改良型富血小板纤维蛋白预防下颌阻生智齿拔除术后并发症的效果

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摘要目的探讨应用改良型富血小板纤维蛋白(advanced platelet-rich fibrin,A-PRF)预防下颌阻生智齿拔除术后并发症的效果。方法选取20例需拔除双侧下颌智齿患者,每名患者随机筛选一侧牙槽窝,行A-PRF填充(试验组);另一侧行常规缝合处理(对照组)。比较术后1、7d两侧拔牙窝疼痛程度、疼痛发生率及软组织肿胀程度,同时评价不同处理方式后张口度及术后3个月第二磨牙远中牙周袋深度。结果试验组牙槽窝术后1d后疼痛分级为4.25,低于对照组的6.20(P<0.05),且疼痛发生比例低于对照组牙槽窝。随着时间延长,两侧牙槽窝的术后疼痛级别都显著下降。拔牙后1 d,试验组牙槽窝肿胀度为(0.59±0.09)cm,张口度为(3.79±1.25)cm,皆显著低于对照组(P<0.05);7 d后对照组和试验组两侧肿胀程度分别为(0.025±0.09)cm和(0.013±0.07)cm,两组无统计学差异;术后3个月两侧第二磨牙远中牙周袋探诊深度分别为(4.61±0.27)mm和(3.39±0.29)mm(P<0.05)。结论 A-PRF的应用可以有效减少下颌阻生智齿拔牙术后并发症的发生。

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关键词 ：改良型富血小板纤维蛋白, 术后疼痛, 肿胀程度, 张口度, 牙周袋探诊深度。

Abstract：Objective To study the effect of advanced platelet-rich fibrin (A-PRF) on prevention of postoperative complications after extraction of impacted mandibular wisdom teeth.Methods According to the inclusion criteria, 20 patients with bilateral mandibular wisdom teeth that needed to be removed were selected, and one alveolar fossa was randomly selected from each patient to receive A-PRF filling (experimental group). Conventional suture was performed on the other side (control group). The pain index of on postoperative day 1 and 7 was evaluated by the VAS system and the incidence of pain was also calculated. Meanwhile, the swelling degree, mouth opening degree on postoperative day 1 and 7and the depth of the distal periodontal pocket of the second molar three months after operation were compared to analyze the clinical effect of A-PRF.Results The pain grade of the experimental group was 4.25 on the first day after operation, much lower than that of the control group (P<0.05). The incidence of pain was lower than that of the alveolar fossa on the control side. The pain degree decreased substantially with time. On the first day after tooth extraction, the alveolar swelling degree of the experimental group was 0.59±0.09 cm, and the opening degree was 3.79±1.25 cm, significantly lower than in the control group (P<0.05). Seven days after operation, the swelling degree on both sides was 0.025±0.09 and 0.013±0.07, respectively, so there was no statistically significant difference between the two groups(P>0.05). Three months after operation, the depth of distal periodontal pockets of the second molars on both sides was 4.61±0.27mm and 3.39±0.29mm respectively and there was significant difference between the two groups(P<0.05).Conclusions The application of A-PRF can effectively reduce the occurrence of postoperative complications after tooth extraction of impacted mandibular wisdom teeth.

Key words： advanced platelet-rich fibrin post-operative pain swelling degree mouth opening degree pocket probing depth

收稿日期: 2020-11-02

ZTFLH:

R78

作者简介: 王立军,博士,主任医师。

引用本文:

王立军, 王晴, 候文辉, 袁旭红, 刘效群. 改良型富血小板纤维蛋白预防下颌阻生智齿拔除术后并发症的效果[J]. 武警医学, 2021, 32(4): 300-303. WANG Lijun, WANG Qing, HOU Wenhui, YUAN Xuhong, LIU Xiaoqun. Clinical effect of A-PRF on postsurgical complications of extraction of impacted mandibular teeth. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(4): 300-303.

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http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2021/V32/I4/300

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