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集中生长因子能否预防阻生第三磨牙术后并发症?一项分口随机双盲试验。

Can concentrated growth factor prevent postoperative complications of impacted third molar surgery? A split-mouth randomized double-blind trial.

机构信息

Department of Stomatology, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, 1279, Sanmen Road, Shanghai, 200434, China.

Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, 301, Middle Yanchang Road, Shanghai, 200072, China.

出版信息

Clin Oral Investig. 2024 Apr 1;28(4):234. doi: 10.1007/s00784-024-05638-x.

Abstract

OBJECTIVES

The purpose of the present study was to evaluate the effect of concentrated growth factor (CGF) on prevention of postoperative complications in the impacted third molar extraction.

MATERIALS AND METHODS

A total of 25 healthy patients with symmetrical bilaterally impacted third molars (50 extraction sites) were enrolled in this split-mouth, randomized, double-blind clinical trial. Third molar extractions were performed in both sites of the mandible at the same appointment. Randomization was performed using a coin toss to choose the test and control sites. CGF was placed in the extraction socket and the socket was sutured (test group), while the contralateral socket was only sutured (control group). Each patient acted as their own control. The primary outcome were pain assessed by visual analog scale (VAS) and facial swelling on the1st, 3rd and 7th postoperative days. The secondary outcomes were bone healing in extraction sockets through alveolar bone height (ABH) and alveolar bone density (ABD) evaluated by cone beam computed tomography (CBCT) immediately after extraction and in the 3rd and 6th months.

RESULTS

Twenty-five patients (12 female, 13 male; mean age 29.17) with bilateral impacted third molars participated in the study. A statistically significant reduction in pain was determined on the 3rd and 7th postoperative days in the CGF sites compared to the control sites while no statistically significant difference was found between the groups on the 1st postoperative day (3rd day, p = 0.009; 7th day, p = 0.039). There were no statistically significant differences in facial swelling and bone healing between the test and control groups at different time intervals, although the data obtained were slightly favoring the CGF group (p > 0.05). There were no serious adverse effects such as infection, alveolitis, paraesthesia, fracture through the follow-up period in all of the cases.

CONCLUSION

The study has demonstrated the effect of CGF on relieving the severity of pain after the third molar extraction.

CLINICAL RELEVANCE

Placement of CGF in the extraction socket could relieve postoperative pain and reduce patient discomfort after the third molar extraction. CGF is recommended during the third molar extraction due to its good biological effects, low cost and simple preparation procedures.

TRIAL REGISTRATION NUMBER

ChiCTR2300077819.

摘要

目的

本研究旨在评估浓缩生长因子(CGF)在预防第三磨牙阻生拔除术后并发症方面的效果。

材料和方法

本研究采用随机、双盲、自身对照的Split-mouth 设计,共纳入 25 名双侧对称第三磨牙阻生的健康患者(50 个拔牙窝)。所有患者均在同一时间于下颌双侧进行第三磨牙拔除术。采用抛硬币的方法进行随机分组,选择试验组和对照组拔牙窝。试验组将 CGF 置于拔牙窝内并缝合,对照组仅缝合拔牙窝。每位患者自身作为对照。主要结局指标为术后第 1、3、7 天视觉模拟评分(VAS)评估的疼痛程度和面部肿胀程度。次要结局指标为通过锥形束 CT(CBCT)评估拔牙窝内的骨愈合情况,包括拔牙窝牙槽骨高度(ABH)和牙槽骨密度(ABD),分别在拔牙即刻、术后 3 个月和 6 个月进行。

结果

本研究共纳入 25 名双侧第三磨牙阻生患者(12 名女性,13 名男性;平均年龄 29.17 岁)。与对照组相比,CGF 组术后第 3、7 天的疼痛评分明显降低(第 3 天,p=0.009;第 7 天,p=0.039),而两组在术后第 1 天的疼痛评分无统计学差异。在不同时间点,两组间的面部肿胀和骨愈合情况无统计学差异,尽管 CGF 组的数据略有优势(p>0.05)。在所有患者的随访期间,均未发生感染、牙槽炎、感觉异常、骨折等严重不良事件。

结论

本研究表明 CGF 可减轻第三磨牙拔除术后的疼痛程度。

临床意义

在第三磨牙拔牙窝内放置 CGF 可减轻术后疼痛,减轻患者的不适。由于 CGF 具有良好的生物学效应、成本低、制备简单,因此推荐在第三磨牙拔除术中使用。

临床试验注册

ChiCTR2300077819。

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