Associate Professor, Head Department of Odontostomatology, School of Dentistry, Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile.
Clinical Instructor, Department of Odontostomatology, School of Dentistry, Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile.
J Oral Maxillofac Surg. 2021 Mar;79(3):575-584. doi: 10.1016/j.joms.2020.10.006. Epub 2020 Oct 15.
Leukocyte- and platelet-rich fibrin (L-PRF) has been used for alveolar ridge preservation (ARP) in postextraction tooth sockets. However, current reports have measured its effectiveness in linear measurements of 3-dimensional ridge preservation. The purpose of this study was to determine the effectiveness of the use of L-PRF filling versus natural clot blood healing in ARP according to the clinical, radiographic, and volumetric measurements of postextraction tooth sockets.
A split-mouth randomized clinical trial was designed. Healthy patients who needed bilateral extraction of upper third molars were selected. After the tooth extraction, the socket was filled and distributed randomly with L-PRF and the contralateral socket only with the blood clot. The dimensional change of soft tissue healing around the sockets, and the length, depth, and difference of bone formation were examined using standardized periapical radiographs. Volumetric measurement variation of the sockets was evaluated by 3-dimensional scanning of dental casts. Changes of all measures were analyzed at 7 days (initial) and 3 months (final) after the tooth extraction and compared between both groups (t test; P < .05).
Sixteen patients (aged 24.75 ± 3.53 years; 56.25% women) participated. Measurements of wound healing and the length, depth, and difference of bone formation were similar for both study groups at initial and final times. The calculation of initial-final volumetric socket variation was 15.45 ± 13.12 μL using L-PRF and 14.12 ± 11.23 μL using blood clot (P = .78).
L-PRF filling showed the same dimensional and volumetric behavior as normal blood clot healing in the ARP of postextraction tooth sockets. Future investigations will have to analyze the use of surgical models and digital instruments in ARP techniques.
富白细胞和血小板纤维蛋白(L-PRF)已被用于拔牙窝的牙槽嵴保存(ARP)。然而,目前的报告仅测量了其在三维嵴保存的线性测量中的有效性。本研究旨在根据拔牙窝的临床、放射学和体积测量结果,确定使用 L-PRF 填充与自然血凝块血液愈合在 ARP 中的效果。
设计了一项分口随机临床试验。选择需要双侧上颌第三磨牙拔除的健康患者。拔牙后,牙槽窝内随机填充 L-PRF 和对侧牙槽窝仅填充血凝块。使用标准根尖片检查牙槽窝周围软组织愈合的尺寸变化,以及骨形成的长度、深度和差异。通过牙模的 3 维扫描评估牙槽窝的体积测量变化。分析所有测量值在拔牙后 7 天(初始)和 3 个月(最终)的变化,并在两组之间进行比较(t 检验;P < 0.05)。
16 名患者(年龄 24.75 ± 3.53 岁;56.25%为女性)参与了研究。两组在初始和最终时间的伤口愈合以及长度、深度和骨形成差异的测量均相似。使用 L-PRF 计算初始-最终容积牙槽窝变化为 15.45 ± 13.12 μL,使用血凝块为 14.12 ± 11.23 μL(P = 0.78)。
L-PRF 填充在拔牙窝的 ARP 中表现出与正常血凝块愈合相同的尺寸和体积行为。未来的研究将不得不分析手术模型和数字仪器在 ARP 技术中的应用。