***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE The surgical removal of m and ibular third molars is frequently accompanied by significant postsurgical sequelae , and different protocol s have been described to decrease such adverse events . The aim of this study was to investigate the performance of piezosurgery compared with traditional rotating instruments during m and ibular third molar removal . PATIENTS AND METHODS A single-center , r and omized , split-mouth study was performed using a consecutive series of unrelated healthy patients attending the Oral Surgery Unit of the University of Turin for surgical removal of bilateral m and ibular third molar teeth . Each patient was treated , at the same appointment , using bur removal on 1 side of the m and ible and a piezoelectric device on the contralateral side . The primary outcomes reported were postoperative pain , objective orofacial swelling , and surgical duration ; secondary outcomes were gender , age , and possible adverse events . Analysis of variance or paired t test was used as appropriate to test any significant differences at baseline according to each treatment subgroup , and categorical variables were analyzed by χ(2 ) test . RESULTS The study sample consisted of 100 otherwise healthy patients . The mean pain evaluation reported by patients who underwent surgery with piezosurgery was significantly lower than that reported after bur ( conventional ) removal , reaching statistical difference after 4 days ( P = .043 ) . The clinical value of orofacial swelling at day 7 , normalized to baseline , was lower in the piezosurgery group ( P < .005 ) . The average surgical duration was significantly shorter in the bur group than in the piezosurgery group ( P < .05 ) . Three patients having bur removal developed short-term complications ( 2 dry sockets and 1 temporary paraesthesia ) , which totally resolved by 4 weeks . CONCLUSIONS To date , this prospect i ve investigation is the largest reported split-mouth study on piezosurgery for lower third molar tooth removal . This study also compared surgeons with different degrees of experience . It is evident that using a piezoelectric device can enhance the patient experience and decrease postoperative pain and swelling Objective : The aim of this study was to determine whether the use of platelet rich fibrin ( PRF ) improved the healing of extraction sockets .  Study Design : A total of 20 patients with bilateral soft tissue impacted m and ibular third molars were included in this study . The left and right third molars were extracted during the same session . Subsequently , the PRF membrane was r and omly administered to one of the extraction sockets , whereas the contra lateral sockets were left without treatment . On postoperative 30 . and 90 . days , panoramic images and bone scintigrams were taken to evaluate the bone healing between PRF-treated and non-PRF-treated sockets . Also , periodontal evaluation was performed in the same control sessions . Dependent group t test for paired sample s was used for statistical analysis . Results : The average increase in technetium-99 m methylene diphosphonate uptake as an indication of enhanced bone healing did not differ significantly between PRF-treated and non-PRF-treated sockets 30 and 90 days post operatively . Radio opacity that can show the bone healing on panoramic images were measured by Image J programmer and they did not differ significantly . Also periodontal values did not differ significantly . Conclusions : PRF might not lead to enhanced bone healing in impacted m and ibular third molar extraction sockets 30 and 90 days after surgery . It is thought that PRF has the potential characteristics of an autologous fibrin matrix and can accelerate the healing . To better underst and the effects of PRF on healing , further research is warranted with larger sample sizes . Key words : PRF , scintigraphy , healing , extraction sockets Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more PURPOSE The purpose of this study was to investigate and compare , in a r and omized and controlled clinical trial , the use of ultrasound bone surgery devices and the use of rotary instruments in lower third molar extraction s. MATERIAL S AND METHODS We selected 26 patients ( 12 women and 14 men ) for this study ; the mean age was 31.2 years ( range , 24 - 45 years ) . A r and omized clinical trial was planned . Patients in the control group received treatment with the conventional rotary instruments ; patients in the test group received treatment with the ultrasound bone surgery tools . Twenty-six third molars were allocated to the test and control groups according to a computer-generated r and omization list . All the surgical procedures were performed by the same surgeon . Pain , trismus , cheek swelling , and number of analgesics