富血小板纤维蛋白对正畸牙移动影响的系统评价  

Effect of platelet⁃rich fibrin on orthodontic tooth movement:a systematic review

作　　者：尧可 吴勇志 赵志河[1] YAO Ke;WU Yongzhi;ZHAO Zhihe(State Key Laboratory of Oral Diseases,National Clinical Research Center for Oral Diseases,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病研究国家重点实验室,国家口腔疾病临床医学研究中心,四川大学华西口腔医院,四川成都610041

出　　处：《口腔疾病防治》2023年第2期117-122,共6页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(81771048);四川省科学技术厅重点研发计划(22ZDZX0043)。

摘　　要：目的评估富血小板纤维蛋白(platelet⁃rich fibrin,PRF)对正畸牙移动的影响,为临床应用提供依据。方法通过检索7个电子数据库,以及手动检索方法,检索报道在正畸牙移动中使用PRF的随机对照临床试验。使用Cochrane偏倚风险评估工具对纳入研究进行偏倚风险评估。最终,由于各研究中患者临床特征和研究方法的异质性,所以采用定性的方法对结果进行总结和描述。结果共纳入6篇研究;其中5篇为自身对照设计试验,1篇为平行对照试验;2篇使用富白细胞PRF,4篇使用可注射PRF;3项研究的偏倚风险评估为“有一定风险”,3项研究为“低风险”;试验周期最短为4周,最长为5个月;4项研究结论支持PRF可加速正畸牙移动,1篇文献表明PRF无影响,1篇文献显示PRF抑制正畸牙移动;中等质量的证据表明PRF在使用前3个月可加速正畸牙移动,而低质量的证据支持PRF在使用4个月后将失去其促进正畸牙移动的作用。结论目前的证据显示,PRF早期可促进正畸牙移动,然而其长效作用仍有待进一步探究。Objective To evaluate the effect of platelet⁃rich fibrin(PRF)on orthodontic tooth movement(OTM)and to provide a basis for clinical application.Methods Literature searches were conducted in 7 electronic databases sup⁃plemented with a hand search.Randomized controlled trials focusing on OTM with PRF were included.The risk of bias was assessed by the Cochrane tool.Finally,due to the heterogeneity of patient clinical characteristics and research meth⁃ods,the results in every study were qualitatively described.Results Six studies were included.Five studies were split⁃mouth designs,and 1 was a two⁃arm parallel design.Two studies used leukocyte⁃and platelet⁃rich fibrin,while the other 4 used injectable PRF.The risk of bias of 3 studies was graded as“Some concerns”,and 3 were graded as“Low risk”.The trials lasted from 4 weeks to 5 months.Four studies supported that PRF could accelerate OTM,1 study demonstrat⁃ed that PRF had no effect on OTM,and 1 study reported that PRF decreased OTM.There is moderate⁃quality evidence that PRF accelerates OTM in the first 3 months after application,while low⁃quality evidence supports that PRF loses its tooth⁃acceleration effect after 4 months.Conclusion Limited clinical evidence suggests that PRF could accelerate OTM in the early stages,but its long⁃term effect needs clarification.

关 键 词：错[牙合]畸形 正畸 拔牙矫治 牙移动 富血小板纤维蛋白 浓缩血小板 生长因子 局部应用 随机对照试验 系统评价 

分 类 号：R78[医药卫生—口腔医学]