富血小板纤维蛋白与羟基磷灰石治疗根尖周围炎性病变：前瞻性临床放射学比较分析

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology Pub Date : 2025-03-10 DOI:10.1016/j.ajoms.2025.03.005

Swasti Bhardwaj, Gaurav Singh, Amit Gaur

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引用次数: 0

摘要

目的评价和比较富血小板纤维蛋白（PRF）或羟基磷灰石（HA）骨移植作为根尖周缺损填充材料后的临床和影像学结果。方法选取上颌前区（1 ~ 2 cm）根尖周病变患者60例。他们被随机分为三组，每组20名患者。切除整个根尖周病变，手工刮除。完成根尖周围手术（根尖切除术）后；ⅰ组（对照组）缺损不补，ⅱ组采用HA骨移植，ⅲ组采用PRF。在不同的时间间隔评估临床和放射学参数。结果两组患者术后疼痛程度差异无统计学意义，第三组患者术后疼痛程度最低。所有组最初均出现肿胀，但第三组消退更快。第1个月和第3个月时，第三组的牙齿活动最少，第6个月时，第二组和第三组的牙齿没有活动。第三组软组织愈合效果最好。第1、6、9个月时，III组平均骨密度最高，差异有统计学意义（P = .033）；第9个月时，I组与III组间比较差异有统计学意义（P = .043）。结论prf因其自身的特性、成本效益和通过释放生长因子促进愈合的能力而成为首选的移植材料。然而，在PRF和羟基磷灰石之间的选择应以具体的临床要求和期望的结果为指导。

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Platelet rich fibrin versus hydroxyapatite in the management of periapical inflammatory lesions: A prospective clinico-radiographic comparative analysis

Objective

This study evaluates and compares clinical and radiographic outcomes following periapical surgery using Platelet Rich Fibrin (PRF) or Hydroxyapatite (HA) bone graft as filling materials for periapical defects.

Method

Sixty patients with periapical pathology in the maxillary anterior region (1–2 cm) were included. They were randomly divided into three groups of 20 patients each. The entire periapical lesion was removed and manual curettage was done. After completion of periapical surgery (Apicoectomy); Group I(control) had the defect left unfilled, Group II received HA bone graft, and Group III received PRF. Clinical and radiographic parameters were assessed at various intervals.

Result

No statistically significant difference in post-operative pain was found among the groups, though Group III experienced the least pain. Swelling was present initially in all groups but resolved faster in Group III. Tooth mobility was least in Group III at the 1st and 3rd months, with no mobility in Groups II and III by the 6th month. Group III exhibited the best soft tissue healing. Mean bone density was highest in Group III at 1st, 6th, and 9th months, with a statistically significant result in group III(P = .033) and in intragroup comparison between Groups I and III at 9 months (P = .043).

Conclusion

PRF emerged as the preferred graft material due to its autologous nature, cost-effectiveness and ability to promote healing through the release of growth factors. However, the choice between PRF and hydroxyapatite should be guided by specific clinical requirements and desired outcomes.

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