Macedo Dhiancarlo Rocha, Rodrigues Jéssica Ferreira, de Paulo Luiz Fernando Barbosa, de Oliveira Guilherme José Pimentel Lopes, Soares Priscilla Barbosa Ferreira
School of Dentistry, Graduate Program in Dentistry, Hospital Dentistry Area, Federal University of Uberlandia, Uberlandia, MG, Brazil.
School of Dentistry, Graduate Program in Dentistry, Federal University of Uberlandia, Uberlandia, MG, Brazil.
Support Care Cancer. 2025 Apr 21;33(5):397. doi: 10.1007/s00520-025-09428-3.
Osteoradionecrosis (ORN) of the jaw is one of the most significant complications of radiotherapy (RT) for head and neck cancer (HNC), and is primarily attributable to tooth extraction. The objective of this study was to assess the efficacy of advanced platelet-rich fibrin (A-PRF) in preventing ORN after tooth extraction in patients with post-irradiated HNC and other postoperative complications.
The study population comprised 30 patients who previously underwent radiotherapy for HNC and subsequently underwent tooth extraction, with a total of 134 extractions performed. Extraction sockets were randomly assigned to receive either A-PRF (n = 67 [experimental group]); or clot maintenance alone (n = 67 [control group]). Patients were clinically evaluated at 7, 14, 30, 60, 90, and 120 days postoperatively to assess pain and healing of the surgical site. The intensity of postoperative pain was quantified using a visual analog scale. Patients were clinically evaluated for up to 120 days to diagnose ORN. Other postoperative complications, including edema, bleeding, tissue color, consistency, and suppuration, were also evaluated.
In terms of pain and healing, there was no statistically significant difference between the two groups. No ORN or other surgical complications were observed. The use of A-PRF demonstrated no statistically significant differences compared with the control group in most of the parameters evaluated.
A-PRF yielded no additional benefits and did not influence the healing process in the short or medium term. RBR- 3 TDK22P: Date of registration: 02/14/2022.
颌骨放射性骨坏死（ORN）是头颈部癌（HNC）放射治疗（RT）最严重的并发症之一，主要归因于拔牙。本研究的目的是评估高级富血小板纤维蛋白（A-PRF）在预防放疗后HNC患者拔牙后ORN及其他术后并发症方面的疗效。
研究人群包括30例先前接受过HNC放疗并随后接受拔牙的患者，共进行了134次拔牙。拔牙窝随机分为接受A-PRF组（n = 67 [实验组]）；或仅进行血凝块维持组（n = 67 [对照组]）。术后7、14、30、60、90和120天对患者进行临床评估，以评估手术部位的疼痛和愈合情况。使用视觉模拟量表对术后疼痛强度进行量化。对患者进行长达120天的临床评估以诊断ORN。还评估了其他术后并发症，包括水肿、出血、组织颜色、质地和化脓情况。
在疼痛和愈合方面，两组之间无统计学显著差异。未观察到ORN或其他手术并发症。在大多数评估参数中，与对照组相比，使用A-PRF未显示出统计学显著差异。
A-PRF未带来额外益处，且在短期或中期内不影响愈合过程。RBR-3 TDK22P：注册日期：2022年2月14日。
