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Autologous platelet concentrates as adjuvant in the surgical management of medication‐related osteonecrosis of the jaw 自体血小板浓缩物作为手术治疗药物性颌骨坏死的辅助药物
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-30 DOI: 10.1111/prd.12608
Francesco Bennardo, Selene Barone, Alessandro Antonelli, Amerigo Giudice
Medication‐related osteonecrosis of the jaw (MRONJ) is an infectious side effect associated with bisphosphonates and monoclonal antibodies (denosumab, immune modulators, and antiangiogenic medications). Adjunctive therapies for the surgical management of MRONJ include autologous platelet concentrates (APCs). These APCs serve as a source of various cells and growth factors that aid tissue healing and regeneration. This review evaluated the use of platelet‐rich plasma (PRP), plasma‐rich in growth factors (PRGF), and leukocyte‐ and platelet‐rich fibrin (L‐PRF) as adjuvant therapies for the surgical management of MRONJ by conducting analyses on the results of 58 articles. Compared to surgical treatment alone, the application of PRP and L‐PRF after surgery appears to increase healing in the management of patients with MRONJ. No studies have reported unhealed lesions as a result of surgical treatment of MRONJ with PRGF application or compared it with surgical treatment alone. The overall results of this review have shown favorable healing rates of MRONJ lesions managed with the application of APCs after surgical treatment; however, significant methodological limitations may limit the scientific evidence supporting their use. Further randomized controlled trials with strict criteria are needed to establish the extent to which APCs can improve wound healing and quality of life in patients with MRONJ requiring surgical treatment.
药物相关性颌骨坏死(MRONJ)是与双磷酸盐类药物和单克隆抗体(地诺苏单抗、免疫调节剂和抗血管生成药物)相关的一种感染性副作用。手术治疗 MRONJ 的辅助疗法包括自体血小板浓缩物(APC)。这些 APCs 可作为各种细胞和生长因子的来源,帮助组织愈合和再生。本综述通过对58篇文章的结果进行分析,评估了富血小板血浆(PRP)、富含生长因子的血浆(PRGF)以及白细胞和富血小板纤维蛋白(L-PRF)作为辅助疗法用于MRONJ手术治疗的情况。与单纯的手术治疗相比,术后应用 PRP 和 L-PRF 似乎能提高 MRONJ 患者的愈合率。没有研究报告称 MRONJ 手术治疗后应用 PRGF 导致病变未愈合,也没有研究将其与单纯手术治疗进行比较。本综述的总体结果表明,手术治疗后应用 APCs 治疗 MRONJ 病变的愈合率较高;然而,方法上的重大局限性可能会限制支持使用 APCs 的科学证据。需要进一步开展严格标准的随机对照试验,以确定 APC 在多大程度上可以改善需要手术治疗的 MRONJ 患者的伤口愈合和生活质量。
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引用次数: 0
Periodontal regeneration using platelet-rich fibrin. Furcation defects: A systematic review with meta-analysis. 使用富血小板纤维蛋白进行牙周再生。毛面缺损:系统回顾与荟萃分析。
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-26 DOI: 10.1111/prd.12583
Richard J Miron,Vittorio Moraschini,Nathan E Estrin,Jamil Awad Shibli,Raluca Cosgarea,Karin Jepsen,Pia-Merete Jervøe-Storm,Anton Sculean,Søren Jepsen
The objective of the study was to compare the treatment outcomes of periodontal furcation defects by using platelet-rich fibrin (PRF) with other commonly utilized modalities. The eligibility criteria comprised randomized controlled trials (RCTs) comparing the clinical outcomes of PRF with those of other modalities for the treatment of furcation defects. Studies were classified into 11 categories in 3 different groups as follows: Group I (addition of PRF): (1) open flap debridement (OFD) alone versus OFD/PRF, (2) OFD/bone graft (OFD/BG) versus OFD/BG/PRF; Group II (comparative studies to PRF): (3) OFD/BG versus OFD/PRF, (4) OFD/collagen membrane versus OFD/PRF, (5) OFD/PRP versus OFD/PRF, (6) OFD/rhBMP2 versus OFD/PRF; and Group III (addition of biomaterial/biomolecule to PRF): OFD/PRF versus … (7) OFD/PRF/BG, (8) OFD/PRF/amniotic membrane (AM), (9) OFD/PRF/metformin, (10) OFD/PRF/bisphosphonates, (11) OFD/PRF/statins. Weighted means and forest plots were calculated for the reduction of probing pocket depth (PPD), gain of vertical and