Araştırma Makalesi
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Alt Gömülü 20 Yaş Diş Çekimlerinde Konsantre Büyüme Faktörü ve Trombositten Zengin Fibrinin Postoperatif Ağrı, Ödem ve İyileşme Üzerine Etkilerinin Araştırılması

Yıl 2024, Cilt: 15 Sayı: 3, 368 - 379, 25.12.2024
https://doi.org/10.22312/sdusbed.1477373

Öz

Gömülü alt 20 yaş dişlerinin çekimi ağız, diş ve çene cerrahisinde en sık uygulanan cerrahi işlemlerdendir. Bu cerrahi işlemde genellikle; bir dizi fizyolojik, hücresel yanıtı uyaran bir travma oluşur. Bu durum trismus, ödem ve ağrı gibi postoperatif semptomların ortaya çıkışını sağlar. Bu komplikasyonların azaltılmasına yönelik çeşitli yöntemler uygulanmaktadır. TZF-KBF gibi otolog kan ürünleri bu etkilerin azaltılması amacı ile kullanılan yöntemlerdendir. Çalışmamızda TZF’ye göre daha zengin büyüme faktörleri içeren ve daha yoğun fibrin yapısı olan KBF’nin, postoperatif ağrı, ödem ve yara iyileşmesi üzerindeki etkilerinin, TZF’ye göre farkını incelemek amaçlanmıştır. Çalışmamızda 2021 Aralık– 2022 Aralık tarihleri arası XXX, Anabilim Dalı’nda kayıt altına alınan bilateral gömülü alt yirmi yaş dişi cerrahisi yapılmış, 18 yaş üstü 30 hastanın bilgileri, formları ve röntgenleri kullanılmıştır. Çalışmamızda ağrının değerlendirilmesi, postoperatif 2. ve 7.günlerde VAS ile ödemin değerlendirilmesi postoperatif 2. ve 7. Günlerde; hastaların, tragus-ağız köşesi, tragus-pogonion ve lateral göz köşesi-angulus mandibula arası mesafelerin ölçülmesiyle, yara iyileşmesinin değerlendirilmesi postoperatif 7. günde LTH yara iyileşme indeksiyle yapılmıştır. Sonuçlar istatistiksel olarak değerlendirilmiştir. Çalışmamızda KBF ve TZF uygulamasının yara iyileşmesine, postoperatif ödeme ve postoperatif ağrıya olan etkileri incelendiğinde; istatistiksel olarak KBF’nin, TZF’den yara iyileşmesinde daha iyi sonuçlar verdiği ve ağrıyı daha fazla azalttığı saptanmıştır. Postoperatif ödem üzerinde ise KBF’nin TZF’ den istatistiksel olarak farklı olmadığı saptanmıştır.

Etik Beyan

Bu çalışmada, “Yükseköğretim Kurumları Bilimsel Araştırma ve Yayın Etiği Yönergesi” kapsamında uyulması gerekli tüm kurallara uyulduğunu, bahsi geçen yönergenin “Bilimsel Araştırma ve Yayın Etiğine Aykırı Eylemler” başlığı altında belirtilen eylemlerden hiçbirinin gerçekleştirilmediğini taahhüt ederiz.

