ABSTRACTIntroduction: Alveolar osteitis (AO), or dry socket, is a painful postoperative complication commonly occurring after mandibular third molar extractions. It results from the loss or disintegration of the blood clot, leaving exposed alveolar bone. Platelet-Rich Fibrin (PRF), an autologous biomaterial, and ozone gel have been explored for their regenerative and anti-inflammatory potential in AO management. This study aims to compare the clinical efficacy of PRF and ozone gel in treating AO. Materials and methods: A randomized clinical trial was conducted on 28 patients aged 20–70 years with clinically diagnosed AO. Participants were randomly assigned to two groups: Group 1 (PRF) and Group 2 (ozone gel). PRF was prepared using Choukroun’s protocol and placed into the socket with sutures. In the ozone group, commercially available ozone gel (450 mcg/ml) was applied into the socket. Both groups received standard analgesics as needed. Pain (VAS), perisocket inflammation, wound healing, and analgesic intake were evaluated on days 1, 3, and 7 post-treatments. Statistical analyses were performed using Friedman and Mann-Whitney U tests, with a significance level set at p < 0.05. Results: PRF showed a statistically significant reduction in pain, inflammation, and analgesic intake from days 1 to 7 (p < 0.05). Wound healing scores were also significantly higher in the PRF group on the 7th day. In comparison, the ozone group showed clinical improvement, but with higher pain and inflammation scores and increased analgesic use, particularly in the first five days post-intervention. Intergroup comparisons revealed significantly better outcomes for PRF in all assessed parameters by day 7. Conclusion: PRF was more effective than ozone gel in reducing pain, inflammation, and enhancing wound healing in AO. PRF should be considered a preferred treatment, with ozone gel as a supportive adjunct when PRF is unavailable.Keywords: Alveolar osteitis, dry socket, platelet-rich fibrin, ozone gel, wound healing