horizontal clinical attachment levels (VCAL and HCAL), gain in vertical and horizontal bone levels (VBL, HBL), and radiographic bone fill (RBF). From 45 articles identified, 21 RCTs reporting on class II furcations were included. The use of OFD/PRF and OFD/BG/PRF statistically significantly reduced PPD and improved VCAL and HCAL when compared to OFD or OFD/BG, respectively. The comparison between OFD/PRF alone versus OFD/BG, OFD/CM, OFD/PRP, or OFD/rhBMP2 led to similar outcomes for all investigated parameters, including a reduction in PPD, VCAL/HCAL gain, and RBF. The additional incorporation of a BG to OFD/PRF only mildly improved outcomes, whereas the addition of AM improved clinical outcomes. The addition of small biomolecules such as metformin, bisphosphonates, or statins all led to significant improvements in PPD, VCAL, and HCAL when compared to OFD/PRF alone. Noteworthy, a very high heterogeneity was found in the investigated studies. The use of PRF significantly improved clinical outcomes in class II furcation defects when compared to OFD alone, with similar levels being observed between OFD/PRF and/or OFD/BG, OFD/CM, OFD/PRP, or OFD/rhBMP2. Future research geared toward better understanding potential ways to enhance the regenerative properties of PRF with various small biomolecules may prove valuable for future clinical applications. Future histological research investigating PRF in human furcation defects is largely needed. The use of PRF in conjunction with OFD statistically significantly improved PPD, VCAL, and HCAL values, yielding comparable outcomes to commonly used biomaterials. The combination of PRF to bone grafts or the addition of small biomolecules may offer additional clinical benefits, thus warranting future investigation.
本研究的目的是比较使用富血小板纤维蛋白(PRF)和其他常用方法治疗牙周沟缺损的效果。研究资格标准包括随机对照试验(RCT),这些试验比较了富血小板纤维蛋白与其他方法治疗毛囊缺损的临床效果。研究分为以下 3 组,共 11 类:第一组(增加 PRF):(1) 单纯开放皮瓣清创术 (OFD) 与 OFD/PRF 比较,(2) OFD/骨移植术 (OFD/BG) 与 OFD/BG/PRF比较;第二组(与 PRF 比较研究):(3) OFD/BG 与 OFD/PRF,(4) OFD/胶原膜与 OFD/PRF,(5) OFD/PRP 与 OFD/PRF,(6) OFD/rhBMP2 与 OFD/PRF;第 III 组(在 PRF 中添加生物材料/生物分子):OFD/PRF与......(7)OFD/PRF/BG,(8)OFD/PRF/羊膜(AM),(9)OFD/PRF/甲福明,(10)OFD/PRF/双膦酸盐,(11)OFD/PRF/胱氨酸。计算了探查袋深度减少(PPD)、垂直和水平临床附着水平增加(VCAL 和 HCAL)、垂直和水平骨水平增加(VBL 和 HBL)以及放射骨填充(RBF)的加权平均值和森林图。从已确定的 45 篇文章中,纳入了 21 项报告 II 类疖肿的 RCT。与 OFD 或 OFD/BG 相比,OFD/PRF 和 OFD/BG/PRF 在统计学上分别显著降低了 PPD,改善了 VCAL 和 HCAL。将 OFD/PRF 单独与 OFD/BG、OFD/CM、OFD/PRP 或 OFD/rhBMP2 进行比较,所有研究参数的结果相似,包括 PPD、VCAL/HCAL 增益和 RBF 的降低。在 OFD/PRF 中添加 BG 仅能轻微改善疗效,而添加 AM 则能改善临床疗效。与单独使用 OFD/PRF 相比,添加二甲双胍、双磷酸盐或他汀类药物等小分子生物制剂都能显著改善 PPD、VCAL 和 HCAL。值得注意的是,所调查研究的异质性非常高。与单独使用 OFD 相比,使用 PRF 能明显改善 II 类毛囊缺损的临床疗效,OFD/PRF 和/或 OFD/BG、OFD/CM、OFD/PRP 或 OFD/rhBMP2 之间的临床疗效相似。未来的研究旨在更好地了解利用各种小型生物分子增强 PRF 再生特性的潜在方法,这可能对未来的临床应用很有价值。未来还需要对 PRF 在人类毛囊缺损中的应用进行组织学研究。PRF与OFD的结合使用在统计学上显著改善了PPD、VCAL和HCAL值,其结果与常用的生物材料相当。将 PRF 与骨移植物结合使用或添加小分子生物材料可能会带来更多临床益处,因此值得在未来进行研究。
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引用次数: 0
Impact of public health and patient-centered prevention strategies on periodontitis and caries as causes of tooth loss in high-income countries. 公共卫生和以患者为中心的预防战略对高收入国家牙周炎和龋齿作为牙齿脱落原因的影响。
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-25 DOI: 10.1111/prd.12592
Thomas Kocher,Peter Meisel,Sebastian Baumeister,Birte Holtfreter