Kaynakça

  • 1. Malik NA. Textbook of Oral and Maxillofacial Surgery. 5th ed. Jaypee Brothers Medical Publishers; 2021. p. 307–37.
  • 2. Ness GM, Blakey GH, Hechler BL. Impacted teeth. In: Peterson’s Principles of Oral and Maxillofacial Surgery. 2022. p. 131–69.
  • 3. Marković AB, Todorović L. Postoperative analgesia after lower third molar surgery: contribution of the use of long-acting local anesthetics, low-power laser, and diclofenac. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102(5):e4–8.
  • 4. Canellas J, Ritto FG, Medeiros PJD. Evaluation of postoperative complications after mandibular third molar surgery with the use of platelet-rich fibrin: a systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2017;46(9):1138–46.
  • 5. Saglanmak A, Cinar C, Gultekin A. Platelet rich fibrin (PRF) application in oral surgery. Platelets. 2020.
  • 6. Miron RJ, Zucchelli G, Pikos MA, Salama M, Lee S, Guillemette V, et al. Use of platelet-rich fibrin in regenerative dentistry: a systematic review. Clin Oral Investig. 2017;21:1913–27.
  • 7. Rodella LF, Favero G, Boninsegna R, Buffoli B, Labanca M, Scarì G, et al. Growth factors, CD34 positive cells, and fibrin network analysis in concentrated growth factors fraction. Microsc Res Tech. 2011;74(8):772–7.
  • 8. Khorshidi H, Raoofi S, Bagheri R, Banihashemi H. Comparison of the mechanical properties of early leukocyte-and platelet-rich fibrin versus PRGF/endoret membranes. Int J Dent. 2016;2016:1849207.
  • 9. Choukroun J, Diss A, Simonpieri A, Girard M-O, Schoeffler C, Dohan SL, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(3):e56–60.
  • 10. Qiao J, An N, Ouyang X. Quantification of growth factors in different platelet concentrates. Platelets. 2017;28(8):774–8.
  • 11. Chen X, Wang J, Yu L, Zhou J, Zheng D, Zhang B. Effect of concentrated growth factor (CGF) on the promotion of osteogenesis in bone marrow stromal cells (BMSC) in vivo. Sci Rep. 2018;8(1):5876.
  • 12. Kim TH, Kim SH, Sándor GK, Kim YD. Comparison of platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and concentrated growth factor (CGF) in rabbit-skull defect healing. Arch Oral Biol. 2014;59(5):550–8.
  • 13. Li J, Zheng L, Daraqel B, Liu J, Hu Y. The efficacy of concentrated growth factor and platelet-rich fibrin as scaffolds in regenerative endodontic treatment applied to immature permanent teeth: a retrospective study. BMC Oral Health. 2023;23(1):482.
  • 14. Lee D, Kim DW, Cho JY. Role of growth factors in hematopoietic stem cell niche. Cell Biol Toxicol. 2020;36(2):131–44.
  • 15. Isobe K, Watanebe T, Kawabata H, Kitamura Y, Okudera T, Okudera H, et al. Mechanical and degradation properties of advanced platelet-rich fibrin (A-PRF), concentrated growth factors (CGF), and platelet-poor plasma-derived fibrin (PPTF). Int J Implant Dent. 2017;3(1):1–6.
  • 16. Lee HM, Shen EC, Shen JT, Fu E, Chiu HC, Hsia YJ. Tensile strength, growth factor content and proliferation activities for two platelet concentrates of platelet-rich fibrin and concentrated growth factor. J Dent Sci. 2020;15(2):141–6.
  • 17. Ustaoğlu G, Bulut DG, Gümüş KÇ. Evaluation of different platelet-rich concentrates effects on early soft tissue healing and socket preservation after tooth extraction. J Stomatol Oral Maxillofac Surg. 2020;121(5):539–44.
  • 18. Mijiritsky E, Assaf HD, Peleg O, Shacham M, Cerroni L, Mangani L. Use of PRP, PRF and CGF in periodontal regeneration and facial rejuvenation: a narrative review. Biology (Basel). 2021;10(4):317.
  • 19. Kumar N, Prasad K, Ramanujam L, KR, Dexith J, Chauhan A. Evaluation of treatment outcome after impacted mandibular third molar surgery with the use of autologous platelet-rich fibrin: a randomized controlled clinical study. J Oral Maxillofac Surg. 2015;73(6):1042–9.
  • 20. Bilginaylar K, Uyanik L. Evaluation of the effects of platelet-rich fibrin and piezosurgery on outcomes after removal of impacted mandibular third molars. Br J Oral Maxillofac Surg. 2016;54(6):629–33.
  • 21. Bao M, Du G, Zhang Y, Ma P, Cao Y, Li C. Application of platelet-rich fibrin derivatives for mandibular third molar extraction related post-operative sequelae: A systematic review and network meta-analysis. J Oral Maxillofac Surg. 2021;79(12):2421–32.
  • 22. Uyanık LO, Bilginaylar K, Etikan İ. Effects of platelet-rich fibrin and piezosurgery on impacted mandibular third molar surgery outcomes. Head Face Med. 2015;11(1):1–7.
  • 23. Asutay F, Yolcu Ü, Geçör O, Acar A, Öztürk S, Malkoç S. An evaluation of effects of platelet-rich fibrin on postoperative morbidities after lower third molar surgery. Niger J Clin Pract. 2017;20(12):1531–6.
  • 24. Singh A, Kohli M, Gupta N. Platelet-rich fibrin: a novel approach for osseous regeneration. J Maxillofac Oral Surg. 2012;11(4):430–4.
  • 25. Daugela P, Grimuta V, Sakavicius D, Jonaitis J, Juodzbalys G. Influence of leukocyte- and platelet-rich fibrin (L-PRF) on the outcomes of impacted mandibular third molar removal surgery: A split-mouth randomized clinical trial. Quintessence Int. 2018;49(5):377–88.
  • 26. Gülşen U, Şentürk MF. Effect of platelet-rich fibrin on edema and pain following third molar surgery: A split-mouth control study. BMC Oral Health. 2017;17(1):79.
  • 27. Yu TT, Liu J, Yin JJ, Xu XN, Yan SJ, Lan J. Effects of concentrated growth factors on relieving postoperative reaction of guided bone regeneration in the esthetic zone. West China J Stomatol. 2019;37(4):398–402.
  • 28. Koyuncu BÖ, Işık G, Yüce MÖ, Günbay S, Günbay T. Effect of concentrated growth factor (CGF) on short-term clinical outcomes after partially impacted mandibular third molar surgery: A split-mouth randomized clinical study. J Stomatol Oral Maxillofac Surg. 2020;121(2):118–23.
  • 29. Bozkurt E, Uslu M. Evaluation of the effects of platelet-rich fibrin, concentrated growth factors, and autologous fibrin glue application on wound healing following gingivectomy and gingivoplasty operations: a randomized controlled clinical trial. Quintessence Int. 2022;53(4):328–41.
  • 30. Krishnakumar D, Mahendra J, Ari G, Perumalsamy R. A clinical and histological evaluation of platelet-rich fibrin and CGF for root coverage procedure using coronally advanced flap: A split-mouth design. Indian J Dent Res. 2019;30(6):970.
  • 31. Torul D, Omezli MM, Kahveci K. Evaluation of the effects of concentrated growth factors or advanced platelet-rich fibrin on postoperative pain, edema, and trismus following lower third molar removal: A randomized controlled clinical trial. J Stomatol Oral Maxillofac Surg. 2020;121(6):646–51.
  • 32. Mozzati M, Gallesio G, Tumedei M, Del Fabbro M. Concentrated growth factors vs. leukocyte-and-platelet-rich fibrin for enhancing postextraction socket healing: A longitudinal comparative study. Appl Sci. 2020;10(22):8256.

