Anitua Eduardo, Murias-Freijo Alia, Alkhraisat Mohammad Hamdan, Orive Gorka
, Vitoria, Spain,
Clin Oral Investig. 2015 Apr;19(3):589-600. doi: 10.1007/s00784-014-1278-2. Epub 2014 Jul 8.
Platelet-rich plasma has been used in the treatment of extraction socket; however, randomized controlled clinical trial is still lacking to evaluate its effect on extraction socket healing.
Single center, assessor-blinded, parallel group, randomized controlled clinical trial was conducted. Sixty patients with indication of a simple one molar extraction in the mandible were randomized to receive plasma rich in growth factors (PRGF) or blood clot. A cross-stitch suture was placed in both groups. Clinical, radiographical, and histological assessments were performed during 10-12 weeks of follow-up.
Cone beam CT analysis has shown that the percentage of patients where the sockets are regenerated at ≥75 % of the baseline volume was significantly higher in PRGF group (96.7 %) than the control group (45.5 %). Pain and inflammation (day 3 and day 7) have been significantly lower in PRGF group than the control group but not at day 15. Soft tissue healing scores have been significantly higher in the test group. No serious adverse events have been occurred in both groups. Histological analysis has indicated the presence of significantly thicker keratinized epithelium and significantly higher newly formed bone in the PRGF group.
PRGF was associated with enhanced healing of extraction socket of mandibular molars throughout the observation period.
Plasma rich in growth factors could be a useful tool to enhance the healing of extraction sockets by minimizing postoperative complications and stimulating the hard and soft tissues regeneration.
富血小板血浆已用于拔牙创的治疗;然而,仍缺乏随机对照临床试验来评估其对拔牙创愈合的影响。
进行单中心、评估者盲法、平行组随机对照临床试验。60例有下颌单颗磨牙简单拔牙指征的患者被随机分为接受富含生长因子的血浆(PRGF)或血凝块治疗。两组均采用十字缝合法缝合。在10 - 12周的随访期间进行临床、影像学和组织学评估。
锥形束CT分析显示,PRGF组拔牙创再生至基线体积≥75%的患者百分比(96.7%)显著高于对照组(45.5%)。PRGF组在第3天和第7天的疼痛和炎症明显低于对照组,但在第15天无差异。试验组的软组织愈合评分明显更高。两组均未发生严重不良事件。组织学分析表明,PRGF组存在明显更厚的角化上皮和明显更多的新形成骨。
在整个观察期内,PRGF与下颌磨牙拔牙创愈合增强相关。
富含生长因子的血浆可能是一种有用的工具,通过减少术后并发症并刺激软硬组织再生来促进拔牙创的愈合。