In high-income countries, the oral health of the population is influenced by public health interventions, widespread use of oral care products, dental practice measures, and the cost of dental treatment. We compiled information on changes of the prevalence of proximal and upstream determinants of periodontitis, caries, and tooth loss over the last three decades to outline their potential effects on changes of oral health during this period. Information was retrieved from repeated cross-sectional studies and from published literature. While both the prevalence of edentulism and the number of missing teeth (from the DMF-T index) decreased, the number of sound teeth as well as the total number of teeth increased. The prevalence of severe periodontitis was unchanged, whereas the prevalence of periodontal health and moderate periodontitis may have increased to a minor extent. Concerning oral health risk factors, the proportion of individuals with tertiary education increased, while smoking prevalence declined. More and more people used oral care products. Whether one reimbursement system worked better than another one in terms of tooth retention could not be elucidated. In tooth retention, population-wide use of fluoridated toothpastes had the greatest impact. To some extent, the higher number of teeth present may be related to the more frequent use of interdental cleaning aids and powered toothbrushes. Since there was no decrease in severe periodontitis in most cohorts, periodontal interventions probably contributed little to improved tooth retention.
在高收入国家,人口的口腔健康受到公共卫生干预、口腔护理产品的广泛使用、牙科实践措施和牙科治疗费用的影响。我们汇编了过去三十年牙周炎、龋齿和牙齿脱落的近端和上游决定因素流行率变化的信息,以概述它们在此期间对口腔健康变化的潜在影响。我们从反复进行的横断面研究和已发表的文献中获取了相关信息。虽然缺牙症的发病率和缺失牙齿的数量(来自 DMF-T 指数)都有所下降,但健全牙齿的数量和牙齿总数却有所增加。重度牙周炎的患病率没有变化,而牙周健康和中度牙周炎的患病率可能略有增加。在口腔健康风险因素方面,受过高等教育的人的比例增加了,而吸烟率下降了。越来越多的人使用口腔护理产品。在保持牙齿方面,一种报销制度是否比另一种报销制度更有效,目前还无法阐明。在牙齿保留方面,全民使用含氟牙膏的影响最大。在某种程度上,牙齿数量增加可能与更频繁地使用牙间清洁辅助工具和电动牙刷有关。由于大多数队列中的严重牙周炎没有减少,因此牙周干预措施可能对提高牙齿保留率作用不大。
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引用次数: 0
Inflammation indices in association with periodontitis and cancer. 与牙周炎和癌症相关的炎症指数。
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-24 DOI: 10.1111/prd.12612
Kay-Arne Walther,Sabine Gröger,Jonas Adrian Helmut Vogler,Bernd Wöstmann,Jörg Meyle
Inflammation is a complex physiological process that plays a pivotal role in many if not all pathological conditions, including infectious as well as inflammatory diseases, like periodontitis and autoimmune disorders. Inflammatory response to periodontal biofilms and tissue destruction in periodontitis is associated with the release of inflammatory mediators. Chronic inflammation can promote the development of cancer. Persistence of inflammatory mediators plays a crucial role in this process. Quantification and monitoring of the severity of inflammation in relation to cancer is essential. Periodontitis is mainly quantified based on the severity and extent of attachment loss and/or pocket probing depth, in addition with bleeding on probing. In recent years, studies started to investigate inflammation indices in association with periodontal diseases. To date, only few reviews have been published focusing on the relationship between blood cell count, inflammation indices, and periodontitis. This review presents a comprehensive overview of different systemic inflammation indices, their methods of measurement, and the clinical applications in relation to periodontitis and cancer. This review outlines the physiological basis of inflammation and the underlying cellular and molecular mechanisms of the parameters described. Key inflammation indices are commonly utilized in periodontology such as the neutrophil to lymphocyte ratio. Inflammation indices like the platelet to lymphocyte ratio, platelet distribution width, plateletcrit, red blood cell distribution width, lymphocyte to monocyte ratio, delta neutrophil index, and the systemic immune inflammation index are also used in hospital settings and will be discussed. The clinical roles and limitations, relationship to systemic diseases as well as their association to periodontitis and treatment response are described.
