Brazdeikytė Valdonė, Baliutavičiūtė Diana, Rokicki Jan Pavel
Quintessence Int. 2021 Dec 1;53(1):58-67. doi: 10.3290/j.qi.b1492237.
Healing of postextraction alveolus is a complex process that involves soft and hard tissue regeneration. Pain, swelling, difficulty in opening the mouth, delayed bone tissue healing, alveolitis, and horizontal or vertical resorption of bone tissue are the main problems that impact on consequent treatment. Blood concentrates PRGF (plasma rich in growth factors) and PRF (platelet-rich fibrin), which are rich in growth factors, create better conditions for postextraction alveolus healing, enhance quality of soft tissues and bone regeneration, and decrease pain. The study objective was to compare physiologic healing of the postextraction zone with PRF- and PRGF-induced changes.
In total, 43 patients were randomly divided into three groups: control group (mandibular molar extraction and filling of postextraction alveolus with hemostatic sponge containing gentamicin), group 2 (postextraction alveolus filled with PRGF), and group 3 (postextraction alveolus filled with PRF). Bone regeneration was evaluated in CBCT scans after 1 month. Pain was evaluated using the visual analog scale (VAS).
After evaluating VAS results 1 day after surgery the lowest pain score was in the PRGF group. Tooth alveolus vertical and diagonal dimensions in the control group were significantly (P = .017) smaller than in the PRGF group. The vertical dimension of the alveolar ridge did not change significantly (P = .859) in the PRGF group; however, it was significantly reduced (P = .04) in the PRF group. One month after surgery the age of the control group was inversely proportionally correlated with the height and diagonal dimension of callus.
Both blood concentrates had great anti-inflammatory properties, but PRGF had better osteoblastic properties and resulted in lower postoperative pain.
拔牙后牙槽窝的愈合是一个复杂的过程，涉及软组织和硬组织的再生。疼痛、肿胀、张口困难、骨组织愈合延迟、干槽症以及骨组织的水平或垂直吸收是影响后续治疗的主要问题。富含生长因子的血液浓缩物PRGF（富含生长因子的血浆）和PRF（富含血小板的纤维蛋白）为拔牙后牙槽窝的愈合创造了更好的条件，提高了软组织和骨再生的质量，并减轻了疼痛。本研究的目的是比较拔牙后区域的生理愈合与PRF和PRGF诱导的变化。
总共43例患者被随机分为三组：对照组（下颌磨牙拔除并用含庆大霉素的止血海绵填充拔牙后牙槽窝）、第2组（拔牙后牙槽窝用PRGF填充）和第3组（拔牙后牙槽窝用PRF填充）。术后1个月通过CBCT扫描评估骨再生情况。使用视觉模拟量表（VAS）评估疼痛程度。
术后1天评估VAS结果时，PRGF组的疼痛评分最低。对照组牙槽窝的垂直和对角线尺寸显著（P = .017）小于PRGF组。PRGF组牙槽嵴的垂直尺寸没有显著变化（P = .859）；然而，PRF组的垂直尺寸显著减小（P = .04）。术后1个月，对照组的年龄与骨痂的高度和对角线尺寸呈负相关。
两种血液浓缩物都具有很强的抗炎特性，但PRGF具有更好的成骨特性，且术后疼痛更低。
