Section for Oral Surgery and Oral Pathology, Department of Dentistry and Oral Health, Health, Aarhus University, Aarhus C, Denmark.
Section for Oral Surgery and Oral Pathology, Department of Dentistry and Oral Health, Health, Aarhus University, Aarhus C, Denmark; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus N, Denmark.
Int J Oral Maxillofac Surg. 2021 Mar;50(3):384-390. doi: 10.1016/j.ijom.2020.07.009. Epub 2020 Aug 12.
The purpose of this study was to evaluate pain after mandibular ramus block harvesting and lateral ridge augmentation. Autogenous bone block grafts were covered with platelet-rich fibrin (PRF) membranes (test group) or deproteinized bovine bone and a resorbable collagen membrane (control group). This study included 27 partially edentulous patients (test = 14, control = 13) with an indication for bone block augmentation before staged implant placement. Postoperative methylprednisolone (32 mg, day 1) and analgesics comprising ibuprofen (400 mg, four times daily) and paracetamol (1 g, four times daily) were prescribed for 1 week. Pain was recorded by the patient on a 100-mm visual analogue scale (VAS), hourly on the day of surgery and daily for the following 7 days. The average (mean ± standard deviation) maximum pain score over the whole observation period was similar in the test (13.6 ± 13.5) and control (21.0 ± 19.9) groups (P = 0.17). In conclusion, harvesting of a mandibular ramus block and lateral ridge augmentation, in conjunction with the pharmacological protocol described, is characterized by low postoperative pain. Adding PRF membranes to the surgical site generally resulted in slightly lower pain perception, although a statistically significant difference between the test and control groups was only identified on day 1 postoperative.
本研究旨在评估下颌支骨块取骨和外侧嵴增高术后的疼痛情况。自体骨块移植后覆盖富血小板纤维蛋白（PRF）膜（实验组）或脱蛋白牛骨和可吸收胶原膜（对照组）。本研究纳入 27 名部分缺牙患者（实验组 14 例，对照组 13 例），这些患者有分期种植前进行骨块增高的指征。术后给予甲基强的松龙（32mg，第 1 天）和包含布洛芬（400mg，每日 4 次）和扑热息痛（1g，每日 4 次）的镇痛药，持续 1 周。患者通过 100mm 视觉模拟评分（VAS）记录疼痛，手术当天每小时记录一次，随后 7 天每天记录一次。整个观察期内，实验组（13.6±13.5）和对照组（21.0±19.9）的平均（均值±标准差）最大疼痛评分相似（P=0.17）。结论：下颌支骨块取骨和外侧嵴增高术，结合所描述的药理学方案，具有较低的术后疼痛。在手术部位添加 PRF 膜通常会导致疼痛感知略有降低，但实验组和对照组仅在术后第 1 天存在统计学显著差异。