炎症是一个复杂的生理过程,在许多甚至所有病理情况下都起着关键作用,包括感染性和炎症性疾病,如牙周炎和自身免疫性疾病。牙周炎中对牙周生物膜和组织破坏的炎症反应与炎症介质的释放有关。慢性炎症可促进癌症的发展。炎症介质的持续存在在这一过程中起着至关重要的作用。量化和监测与癌症相关的炎症严重程度至关重要。牙周炎的量化主要基于附着丧失和/或牙周袋探诊深度的严重程度和范围,以及探诊时的出血情况。近年来,研究开始调查与牙周疾病相关的炎症指数。迄今为止,关于血细胞计数、炎症指数和牙周炎之间关系的综述还寥寥无几。本综述全面概述了不同的全身炎症指数、其测量方法以及与牙周炎和癌症有关的临床应用。本综述概述了炎症的生理基础以及所述参数的潜在细胞和分子机制。牙周病学中常用的主要炎症指数包括中性粒细胞与淋巴细胞比值。血小板与淋巴细胞比值、血小板分布宽度、血小板crit、红细胞分布宽度、淋巴细胞与单核细胞比值、δ中性粒细胞指数和全身免疫炎症指数等炎症指数也在医院环境中使用,将对这些指数进行讨论。此外,还将介绍这些指标的临床作用和局限性、与全身性疾病的关系以及与牙周炎和治疗反应的关系。
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引用次数: 0
Autologous platelet concentrates after third molar extraction: A systematic review. 第三磨牙拔除术后的自体血小板浓缩物:系统综述。
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-24 DOI: 10.1111/prd.12600
S A M Siawasch,J Yu,A B Castro,A Temmerman,W Teughels,M Quirynen
Surgical removal of impacted mandibular third molars is often followed by postoperative sequelae like pain, swelling, trismus, etc. This systematic review explored the benefits of applying different autologous platelet concentrates (APCs) in the extraction socket of third molars. For this systematic review, PubMed, EMBASE, Web of Science, and Scopus have been utilized, initially yielding 544 papers. The search was narrowed to randomized controlled trials (RCTs, n = 59) published before 2024, all comparing the outcome of applying APCs in the extraction socket of surgically removed impacted mandibular third molars with unassisted healing (blood clot). Most RCTs primarily assessed the impact of APCs on postoperative sequelae. Some RCTs looked at soft- and hard-tissue healing. Eleven studies used PRP, three PRGF, and 45 L-PRF. A detailed analysis revealed a large heterogeneity between studies rendering a meta-analysis impossible. Moreover, the risk of bias was considered high. In the majority of RCTs, the application of an APC resulted in statistically significant reductions of postoperative sequelae (lower pain intensity, lower consumption of analgesics, less postoperative edema, and a lower incidence of trismus and alveolar osteitis), as well as a faster soft tissue healing, and qualitatively and quantitatively better bone healing. A minority of studies reported significant differences in periodontal parameters distally from the second molar.
