Mozzati Marco, Gallesio Giorgia, di Romana Sara, Bergamasco Laura, Pol Renato
Doctor, SIOM Oral Surgery and Implantology Center, Turin, Italy.
Doctor, SIOM Oral Surgery and Implantology Center, Turin, Italy.
J Oral Maxillofac Surg. 2014 Mar;72(3):456-62. doi: 10.1016/j.joms.2013.10.010. Epub 2013 Oct 30.
To evaluate the efficacy of plasma-rich growth factor (PRGF) in improving socket healing after tooth extraction in diabetic patients.
This was a split-mouth study in which each patient also served as the control: the study socket was treated with PRGF, whereas the control socket underwent natural healing. The outcome variables were the Healing Index, residual socket volume, visual analog scale score, postsurgical complications, and outcome of a patient questionnaire. The investigation considered the impact of hyperglycemia, glycated hemoglobin, End Organ Disease Score, and smoking habits. Follow-up included 4 postextraction checkups over a 21-day period. Pairs of correlated continuous variables were analyzed with the Wilcoxon test, independent continuous variables with the Mann-Whitney test, and categorical variables with the χ(2) test or Fisher test.
From January 2012 to December 2012, 34 patients affected by insulin-dependent diabetes mellitus underwent contemporary bilateral extractions of homologous teeth. The treatment-versus-control postoperative comparison showed that PRGF resulted in significantly smaller residual socket volumes and better Healing Indices from days 3 to 14. The patients' questionnaire outcomes were unanimously in favor of PRGF treatment. The small sample of patients with glycemia values of at least 240 mg/dL showed worse Healing Index and minor socket decreases.
PRGF application after extraction improved the healing process in diabetic patients by accelerating socket closure (epithelialization) and tissue maturation, proving the association between PRGF use and improved wound healing in diabetic patients.
评估富血小板生长因子(PRGF)在改善糖尿病患者拔牙后牙槽窝愈合方面的疗效。
这是一项自身对照的半口研究,每位患者自身作为对照:研究侧牙槽窝用PRGF治疗,而对照侧牙槽窝自然愈合。观察指标包括愈合指数、剩余牙槽窝体积、视觉模拟评分、术后并发症以及患者问卷调查结果。研究考虑了高血糖、糖化血红蛋白、终末器官疾病评分和吸烟习惯的影响。随访包括在拔牙后21天内进行4次检查。对相关连续变量对采用Wilcoxon检验进行分析,独立连续变量采用Mann-Whitney检验,分类变量采用χ(2)检验或Fisher检验。
2012年1月至2012年12月,34例胰岛素依赖型糖尿病患者同期进行了双侧同名牙拔除。治疗组与对照组术后比较显示,从第3天到第14天,PRGF治疗组的剩余牙槽窝体积显著更小,愈合指数更好。患者问卷调查结果一致支持PRGF治疗。血糖值至少为240 mg/dL的患者样本量较小,其愈合指数较差,牙槽窝缩小也较小。
拔牙后应用PRGF可通过加速牙槽窝封闭(上皮化)和组织成熟来改善糖尿病患者的愈合过程,证明了PRGF的使用与糖尿病患者伤口愈合改善之间的关联。