Investigation of the Effects of Concentrated Growth Factor and Platelet-Rich Fibrin on Postoperative Pain, Edema and Wound Healing in Impacted Mandibular Third Molar Surgery

Yıl 2024, Cilt: 15 Sayı: 3, 368 - 379, 25.12.2024
https://doi.org/10.22312/sdusbed.1477373

Öz

Extraction of impacted lower wisdom teeth is one of the most common surgical procedures in oral, dental and maxillofacial surgery. This surgical procedure usually involves trauma that stimulates a series of physiologic, cellular responses. This leads to postoperative symptoms such as trismus, edema and pain. Various methods have been applied to reduce these complications. One of the methods used to reduce these effects is autologous blood products such as PRF-CGF. In our study, we aimed to investigate the effects of CGF, which contains richer growth factors and has a denser fibrin structure compared to PRF, on postoperative pain, edema and wound healing compared to PRF. In our study, the information, forms and X-rays of 30 patients over the age of 18 who underwent bilateral impacted lower wisdom tooth surgery between December 2021 and December 2022 at XXX, were used. In our study, pain was evaluated by VAS on postoperative days 2 and 7, edema was evaluated by measuring the distances between the tragus and the corner of the mouth, tragus and pogonion, and lateral eye corner and angulus, and wound healing was evaluated by LTH wound healing index on postoperative day 7. The results were evaluated statistically. In our study, when the effects of CGF and PRF application on wound healing, postoperative edema and postoperative pain were examined; it was found that CGF gave better results in wound healing and reduced pain more than PRF. It was found that CGF was not statistically different from PRF on postoperative edema.