下颌第三磨牙手术拔除后往往会出现疼痛、肿胀、三趾挛缩等术后后遗症。本系统综述探讨了在第三磨牙拔牙窝中应用不同自体血小板浓缩物(APC)的益处。本次系统性综述使用了 PubMed、EMBASE、Web of Science 和 Scopus 等数据库,最初共检索到 544 篇论文。搜索范围缩小到 2024 年之前发表的随机对照试验(RCT,n = 59),所有这些试验都比较了在手术拔除的下颌第三磨牙牙槽窝中应用 APC 与无辅助愈合(血凝块)的结果。大多数研究性临床试验主要评估了 APC 对术后后遗症的影响。一些 RCT 研究了软组织和硬组织的愈合情况。有 11 项研究使用了 PRP,3 项使用了 PRGF,45 项使用了 L-PRF。详细分析显示,不同研究之间存在很大的异质性,因此无法进行荟萃分析。此外,偏倚风险也很高。在大多数研究中,APC 的应用在统计学上显著减少了术后后遗症(疼痛强度降低、镇痛剂用量减少、术后水肿减轻、三趾畸形和牙槽骨炎发生率降低),同时软组织愈合更快,骨愈合的质量和数量也更好。少数研究报告称,第二磨牙远端牙周参数存在明显差异。
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引用次数: 0
L‐PRF in extra‐oral wound care L-PRF 在口腔外伤口护理中的应用
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-21 DOI: 10.1111/prd.12605
Nelson Pinto, Jize Yu, Sushil Koirala, Carlos Fernando Mourão, Catherine Andrade, Enrico Rescigno, Yelka Zamora, Diego Pinto, Marc Quirynen
Leukocyte‐ and platelet‐rich fibrin (L‐PRF), a by‐product of centrifuged autologous whole blood, contains high concentrations of platelets, leukocytes, and fibrin (the latter spontaneously creating a strong 3‐D network (a membrane)). L‐PRF membranes possess several characteristics essential in wound healing, including a barrier function, an antibacterial and analgesic activity, and the release of growth factors enhancing tissue regeneration and neo‐vasculogenesis. This review investigated the role of L‐PRF in treating non‐responding chronic wounds such as diabetic foot, venous leg ulcers, pressure ulcers, complex wounds, leprosy ulcers (Hansen's Disease), and other demanding wounds. Chronic wounds affect millions worldwide, negatively impacting their quality of life, productivity, and life expectancy while incurring high treatment costs for themselves and private and public health systems. L‐PRF has demonstrated clear adjunctive advantages in treating chronic skin wounds, shortening the time to complete wound closure, and improving patient‐reported outcome measures (including reducing pain and minimizing the need for analgesics). Also, in other demanding wounds, L‐PRF facilitates healing. To help clinicians, this article also proposes recommendations for the use of L‐PRF in the treatment of extra‐oral wounds.
富含白细胞和血小板的纤维蛋白(L-PRF)是离心自体全血的副产品,含有高浓度的血小板、白细胞和纤维蛋白(后者会自发形成一个强大的三维网络(膜))。L-PRF 膜具有对伤口愈合至关重要的几个特性,包括屏障功能、抗菌和镇痛活性,以及释放生长因子,促进组织再生和新血管生成。这篇综述探讨了 L-PRF 在治疗无反应慢性伤口(如糖尿病足、静脉腿部溃疡、压疮、复杂伤口、麻风病溃疡(汉森氏病)和其他高难度伤口)中的作用。慢性伤口影响着全球数以百万计的人,对他们的生活质量、生产力和预期寿命造成了负面影响,同时也为他们自身以及私营和公共卫生系统带来了高昂的治疗费用。L-PRF 在治疗慢性皮肤伤口、缩短伤口完全闭合的时间以及改善患者报告的疗效指标(包括减轻疼痛和最大限度地减少对镇痛剂的需求)方面具有明显的辅助优势。此外,在其他要求较高的伤口中,L-PRF 也能促进伤口愈合。为了帮助临床医生,本文还提出了使用 L-PRF 治疗口外伤口的建议。
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引用次数: 0
Epidemiological associations between periodontitis and cancer. 牙周炎与癌症之间的流行病学关联。
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-20 DOI: 10.1111/prd.12599
Jon Higham,Frank A Scannapieco
There is a postulated association of periodontitis with a number of human cancers. This narrative review provides current epidemiological evidence on the association between periodontitis and cancer. A PubMed search with the relevant keywords (periodontal disease, periodontitis, cancer, and malignancy) was completed to identify relevent articles. We present a narrative review on the association between periodontal disease and a range of cancers, including oral cancer, stomach and esophageal cancer, colorectal cancer, lung cancer, pancreatic cancer, prostate cancer, hematological malignancies, liver cancer, breast cancer, and ovarian cancer. While there is a considerable body of epidemiological evidence that supports the association between periodontal disease and cancer, this is largely from cohort and case-control studies and the association may therefore be circumstantial as little evidence exists in the form of treatment trials that would validate the role of periodontal disease in the process of cancer initiation and development.
