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富白细胞和血小板纤维蛋白(L-PRF)对下颌阻生第三磨牙拔除手术结果的影响:一项双侧对照随机临床试验。

Influence of leukocyte- and platelet-rich fibrin (L-PRF) on the outcomes of impacted mandibular third molar removal surgery: A split-mouth randomized clinical trial.

作者信息

Daugela Povilas, Grimuta Vaidas, Sakavicius Dalius, Jonaitis Juozas, Juodzbalys Gintaras

出版信息

Quintessence Int. 2018;49(5):377-388. doi: 10.3290/j.qi.a40113.

DOI:10.3290/j.qi.a40113
PMID:29629438
Abstract

OBJECTIVES

The purpose of this study was to evaluate the influence of leukocyte- and platelet-rich fibrin (L-PRF) on impacted mandibular third molar (IMTM) extraction wound healing, patient postoperative discomfort, and incidence of alveolar osteitis.

METHOD AND MATERIALS

Thirty-four patients (20 female, 14 male) who met the inclusion criteria for this split-mouth randomized clinical trial were enrolled and 30 patients completed the study. Patients were randomized and underwent bilateral IMTM surgical extractions. Following extraction, one socket randomly received L-PRF, and the other socket served as a regular blood clot control. Postoperatively, the soft tissue healing index (HI), pain according to visual analog scale (VAS), facial swelling using a horizontal and vertical guide, and incidence of alveolar osteitis were evaluated 1, 3, 7, and 14 days after surgery.

RESULTS

Sites treated with L-PRF resulted in improved HI (P = .001) and lower pain VAS scores (P = .001) in the first postoperative week. Significant reduction of facial swelling was recorded on first (P = .035) and third (P = .023) postoperative days in L-PRF sites versus controls, ceasing to nonsignificant difference at day 7 (P = .224). None of the L-PRF sites and four control sites were affected by alveolar osteitis (P = .001).

CONCLUSION

Within the limitations of this split-mouth study, L-PRF improved soft tissue healing and reduced postoperative pain, swelling, and incidence of alveolar osteitis after IMTM surgical extractions.

摘要

目的

本研究旨在评估富含白细胞和血小板的纤维蛋白(L-PRF)对下颌阻生第三磨牙(IMTM)拔牙创愈合、患者术后不适及干槽症发生率的影响。

方法和材料

34例符合本双侧随机临床试验纳入标准的患者(20例女性,14例男性)入组,30例患者完成研究。患者被随机分组并接受双侧IMTM外科拔牙。拔牙后,一个牙槽窝随机接受L-PRF,另一个牙槽窝作为常规血凝块对照。术后,在术后1、3、7和14天评估软组织愈合指数(HI)、视觉模拟量表(VAS)疼痛评分、使用水平和垂直标尺测量的面部肿胀情况以及干槽症发生率。

结果

在术后第一周,接受L-PRF治疗的部位HI改善(P = .001),VAS疼痛评分较低(P = .001)。与对照组相比,L-PRF治疗部位在术后第一天(P = .035)和第三天(P = .023)面部肿胀明显减轻,在第7天不再有显著差异(P = .224)。L-PRF治疗部位和四个对照部位均未发生干槽症(P = .001)。

结论

在本双侧研究的局限性范围内,L-PRF改善了IMTM外科拔牙后的软组织愈合,减轻了术后疼痛、肿胀及干槽症的发生率。

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