评价牙周手术后使用和不使用釉基质衍生物的早期不适和伤口愈合结果：一项观察性回顾性病例对照研究。
Assessment of early discomfort and wound healing outcomes after periodontal surgery with and without enamel matrix derivative: an observational retrospective case-control study.
机构信息
Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, 77 Dunsan-ro, Seo-gu, Daejeon, 35233, South Korea.
出版信息
Clin Oral Investig. 2020 Jan;24(1):229-237. doi: 10.1007/s00784-019-02941-w. Epub 2019 May 12.
OBJECTIVE
The aim of this study was to evaluate and compare early postoperative discomfort and wound healing outcomes between patients who underwent periodontal surgery with and without enamel matrix derivative (EMD), using retrospective questionnaires and postoperative clinical examinations.
MATERIALS AND METHODS
All enrolled patients filled out the self-report questionnaire after suture removal. The severity and duration of subjective pain and swelling were evaluated using visual analog scale (VAS) scores and wound healing parameters (dehiscence/fenestration, spontaneous bleeding, persistent swelling, and ulceration). Chi-squared tests, two-tailed independent t tests, analysis of variance, and multiple logistic regression analysis were performed to identify significant differences between the two groups (surgery with EMD and surgery without EMD).
RESULTS
The severity of pain and swelling did not differ between patients who underwent surgery with and without EMD, but the durations of pain (P < 0.001) and swelling (P = 0.019) were significantly lower in patients who underwent surgery with EMD. Multivariate analysis with adjustment for confounding variables showed that wound healing outcomes including dehiscence/fenestration, spontaneous bleeding, and ulceration did not differ significantly between the two groups, and only persistent swelling showed significant differences (odds ratio 4.03, 95% CI 1.17-13.78; P = 0.026).
CONCLUSIONS
No difference was observed in the severity of early postoperative discomfort and wound healing outcomes between patients who underwent surgery with and without EMD, but shorter durations of postoperative pain and swelling were evident in patients who underwent surgery with EMD.
CLINICAL RELEVANCE
Adjunctive EMD used in periodontal surgery has clinical advantages for reducing the durations of postoperative pain and swelling.
目的
本研究旨在通过回顾性问卷调查和术后临床检查，评估和比较使用和不使用釉基质衍生物（EMD）进行牙周手术的患者的早期术后不适和伤口愈合结果。
材料和方法
所有入组患者均在拆线后填写自我报告问卷。使用视觉模拟量表（VAS）评分和伤口愈合参数（裂开/窗、自发性出血、持续肿胀和溃疡）评估主观疼痛和肿胀的严重程度和持续时间。采用卡方检验、双尾独立 t 检验、方差分析和多因素逻辑回归分析，比较两组（使用 EMD 手术和不使用 EMD 手术）之间的差异。
结果
使用和不使用 EMD 手术的患者的疼痛和肿胀严重程度无差异，但使用 EMD 手术的患者的疼痛（P<0.001）和肿胀（P=0.019）持续时间明显更短。调整混杂因素的多因素分析显示，包括裂开/窗、自发性出血和溃疡在内的伤口愈合结果在两组之间无显著差异，只有持续性肿胀有显著差异（比值比 4.03，95%置信区间 1.17-13.78；P=0.026）。
结论
使用和不使用 EMD 手术的患者的早期术后不适和伤口愈合结果的严重程度无差异，但使用 EMD 手术的患者的术后疼痛和肿胀持续时间更短。
临床意义
牙周手术中使用辅助 EMD 具有减少术后疼痛和肿胀持续时间的临床优势。
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