关节内注射富含血小板的纤维蛋白与富含血小板的血浆治疗颞下颌关节紊乱病的比较分析:一项随机对照试验。

National Journal of Maxillofacial Surgery Pub Date : 2023-05-01 Epub Date: 2023-07-13 DOI:10.4103/njms.njms_498_21
Preeti Sharma, Jitender K Aurora, K N Dubey, Parul Tandon, Shamita Tiwari
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摘要

背景:浓缩血小板已成为多种牙科和外科手术中越来越受欢迎的生长因子替代来源。它可以改善愈合,刺激细胞增殖、基质重塑和血管生成。与富含血小板的血浆(PRP)相比,可注射的富含血小板的纤维蛋白(i-PRF)具有各种优点。我们研究的目的是评估关节内注射i-PRF与PRP治疗颞下颌关节紊乱病(TDMs)的疗效。方法:前瞻性随机研究涉及14名20至50岁年龄组的内部紊乱患者(N=28个关节),随机分为两组,每组7名患者(N=14个关节)。对于所有患者,在第一次坐着时进行关节穿刺,然后在第一组和第二组分别进行PRP和i-PRF的关节内注射,间隔1个月,持续6个月。只有一个外科医生做了这个手术。所有患者均接受了疼痛、最大开口(MMO)、侧向运动、向前运动和关节音的临床评估,并接受了椎间盘位置和关节积液(JE)的放射学评估。结果:疼痛减轻、MMO、侧移、前伸运动和关节音在两组中均显著,在第二组中更为显著。两组的椎间盘位置均已改善至正常,并且在9个月的随访中两组均显示出显著变化,II组的结果更好。结论:PRP和i-PRF注射是一种简单安全的方法,具有潜在的有益效果,成本效益高。在这项初步研究中,发现i-PRF在所有设定参数中的疗效优于PRP。
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A comparative analysis between intra articular injections of injectable platelet rich fibrin versus platelet rich plasma in the management of temporomandibular disorders: A randomized control trial.

Background: Platelet concentrate has become an increasingly popular alternative source of growth factors for several types of dental and surgical procedures. It improves healing and stimulates cell proliferation, matrix remodeling, and angiogenesis. The injectable platelet-rich fibrin (i-PRF) has various advantages over platelet-rich plasma (PRP). The aim of our study was to evaluate the efficacy of intra-articular injections of i-PRF versus PRP in the management of temporomandibular disorders (TDMs).

Method: The prospective randomized study involved 14 patients (N = 28 joints) of internal derangement between the age groups of 20 to 50 years divided randomly into two groups with seven patients (N = 14 joints) in each group. For all the patients, arthrocentesis was carried out in the first sitting followed by intra-articular injections of PRP and i-PRF in group I and group II, respectively, at 1-month interval for 6 months. A single surgeon has performed the procedure. All patients were assessed clinically for pain, maximal mouth opening (MMO), lateral movement, protrusive movement, and joint sounds and radiographically for disc position and joint effusion (JE).

Results: Pain reduction, MMO, lateral movement, protrusive movement, and joint sounds were significant in both groups with more significance in group II. Disc position had improved toward normal in both groups and showed significant changes in both groups at the 9-month follow-up with better results in group II.

Conclusion: PRP and i-PRF injections are regarded as simple and safe methods with potential beneficial effects and are cost-effective. In this preliminary study, i-PRF has been found to be scoring better in terms of efficacy over PRP across all set parameters.

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