review only | Clinical attachment level (CAL) gain; Probing depth (PD) reduction; Alveolar bone level (ABL) gain | not extracted yet |
| Andrade Munhoz 2011 Bone crestal height and bone density after third-molar extraction and grafting: a long-term follow-up study. PMID:20440633 | 2011 | this review only | Alveolar bone level (ABL) gain; Adverse events | not extracted yet |
| Cortell-Ballester 2015 Effects of Collagen Resorbable Membrane Placement After the Surgical Extraction of Impacted Lower Third Molars. PMID:25959878 | 2015 | this review only | Clinical attachment level (CAL) gain; Probing depth (PD) reduction; Alveolar bone level (ABL) gain; Adverse events | not extracted yet |
| Dodson 1996 Reconstruction of alveolar bone defects after extraction of mandibular third molars: a pilot study. PMID:8884819 | 1996 | this review only | Clinical attachment level (CAL) gain; Adverse events | not extracted yet |
| Dodson 2004 Management of mandibular third molar extraction sites to prevent periodontal defects. PMID:15452808 | 2004 | this review only | Clinical attachment level (CAL) gain; Probing depth (PD) reduction; Adverse events | not extracted yet |
| Gasparro 2020 Treatment of periodontal pockets at the distal aspect of mandibular second molar after surgical removal of impacted third molar and… PMID:32020130 | 2020 | this review only | Clinical attachment level (CAL) gain; Probing depth (PD) reduction | not extracted yet |
| Ge 2017 Autogenous bone grafting for treatment of osseous defect after impacted mandibular third molar extraction: A randomized controlled trial. PMID:27933720 | 2017 | this review only | Alveolar bone level (ABL) gain; Adverse events | not extracted yet |
| Hassan 2012 Does grafting of third molar extraction sockets enhance periodontal measures in 30- to 35-year-old patients? PMID:22177808 | 2012 | this review only | Clinical attachment level (CAL) gain; Probing depth (PD) reduction; Alveolar bone level (ABL) gain | not extracted yet |
| Karapataki 2000 Healing following GTR treatment of bone defects distal to mandibular 2nd molars after surgical removal of impacted 3rd molars. PMID:10847536 | 2000 | this review only | Alveolar bone level (ABL) gain; Adverse events | not extracted yet |
| Kilinc 2017 How effective is collagen resorbable membrane placement after partially impacted mandibular third molar surgery on postoperative… PMID:28982352 | 2017 | this review only | Adverse events | not extracted yet |
| Kim 2020 Randomized controlled trial on the effectiveness of absorbable collagen sponge after extraction of impacted mandibular third molar:… PMID:32183831 | 2020 | this review only | Probing depth (PD) reduction | not extracted yet |
| Kumar 2015 Evaluation of treatment outcome after impacted mandibular third molar surgery with the use of autologous platelet-rich fibrin: a… PMID:25659357 | 2015 | this review only | Probing depth (PD) reduction; Adverse events | not extracted yet |
| Moraes 2024 Impact of L-PRF on pain and healing outcomes in lower third molar surgery: a randomized split-mouth trial. PMID:39292127 | 2024 | this review only | Probing depth (PD) reduction | not extracted yet |
| O'Sullivan 2022 Effect of plasma rich in growth factors on quality of life following mandibular third molar removal: a double-blind randomized controlled… PMID:35184905 | 2022 | this review only | Adverse events | not extracted yet |
| Oxford 1997 Treatment of 3rd molar-induced periodontal defects with guided tissue regeneration. PMID:9226386 | 1997 | this review only | Adverse events | not extracted yet |
| Pecora 1993 matched by author and year (probable) | NR | this review only | Clinical attachment level (CAL) gain; Probing depth (PD) reduction; Adverse events | not extracted yet |
| Ruga 2011 Platelet-rich fibrin and piezoelectric surgery: a safe technique for the prevention of periodontal complications in third molar surgery. PMID:21959479 | 2011 | this review only | Probing depth (PD) reduction | not extracted yet |
| Sammartino 2005 Use of autologous platelet-rich plasma (PRP) in periodontal defect treatment after extraction of impacted mandibular third molars. PMID:15944972 | 2005 | this review only | Clinical attachment level (CAL) gain; Probing depth (PD) reduction | not extracted yet |
| Sammartino 2009 Prevention of mandibular third molar extraction-associated periodontal defects: a comparative study. PMID:19254122 | 2009 | this review only | Clinical attachment level (CAL) gain; Probing depth (PD) reduction | not extracted yet |
| Singh 2015 The effect of alloplastic bone graft and absorbable gelatin sponge in prevention of periodontal defects on the distal aspect of mandibular… PMID:25729233 | 2015 | this review only | Alveolar bone level (ABL) gain | not extracted yet |
| Sun 2023 A novel concentrated growth factor (CGF) and bio-oss based strategy for second molar protection after impacted mandibular third molar… PMID:37828455 | 2023 | this review only | Probing depth (PD) reduction | not extracted yet |
| Throndson 2002 Grafting mandibular third molar extraction sites: a comparison of bioactive glass to a nongrafted site. PMID:12374912 | 2002 | this review only | Clinical attachment level (CAL) gain; Alveolar bone level (ABL) gain; Adverse events | not extracted yet |
| Zahid 2019 Effect of Advanced Platelet-rich Fibrin on Wound Healing after Third Molar Extraction: A Split-mouth Randomized Double-blind Study. PMID:31883251 | 2019 | this review only | Clinical attachment level (CAL) gain; Probing depth (PD) reduction; Adverse events | not extracted yet |
| Zwittnig 2024 Effectiveness of platelet-rich fibrin in third molar extractions: a randomized controlled split-mouth study. PMID:39467892 | 2024 | this review only | Probing depth (PD) reduction; Adverse events | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Systemically healthy patients requiring impacted third molar extraction | Patients undergoing impacted third molar extraction (N=1300; 32 RCTs, 24 split-mouth and 8 parallel) |
| Intervention | Regenerative periodontal therapy at the distal surface of the adjacent second molar or the extraction socket: GTR, PRP, GBR, osseous grafting or similar site-specific regenerative techniques | GTR membranes, GBR, osseous grafts, platelet concentrates (PRP, PRF, CGF) |
| Comparison | Standard treatment or spontaneous healing | Spontaneous healing, regular blood clot, or absorbable gelatin sponge |
| Outcomes | CAL gain, PD reduction, ABL gain at the distal surface of the second molar; incidence of adverse events at the extraction site | CAL gain (n=11 RCTs), PD reduction (n=15), ABL gain (n=8), adverse events (n=22) |
| Study designs | RCTs | RCTs (n=32) |
| Timing | Not specified | Short to medium follow-up; 87.5% up to 6 months, 12.5% 9 to 12 months |