超声骨刀联合富血小板纤维蛋白在上颌窦底外提升术中的应用

The clinical outcome of platelet-rich fibrin and piezosurgery in lateral sinus lift: a preliminary study

目的:探讨超声骨刀联合富血小板纤维蛋白(PRF)在上颌窦底外提升术中应用的临床效果。方法:选取2015年5月1日至2016年5月1日于温州医科大学附属口腔医院就诊需行上颌窦底外提升术的种植患者56例,随机分为2组(A组和B组)。A组(n=28)为超声骨刀组:A1组(n=14):超声骨刀联合PRF行上颌窦底外提升术,A2组(n=14):超声骨刀行上颌窦底外提升术;B组(n=28)为传统球钻组:B1组(n=14):传统球钻联合PRF行上颌窦底外提升术,B2组(n=14):传统球钻行上颌窦底外提升术。采用视觉模拟量表(VAS)评价患者术中舒适度、术后疼痛水平(第1、2、3、7天),比较各组上颌窦黏膜破裂率、术后止痛药服用量的差别(第1、第2、第3、第7天)。结果:A组术中舒适度评分显著优于B组,差异有统计学意义(P<0.05);A组上颌窦黏膜破裂率低于B组,差异有统计学意义(P<0.05);A1组与B1组、A2组与B2组术后疼痛评分和止痛药剂量差异均无统计学意义(P>0.05),A1组与A2组、B1组与B2组的术后疼痛评分和止痛药剂量差异均有统计学意义(P<0.05)。结论:超声骨刀在上颌窦底外提升术中安全可靠,与PRF联合应用能够有效减轻患者术中和术后不适。

Objective： To investigate the clinical outcome of platelet-rich fibrin （PRF） and piezosurgery in lateral sinus lift （LSL）. Methods： Fifty-six patients from Stomatology Hospital of Wenzhou Medical University were randomly divided into two main groups：group A and group B. The piezosurgery was used in group A （n=28） for LSL with PRF （Group A1, n=14） or without PRF （Group A2, n=14）, and the traditional surgery was per-formed in group B （n=28） for LSL with PRF （Group B1, n=14） or without PRF （Group B2, n=14）. The feelling of treatment and postoperative pain （postoperative days 1, 2, 3, and 7） were analyzed by visual analog scale （VAS）, and the perforation rate of maxillary sinus membrane and the number of analgesics taken （postoperative days 1, 2, 3, and 7） were also recorded. All of these data were analyzed with SPSS 17.0 software. Results： A significant lower VAS score （the feeling of treatment） was found in group A, compared with group B （P〈0.05）. Meanwhile, the perforation rate of maxillary sinus membrane of group A was lower than that of group B （P〈0.05）. The differ-ence of postoperative pain and the number of analgesics taken in group A1-B1 and group A2-B2 were both not significant （P〉0.05）. However, a significant difference of postoperative pain and the number of analgesics taken was found in group A1-A2 and group B1-B2 （P〈0.05）. Conclusion： Piezosurgery is safe and reliable in LSL, which can also reduce intraoperative and postoperative discomfort feeling when combined with PRF.