Suttapreyasri Srisurang, Leepong Narit
Department of Surgery, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
J Craniofac Surg. 2013 Jul;24(4):1088-94. doi: 10.1097/SCS.0b013e31828b6dc3.
The aim of this study was to investigate the influence of platelet-rich fibrin (PRF) on early wound healing and preservation of the alveolar ridge shape following tooth extraction.
In this clinical trial, 20 symmetrical, premolar extraction sockets using split-mouth design were randomly selected with PRF or blood clot. The evaluations of wound healing, alveolar ridge contour changes, and crestal bone resorption were performed in dental casts and periapical radiographs (T0, initial; T1, 1 week; T2, 2 weeks; T4, 4 weeks; T6, 6 weeks; T8, 8 weeks).
Platelet-rich fibrin clinically showed early healing of soft tissue covering socket orifices in the first 4 weeks. At the first week, the horizontal resorption on buccal aspect of PRF (1.07 ± 0.31 mm) was significantly less than that of the control (1.81 ± 0.88 mm). Platelet-rich fibrin demonstrated the tendency to enter the steady stage after the fourth week following tooth extraction, whereas in the control group the progression of buccal contour contraction was still detected through the eighth week. Radiographically, the overall resorption of marginal bone levels at mesial and distal to the extraction site in PRF (0.70, 1.23 mm) was comparable to that of the control (1.33, 1.14 mm). Although the PRF group demonstrated faster bone healing compared with the control, no statistically significant difference was detected.
This preliminary result demonstrated neither better alveolar ridge preservation nor enhanced bone formation of PRF in the extraction socket. The use of PRF revealed limited effectiveness by accelerated soft-tissue healing on the first 4 weeks.
本研究旨在探讨富血小板纤维蛋白(PRF)对拔牙后早期伤口愈合及牙槽嵴形态维持的影响。
在这项临床试验中,采用分口设计随机选择20个对称的前磨牙拔牙创,分别使用PRF或血凝块。在石膏模型和根尖片上(T0,初始;T1,1周;T2,2周;T4,4周;T6,6周;T8,8周)对伤口愈合、牙槽嵴轮廓变化和牙槽嵴顶骨吸收进行评估。
富血小板纤维蛋白在临床上显示在最初4周内软组织覆盖拔牙创开口的早期愈合。在第1周,PRF组颊侧的水平吸收(1.07±0.31mm)明显少于对照组(1.81±0.88mm)。富血小板纤维蛋白在拔牙后第4周后显示进入稳定期的趋势,而在对照组中,颊侧轮廓收缩的进展在第8周仍可检测到。影像学上,PRF组拔牙位点近中和远中边缘骨水平的总体吸收(0.70,1.23mm)与对照组(1.33,1.14mm)相当。虽然PRF组与对照组相比显示出更快的骨愈合,但未检测到统计学上的显著差异。
这一初步结果表明,PRF在拔牙创中既没有更好地保留牙槽嵴,也没有增强骨形成。使用PRF显示出在最初4周通过加速软组织愈合的有限效果。