Yuzbasioglu Alper, Eroglu Cennet Neslihan
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, 07058, Turkey.
BMC Oral Health. 2024 Dec 26;24(1):1559. doi: 10.1186/s12903-024-05372-6.
Alveolar osteitis is a type of small-scale osteomyelitis of the alveolar bone that occurs after tooth extraction, the etiology of which remains unknown, and alternative methods are being investigated for its treatment. The aim of this study was to compare the effectiveness of advanced platelet-rich fibrin (A-PRF), photobiomodulation (PBM), and Alveogyl (butamben, idoform, eugenol), which have shown success in the treatment of alveolar osteitis, with that of pentoxifylline (PTX) to determine whether PTX could be an alternative treatment for alveolar osteitis.
This study included 80 healthy volunteers diagnosed with alveolar osteitis in the extraction sockets of their mandibular first, second, and third molars. The patients were divided into four groups, with 20 patients in each group: A-PRF, PBM, PTX, and Alveogyl. After physiological saline irrigation, the patients were treated according to their respective group. The patients were followed up on the 2nd, 4th, 7th, and 14th days. Primary outcomes included pain assessment and the evaluation of soft tissue healing. Pain was assessed via the visual analog scale (VAS), soft tissue healing was evaluated via the Landry Healing Index (LHI), and granulation tissue was measured. Age and sex were used as study variables. The data were analyzed via ANOVA and post hoc tests to compare the treatment groups.
There was no statistically significant difference in the mean VAS score between the groups (p > 0.05). However, the degree of reduction in the VAS score increased in the following order: A-PRF, PBM, PTX, and Alveogyl. In the LHI data, there was a statistically significant difference in the mean scores between the groups, with Alveogyl being favored preoperatively and PBM being favored at the 2nd week (p < 0.05). Statistically significant differences were observed in granulation tissue measurements on the preoperative day, as well as on Days 4 and 7, in favor of Alveogyl on Day 4 and PBM on Day 7 (p < 0.05). The greatest increase in granulation tissue scores was observed in the A-PRF group, whereas the greatest change in LHI scores was observed in the PBM group. PTX did not produce a statistically significant difference in soft tissue healing, although there were periods when it showed results similar to those of Alveogyl and PBM. There were significant differences between the VAS score, granulation tissue score and LHI score in terms of age and sex within the time periods followed.
The findings of this study indicate that although PTX has similar efficacy in terms of wound healing and analgesic properties to the methods used, it does not offer significant advantages. Compared with other methods, A-PRF and PBM have provided better results in the treatment of alveolar osteitis, particularly regarding pain and soft tissue healing.
The study was retrospectively registered in the clinical trial registry with the number TCTR20231014003 on 14.10.2023.
牙槽骨炎是拔牙后发生的一种牙槽骨小规模骨髓炎，其病因尚不清楚，目前正在研究其替代治疗方法。本研究的目的是比较已在牙槽骨炎治疗中取得成功的高级富血小板纤维蛋白（A-PRF）、光生物调节（PBM）和Alveogyl（布坦苯、碘仿、丁香酚）与己酮可可碱（PTX）的疗效，以确定PTX是否可作为牙槽骨炎的替代治疗方法。
本研究纳入了80名健康志愿者，他们被诊断为下颌第一、第二和第三磨牙拔牙窝处患有牙槽骨炎。患者被分为四组，每组20名患者：A-PRF组、PBM组、PTX组和Alveogyl组。用生理盐水冲洗后，患者根据各自分组进行治疗。在第2、4、7和14天对患者进行随访。主要结局包括疼痛评估和软组织愈合评估。通过视觉模拟量表（VAS）评估疼痛，通过兰德里愈合指数（LHI）评估软组织愈合，并测量肉芽组织。将年龄和性别用作研究变量。通过方差分析和事后检验对各治疗组的数据进行分析比较。
各组间VAS评分均值无统计学显著差异（p＞0.05）。然而，VAS评分的降低程度按以下顺序增加：A-PRF组、PBM组、PTX组和Alveogyl组。在LHI数据中，各组间平均得分有统计学显著差异，术前Alveogyl组占优，第2周时PBM组占优（p＜0.05）。术前以及第4天和第7天的肉芽组织测量结果存在统计学显著差异，第4天Alveogyl组占优，第7天PBM组占优（p＜0.05）。肉芽组织评分增加最多的是A-PRF组，而LHI评分变化最大的是PBM组。尽管PTX在某些时期显示出与Alveogyl和PBM相似的结果，但在软组织愈合方面未产生统计学显著差异。在随访期间，VAS评分、肉芽组织评分和LHI评分在年龄和性别方面存在显著差异。
本研究结果表明，尽管PTX在伤口愈合和镇痛特性方面与所用方法具有相似的疗效，但它没有显著优势。与其他方法相比，A-PRF和PBM在牙槽骨炎治疗中取得了更好的效果，尤其是在疼痛和软组织愈合方面。
该研究于2023年10月14日在临床试验注册中心进行回顾性注册，注册号为TCTR20231014003。