据推测,牙周炎与多种人类癌症有关。这篇叙述性综述提供了当前关于牙周炎与癌症关系的流行病学证据。我们使用相关关键词(牙周病、牙周炎、癌症和恶性肿瘤)在 PubMed 上进行了搜索,以确定相关文章。我们就牙周病与一系列癌症的关系进行了叙述性综述,包括口腔癌、胃癌和食道癌、结直肠癌、肺癌、胰腺癌、前列腺癌、血液恶性肿瘤、肝癌、乳腺癌和卵巢癌。虽然有大量的流行病学证据支持牙周病与癌症之间的关联,但这些证据主要来自队列研究和病例对照研究,因此这种关联可能只是间接的,因为几乎没有治疗试验的证据可以验证牙周病在癌症的发生和发展过程中的作用。
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引用次数: 0
Severe periodontitis and congenital cytomegalovirus: Cleft lip and cleft palate 严重牙周炎和先天性巨细胞病毒:唇裂和腭裂
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-12 DOI: 10.1111/prd.12606
Jørgen Slots, Vanessa Slots
Severe periodontitis lesions can harbor several hundred‐thousand copies of active cytomegalovirus, and this paper proposes that cytomegalovirus in maternal periodontitis can infect the fetus. Cleft lips and palates may be oral examples of congenital cytomegalovirus infection. Anti‐cytomegalovirus periodontal treatment is indicated for high‐risk women who exhibit severe periodontitis and weakened immune system and are contemplating pregnancy or are in the first trimester of pregnancy.
严重的牙周炎病变可携带数十万拷贝的巨细胞病毒,本文提出母体牙周炎中的巨细胞病毒可感染胎儿。唇腭裂可能是先天性巨细胞病毒感染的口腔实例。抗巨细胞病毒牙周治疗适用于表现为严重牙周炎和免疫系统较弱的高危妇女,以及准备怀孕或处于妊娠头三个月的妇女。
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引用次数: 0
Introduction and overview on autogenous Platelet concentrates 自体血小板浓缩物简介和概述
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-11 DOI: 10.1111/prd.12607
Marc Quirynen, Anton Sculean, J. Blanco, Hom‐Lay Wang, Nikos Donos
This special issue on autologous platelet concentrates (APCs) provides clinicians with an overview on the current understanding of the use of these biomaterials for soft and hard‐tissue regeneration. The included papers summarize scientific evidence and the clinical findings, presented in simple tables that outline potential benefits including Patient Reported Outcome Measures (PROMs). This approach enables clinicians to assess clinical relevance and researchers to identify significant gaps in the literature. The first part provides a comprehensive summary of the basic science surrounding APC, with particular focus on their preparation methods. Clear recommendations are outlined, which are crucial for obtaining high‐quality APCs, alongside an exploration of how APCs may influence both soft and hard tissue healing processes. Part 2 delves into the clinical evidence for the potential benefits of APCs across a range of applications: alveolar ridge preservation, sinus floor elevation, periodontal plastic surgery, guided tissue regeneration, guided bone regeneration, the healing of Medication‐Related Osteonecrosis of the Jaw (MRONJ), and endodontic surgery. In the part 3, the discussion turns to the effects of APCs on the healing of extra‐oral wounds, including diabetic foot ulcers, venous leg ulcers, pressure injuries, burns, and more. For those clinicians persuaded by the evidence, the fourth section offers a detailed, step‐by‐step flowchart for each treatment modality, providing a clear guide for clinical application.
