A-PRF、CGF在下颌阻生第三磨牙拔除中的恢复效果及对邻近第二磨牙牙槽嵴的影响

doi:10.19439/j.sjos.2025.01.017

摘要/Abstract

摘要： 目的: 比较改良型富血小板纤维蛋白（advanced platelet-rich fibrin,A-PRF）与浓缩生长因子（concentrated growth factor,CGF）用于下颌阻生第三磨牙（M3）拔除术后的恢复效果,以及对邻近第二磨牙（M2）牙槽嵴的影响。方法: 选择2020年9月—2021年8月于金华市中心医院接受下颌阻生M3拔除患者150例,其中A组（n=49）接受常规缝合,B组（n=51）接受常规缝合+A-PRF填充,C组（n=50）接受常规缝合+CGF填充。比较3组患者术后临床指标、软组织愈合情况、牙槽骨密度变化以及M2牙槽嵴高度变化,分析3组患者并发症和不良反应发生情况。采用SPSS 20.0软件包进行数据分析。结果: 术后1周,3组患者疼痛程度、肿胀程度低于治疗前（P<0.05）,且B组<C组<A组（P<0.05）;开口度均高于治疗前（P<0.05）,且B组>C组>A组（P<0.05）,软组织愈合情况B组优于C组优于A组（P<0.05）。术后6周和12周,3组患者牙槽骨密度高于术后即刻（P<0.05）,且B组>C组>A组（P<0.05）;术后6周、术后12周,B、C两组间比较差异有统计学意义（P<0.05）。术后12周,3组M2牙槽嵴高度（ΔH）低于术后即刻（P<0.05）,且B、C组低于A组（P<0.05）。出血、感染、干槽症等并发症发生率及神经损伤、牙周组织溢脓发生率B组<C组<A组,其中并发症发生率比较差异有统计学意义（P<0.05）。结论: A-PRF和CGF对M2牙槽嵴的影响及术后不良反应情况相似,但A-PRF对颌阻生M3患者的临床症状改善作用以及对患者拔除牙后恢复的促进作用优于浓缩生长因子,且并发症少,值得临床推广。

关键词: 改良型富血小板纤维蛋白, 浓缩生长因子, 下颌阻生第三磨牙拔除术, 远端第二磨牙牙槽嵴高度

Abstract: PURPOSE: To compare the recovery effect of advanced platelet-rich fibrin (A-PRF) and concentrated growth factor (CGF) in the treatment of mandibular impacted third molar(M3) extraction, and the effect on alveolar ridge of the adjacent second molar(M2). METHODS: A total of 150 patients who received mandibular impacted M3 extraction in Jinhua Central Hospital from September 2020 to August 2021 were included. Among them, group A (n=49) received conventional suture, group B (n=51)received conventional suture +A-PRF filling, and group C(n=50) received conventional suture +CGF filling. Postoperative clinical indexes, soft tissue healing, alveolar bone density changes and M2 alveolar ridge height changes were compared among the three groups. Meanwhile, complications and adverse reactions were recorded and compared among the three groups. SPSS 20.0 software package was used for data analysis. RESULTS: One week after surgery, the pain degree and swelling degree of the three groups were lower than before treatment(P<0.05), and group B < group C < group A(P<0.05). Mouth opening degree was higher than before treatment(P<0.05), group B > group C > group A (P<0.05), and the soft tissue healing condition of group B was better than that of group C, and than that of group A(P<0.05). At 6 weeks and 12 weeks after surgery, the alveolar bone mineral density of the three groups was higher than that immediately after surgery(P<0.05), and group B > group C > group A(P<0.05). There were significant differences between group B and C at 6 weeks and 12 weeks after surgery (P<0.05). The M2 alveolar ridge height (ΔH) 12 days after surgery was lower than that immediately after surgery(P<0.05), and group B and C was lower than that of group A (P<0.05). The incidence of complications such as bleeding, infection, dry socket, nerve injury and periodontal pus discharge in group B < group C < group A, and the incidence of complications was statistically significant(P<0.05). CONCLUSIONS: The effects of A-PRF and CGF on M2 alveolar ridge and postoperative adverse reactions are similar, but A-PRF is better than CGF in improving clinical symptoms and promoting postoperative recovery in maxillary impacted M3 patients, with fewer complications, and is worthy of clinical promotion.

Key words: Advanced platelet-rich fibrin, Concentrated growth factor, Extraction of mandibular impacted third molar, Distal second molar alveolar crest height

中图分类号:

R782.1

濮莉莉, 陈春晖, 童熹. A-PRF、CGF在下颌阻生第三磨牙拔除中的恢复效果及对邻近第二磨牙牙槽嵴的影响[J]. 上海口腔医学, 2025, 34(1): 94-99.

PU Li-li, CHEN Chun-hui, TONG Xi. Comparison of the effect of A-PRF and CGF on the recovery of mandibular impacted third molar after extraction and on alveolar ridge of the adjacent second molar[J]. Shanghai Journal of Stomatology, 2025, 34(1): 94-99.

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