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用于控制第三磨牙手术术后并发症的血液浓缩物:一项范围综述

Blood concentrates for controlling postoperative complications from third molar surgeries: a scoping review.

作者信息

Almeida Vinícius Lima de, Costa Marcelo Dias Moreira de Assis, Jesuino Rômulo Dias, Lima Lívia Bonjardim, Silva Zuleni Alexandre da, Lima Rafael Rodrigues, Rode Sigmar de Mello, Paranhos Luiz Renato

机构信息

Universidade Federal de Uberlândia - Postgraduate Program in Dentistry - School of Dentistry - Uberlândia (MG), Brazil.

Universidade Federal de Minas Gerais - Department of Oral and Maxillofacial Surgery - School of Dentistry - Belo Horizonte (MG), Brazil.

出版信息

Acta Cir Bras. 2025 Aug 8;40:e405825. doi: 10.1590/acb405825. eCollection 2025.

Abstract

PURPOSE

To map the literature on blood concentrates for managing postoperative sequelae after third molar extraction through a scoping review.

METHODS

MedLine, Latin American and Caribbean Health Sciences Literature, Scientific Electronic Library Online, EMBASE, Cochrane Library, Scopus, and Web of Science were the search databases. MedRxiv and EASY provided the grey literature. The investigation included observational studies and clinical trials reporting at least one postoperative sequela. After selecting the articles, the extracted data included study author, year, and country, study design, sample size, age distribution, the type of third molar impaction, flap design, the presence of osteotomy and/or odontosection, co-interventions, blood concentrate type, centrifuge model, centrifugation protocol, collection tubes, outcomes, and the main findings for each outcome. After data extraction, an analysis of the geographic distribution of publications was carried out based on the MapChart website.

RESULTS

This review included 63 studies. The leading countries in publications were Turkey, India, and Brazil. Common postoperative sequelae included pain, edema, trismus, alveolar osteitis, and infection. Outcomes varied regarding the effectiveness of concentrates in controlling inflammation, edema, trismus, and alveolar osteitis. Advanced platelet-rich fibrin was the most applied concentrate in recent studies and was associated with reduced edema and trismus.

CONCLUSION

All concentrates demonstrated some effectiveness in managing sequelae after third molar extraction, but most did not show significant outcomes in controlling inflammatory signs. It emphasizes the need for further randomized clinical trials and systematic reviews to strengthen the evidence on blood concentrates for managing postoperative sequelae.

摘要

目的

通过范围综述梳理关于血液浓缩物用于管理第三磨牙拔除术后后遗症的文献。

方法

检索数据库包括医学文献数据库(MedLine)、拉丁美洲和加勒比健康科学文献数据库、科学电子图书馆在线数据库(Scientific Electronic Library Online)、荷兰医学文摘数据库(EMBASE)、考克兰图书馆(Cochrane Library)、Scopus数据库和科学引文索引数据库(Web of Science)。MedRxiv和EASY提供灰色文献。调查纳入报告至少一种术后后遗症的观察性研究和临床试验。文章筛选后,提取的数据包括研究作者、年份、国家、研究设计、样本量、年龄分布、第三磨牙阻生类型、皮瓣设计、是否存在截骨术和/或牙体切割、联合干预措施、血液浓缩物类型、离心机型号、离心方案、采集管、结局指标以及每个结局指标的主要研究结果。数据提取后,基于MapChart网站对出版物的地理分布进行分析。

结果

本综述纳入63项研究。出版物数量领先的国家是土耳其、印度和巴西。常见的术后后遗症包括疼痛、水肿、牙关紧闭、干槽症和感染。关于浓缩物在控制炎症、水肿、牙关紧闭和干槽症方面的有效性,各研究结果不一。近年来的研究中,高级富血小板纤维蛋白是应用最多的浓缩物,与水肿和牙关紧闭减轻相关。

结论

所有浓缩物在管理第三磨牙拔除术后后遗症方面均显示出一定效果,但大多数在控制炎症体征方面未显示出显著结果。这强调需要进一步开展随机临床试验和系统评价,以加强关于血液浓缩物用于管理术后后遗症的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea37/12333574/2e909bf87ace/1678-2674-acb-40-e405825-gf01.jpg

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