Clinica Odontoiatrica Salzano Tirone, Private Practice, Cuneo, Italy.
Freelance Statistician, Ferrara, Italy.
Clin Exp Dent Res. 2021 Dec;7(6):1053-1060. doi: 10.1002/cre2.441. Epub 2021 May 13.
This study aimed to determine the effect of the use of a bipolar coagulator on postoperative pain and complications when used during connective tissue harvesting from the palate.
A randomized controlled clinical trial was conducted with 57 sequential patients requiring a connective tissue graft for periodontal or implant surgery. All samples were harvested superficially and de-epithelized outside the mouth. The patients were randomly allocated to two groups: in one group, the bipolar coagulator was used before suturing to control bleeding, and in the other group, the coagulator was not used. The surgeon was unaware of the randomization until the end of the harvesting phase. Self-reported maximum pain, number of painkillers used, bleeding events, emergency visits at the clinic were recorded 7 days after surgery.
Fifty patients were randomized and treated (seven were excluded for different reasons). The mean harvested area was 75.24 mm (SD, 33.96), and the mean thickness of the samples was 2.47 mm (SD, 0.75). The mean self-reported pain value on the visual analog scale was 3.37 (SD, 2.30), and the mean number of pain medications used was 7.1 (SD, 6.60). Seven patients made an emergency visit each, and 17 delayed bleeding events were reported by 15 patients. No statistically significant differences were reported in postoperative pain, postoperative bleeding, and emergency visit to the clinic between the groups that did and did not use the bipolar coagulator. When smoking habits were taken into consideration, the number of pain medications was higher among male smokers and older smokers than among male non-smokers and younger smokers. This study was not able to find a relationship between harvested sample dimension or thickness and postoperative discomfort.
The bipolar coagulator can be used during connective tissue harvesting from the palate to control bleeding without influencing postoperative pain.
本研究旨在确定在进行 palate 结缔组织采集时使用双极电凝器对术后疼痛和并发症的影响。
进行了一项随机对照临床试验，纳入了 57 名连续需要进行牙周或种植手术的结缔组织移植物的患者。所有样本均在口腔外进行浅层和去上皮化采集。患者被随机分为两组：一组在缝合前使用双极电凝器控制出血，另一组则不使用。直到采集阶段结束，外科医生才知道随机分组情况。术后 7 天记录自我报告的最大疼痛、使用止痛药的数量、出血事件、急诊就诊情况。
50 名患者被随机分组并接受治疗（7 名因不同原因被排除）。平均采集面积为 75.24mm²（SD，33.96），样本平均厚度为 2.47mm（SD，0.75）。自我报告的视觉模拟评分的平均疼痛值为 3.37（SD，2.30），平均使用止痛药的数量为 7.1（SD，6.60）。7 名患者各有一次急诊就诊，15 名患者报告了 17 例延迟性出血事件。使用和不使用双极电凝器的两组之间，术后疼痛、术后出血和急诊就诊率均无统计学差异。考虑吸烟习惯后，男性吸烟者和年龄较大的吸烟者比男性非吸烟者和年龄较小的吸烟者使用止痛药的数量更高。本研究未能发现采集样本的尺寸或厚度与术后不适之间存在关系。
在进行 palate 结缔组织采集时，双极电凝器可用于控制出血，而不会影响术后疼痛。
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