富血小板纤维蛋白、引导组织再生和翻开式手术治疗骨下袋对牙周标志物和糖化血红蛋白的影响。
Impact of Infrabony Defects Treatment on Periodontal Markers and Glycated Hemoglobin Using Platelet-Rich Fibrin, Guided Tissue Regeneration, and Access-Flap Surgery.
机构信息
Faculty of Dental Medicine, "Dunarea de Jos" University, Al. I. Cuza Street 35, 800216 Galati, Romania.
Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, Universitatii Street 16, 700115 Iasi, Romania.
出版信息
Medicina (Kaunas). 2024 Oct 29;60(11):1769. doi: 10.3390/medicina60111769.
: This study evaluated the outcomes of single open-flap debridement, open-flap debridement (OFD) plus resorbable membrane placement, and OFD with resorbable membrane placement plus platelet-rich fibrin (PRF) in terms of periodontal clinical parameters and glycated hemoglobin (HbA1c) levels in 24 adult patients with stage 3 grade C periodontitis and type II diabetes mellitus. : The primary outcome measure for this study was the clinical attachment level (CAL); secondary outcomes included additional periodontal parameters, such as the plaque index (PI), bleeding on probing (BOP), probing depth (PD), as well as glycated hemoglobin (HbA1c) levels to evaluate the systemic impact of the treatments on glycemic control. The parameters were assessed before and at three and six months post-surgery. In Group A, the flap was sutured closed; in Group B, an absorbable collagen membrane was placed over the defect; and in Group C, PRF was utilized in the defect, with two additional PRF membranes used to cover the defect. The wound healing index (WHI) was recorded at 7 and 14 days after the surgery. : The initial findings indicated no significant differences in the periodontal parameters among the three groups. However, improvements in the PD and CAL were most notable in Group C, followed by Group B, with Group A showing the slightest improvement. At six months, there was a highly significant difference in the CAL ( < 0.001). Group C (4.92 ± 0.35) and Group B (4.99 ± 0.31) demonstrated the most significant improvements in the CAL compared to Group A (5.89 ± 0.57). At seven days post-surgery, Group C demonstrated significant healing, with 85% of the sites showing complete healing. By the 14-day mark, all sites in Group C indicated complete healing. Although the HbA1c values did not exhibit statistically significant differences among the groups at baseline, at the 6-month evaluation, all groups showed significantly lower values than baseline. However, the comparison between groups revealed significantly improved values for Group C. : The study's results suggest that PRF is an exceptional material for infrabony defects treatment and notably improves HbA1c levels.
这项研究评估了单瓣清创术、瓣清创术(OFD)加可吸收膜放置以及 OFD 加富含血小板纤维蛋白(PRF)在 24 例患有 3 期 C 级牙周炎和 2 型糖尿病的成年患者的牙周临床参数和糖化血红蛋白(HbA1c)水平方面的结果。这项研究的主要观察指标是临床附着水平(CAL);次要观察指标包括其他牙周参数,如菌斑指数(PI)、探诊出血(BOP)、探诊深度(PD)以及糖化血红蛋白(HbA1c)水平,以评估治疗对血糖控制的系统影响。这些参数在手术前和术后 3 个月和 6 个月进行评估。在 A 组中,瓣缝合关闭;在 B 组中,在缺损处放置可吸收胶原膜;在 C 组中,在缺损处使用富含血小板纤维蛋白(PRF),并用两块额外的 PRF 膜覆盖缺损。在手术后 7 天和 14 天记录伤口愈合指数(WHI)。最初的发现表明,三组之间的牙周参数没有显著差异。然而,PD 和 CAL 的改善在 C 组最为显著,其次是 B 组,A 组的改善最小。在 6 个月时,CAL 有非常显著的差异(<0.001)。C 组(4.92±0.35)和 B 组(4.99±0.31)在 CAL 方面的改善最为显著,而 A 组(5.89±0.57)则改善最小。在手术后 7 天,C 组显示出明显的愈合,85%的部位完全愈合。到第 14 天,C 组的所有部位均显示完全愈合。虽然 HbA1c 值在基线时各组之间没有统计学上的显著差异,但在 6 个月的评估中,所有组的数值均明显低于基线。然而,组间比较显示 C 组的数值显著改善。研究结果表明,富含血小板纤维蛋白(PRF)是治疗骨下缺损的一种极好的材料,可显著改善糖化血红蛋白(HbA1c)水平。