摘要：

目的：探究浓缩生长因子（concentrated growth factor，CGF）在促进下颌阻生第三磨牙拔牙创面愈合中的疗效，及对第二磨牙远中骨缺损深度（osseous defect depth，ODD）、临床附着水平（clinical attachment level，CAL）及疼痛应激指标的影响。方法：选择2022年1月至2022年12月于我院拔除下颌阻生第三磨牙的患者共96例，按照随机数表法将患者随机分为研究组（n=48）及对照组（n=48）。对照组在拔牙后不填入任何植入物，研究组填入CGF凝冻物。比较2组患者的术后视觉模拟评分法（visual analogue scale，VAS）评分、面部肿胀情况、疼痛应激指标[5-羟色胺（5-hydroxytryptamine，5-HT）、半乳糖胺（galactosamine，Gal）、降钙素基因相关肽（calcitonin gene related peptide，CGRP）]含量、ODD、CAL及术后生活质量[术后症状严重程度（postoperative symptom severity，PoSSe）量表]。结果：术后1、3 d，研究组的VAS评分分别为（3.72±0.56）、（2.94±0.43）分，均显著低于对照组的（4.81±0.61）、（3.86±0.57）分（P<0.001）；术后研究组的面部肿胀度为（2.79±0.64）mm，低于对照组的（5.46±1.22）mm（P<0.001）；2组术后3 d的5-HT、Gal、CGRP水平均高于术前，研究组分别为（2.46±0.68）ng/mL、（9.56±1.42）nmol/mL、（1.76±0.52）ng/mL，均低于对照组的（3.15±0.46）ng/mL、（13.19±1.08）nmol/mL、（2.89±0.44）ng/mL（P<0.001）；术后6个月，2组的ODD、CAL水平均低于术后1周，研究组分别为（4.21±0.87）、（0.48±0.12）mm，均低于对照组[（5.75±0.61）、（0.73±0.19）mm, P<0.001]；研究组的各项PoSSe评分均低于对照组（P<0.01）。结论：CGF可降低下颌阻生第三磨牙拔牙后患者术后疼痛应激指标水平，改善其拔牙后的疼痛及面部肿胀情况，提高患者术后生活质量。

关键词: 浓缩生长因子, 下颌阻生第三磨牙, 第二磨牙远中骨缺损深度, 临床附着水平, 疼痛应激指标

Abstract:

Objective: To explore the efficacy of concentrated growth factor (CGF) in promoting wound healing after extraction of mandibular impacted third molar and its influences on distal osseous defect depth (ODD) of second molar, clinical attachment level (CAL) and pain stress indexes. Methods: A total of 96 patients undergoing extraction of mandibular impacted third molar in the hospital between January and December 2022 were enrolled. According to random number table method, they were divided into research group (n=48) and control group (n=48). After extraction, control group was not given any implant, while research group was given CGF congelation. The postoperative scores of visual analogue scale (VAS), degree of facial swelling, contents of pain stress indexes [5-hydroxytryptamine (5-HT), galactosamine (Gal), calcitonin gene-related peptide (CGRP)], ODD, CAL and postoperative quality of life [postoperative symptom severity scale (PoSSe)] were compared between the two groups. Results: At 1 d, and 3 d after surgery, VAS scores in research group were (3.72±0.56) and (2.94±0.43) points, significantly lower than those in control group [(4.81±0.61), (3.86±0.57) points; P<0.001]. After surgery, degree of facial swelling in research group was milder than that in control group [(2.79±0.64) mm vs (5.46±1.22) mm, P<0.001]. At 3 d after surgery, the levels of 5-HT, Gal and CGRP were increased in both groups, which were lower in research group than those before surgery [(2.46±0.68) ng/mL, (9.56±1.42) nmol/mL, (1.76±0.52) ng/mL vs (3.15±0.46) ng/mL, (13.19±1.08) nmol/mL, (2.89±0.44) ng/mL; P<0.001]. At 6 months after surgery, the levels of ODD and CAL were lower than those at one week after surgery in both groups, which were lower in research group than control group [(4.21±0.87), (0.48±0.12) mm vs (5.75±0.61), (0.73±0.19) mm; P<0.001]. PoSSe scores in research group were lower than those in control group (P<0.01). Conclusion: CGF can reduce levels of pain stress indexes after extraction of mandibular impacted third molar, relieve pain and facial swelling, and improve postoperative quality of life in patients.

Key words: concentrated growth factor, mandibular impacted third molar, distal osseous defect depth of second molar, clinical attachment level, pain stress index

中图分类号: 

• R782