中国现代手术学杂志2025，Vol.29Issue(5)：411-418,8.DOI:10.16260/j.cnki.1009-2188.2025.05.010
牙髓血运重建术联合PRF用于年轻恒牙牙髓坏死患儿的临床观察
Clinical observation of pulp revascularization combined with platelet rich fibrin for permanent tooth pulp necrosis in children
摘要
Abstract
Objective To evaluate the clinical efficacy of pulp revascularization combined with platelet rich fibrin(PRF)in the treatment of children with permanent tooth pulp necrosis,and explore the correlation between the levels of cytokines in periodontal crevicular fluid and the efficacy,in order to provide new ideas for the prognosis prediction of pulp revascularization.Methods Ninety children with permanent tooth pulp nec-rosis admitted to our hospital between November 2023 and January 2025 were enrolled as subjects and randomly divided into a study group(n=45)and a control group(n=45).The control group was treated with pulp re-vascularization combined with double antibiotic paste(DAP),while the study group received additional PRF therapy based on the control group's regimen.The two groups were compared in terms of clinical efficacy,dent-al function indicators,lesion healing time,root length,root canal wall thickness,visual analog scale(VAS)for pain,cytokine levels in periodontal crevicular fluid,and incidence of complications.Results ①The total effective rate of the study group was 91.11%(41/45),which was significantly higher than 71.11%(32/45)of the control group(P=0.015).After treatment,both groups showed significant improvements in bite force and masticatory efficiency compared with their pre-treatment baseline values(P<0.05),with the study group exhibiting higher bite force and masticatory efficiency than the control group.The study group also had a shorter lesion healing time than the control group(P<0.05).②At 3 and 6 months post-surgery,both groups demon-strated a significant increase in root canal wall thickness and a significant decrease in VAS compared with pre-treatment(P<0.05).Specifically,the study group had a thicker root canal wall than the control group at both 3 and 6 months post-surgery(P<0.05).At3 months post-surgery,the study group's VAS was lower than that of the control group(P<0.05);however,there was no significant difference in root length between the two groups at 3 or 6 months post-surgery(P>0.05).③Regarding gingival crevicular fluid cytokines,the study group had lower levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),matrix metalloproteinase-8(MMP-8),and matrix metalloproteinase-9(MMP-9)than the control group.In contrast,the study group exhibited higher levels of interleukin-10(IL-10),tissue inhibitor of metalloproteinases-1(TIMP-1),basic fibroblast growth factor(bFGF),and vascular endothelial growth factor(VEGF)than the control group(all P<0.05).Additionally,the study group had a lower incidence of complications than the control group(P=0.026).Conclusion The combination of pulp revascularization and PRF for treating permanent tooth pulp necrosis in children can significantly enhance clinical efficacy,promote an increase in root canal wall thickness,alleviate pain,reduce inflammation,and exhibit high safety.关键词
牙髓血运重建术/富血小板纤维蛋白/抗生素糊剂/年轻恒牙/牙髓坏死/临床效果Key words
pulp revascularization/rich platelet fibrin/antibiotic paste/young permanent tooth/pulp necrosis/clinical efficacy引用本文复制引用
张欣,武甲子,张煦,吴佳怡,蔡诗思,胡雯,张良付..牙髓血运重建术联合PRF用于年轻恒牙牙髓坏死患儿的临床观察[J].中国现代手术学杂志,2025,29(5):411-418,8.基金项目
湖南省自然科学基金项目(2025JJ80540) （2025JJ80540）
湖南中医药大学校院联合基金项目(2024XYLH284) （2024XYLH284）
