浓缩生长因子和血凝块作为支架在牙髓再生术中的疗效比较研究

doi:10.13591/j.cnki.kqyx.2024.09.007

摘要/Abstract

摘要：

目的评价和比较浓缩生长因子(CGF)和血凝块(BC)作为支架在牙髓再生术中的治疗效果。方法将来自18名健康儿童的20颗患有牙髓坏死或根尖周炎的单根年轻恒牙随机分到CGF组和BC组。在CGF组(n=10)中,根尖引血后将CGF置入根管内作为支架。在BC组(n=10)中,通过刺激根尖出血,血液进入根管内产生血凝块作为支架。每次复诊进行临床检查及根尖片拍摄。术前及术后24个月进行两次锥形束计算机断层摄影(CBCT)。测量根长、根管壁厚度增加量及新形成的钙化组织体积。结果 CGF组根长增加(1.68±0.90)mm,BC组增加(2.36±1.34)mm。CGF组根管壁厚度增加(0.44±0.34)mm,BC组增加(0.50±0.31)mm。根长和根管壁厚度增量两组间差异无统计学意义(P>0.05)。CGF组新形成的钙化组织体积((22.13±19.12)mm³)显著少于BC组((42.97±22.69)mm³)(P<0.05)。根据美国牙髓病医师协会(AAE)制定的成功目标,90%(9/10)的CGF病例和100%(10/10)的BC病例实现了一级和二级目标(P>0.05)。40%的CGF病例(4/10)和60%的BC病例(6/10)达到了三级目标(P>0.05)。结论 CGF可作为牙髓再生术的支架,但成功率略低于BC组,差异无统计学意义。

关键词: 血凝块, 浓缩生长因子, 牙髓再生, 锥形束计算机断层摄影

Abstract:

Objective To evaluate and compare the treatment efficacy between concentrated growth factor(CGF) and blood clots(BC) as scaffolds in regenerative endodontic procedures(REPs). Methods Twenty young permanent teeth from 18 healthy children with pulp necrosis or periapical periodontitis were randomly divided into CGF group and BC group. In the CGF group(n=10), after apical bleeding, CGF was inserted into the root canal as a stent. In the BC group(n=10), by stimulating apical bleeding, blood entered the root canal and produced blood clots as scaffolds. Clinical examination and apical X-ray shooting were conducted for each follow-up visit. Cone beam computed tomographic(CBCT) images were acquired preoperatively and at the 24-month recall. The increase of root length, root wall thickness, and newly-formed calcified tissue were calculated. Results The root length increased by (1.68±0.90)mm in the CGF group and (2.36±1.34)mm in the BC group. Root wall thickness increased by (0.44±0.34)mm in the CGF group and (0.50±0.31)mm in the BC group. There was no statistically significant difference in root lengthening and root wall thickening between two groups(P>0.05). The amount of newly formed calcified tissue in the CGF group ((22.13±19.12)mm³) was significantly less than that in the BC group ((42.97±22.69)mm³)(P<0.05). According to the goals for success outlined by American Association of Endodontists(AAE), 90%(9/10) of the CGF cases and 100%(10/10) of the BC cases achieved the primary and secondary goals(P>0.05). 40% of the CGF cases(4/10) and 60% of the BC cases(6/10) achieved the tertiary goal(P>0.05). Conclusion CGF is found to be useful as a scaffold for REPs, but the success rate is slightly lower than that of BC group and the difference is not statistically significant.

Key words: blood clot, concentrated growth factor, pulp regeneration, cone beam computed tomography

中图分类号:

R781.05

谢妮娜, 魏路明, 袁长永, 刘浩, 刘雨苗, 刘宗响, 朱绍跃. 浓缩生长因子和血凝块作为支架在牙髓再生术中的疗效比较研究[J]. 口腔医学, 2024, 44(9): 678-684.

XIE Nina, WEI Luming, YUAN Changyong, LIU Hao, LIU Yumiao, LIU Zongxiang, ZHU Shaoyue. A comparative evaluation of concentrated growth factor and blood clot as scaffolds in regenerative endodontic procedures[J]. Stomatology, 2024, 44(9): 678-684.

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