血液衍生物(PRF和CGF)在拔牙后牙槽窝处理中的临床研究

Clinical Study of Blood Derivatives(PRF and CGF)in Post-extraction Socket Management

目的探讨血液衍生物富血小板纤维蛋白(platelet rich fibrin,PRF)和浓缩生长因子(concentrated growth factor,CGF)在拔牙后牙槽窝中使用后对牙槽骨保存程度效果。方法选取2020年12月-2021年3月在重庆市江津区中医院就诊的80例拔牙患者为研究对象,采用随机数表法分为对照组和治疗组,各40例。对照组牙槽窝不做处理,治疗组牙槽窝置入PRF和CGF。观察两组牙槽嵴宽度、高度变化,两组患者牙槽嵴骨量的变化、矿化骨部分填充量。结果治疗组拔牙后30 d、拔牙后90 d牙槽嵴宽度(6.71±0.54)mm、(6.67±0.56)mm、高度(15.71±0.45)mm、(15.64±0.65)mm均显著高于对照组,差异有统计学意义(t=17.565、20.148、16.665、24.649,P<0.001)。对照组拔牙后与术前牙槽嵴宽度比较,差异有统计学意义(F=350.362,P<0.001),治疗组拔牙后与术前牙槽嵴宽度比较,差异无统计学意义(F=1.849,P=0.162)。对照组拔牙后与术前牙槽嵴高度比较,差异有统计学意义(F=336.615,P<0.001),治疗组拔牙后与术前牙槽嵴高度比较,差异无统计学意义(F=1.500,P=0.227)。拔牙后90 d,治疗组牙龈退缩(recession,RCE)(1.33±0.41)mm显著高于对照组,差异有统计学意义(t=2.341,P=0.022);两组患者术前与拔牙后REC比较,差异有统计学意义(F=3.982、6.807,P<0.05)。治疗组矿化骨部分填充量(45.84±11.23)mL显著高于对照组,差异有统计学意义(t=4.137,P<0.001)。结论血液衍生物(PRF和CGF)的应用可有效保存拔牙患者牙槽窝的骨高度和骨宽度。

Objective To investigate the effect of platelet rich fibrin(PRF)and concentrated growth factor(CGF)on al⁃veolar bone preservation after tooth extraction.Methods From December 2020 to March 2021,80 patients with tooth extraction who were treated in the Jiangjin District Hospital of Traditional Chinese medicine in Chongqing were se⁃lected as the research objects.They were randomly divided into control group and treatment group,with 40 cases in each group.The alveolar sockets of the control group were left untreated,while the alveolar sockets of the treatment group were implanted with PRF and CGF.The changes of the width and height of the alveolar ridge in the two groups was observed;the changes of the bone mass of the alveolar ridge in the two groups;the filling amount of the mineral⁃ized bone part were observed.Results The alveolar ridge width(6.71±0.54)mm,(6.67±0.56)mm,height(15.71±0.45)mm,(15.64±0.65)mm in the treatment group 30 days and 90 days after tooth extraction were significantly higher than those in the control group,the difference was statistically significant(t=17.565,20.148,16.665,24.649,P<0.001).Compared with the alveolar ridge width before and after tooth extraction in the control group,the difference was statis⁃tically significant(F=350.362,P<0.001),but there was no significant difference between the alveolar ridge width after tooth extraction and before operation in the treatment group(F=1.849,P=0.162).Comparison of alveolar ridge height after tooth extraction and before operation in the control group,the difference was statistically significant(F=336.615,P<0.001),but there was no significant difference between the alveolar ridge height after tooth extraction and before op⁃eration in the treatment group(F=1.500,P=0.227).90 days after tooth extraction,gingival recession(RCE)(1.33±0.41)mm in the treatment group was significantly higher than that in the control group,the difference was statistically significant(t=2.341,P=0.022).The REC of the two groups was compared before operation and after tooth extraction,the difference was statistically significant(F=3.982,6.807,P<0.05).The filling amount of mineralized bone in the treatment group(45.84±11.23)mL was significantly higher than that in the control group,the difference was statisti⁃cally significant(t=4.137,P<0.001).Conclusion The application of blood derivatives(PRF and CGF)can effectively preserve the bone height and bone width of the alveolar socket in patients with tooth extraction.