Kaynakça

  • 1. Malik NA. Textbook of Oral and Maxillofacial Surgery. 5th ed. Jaypee Brothers Medical Publishers; 2021. p. 307–37.
  • 2. Ness GM, Blakey GH, Hechler BL. Impacted teeth. In: Peterson’s Principles of Oral and Maxillofacial Surgery. 2022. p. 131–69.
  • 3. Marković AB, Todorović L. Postoperative analgesia after lower third molar surgery: contribution of the use of long-acting local anesthetics, low-power laser, and diclofenac. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102(5):e4–8.
  • 4. Canellas J, Ritto FG, Medeiros PJD. Evaluation of postoperative complications after mandibular third molar surgery with the use of platelet-rich fibrin: a systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2017;46(9):1138–46.
  • 5. Saglanmak A, Cinar C, Gultekin A. Platelet rich fibrin (PRF) application in oral surgery. Platelets. 2020.
  • 6. Miron RJ, Zucchelli G, Pikos MA, Salama M, Lee S, Guillemette V, et al. Use of platelet-rich fibrin in regenerative dentistry: a systematic review. Clin Oral Investig. 2017;21:1913–27.
  • 7. Rodella LF, Favero G, Boninsegna R, Buffoli B, Labanca M, Scarì G, et al. Growth factors, CD34 positive cells, and fibrin network analysis in concentrated growth factors fraction. Microsc Res Tech. 2011;74(8):772–7.
  • 8. Khorshidi H, Raoofi S, Bagheri R, Banihashemi H. Comparison of the mechanical properties of early leukocyte-and platelet-rich fibrin versus PRGF/endoret membranes. Int J Dent. 2016;2016:1849207.
  • 9. Choukroun J, Diss A, Simonpieri A, Girard M-O, Schoeffler C, Dohan SL, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(3):e56–60.
  • 10. Qiao J, An N, Ouyang X. Quantification of growth factors in different platelet concentrates. Platelets. 2017;28(8):774–8.
  • 11. Chen X, Wang J, Yu L, Zhou J, Zheng D, Zhang B. Effect of concentrated growth factor (CGF) on the promotion of osteogenesis in bone marrow stromal cells (BMSC) in vivo. Sci Rep. 2018;8(1):5876.
  • 12. Kim TH, Kim SH, Sándor GK, Kim YD. Comparison of platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and concentrated growth factor (CGF) in rabbit-skull defect healing. Arch Oral Biol. 2014;59(5):550–8.
  • 13. Li J, Zheng L, Daraqel B, Liu J, Hu Y. The efficacy of concentrated growth factor and platelet-rich fibrin as scaffolds in regenerative endodontic treatment applied to immature permanent teeth: a retrospective study. BMC Oral Health. 2023;23(1):482.
  • 14. Lee D, Kim DW, Cho JY. Role of growth factors in hematopoietic stem cell niche. Cell Biol Toxicol. 2020;36(2):131–44.
  • 15. Isobe K, Watanebe T, Kawabata H, Kitamura Y, Okudera T, Okudera H, et al. Mechanical and degradation properties of advanced platelet-rich fibrin (A-PRF), concentrated growth factors (CGF), and platelet-poor plasma-derived fibrin (PPTF). Int J Implant Dent. 2017;3(1):1–6.
  • 16. Lee HM, Shen EC, Shen JT, Fu E, Chiu HC, Hsia YJ. Tensile strength, growth factor content and proliferation activities for two platelet concentrates of platelet-rich fibrin and concentrated growth factor. J Dent Sci. 2020;15(2):141–6.
  • 17. Ustaoğlu G, Bulut DG, Gümüş KÇ. Evaluation of different platelet-rich concentrates effects on early soft tissue healing and socket preservation after tooth extraction. J Stomatol Oral Maxillofac Surg. 2020;121(5):539–44.
  • 18. Mijiritsky E, Assaf HD, Peleg O, Shacham M, Cerroni L, Mangani L. Use of PRP, PRF and CGF in periodontal regeneration and facial rejuvenation: a narrative review. Biology (Basel). 2021;10(4):317.
  • 19. Kumar N, Prasad K, Ramanujam L, KR, Dexith J, Chauhan A. Evaluation of treatment outcome after impacted mandibular third molar surgery with the use of autologous platelet-rich fibrin: a randomized controlled clinical study. J Oral Maxillofac Surg. 2015;73(6):1042–9.
