Marmara University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Turkey.
Marmara University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Turkey.
J Craniomaxillofac Surg. 2019 Feb;47(2):280-286. doi: 10.1016/j.jcms.2018.11.023. Epub 2018 Dec 3.
In this prospective, randomized, double-blind, controlled study, we evaluated the effects of leukocyte- and platelet-rich fibrin (L-PRF) alone and combined with hyaluronic acid (HA) sponge on early healing of soft tissue after mandibular third molar (M3) surgery.
In total, 60 patients aged 18-30 (mean 22.3), 22 male and 38 female, were included in this study. After surgical extraction of the impacted M3, L-PRF was applied to the socket in the L-PRF group (n = 20), and a combination of L-PRF and HA was applied in the L-PRF + HA group (n = 20). Nothing was applied in the control group (n = 20). The primary outcome variable was healing score for the mucosa over the extraction socket on the 7th, 14th, and 21st days. Secondary outcome variables were frequencies of postoperative complications: hemorrhagic complications, alveolar osteitis (AO), and postoperative wound infection.
Mean healing scores for the mucosa on the 7th, 14th, and 21st days for both the L-PRF group and the L-PRF + HA group were significantly better than those for the control group. The ratio of alveolar osteitis for the control group was 1:20 and the ratio of postoperative wound infection for the control group was 1:20. There were no cases of alveolar osteitis or postoperative wound infection in the L-PRF and L-PRF + HA groups. No hemorrhagic complications were observed in this study.
The results of this study suggest that L-PRF alone and when combined with HA can be an effective way to improve soft tissue healing, and could be used to prevent postoperative alveolar osteitis and infection after M3 surgery. Further studies with larger study groups are necessary.
在这项前瞻性、随机、双盲、对照研究中,我们评估了富白细胞纤维蛋白(L-PRF)单独使用和与透明质酸(HA)海绵联合使用对下颌第三磨牙(M3)手术后软组织早期愈合的影响。
共纳入 60 名年龄在 18-30 岁(平均 22.3 岁)的患者,其中 22 名男性和 38 名女性。在 M3 切开拔除术后,将 L-PRF 应用于牙槽窝中的 L-PRF 组(n=20),将 L-PRF 和 HA 联合应用于 L-PRF+HA 组(n=20)。对照组(n=20)不应用任何药物。主要观察变量为术后第 7、14 和 21 天牙槽窝上黏膜的愈合评分。次要观察变量为术后并发症的发生频率:出血性并发症、牙槽骨炎(AO)和术后伤口感染。
L-PRF 组和 L-PRF+HA 组术后第 7、14 和 21 天的黏膜平均愈合评分明显优于对照组。对照组的牙槽骨炎发生率为 1:20,术后伤口感染率为 1:20。L-PRF 和 L-PRF+HA 组均无牙槽骨炎或术后伤口感染病例。本研究未观察到出血性并发症。
本研究结果表明,L-PRF 单独使用和与 HA 联合使用可有效改善软组织愈合,并可用于预防 M3 手术后的牙槽骨炎和感染。需要进行更大样本量的研究。