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富血小板纤维蛋白与明胶海绵在上皮化游离龈瓣移植术后腭部伤口处理中的临床比较:一项随机临床试验

Clinical Comparison of Platelet-Rich Fibrin and a Gelatin Sponge in the Management of Palatal Wounds After Epithelialized Free Gingival Graft Harvest: A Randomized Clinical Trial.

作者信息

Femminella Beatrice, Iaconi Maria Chiara, Di Tullio Marcella, Romano Luigi, Sinjari Bruna, D'Arcangelo Camillo, De Ninis Paolo, Paolantonio Michele

机构信息

Department of Medical, Oral, and Biotechnological Sciences; G. D'Annunzio University; Chieti-Pescara, Italy.

Luisa D'Annunzio Institute for High Culture, Pescara, Italy.

出版信息

J Periodontol. 2016 Feb;87(2):103-13. doi: 10.1902/jop.2015.150198. Epub 2015 Aug 27.

Abstract

BACKGROUND

Platelet-rich fibrin (PRF) promotes tissue regeneration by releasing various growth factors. The palatal donor site of the epithelialized connective tissue (CT) graft significantly influences the patient's morbidity. The aim of this study is to compare the effects of PRF and gelatin sponge on the healing of palatal donor sites and the patient's morbidity.

METHODS

Forty patients with at least one site of Miller Class I or II gingival recession were treated by a coronally advanced flap with CT graft resulting from the de-epithelialization of a free gingival graft. In the test group (20 patients), a PRF membrane was placed over the palatal wounds; conversely, the 20 control group patients were treated with an absorbable gelatin sponge. Patients were monitored at 1, 2, 3, and 4 weeks after surgery for the complete re-epithelialization of the palatal wound (CWE), the alteration of sensitivity around the wound area, postoperative discomfort, and changes in feeding habits (CFH). Furthermore, the consumption of analgesics during the postoperative week 1 was assessed.

RESULTS

The test group showed a significantly faster CWE (P <0.001); 35% of the test patients showed CWE at the end of week 2 (controls, 10%), whereas at the end of week 3, all palatal wounds in the test patients epithelialized completely (controls, 25%). Similarly, test patients reported significantly less discomfort and CFH (P ≤ 0.02) and took a significantly lower dose of analgesics (P = 0.02).

CONCLUSION

The PRF-enriched palatal bandage significantly accelerates palatal wound healing and reduces the patient's morbidity.

摘要

背景

富血小板纤维蛋白(PRF)通过释放多种生长因子促进组织再生。上皮化结缔组织(CT)移植物的腭部供区对患者的发病率有显著影响。本研究的目的是比较PRF和明胶海绵对腭部供区愈合及患者发病率的影响。

方法

40例至少有一处Miller I类或II类牙龈退缩的患者,采用游离龈瓣去上皮化后的冠向推进瓣联合CT移植进行治疗。试验组(20例患者)在腭部伤口上放置PRF膜;相反,20例对照组患者使用可吸收明胶海绵治疗。在术后1、2、3和4周对患者进行监测,观察腭部伤口完全再上皮化(CWE)情况、伤口周围感觉变化、术后不适以及饮食习惯变化(CFH)。此外,评估术后第1周的镇痛药消耗量。

结果

试验组的CWE明显更快(P<0.001);35%的试验组患者在第2周结束时出现CWE(对照组为10%),而在第3周结束时,试验组患者的所有腭部伤口均完全上皮化(对照组为25%)。同样,试验组患者报告的不适和CFH明显更少(P≤0.02),服用的镇痛药剂量也明显更低(P = 0.02)。

结论

富含PRF的腭部绷带可显著加速腭部伤口愈合并降低患者发病率。

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