  • 20. Bilginaylar K, Uyanik L. Evaluation of the effects of platelet-rich fibrin and piezosurgery on outcomes after removal of impacted mandibular third molars. Br J Oral Maxillofac Surg. 2016;54(6):629–33.
  • 21. Bao M, Du G, Zhang Y, Ma P, Cao Y, Li C. Application of platelet-rich fibrin derivatives for mandibular third molar extraction related post-operative sequelae: A systematic review and network meta-analysis. J Oral Maxillofac Surg. 2021;79(12):2421–32.
  • 22. Uyanık LO, Bilginaylar K, Etikan İ. Effects of platelet-rich fibrin and piezosurgery on impacted mandibular third molar surgery outcomes. Head Face Med. 2015;11(1):1–7.
  • 23. Asutay F, Yolcu Ü, Geçör O, Acar A, Öztürk S, Malkoç S. An evaluation of effects of platelet-rich fibrin on postoperative morbidities after lower third molar surgery. Niger J Clin Pract. 2017;20(12):1531–6.
  • 24. Singh A, Kohli M, Gupta N. Platelet-rich fibrin: a novel approach for osseous regeneration. J Maxillofac Oral Surg. 2012;11(4):430–4.
  • 25. Daugela P, Grimuta V, Sakavicius D, Jonaitis J, Juodzbalys G. Influence of leukocyte- and platelet-rich fibrin (L-PRF) on the outcomes of impacted mandibular third molar removal surgery: A split-mouth randomized clinical trial. Quintessence Int. 2018;49(5):377–88.
  • 26. Gülşen U, Şentürk MF. Effect of platelet-rich fibrin on edema and pain following third molar surgery: A split-mouth control study. BMC Oral Health. 2017;17(1):79.
  • 27. Yu TT, Liu J, Yin JJ, Xu XN, Yan SJ, Lan J. Effects of concentrated growth factors on relieving postoperative reaction of guided bone regeneration in the esthetic zone. West China J Stomatol. 2019;37(4):398–402.
  • 28. Koyuncu BÖ, Işık G, Yüce MÖ, Günbay S, Günbay T. Effect of concentrated growth factor (CGF) on short-term clinical outcomes after partially impacted mandibular third molar surgery: A split-mouth randomized clinical study. J Stomatol Oral Maxillofac Surg. 2020;121(2):118–23.
  • 29. Bozkurt E, Uslu M. Evaluation of the effects of platelet-rich fibrin, concentrated growth factors, and autologous fibrin glue application on wound healing following gingivectomy and gingivoplasty operations: a randomized controlled clinical trial. Quintessence Int. 2022;53(4):328–41.
  • 30. Krishnakumar D, Mahendra J, Ari G, Perumalsamy R. A clinical and histological evaluation of platelet-rich fibrin and CGF for root coverage procedure using coronally advanced flap: A split-mouth design. Indian J Dent Res. 2019;30(6):970.
  • 31. Torul D, Omezli MM, Kahveci K. Evaluation of the effects of concentrated growth factors or advanced platelet-rich fibrin on postoperative pain, edema, and trismus following lower third molar removal: A randomized controlled clinical trial. J Stomatol Oral Maxillofac Surg. 2020;121(6):646–51.
  • 32. Mozzati M, Gallesio G, Tumedei M, Del Fabbro M. Concentrated growth factors vs. leukocyte-and-platelet-rich fibrin for enhancing postextraction socket healing: A longitudinal comparative study. Appl Sci. 2020;10(22):8256.
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Ağız ve Çene Cerrahisi
Bölüm Araştırma Makaleleri
Yazarlar

Şükrü Buğra Kara 0009-0009-9145-2814

Müge Çına 0000-0003-2005-3153

Yayımlanma Tarihi 25 Aralık 2024
Gönderilme Tarihi 2 Mayıs 2024
Kabul Tarihi 4 Haziran 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 15 Sayı: 3

Kaynak Göster

Vancouver Kara ŞB, Çına M. Alt Gömülü 20 Yaş Diş Çekimlerinde Konsantre Büyüme Faktörü ve Trombositten Zengin Fibrinin Postoperatif Ağrı, Ödem ve İyileşme Üzerine Etkilerinin Araştırılması. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2024;15(3):368-79.

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