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Use of leukocyte and platelet-rich fibrin (L-PRF) in periodontally accelerated osteogenic orthodontics (PAOO): clinical effects on edema and pain

机译:白细胞和富含血小板的纤维蛋白(L-PRF)在牙周加速成骨正畸(PAOO)中的应用:对水肿和疼痛的临床影响

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摘要

Background: Demand for shorter treatment time is common in orthodontic patients. Periodontally Accelerated Osteogenic Orthodontics (PAOO) is a somewhat new surgical procedure which allows faster tooth movement via combining orthodontic forces with corticotomy and grafting of alveolar bone plates. Leukocyte and Platelet-Rich Fibrin (L-PRF) possess hard- and soft-tissue healing properties. Further, evidence of pain-inhibitory and anti-inflammatory potential is growing. Therefore, this study explores the feasibility, intra- and post-operative effects of using L-PRF in PAOO in terms of post-operative pain, inflammation, infection and post-orthodontic stability. Material and Methods: A pilot prospective observational study involving a cohort of 11 patients was carried out. A Wilcko’s modified PAOO technique with L-PRF (incorporated into the graft and as covering membrane) was performed with informed consent. Post-surgical pain, inflammation and infection were recorded for 10 days post-operatively, while the overall orthodontic treatment and post-treatment stability were followed up to 2 years. Results: Accelerated wound healing with no signs of infection or adverse reactions was evident. Post-surgical pain was either “mild” (45.5%) or “moderate” (54.5%). Immediate post-surgical inflammation was either “mild” (89.9%) or “moderate” (9.1%). Resolution began on day 4 where most patients experienced either “mild” or no inflammation (72.7% and 9.1%, respectively). Complete resolution was achieved in all patients by day 8. The average orthodontic treatment time was 9.3 months. All cases were deemed stable for 2 years. Conclusions: L-PRF is simple and safe to use in PAOO. Combination with traditional bone grafts potentially accelerates wound healing and reduces post-surgical pain, inflammation, infection without interfering with tooth movement and/or post-orthodontic stability, over a 2 years period; thus alleviating the need for analgesics and anti-inflammatory medications.
机译:背景:正畸患者普遍要求缩短治疗时间。牙周加速成骨正畸(PAOO)是一种新的外科手术方法,它通过结合正畸力与皮质切开术和牙槽骨接骨板的结合,实现更快的牙齿运动。白细胞和富含血小板的纤维蛋白(L-PRF)具有硬组织和软组织的愈合特性。此外,止痛和抗炎潜力的证据正在增长。因此,本研究从术后疼痛,炎症,感染和正畸后稳定性方面探讨了在PAOO中使用L-PRF的可行性,术中和术后效果。材料和方法:进行了一项涉及11名患者的前瞻性前瞻性观察研究。在获得知情同意的情况下,进行了Wilcko改良的带有L-PRF的PAOO技术(掺入移植物并作为覆盖膜)。术后10天记录手术后疼痛,炎症和感染情况,而总体正畸治疗和治疗后稳定性随访2年。结果:伤口愈合加快,无感染或不良反应迹象。手术后疼痛为“轻度”(45.5%)或“中度”(54.5%)。术后立即发炎为“轻度”(89.9%)或“中度”(9.1%)。解决方法从第4天开始,大多数患者出现“轻度”炎症或无炎症(分别为72.7%和9.1%)。到第8天,所有患者均获得完全解决。正畸平均治疗时间为9.3个月。所有病例均被视为稳定2年。结论:L-PRF在PAOO中使用简单且安全。与传统的骨移植物相结合可以在2年的时间内加速伤口的愈合并减轻术后疼痛,炎症,感染,而不会影响牙齿的移动和/或正畸后的稳定性;因此减轻了对止痛药和消炎药的需求。

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