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注射用富血小板纤维蛋白治疗颞下颌关节骨关节炎的随机对照临床试验。

Injectable platelet-rich fibrin as treatment for temporomandibular joint osteoarthritis: A randomized controlled clinical trial.

机构信息

Department of Oral and Maxillofacial Surgery, School of Dentistry, Ege University, Turkey.

Department of Oral and Maxillofacial Surgery, School of Dentistry, Ege University, Turkey.

出版信息

J Craniomaxillofac Surg. 2022 Jul;50(7):576-582. doi: 10.1016/j.jcms.2022.06.006. Epub 2022 Jun 30.

Abstract

The purpose of this study was to assess the treatment outcomes of intraarticular injection of injectable platelet-rich fibrin (i-PRF) after arthrocentesis in patients with temporomandibular joint osteoarthritis (TMJ-OA). Patients were randomly assigned to one of two treatment groups: those who received intraarticular injection of i-PRF after arthrocentesis procedure - the i-PRF group; and those who underwent the arthrocentesis procedure alone - the control group. The primary outcome variable was pain, the level of which was measured preoperatively and at 1, 2, 3, 6, and 12 months postoperatively. The secondary outcome variables included maximum mouth opening (MMO), and lateral and protrusive movements. Of the total of 36 patients, 18 were analyzed in the i-PRF group and 18 in the control group. There were significant differences between the groups in terms of pain levels and measurements of MMO, lateral movement, and protrusive movement over the 12 months of follow-up (p < 0.001). Significant increases in pain levels and decreases in measurements of MMO, lateral movement, and protrusive movement were observed in the control group from the 6th to 12th month postoperatively (p < 0.001). In contrast, no significant differences were found in both pain levels and measurements of MMO, lateral, and protrusive movements for the i-PRF group from the 2nd to the 12th month postoperatively. Within the limitations of the study it seems that intraarticular injection of i-PRF after arthrocentesis should be preferred whenever appropriate because when reducing pain intensity and improving functional jaw movement is the priority.

摘要

本研究旨在评估关节内注射富含血小板的纤维蛋白(i-PRF)在颞下颌关节骨关节炎(TMJ-OA)患者关节穿刺术后的治疗效果。患者被随机分配到两个治疗组之一:接受关节内注射 i-PRF 的患者 - i-PRF 组;仅接受关节穿刺术的患者 - 对照组。主要观察变量为疼痛,术前和术后 1、2、3、6 和 12 个月进行评估。次要观察变量包括最大张口度(MMO)和侧向及前伸运动。在总共 36 名患者中,18 名患者在 i-PRF 组中进行了分析,18 名患者在对照组中进行了分析。在 12 个月的随访期间,两组在疼痛水平和 MMO、侧向运动和前伸运动的测量值方面存在显著差异(p<0.001)。对照组在术后第 6 至 12 个月观察到疼痛水平和 MMO、侧向运动和前伸运动的测量值显著增加(p<0.001)。相比之下,在术后第 2 至 12 个月,i-PRF 组在疼痛水平和 MMO、侧向和前伸运动的测量值方面均未发现显著差异。在研究的限制范围内,似乎在关节内注射 i-PRF 后进行关节穿刺术应根据具体情况优先选择,因为当减轻疼痛强度和改善下颌功能运动是优先事项时。

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