PRF联合自体骨对下颌第三磨牙拔除后第二磨牙远中骨缺损修复的效果研究

Effect of PRF combined with autogenous bone on repair of distal bone defect of second molar after mandibular third molar extraction

目的探讨富血小板纤维蛋白(PRF)联合自体骨对下颌第三磨牙拔除后第二磨牙远中骨缺损修复的效果。方法采用随机数字表法将2020年1月至2021年10月该院收治的61例因拔除下颌阻生第三磨牙致第二磨牙远中骨缺损患者分为观察组(31例)和对照组(30例)。对照组给予单纯下颌第三磨牙拔除术治疗,观察组在单纯下颌第三磨牙拔除术治疗基础上给予PRF联合自体骨治疗。观察2组患者不同时间点磨牙修复情况、术后恢复情况、骨组织指标、并发症发生率等。结果观察组患者随访结束后第二磨牙远颊角骨缺损深度、磨牙远颊至牙周袋间距、磨牙远颊至釉牙骨质界距离均明显低于对照组,修复24 h、7 d后视觉模拟疼痛量表评分均明显低于对照组,张口度明显大于对照组,肿胀度明显轻于对照组,修复1、3个月,随访结束后平均灰度值均明显高于对照组,并发症发生率明显低于对照组,差异均有统计学意义(P<0.05)。结论PRF联合自体骨不仅可通过提高第二磨牙缺损患者骨密度,改善骨组织,修复磨牙远中骨缺损,明显降低并发症发生率,还可减轻患者面部肿胀程度及疼痛反应,改善张口受限,有效促进疾病恢复。

Objective To investigate the effect of platelet rich fibrin(PRF)combined with autogenous bone on the repair of distal bone defect of second molar after mandibular third molar extraction.Methods Sixty-one patients with distal bone defect of the second molar caused by the extraction of the impacted mandibular third molar in this hospital from January 2020 to October 2021 were divided into the observation group(31 cases)and control group(30 cases)by the random number table method.The control group was treated by simple mandibular third molar extraction and the observation group was given the PRF combined with autogenous bone treatment on this basis.The molar repair,postoperative recovery,bone tissue indexes and the incidence rate of complications at different time points were observed in the two groups.Results After the follow-up end,the depth of distal buccal horn defect of second molar,distance between distal buccal and periodontal pockets of molars and the distance of molar distal cheek to cementum border in the observation group were lower than those in the control group;at 24 h and on 7 d after repair,the VAS score of the observation group was lower than that of the control group,the mouth opening degree was greater than that of the control group,and the swelling degree was lighter than that of the control group;the average grayscale value(MGVs)in 1,3 months after repair and at the follow up end in the observation group was significantly higher than that in the control group;the incidence rate of complications in the observation group was lower than that in the control group(P<0.05).Conclusion PRF combined with autogenous bone not only can repair the distal bone defect of the second molar and significantly reduce the incidence rate of complications by increasing the bone density and improving bone tissue,but also reduce the degree of facial swelling and pain reaction,improve the mouth opening limitation,and effectively promote the recovery of the disease.