浓缩生长因子在自体牙移植术中的临床应用研究

Clinical application of concentrated growth factors in autotransplantation of teeth

目的评价浓缩生长因子(concentrated growth factor,CGF)在自体牙移植中的临床应用效果。方法选取2018年9月至2019年9月于新疆医科大学第一附属医院颌面外科门诊行自体牙移植的82例患者,共有84颗患牙完成自体牙移植,并随机分为CGF组和单纯移植组,每组42颗。两组患者均在术前拍摄锥形束CT(CBCT),并应用3D打印供牙模型指导牙槽窝预备。CGF组患者在受区牙槽窝内放置CGF后再将供牙植入;单纯移植组患者仅植入供牙,牙槽窝内不放置CGF。分析比较两组患者术中供牙植入后的初期稳定性,以及术后第1、3、7天临床症状[包括疼痛程度(VAS评分)、肿胀度、开口度],并对术后1年疗效进行评价。结果 CGF组术中供牙初期稳定性优于单纯移植组(P <0.05)。CGF组术后第1、3天疼痛程度低于单纯移植组,差异具有统计学意义(P <0.05);术后第7天两组的疼痛程度差异无统计学意义(P> 0.05)。两组术后第1、7天开口度及肿胀度差异无统计学意义(P> 0.05);术后第3天CGF组开口度及肿胀度优于单纯移植组,差异具有统计学意义(P <0.05)。术后随访1年,CGF组成功率和存留率分别为92.9%和97.6%,单纯移植组成功率和存留率分别为76.2%和90.5%;CGF组成功率高于单纯移植组,差异有统计学意义(P <0.05);两组存留率差异无统计学意义(P> 0.05)。结论 CGF应用于自体牙移植取得较好的临床应用效果,可减轻患者术后症状,有利于移植牙稳固,提高自体牙移植成功率。

Objective To evaluate the clinical effect of concentrated growth factors(CGF)in autotransplantation of teeth. Methods Totally 84 teeth from 82 patients receiving autotransplantation of teeth were involved in this study,and they were randomly divided into two groups(CGF group and pure transplantation group),each group including 42 teeth. Two groups took CBCT before surgery and 3 D printing model was used to guide alveolar socket preparation. In CGF group,CGF was implanted into the alveolar socket before autotransplantation of teeth,while in the other group,only autotransplantation of teeth was performed. The two groups were analyzed concerning the initial stability of donor teeth,the clinical symptom indexes including pain degree(VAS score),swelling and opening degree,and the clinical effect at1 year after surgery. Results The initial stability of donor teeth in CGF group was better than that in the other group(P < 0.05). The pain degree of CGF group was lower than that of the other group on the 1 st and 3 rd day after surgery,and the difference was statistically significant(P <0.05). There was no significant difference in pain degree between the two groups on the 7 th day(P >0.05). There was no significant difference in the opening or swelling degree between the two groups on the 1 st and 7 th day after surgery(P > 0.05),but CGF group was better on the 3 rd day,with statistical difference(P < 0.05). After 1-year follow-up,the success and survival rate of CGF group was 92.9% and 97.6%,respectively,while the success and survival rate of the other group was76.2% and 90.5%,respectively. The success rate of CGF group was higher than that of the other group,and the difference was statistically significant(P < 0.05). There was no significant difference in survival rate between the two groups(P > 0.05). Conclusion The application of concentrated growth factors in autotransplantation of teeth has achieved good clinical efficacy,which can alleviate postoperative symptoms,is beneficial to the stability of transplanted teeth,and increase the success rate of autotransplantation of teeth.