Yen C Alec, Griffin Terrence J, Cheung Wai S, Chen Jake
Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA 02111, USA.
J Periodontol. 2007 Apr;78(4):601-10. doi: 10.1902/jop.2007.060275.
Platelet concentrate (PC) is known to contain growth factors that stimulate cellular proliferation and differentiation. In this double-blind, placebo-controlled, randomized study, the objective was to determine whether PC accelerated connective tissue graft (CTG) wound healing and maintained donor site tissue thickness.
Twenty healthy adult subjects with multiple bilateral gingival recessions were treated with CTGs and PC combined with CTGs. The donor sites were treated with PC and placebo. Clinical wound healing was observed for an average of 6 weeks. Biopsies were taken from donor sites and submitted for histology and immunohistochemical analysis for type I and III collagens. Palatal tissue thickness, post-surgical complications, and pain level were evaluated. Wilcoxon, Cronbach, one-sample t, and paired-sample t tests were used to assess statistical significance at P <0.05.
PC-treated palatal donor sites were 1.10 mm thicker than control sites. PC-treated recipient sites showed accelerated clinical healing compared to controls. PC did not accelerate donor site clinical healing. No significant statistical differences in complication occurrence and perceived pain levels were found between control and PC-treated sites. Biopsy samples revealed that during healing, PC-treated sites contained lower concentrations of inflammatory cells, more type I mature collagen, and less type III immature collagen than control sites.
PC may accelerate wound healing and hasten the regeneration of palatal donor tissue. PC did not influence complication occurrences or mediate pain level. PC has the potential to shorten the treatment time for patients who need multiple CTG procedures.
已知血小板浓缩物(PC)含有刺激细胞增殖和分化的生长因子。在这项双盲、安慰剂对照、随机研究中,目的是确定PC是否能加速结缔组织移植(CTG)伤口愈合并维持供区组织厚度。
20名患有多处双侧牙龈退缩的健康成年受试者接受了CTG和PC联合CTG治疗。供区分别用PC和安慰剂处理。平均观察临床伤口愈合6周。从供区取活检组织进行I型和III型胶原的组织学和免疫组化分析。评估腭部组织厚度、术后并发症和疼痛程度。采用Wilcoxon、Cronbach、单样本t检验和配对样本t检验评估P<0.05时的统计学意义。
接受PC治疗的腭部供区比对照部位厚1.10mm。与对照组相比,接受PC治疗的受区临床愈合加快。PC未加速供区临床愈合。对照部位和接受PC治疗的部位在并发症发生率和疼痛感知水平上没有显著统计学差异。活检样本显示,在愈合过程中,接受PC治疗的部位比对照部位含有更低浓度的炎性细胞、更多的I型成熟胶原和更少的III型未成熟胶原。
PC可能加速伤口愈合并促进腭部供区组织的再生。PC不影响并发症的发生或调节疼痛程度。PC有潜力缩短需要多次CTG手术的患者的治疗时间。