Taschieri S, Corbella S, Tsesis I, Del Fabbro M
Department of Biomedical, Surgical and Dental Sciences, IRCCS Istituto Ortopedico Galeazzi, Università degli Studi di Milano, Milan, Italy.
Oral Maxillofac Surg. 2014 Mar;18(1):43-52. doi: 10.1007/s10006-012-0386-x. Epub 2013 Jan 10.
The aim of this retrospective investigation was to evaluate the postoperative quality of life after endodontic surgery in maxillary molars when a sinus membrane perforation occurred and platelet concentrates were used.
Included patients were treated by microsurgical endodontic treatment in molar and premolar maxillary regions between 2007 and 2010. Patients who fulfilled the inclusion criteria were screened. Data from the quality of life questionnaire were analyzed. The use of plasma rich in growth factors (PRGF) (test group) was compared with a control group when a Schneiderian membrane perforation occurred during endodontic surgery performed with a modern technique in maxillary molars and premolars.
A total of 20 patients (12 in the control group and eight in the test group) fulfilled the inclusion criteria. No differences were evaluated at baseline for clinical parameters. Significantly improved patients' quality of life was observed in the test group considering symptoms as swelling, bad breath or taste, and pain. Functional activities were less impaired in the test group and swelling was significantly higher in the control group. In the test group, pain was significantly lower than the control group during the first 6 days after surgery and also, the consumption of painkillers was lower for patients belonging to the test group even if it was not statistically significant.
In general, a small sinus membrane perforation (less than 6 mm) during endodontic surgery did not cause severe complications. The use of platelet concentrates could be effective in reducing the impact on patients' quality of life, decreasing pain and surgery side effects as well as swelling.
本回顾性研究的目的是评估上颌磨牙根管治疗术后发生上颌窦黏膜穿孔并使用浓缩血小板时患者的术后生活质量。
纳入2007年至2010年间在上颌磨牙和前磨牙区域接受显微根管治疗的患者。筛选符合纳入标准的患者。分析生活质量问卷数据。将上颌磨牙和前磨牙采用现代技术进行根管治疗手术时发生施奈德氏膜穿孔的患者使用富含生长因子的血浆(PRGF)(试验组)与对照组进行比较。
共有20例患者(对照组12例,试验组8例)符合纳入标准。临床参数在基线时未评估出差异。试验组患者在肿胀、口臭或味觉以及疼痛等症状方面的生活质量有显著改善。试验组功能活动受损较少,对照组肿胀明显更严重。试验组术后前6天疼痛明显低于对照组,试验组患者的止痛药消耗量也较低,尽管无统计学意义。
一般来说,根管治疗手术中较小的上颌窦黏膜穿孔(小于6毫米)不会引起严重并发症。使用浓缩血小板可能有效地减少对患者生活质量的影响,减轻疼痛和手术副作用以及肿胀。