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自体富血小板血浆凝胶能否增强下颌第三磨牙手术拔除后的愈合?

Can autologous platelet-rich plasma gel enhance healing after surgical extraction of mandibular third molars?

作者信息

Ogundipe Olufemi K, Ugboko Vincent I, Owotade Folusho J

机构信息

Dental Services Department, Federal Medical Centre, OWO, Nigeria.

出版信息

J Oral Maxillofac Surg. 2011 Sep;69(9):2305-10. doi: 10.1016/j.joms.2011.02.014. Epub 2011 May 7.

Abstract

PURPOSE

This investigation assesses the effect of platelet-rich plasma (PRP) gel on postoperative pain, swelling, and trismus as well as healing and bone regeneration potential on mandibular third molar extraction sockets.

PATIENTS AND METHODS

A prospective randomized comparative clinical study was undertaken over a 2-year period. Patients requiring surgical extraction of a single impacted third molar and who fell within the inclusion criteria and indicated willingness to return for recall visits were recruited. The predictor variable was application of PRP gel to the socket of the third molar in the test group, whereas the control group had no PRP. The outcome variables were pain, swelling, and maximum mouth opening, which were measured using a 10-point visual analog scale, tape, and millimeter caliper, respectively. Socket healing was assessed radiographically by allocating scores for lamina dura, overall density, and trabecular pattern. Quantitative data were presented as mean. Mann-Whitney test was used to compare means between groups for continuous variables, whereas Fischer exact test was used for categorical variables. Statistical significance was inferred at P < .05.

RESULTS

Sixty patients aged 19 to 35 years (mean: 24.7 ± 3.6 years) were divided into both test and control groups of 30 patients each. The mean postoperative pain score (visual analog scale) was lower for the PRP group at all time points and this was statistically significant (P < .05). Although the figures for swelling and interincisal mouth opening were lower in the test group, this difference was not statistically significant. Similarly, the scores for lamina dura, trabecular pattern, and bone density were better among patients in the PRP group. This difference was also not statistically significant.

CONCLUSION

The PRP group recorded reduced pain, swelling, and trismus as well as enhanced and faster bone healing compared with those in the control. Hence the study showed that topical application of PRP gel has a beneficial effect in enhancing socket healing after third molar surgery.

摘要

目的

本研究评估富血小板血浆(PRP)凝胶对下颌第三磨牙拔除术后疼痛、肿胀、牙关紧闭以及创口愈合和骨再生潜能的影响。

患者与方法

在2年期间进行了一项前瞻性随机对照临床研究。招募需要手术拔除单颗阻生第三磨牙且符合纳入标准并表示愿意复诊的患者。预测变量为试验组中PRP凝胶应用于第三磨牙创口,而对照组未使用PRP。观察变量为疼痛、肿胀和最大开口度,分别使用10分视觉模拟量表、卷尺和毫米卡尺进行测量。通过对硬骨板、整体密度和骨小梁模式评分进行影像学评估创口愈合情况。定量数据以均值表示。采用Mann-Whitney检验比较连续变量组间均值,而Fischer精确检验用于分类变量。P <.05时推断具有统计学意义。

结果

60例年龄在19至35岁(平均:24.7±3.6岁)的患者被分为试验组和对照组,每组30例。PRP组在所有时间点的术后平均疼痛评分(视觉模拟量表)均较低,且具有统计学意义(P <.05)。虽然试验组的肿胀和切牙间开口度数值较低,但差异无统计学意义。同样,PRP组患者的硬骨板、骨小梁模式和骨密度评分更好。这种差异也无统计学意义。

结论

与对照组相比,PRP组疼痛、肿胀和牙关紧闭减轻,骨愈合增强且更快。因此,该研究表明局部应用PRP凝胶对促进第三磨牙手术后创口愈合具有有益作用。

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