Annunziata Marco, Guida Luigi, Nastri Livia, Piccirillo Angelantonio, Sommese Linda, Napoli Claudio
Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania 'Luigi Vanvitelli', Naples, Italy.
U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine and Transplant Immunology, Regional Reference Laboratory of Transplant Immunology, Azienda Ospedaliera Universitaria, Department of Experimental Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy.
Transfus Med Hemother. 2018 May;45(3):195-203. doi: 10.1159/000488061. Epub 2018 May 3.
Prevention of alveolar bone resorption after tooth extraction may be useful for implant rehabilitation of the edentulous site minimizing the future need for bone augmentation procedures. A number of studies have investigated the efficacy of autologous platelet concentrates for the preservation of the alveolar bone volume after tooth extraction. Although encouraging results have been published, the available data are still controversial. The aim of the present systematic review was to assess the effect of platelet concentrates on alveolar socket preservation after tooth extraction. A literature search was carried out up to September 2017 for prospective controlled trials in which a test group using exclusively a platelet concentrate was compared with a control group in which extraction sockets were left to heal spontaneously. Seven controlled clinical trials published between 2010 and 2016 were included. A total of 320 extractions (170 tests and 150 controls) in 190 patients was considered. A great heterogeneity was found in terms of study design, methodological aspects, and outcome evaluation. For this reason, a quantitative analysis followed by meta-analysis was not possible, and only a descriptive analysis on the role of platelet concentrates in alveolar socket preservation was carried out. There is growing evidence that platelet concentrates may be advantageously used in postextraction sites, mainly to improve soft tissue healing and to reduce postoperative symptoms. Data about their potential in preserving the alveolar bone volume are still scarce and controversial, although recently encouraging results have been presented using more reliable and accurate evaluation technologies, such as the computed tomography. Further, well-designed and methodologically standardized investigations are strongly demanded to reach a higher level of evidence on this topic.
拔牙后预防牙槽骨吸收可能有助于无牙区的种植修复，减少未来骨增量手术的需求。许多研究调查了自体血小板浓缩物在拔牙后保存牙槽骨体积方面的疗效。尽管已发表了令人鼓舞的结果，但现有数据仍存在争议。本系统评价的目的是评估血小板浓缩物对拔牙后牙槽窝保存的影响。截至2017年9月进行了文献检索，以查找前瞻性对照试验，其中仅使用血小板浓缩物的试验组与拔牙窝自然愈合的对照组进行比较。纳入了2010年至2016年间发表的7项对照临床试验。共考虑了190例患者的320颗拔牙（170颗试验组和150颗对照组）。在研究设计、方法学方面和结果评估方面发现了很大的异质性。因此，无法进行定量分析和荟萃分析，仅对血小板浓缩物在牙槽窝保存中的作用进行了描述性分析。越来越多的证据表明，血小板浓缩物可能有利地用于拔牙后部位，主要是为了改善软组织愈合和减轻术后症状。尽管最近使用计算机断层扫描等更可靠和准确的评估技术取得了令人鼓舞的结果，但关于它们在保存牙槽骨体积方面潜力的数据仍然稀少且存在争议。此外，强烈需要设计良好且方法学标准化的调查，以在该主题上获得更高水平的证据。
