布洛芬派力奥缓释凝胶联合富血小板纤维蛋白用于年轻恒牙脱位再植的研究  

Clinical effects of ibuprofen-minocycline hydrochloride sustained-release gel combined with platelet-rich fibrin in replantation of young permanent teeth dislocation

作　　者：胥阳 刘学 闫巍 XU Yang;LIU Xue;Yan Wei(Chengde Stomatological Hospital,Hebei,Chengde 067000,China)

机构地区：[1]河北省承德市口腔医院,067000

出　　处：《河北医药》2021年第16期2432-2435,2441,共5页Hebei Medical Journal

摘　　要：目的探讨布洛芬缓释凝胶联合富血小板纤维蛋白用于年轻恒牙脱位再植术的临床效果研究。方法将2016年3月至2019年3月河北省承德市口腔医院就诊的年轻恒牙脱位患儿108例根据脱位时间分为A区组(脱位≤1 h,n=36)及B区组(脱位>1 h,n=72),2区组按照就诊顺序随机分为布洛芬派力奥缓释凝胶组(IMSG组,n=27)、富血小板纤维蛋白组(PRF组,n=27)、布洛芬派力奥缓释凝胶联合富血小板纤维蛋白组(IMSG+PRF组,n=27)和对照组(C组,n=27),对脱位牙行再植术,随访半年,术日、1个月、3个月、6个月分别获取患牙周围龈沟液,检测龈沟液中IL-1β、IL-6、TNF-α的水平及RANKL、OPG水平,并评价患牙愈合情况。结果IMSG组、PRF组、IMSG+PRF组均可提高牙周膜愈合,降低炎症吸收,快速降低IL-1β、IL-6、TNF-α炎性因子水平和加快RANKL升高和OPG降低速率。IMSG+PRF组与单独应用IMSG组比较可提高牙膜愈合,但与PRF组比较对提高牙周膜愈合差异无统计学意义(P>0.05);但在降低炎性反应吸收愈合、加快IL-1β、IL-6、TNF-α等炎性因子变化速率、加快RANKL升高和OPG降低速率方面明显优于单独应用IMSG或PRF。结论布洛芬缓释凝胶联合富血小板纤维蛋白用于年轻恒牙脱位再植术能够快速降低牙周组织炎性因子水平,有助于促进牙周膜愈合,应在临床中予以推广。Objective To investigate the clinical effects of ibuprofen-minocycline hydrochloride sustained-release gel combined with platelet-rich fibrin in replantation of young permanent teeth dislocation.Methods A total of 108 patients with young permanent teeth dislocation who were treated in our hospital from March 2016 to March 2019 were enrolled in the study,who were divided into group A(dislocation≤1h,n=36)and group B(dislocation>1h,n=72)according to injure time.The patients in the two groups were redivided into ibuprofen-minocycline hydrochloride sustained-release gel group(IMSG group,n=27),platelet-rich fibrin group(PRF group,n=27),ibuprofen-minocycline hydrochloride sustained-release gel combined with platelet-rich fibrin group(IMSG+PRF group,n=27)according to registration number.All the dislocation teeth were replanted and followed up for 6 months.The levels of IL-1β,IL-6,TNF-α,RANKL,OPG in gingival crevicular fluid(GCF)at the operation day and at 1m,3m,6m after operation were detected.Meanwhile,the healing status of the replanted teeth was evaluated.Results The healing rates of periodontal membrane were improved in IMSG group,PRF group,IMSG+PRF group,and the levels of IL-1β,IL-6,TNF-αwere decreased,and the velocities of the increase of RANKL and the decrease of OPG were accelerated.There was no significant difference in the pericementum heling rate between IMSG+PRF group and IMSG group or PRF group(P>0.05).However,IMSG+PRF was superior to IMSG or PRF in reducing inflammatory absorption,accelerating the change velocity of inflammatory cytokine,and accelerating the velocities of the increase of RANKL and the decrease of OPG.Conclusion Ibuprofen-minocycline hydrochloride sustained-release gel combined with platelet-rich fibrin can rapidly decrease the levels of inflammatory factors in periodontium and promote periodontal membrane healing,thus,it is worth being popularized in clinical practice.

关 键 词：布洛芬派力奥缓释凝胶 富血小板纤维蛋白 年轻恒牙 牙再植术 

分 类 号：R782.12[医药卫生—口腔医学]