浓缩生长因子在受区伴有炎症的自体牙移植术中应用效果研究

Application of concentrated growth factor in autogenous tooth transplantation with inflammation in recipient area

目的探讨浓缩生长因子(concentrated growth factor,CGF)在受区伴有炎症的自体牙移植术中应用的临床效果。方法选取2018年6—12月于新疆医科大学第一附属医院颌面外科门诊就诊的需行自体牙移植术且受区伴有炎症患者42例(移植牙42颗),随机分为CGF组和对照组,每组21例。两组患者术前均拍摄锥形束CT并3D打印移植牙模型。受区牙槽窝刮净炎症组织后,CGF组将CGF置于牙槽窝内后再植入移植牙,对照组则直接植入移植牙。术后定期随访,比较两组患者术后疼痛视觉模拟评分(visual analogue scale,VAS)、移植牙松动度及骨愈合等情况。结果术后1、3 d,CGF组VAS分值低于对照组,差异均有统计学意义(均P<0.05)。两组术后即刻及术后1、4周移植牙松动度比较,差异均无统计学意义(均P>0.05)。术后3个月,CGF组受区牙槽骨愈合率显著高于对照组(χ^(2)=14.538,P<0.05);术后6个月,两组受区牙槽骨愈合率比较,差异无统计学意义(P>0.05)。术后24个月,CGF组所有移植牙均达到成功标准,治疗成功率为100%;对照组中有1例发生根外吸收,治疗成功率为95.24%;两组治疗成功率比较,差异无统计学意义(χ^(2)=2.100,P>0.05)。结论在受区伴有炎症的自体牙移植术中应用CGF可能有助于减轻术后愈合早期的疼痛,促进牙槽骨早期愈合。

Objective To investigate the clinical effect of concentrated growth factor(CGF)in autologous tooth transplantation with inflammation in the recipient area.Methods A total of 42 patients(42 teeth)who underwent autologus tooth transplantation(ATT)in our Outpatient Department of Oral and Maxillofacial Surgery from June to December 2018 were selected,and they were divided randomly into CGF group and control group,21 in each group.Cone beam computed tomography(CBCT)was taken and 3D model of donor teeth was printed before operation in both groups.In CGF group,CGF was placed in the alveolar fossa of the recipient site after the inflammatory tissue was curetted,and then the donor teeth were transplanted into the recipient area.In control group,the donor teeth were directly transplanted after inflammatory tissue was curetted.The patients in the two groups were followed up regularly after operation,and the postoperative pain visual analogue scale(VAS),the mobility of transplanted teeth and bone healing were compared between the two groups.Results At 1 and 3 days after operation,the VAS score of CGF group was lower than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the mobility of trans-planted teeth between the two groups immediately and 1 and 4 weeks after operation(P>0.05).The healing rate of alveolar bone of CGF group was significantly higher than that of control group 3 months after operation(χ^(2)=14.538,P<0.05).There wasno significant difference in the healing rate of alveolar bone between the two groups 6 months after operation(P>0.05).At 24 months after operation,all transplanted teeth in CGF group reached the success standard,and the success rate of treatment was 100%.One case in the control group had extraradicular absorption,and the success rate of treatment was95.24%.There was no significant difference in the success rate between the two groups(χ^(2)=2.100,P>0.05).Conclusion The application of CGF in recipient site with chronic periapical lesions may reduce postoperative pain and reaction at the early stage of healing and promote the healing of alveolar bone.