taken were evaluated at baseline ( before surgery ) and at the first- , third- , fifth- , and seventh-day visits . RESULTS Pain levels ( evaluated on a visual analog scale ) were higher in the control group when compared with the ultrasonic group ; however , no statistically significant differences were found . On the contrary , the number of analgesics taken in the test group was significantly lower when compared with the control group . The occurrence of trismus was significantly higher in the control group when compared with the test group . The clinical values of cheek swelling were higher in the rotary group when compared with the ultrasound group at the fifth-day visit . CONCLUSION This study showed that the use of ultrasound bone surgery for third molar extraction significantly reduced the occurrence of postsurgical trismus , the occurrence of swelling , and the number of analgesics taken after surgery The aim of this prospect i ve r and omised study was to assess the effects of tube drainage on postoperative discomfort after the extraction of impacted m and ibular third molars . We studied 40 patients ( 11 men and 29 women ) 18 years or older ( mean ( SD ) 21 ( 3 ) , range 18 - 29 ) who required extraction of m and ibular third molars . We used a r and omised crossover design by which if a drain was inserted on one side , then the other side was managed without a drain on a later occasion . Pain , swelling , and mouth opening were evaluated after 48 h and 7 days postoperatively in both groups . Facial swelling ( p=0.001 ) , pain p=0.001 ) , and trismus ( p=0.001 ) were significantly less common in the drained group compared with those not drained . We conclude that the use a tube drain is of benefit in minimising postoperative swelling , pain , and trismus after extraction of m and ibular third molars Aim : The purpose of this study was to compare the efficacy of platelet-rich plasma ( PRP ) , platelet-rich fibrin ( PRF ) , and hydroxyapatite ( HA ) for reduction of pain and swelling , absence of dry socket , soft tissue healing , and bone regeneration after m and ibular third molar extraction in human patients . Material s and Methods : Forty patients requiring extraction of m and ibular third molars were r and omly grouped as control , PRP , PRF , and HA-treated . The patients were assessed for postoperative pain , swelling , dry socket , and soft tissue healing on the 3rd , 7th , and 14th day of postoperative periods depending on the st and ard methods . Radiological assessment of the extraction site was done at 1 , 2 , and 6 months interval to compare the change in bone density in the sockets in control and treated patients . Results : Pain and swelling were less on PRP and PRF site when compared to HA and control site . PRP and PRF site showed better soft tissue healing when compared to HA and control site . Radiographic assessment showed comparatively lesser bone density values in PRP , PRF , and control site at 1 , 2 , and 6 months than HA site . Conclusion : Our study showed that PRP and PRF are better graft material s than HA regarding pain , swelling , dry socket , and soft tissue healing . Bone regeneration is induced promptly by HA as compared to other graft material s. However , a more elaborate study with a larger number of clinical cases is very much essential to be more conclusive regarding the efficacy of the graft material Background To evaluate the efficacy of platelet-rich fibrine ( PRF ) on postoperative edema and pain after impacted m and ibular third molar surgery . Methods The prospect i ve study was comprised 30 patients who presented for the removal of bilateral impacted m and ibular third molar teeth . After extraction , the sockets were filled with PRF or without PRF in the study and control groups , respectively . Postoperative edema was measured with a flexible tape measure by calculating the distance between several facial l and marks on postoperative days two and seven . Postoperative pain was evaluated with a line-type visual analogue scale ( VAS ) and a verbal scale ( VRS ) . SPSS version 20.0 was used for data analysis . Results Both groups recorded significant improvement compared to the baseline levels in almost all of the outcome variables . There was no statistically significant difference between the study and control groups ( p > 0.05 ) . Conclusions Using or not using PRF to reduce postoperative pain and edema in third molar surgery was equally successful . Trial registration This study was retrospectively registered at the IS RCT N registry ( IS RCT N16849867 ) on 6 March 2017 This study aim ed to compare the effect of nimesulide and ketoprofen on inflammatory parameters related to the surgical removal of third molars . A split-mouth , prospect i ve , r and omized , double-blind study was conducted in patients undergoing