本期特刊介绍自体血小板浓缩物 (APC),向临床医生概述目前对这些生物材料用于软组织和硬组织再生的认识。收录的论文总结了科学证据和临床发现,并以简单的表格呈现,概述了包括患者报告结果指标 (PROM) 在内的潜在益处。这种方法能让临床医生评估临床相关性,让研究人员找出文献中的重大空白。第一部分全面总结了有关 APC 的基础科学,尤其关注其制备方法。在探讨 APC 如何影响软组织和硬组织愈合过程的同时,还概述了对获得高质量 APC 至关重要的明确建议。第二部分深入探讨了 APCs 在一系列应用中潜在益处的临床证据:牙槽脊保存、窦底抬高、牙周整形手术、引导组织再生、引导骨再生、药物相关性颌骨坏死 (MRONJ) 的愈合以及牙髓手术。在第 3 部分中,讨论将转向 APC 对口外伤口愈合的影响,包括糖尿病足溃疡、静脉腿部溃疡、压伤、烧伤等。对于那些被证据说服的临床医生,第四部分为每种治疗方式提供了详细的分步流程图,为临床应用提供了明确的指导。
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引用次数: 0
A narrative review on the use of autologous platelet concentrates during alveolar bone augmentation: Horizontal (simultaneous/staged) & vertical (simultaneous/staged). 自体血小板浓缩物在牙槽骨增量术中的应用综述:水平(同时/分阶段)和垂直(同时/分阶段)。
IF 17.5 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-08-28 DOI: 10.1111/prd.12604
J Blanco, J Caramês, M Quirynen

This review aimed to answer the general question of whether autologous platelet concentrates (APCs, an autologous blood-derivative) can improve the outcome of alveolar bone augmentation. Three clinical scenarios were assessed: horizontal/vertical bone augmentation in combination with implant placement (simultaneous approach), horizontal bone augmentation in a staged approach, and vertical bone augmentation in a staged approach. An electronic literature search strategy was conducted for each review from the outset to July 1st, 2023. The titles and abstracts (when available) of all identified studies were screened and imported into a database. If articles appeared to meet the inclusion criteria or their title and abstract had insufficient data, the full text was obtained to make the final decision. All studies that met the inclusion criteria underwent data extraction. Moreover, the references of the identified papers were screened for additional studies. After title and abstract screening and selection criteria application, 14 clinical studies were included for the qualitative analysis: seven for horizontal/vertical bone augmentation in a simultaneous approach, five for horizontal bone augmentation in a staged approach, and two for vertical bone augmentation in a staged approach. There is scarce literature regarding the added value of APCs in bone augmentation, and most studies had small sample sizes, a lack of standardized protocols, and different outcome variables, which makes comparisons between studies difficult. Out of the 14 studies, four were well-designed randomized clinical trials, where we could find better results for the APCs groups. Most studies, particularly comparative and well-designed studies, demonstrated beneficial and promising results of using APCs in alveolar bone augmentation. However, before high-level evidence-based conclusions can be drawn, more randomized clinical trials must compare the benefits of adding APCs to the gold-standard approach.

本综述旨在回答自体血小板浓缩物(APCs,一种自体血液衍生物)能否改善牙槽骨骨质增生效果的一般性问题。研究评估了三种临床情况:结合种植体植入的水平/垂直骨增量(同步进行)、分阶段进行的水平骨增量和分阶段进行的垂直骨增量。从开始到 2023 年 7 月 1 日,对每篇综述都采用了电子文献检索策略。对所有已确定研究的标题和摘要(如有)进行筛选并导入数据库。如果文章似乎符合纳入标准或其标题和摘要数据不足,则会获取全文以做出最终决定。所有符合纳入标准的研究都进行了数据提取。此外,还对已确定论文的参考文献进行了筛选,以寻找其他研究。在对论文标题和摘要进行筛选并应用选择标准后,14 项临床研究被纳入定性分析:其中 7 项研究涉及同时进行的水平/垂直骨增量术,5 项研究涉及分阶段进行的水平骨增量术,2 项研究涉及分阶段进行的垂直骨增量术。有关 APC 在骨增量中的附加值的文献很少,而且大多数研究的样本量较小,缺乏标准化方案,结果变量也各不相同,因此很难在不同研究之间进行比较。在 14 项研究中,有 4 项是精心设计的随机临床试验,我们发现 APCs 组的结果更好。大多数研究,尤其是比较性研究和设计良好的研究,都显示了在牙槽骨增量中使用 APCs 的有益和可喜成果。然而,在得出高水平的循证结论之前,必须有更多的随机临床试验来比较添加 APCs 和黄金标准方法的益处。
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Periodontology 2000
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