背景:浓缩生长因子(CGF),一种新的自体血小板浓缩物,已被广泛研究用于口腔疾病的辅助治疗。本研讨旨在评价CGF在口腔疾病外科医治中的疗效。
方法:MEDLINE,WebofScience,Scopus,科克伦,和EMBASE数据库在2023年7月之前进行了搜索。仅包括随机临床试验。通过Cochrane偏差风险工具评估方法学质量。采用RevMan5.4软件进行数据分析。
结果:在牙周内缺损的治疗中,植骨联合CGF明显优于植骨(P<0.01),平均骨内缺损深度减少1.41mm,平均临床附着水平增加0.55mm。在分叉缺损的再生手术中,CGF组疗效明显优于对照组(P<0.0001),平均探测深度减少0.99毫米,垂直骨增益为0.25mm,水平骨增益为0.34mm。CGF联合冠状进展皮瓣(CAF)比单独CAF更有效(平均角化组织宽度增加0.41mm,平均牙龈厚度增加0.26毫米,P<0.00001),但效果不如结缔组织移植物(CTG)联合CAF(平均根覆盖率差异为-15.1%,平均牙龈厚度差-0.5毫米,P<0.0001)。在牙槽的保存中,与对照组相比,额外使用CGF可使水平骨吸收减少1.41mm,颊垂直骨吸收减少1.01mm(P<0.0001)。CGF组在口腔手术后第1天和第7天的VAS评分明显低于对照组(P<0.0001)。
结论:CGF对牙周内缺损的再生手术具有积极的辅助作用,分叉缺陷,和牙槽嵴保存程序.CGF联合CAF对牙龈萎缩的治疗效果优于单纯CAF,尽管它不如CTG联合CAF有效。CGF可以在一周内促进口腔手术的术后愈合和疼痛缓解。目前没有足够的证据支持CGF在其他口腔手术中的临床益处。
Concentrated growth factor (CGF), a new autologous platelet concentrate, has been widely investigated to the adjunctive treatment of oral diseases. This study aims to evaluate the efficacy of CGF in the surgical treatment of oral diseases.
MEDLINE, Web of Science, Scopus, Cochrane, and EMBASE databases were searched up to July 2023. Only randomized clinical trials were included. The methodologic quality was evaluated by the Cochrane Risk of Bias Tool. RevMan 5.4 software was used for data analysis.
In the treatment of periodontal intrabony defects, bone graft combined with CGF was significantly superior to bone graft (P < 0.01), with mean intrabony defect depth reduction of 1.41 mm and mean clinical attachment level gain of 0.55 mm. In the regenerative surgery of furcation defects, the effect of CGF group was significantly better than control group (P < 0.0001), with mean probing depth reduction of 0.99 mm, vertical bone gain of 0.25 mm, and horizontal bone gain of 0.34 mm. CGF combined with coronally advanced flap (CAF) was more effective than CAF alone (mean keratinized tissue width increase of 0.41 mm, mean gingival thickness increase of 0.26 mm, P < 0.00001), but less effective than connective tissue graft (CTG) combined with CAF (mean root coverage difference of -15.1%, mean gingival thickness difference of -0.5 mm, P < 0.0001). In the alveolar ridge preservation, additional use of CGF reduced horizontal bone resorption by 1.41 mm and buccal vertical bone resorption by 1.01 mm compared to control group (P < 0.0001). The VAS score of CGF group was significantly lower than that of the control group at the 1st and 7th day after oral surgery (P < 0.0001).
CGF can exert a positive adjunctive effect for the regenerative surgery of periodontal intrabony defects, furcation defects, and alveolar ridge preservation procedure. CGF combined with CAF has a better therapeutic effect on gingival recession compared to CAF alone, although it is not as effective as CTG combined with CAF. CGF could promote postoperative healing and pain relief in oral surgery within a week. There is currently not enough evidence to support the clinical benefits of CGF in other oral surgeries.