The purpose of the study was to evaluate the clinical efficacy of applying platelet-rich fibrin (A-PRF+®) and its compositions for substitution of post-extraction sockets after atypical removal of the lower third molars. Material and methods. 26 patients (14 women and 12 men aged 17-49 years) were examined and treated with retention and dystopia, caries complications, and “wisdom teeth” pericoronitis. The course of the postoperative period in patients after atypical “wisdom teeth” removal was studied by establishing the duration and level of pain, local thermometry, evaluation of dental health and quality of life of patients, timing of complete epithelialization of the wound and removal of sutures. Additionally, CT scans were performed on a cone-beam computed tomograph "Veraviewepocs 3D R100" (J. Morita Manufacturing Corporation, Japan) for assessment of dimensional changes of alveolar processes, bone tissue volume and bone density in the defect area using i-Dixel 2.1 tomography viewer software. Results and discussion. Intraoperative use of A-PRF+® and its compositions after atypical removal of the lower third molars significantly reduced the duration and intensity of pain, the period of local hyperthermia, stimulated wound epithelization, which ultimately had a positive effect on subjective assessment of dental health and quality of life of patients. Inflammatory complications weren't detected in patients of the basic groups, while in 1 (16.6%) patients of the control group “dry socket” syndrome with subsequent development of acute alveolitis was observed. After 6 months of observation, we noted the decrease in the distance between the occlusal plane and the level of the bone behind the second molar. Accordingly, the bone growth compared to baseline preoperative measurements was 22.4% in patients of the main group A, 27.5% in patients of the main group B, 29.2% in patients of the main group C against 12.9% in the patients of the control group. The level of horizontal atrophy of alveolar processes in this period compared with baseline measurements was 10.1% in patients of the main group A, 6.2% in patients of the main group B, 5.0% in patients of the main group C against 21.2% in patients of the control group. Indicators of bone density at the end of the observation period were recorded at 559.16 ± 31.01 units HU in patients of the main group A, 619.62±31.53 units HU in patients of the main group B, 652.70±48.41 units HU in patients of the main group C, reaching the level of bone density of adjacent areas, while this figure in patients of the control group was only 381.38±35.58 units HU and did not reach the level of mineral density of neighboring bone massifs. Conclusion. The results of the clinical study indicated that intraoperative use of A-PRF+® and its compositions had positive effect on the postoperative period flow, reduced the level of vertical and horizontal atrophy and prevented alveolitis and other inflammatory complications after atypical removal of the lower third molars.

Keywords: advanced platelet rich fibrin (A-PRF), “wisdom teeth”, retention, dystopia

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