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富血小板纤维蛋白促进骨再生的潜力——下颌第三磨牙阻生牙槽窝的比较研究

Potential for Osseous Regeneration of Platelet-Rich Fibrin-A Comparative Study in Mandibular Third Molar Impaction Sockets.

作者信息

Varghese Mathew P, Manuel Suvy, Kumar L K Surej

机构信息

Senior Lecturer, Department of Oral and Maxillofacial Surgery, PMS College of Dental Sciences and Research, Trivandrum, Kerala, India.

Former Professor, Department of Oral and Maxillofacial Surgery, PMS College of Dental Sciences and Research, Trivandrum, Kerala, India.

出版信息

J Oral Maxillofac Surg. 2017 Jul;75(7):1322-1329. doi: 10.1016/j.joms.2017.01.035. Epub 2017 Feb 4.

Abstract

PURPOSE

This study investigated the potential of platelet-rich fibrin (PRF) for osseous regeneration and soft tissue healing in mandibular third molar impaction sockets.

MATERIALS AND METHODS

A prospective in vivo study was performed. Randomization was performed after extraction. On one side, the socket was sutured primarily (control site); on the other side, autologous PRF gel was placed and then the socket was sutured (test site). Postoperatively, grid periapical radiographs were obtained at periodic intervals (weeks 1, 4, and 16) and digitalized. Gray-level values were measured at 3 different regions of the socket (for regions of newly formed bone) compared with the natural bone area using HL Image++ software, and the percentage bone fill was measured. Clinical evaluation of soft tissue healing was performed using the healing index of Landry et al (J Periodontol 60:212, 1994) at the specific intervals.

RESULTS

Thirty healthy men and women (age range, 18 to 35 yr) with bilaterally impacted mandibular third molars were enrolled in this study. In general, there was markedly greater bone formation in sockets treated with PRF (P < .05). In the PRF group, the average gray-level values at the cervical, middle, and apical regions were 61.85 (standard deviation [SD], ±25.186), 64.54 (SD, ±24.831), and 67.80 (SD, ±23.946), respectively, with a mean value of 64.73 (SD, ±24.411). In the control group, these values were 51.58 (SD, ±15.286), 54.30 (SD, ±16.274), and 57.53 (SD, ±16.187), respectively, with a mean of 53.67 (SD, ±16.528). The average percentage of bone fill in the PRF group was 57.90 (SD, ±26.789) and that of the non-PRF group was 46.74 (SD, ±17.713; P < .05). Soft tissue healing as evaluated by the healing index of Landry et al also was found to be better at the PRF test site and it was statistically significant (P < .05).

CONCLUSIONS

There was evidence for better osseous regeneration and soft tissue healing in response to PRF. Further investigations to evaluate the application of PRF in other areas of oral and maxillofacial surgery are imperative.

摘要

目的

本研究调查富血小板纤维蛋白(PRF)在下颌第三磨牙阻生拔牙创骨再生和软组织愈合方面的潜力。

材料与方法

进行一项前瞻性体内研究。拔牙后进行随机分组。一侧拔牙创直接缝合(对照组);另一侧放置自体PRF凝胶后缝合拔牙创(试验组)。术后定期(第1、4和16周)拍摄根尖X线片并数字化。使用HL Image++软件在拔牙创3个不同区域(用于新形成骨区域)测量灰度值,并与天然骨区域比较,同时测量骨填充百分比。在特定时间间隔使用Landry等人(《牙周病学杂志》60:212,1994)的愈合指数对软组织愈合进行临床评估。

结果

30名双侧下颌第三磨牙阻生的健康男性和女性(年龄范围18至35岁)纳入本研究。总体而言,PRF治疗的拔牙创骨形成明显更多(P <.05)。在PRF组中,颈部、中部和根尖区域的平均灰度值分别为61.85(标准差[SD],±25.186)、64.54(SD,±24.831)和67.80(SD,±23.946),平均值为64.73(SD,±24.411)。在对照组中,这些值分别为51.58(SD,±15.286)、54.30(SD,±16.274)和57.53(SD,±16.187),平均值为53.67(SD,±16.528)。PRF组的平均骨填充百分比为57.90(SD,±26.789),非PRF组为46.74(SD,±17.713;P <.05)。通过Landry等人的愈合指数评估,PRF试验组的软组织愈合也更好,且具有统计学意义(P <.05)。

结论

有证据表明PRF能促进更好的骨再生和软组织愈合。必须进一步开展研究以评估PRF在口腔颌面外科其他领域的应用。

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