removal of four third molars . Eighteen eligible patients were allocated to one of two groups to receive treatment two times a day with either ketoprofen 100 mg or nimesulide 100 mg for a period of 3 days . The rescue medication intake ( number ) and pain intensity were evaluated at 6 , 12 , 24 , and 48 h , and at 7 days postoperatively . Swelling and maximum mouth opening were evaluated at 24 h , 72 h , and 7 days postoperatively . The peak pain score occurred at 6h after surgery in the nimesulide group and at 12h in the ketoprofen group . There was no statistically significant difference between the groups , although pain relief was observed after 48 h in the nimesulide group and after 7 days in the ketoprofen group . For each group , there was a statically significant difference in pain scores among the studied periods ( P<0.0001 ) . None of the patients required rescue medication . There was a statistically significant difference in maximum mouth opening between the preoperative and postoperative periods ( P<0.0001 ) . Ketoprofen and nimesulide were effective at controlling pain , swelling , and trismus after the surgical removal of third molars OBJECTIVE Platelet-rich fibrin ( PRF ) belongs to a new generation of platelet concentrates , with simplified processing and without biochemical blood h and ling . The use of platelet gel to improve bone regeneration is a recent technique in implantology . However , the biologic properties and real effects of such products remain controversial . In this article , we therefore attempt to evaluate the potential of PRF in combination with freeze-dried bone allograft ( FDBA ) ( Phoenix ; TBF , France ) to enhance bone regeneration in sinus floor elevation . STUDY DESIGN Nine sinus floor augmentations were performed . In 6 sites , PRF was added to FDBA particles ( test group ) , and in 3 sites FDBA without PRF was used ( control group ) . Four months later for the test group and 8 months later for the control group , bone specimens were harvested from the augmented region during the implant insertion procedure . These specimens were treated for histologic analysis . RESULTS Histologic evaluations reveal the presence of residual bone surrounded by newly formed bone and connective tissue . After 4 months of healing time , histologic maturation of the test group appears to be identical to that of the control group after a period of 8 months . Moreover , the quantities of newly formed bone were equivalent between the 2 protocol s. CONCLUSIONS Sinus floor augmentation with FDBA and PRF leads to a reduction of healing time prior to implant placement . From a histologic point of view , this healing time could be reduced to 4 months , but large-scale studies are still necessary to vali date these first results PURPOSE The present study examined the formation and density of new bone after  sinus membrane elevation  , with and without bone grafting , and evaluated the bone formation at the apices of the implants with these 2 different maxillary sinus floor elevation techniques . MATERIAL S AND METHODS In a prospect i ve r and omized controlled study design , patients requiring reconstruction of their atrophic maxilla were included and divided r and omly into grafted and nongrafted groups . Implants were inserted in each group by way of sinus membrane elevation . The formation and density of new bone were evaluated using cone beam computed tomography , performed preoperatively and 1 week , 3 weeks , and 6 months postoperatively . RESULTS A total of 24 implants were placed in 14 patients , with all implants maintaining stability during 6 months of follow-up . New bone formation was determined in both groups using radiography . No significant differences were found between the 2 groups in terms of new bone density preoperatively nor at 1 week or 3 months postoperatively . However , the density of bone in the nongrafted group was higher than that in the grafted group 6 months after surgery . CONCLUSIONS These results suggest that the simple elevation of the sinus membrane without bone grafting material can lead to bone formation around implants and that the newly formed bone in the nongrafted group was denser than that in the grafted group PURPOSE To evaluate the effect of platelet-rich fibrin ( PRF ) on the early bone healing process with bone scintigraphy based on technetium-99 m methylene 
    Output:
    
Results The current results showed that the local application of PRF during lower third molar extraction prevented postoperative complications .
Conclusion The current study confirms that PRF only reduces some of the postoperative complications but does not prevent all the postoperative complications .
PRF significantly relieved the pain and swelling and reduced the incidence of alveolar osteitis after the extraction of an impacted lower third molar