Efecto de fibrina rica en plaquetas y leucocitos como terapia coadyuvante en el tratamiento no quirúrgico en pacientes con periodontitis crónica Universidad Andrés Bello, año 2015
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2015
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es
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Universidad Andrés Bello
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Antecedentes: La enfermedad periodontal es una de las principales causas de pérdida dentaria a nivel mundial. Por ello, el manejo de pacientes con diagnóstico de periodontitis crónica, es fundamental. La aplicación de la Fibrina Rica en Plaquetas y Leucocitos (L-PRF), ha demostrado excelentes resultados en terapias quirúrgicas. En terapias no quirúrgicas, no existe mayor evidencia científica. Justificación: Se evaluó el efecto de L-PRF aplicado en terapias no quirúrgicas del área odontológica, dicho estudio se fundamentó por la escasez de investigaciones que incluyen este concentrado de plaquetas en los procedimientos no quirúrgicos. Por lo mismo, esta investigación innovadora y de impacto, mediante una nueva técnica y no invasiva, generó nuevos datos y resultados que apoyan los hallazgos previos y plantea un nuevo protocolo de tratamiento para la fase no-quirúrgica del tratamiento de la periodontitis crónica. Objetivo: Determinar el efecto de la fibrina rica en plaquetas y leucocitos sobre los tejidos de inserción utilizada como terapia coadyuvante o alternativa en el tratamiento periodontal de la periodontitis crónica durante la fase no quirúrgica de pacientes atendidos en la Clínica Odontológica de la Universidad Andrés Bello durante el año 2015. Materiales y Métodos: Estudio de campo con abordaje cuantitativo y cuyo diseño es experimental, ensayo clínico intrasujeto, longitudinal, prospectivo y analítico. La muestra estuvo constituida por 19 pacientes y en los que se evaluó, sitios periodontalmente comprometidos en cada sextante (se abordaron para efectos de estudio, sextantes análogos, en los que existió un sextante control y otro sextante experimental, ambos presentando periodontitis crónica moderada o severa y que cumplan con los criterios de inclusión.) A los sitios control se les aplicó la terapia no quirúrgica convencional periodontal, raspado y alisado radicular (RAR), mientras que a los sitios experimentales, se les aplicó la terapia no quirúrgica convencional, raspado y alisado radicular, con la inserción posterior de un trozo de membrana de Fibrina rica en plaquetas y leucocitos (L-PRF) en el mismo sitio y al finalizar, fueron sellados con cemento quirúrgico. Los resultados de los grupos experimentales, se obtuvieron a la tercera semana post tratamiento, mientras que los resultados del grupo control, a la cuarta semana post tratamiento de RAR. Los resultados de ambos grupos se compararon y se analizaron en el programa SPSS versión 22, mediante un análisis estadístico, descriptivo e inferencial. Se evaluó primero normalidad en la distribución de las variables y de acuerdo a presencia o no de ésta, se aplicó el test de Wilcoxon pareado.
Resultados:
Los resultados de los parámetros clínicos evaluados en este estudio, mejoraron significativamente con la utilización del L-PRF.
En cuanto a los tiempos de regeneración, cicatrización e inflamación de los tejidos afectados por la periodontitis crónica, fueron mejores en los que se aplicó la terapia con L-PRF. Al igual, que las mediciones clínicas tales como, Nivel de Inserción Clínica (NIC) y Profundidad al Sondaje (PS), fueron mejores en la terapia con L-PRF, en comparación con los sitios sin la aplicación de L-PRF. Sin embargo, en la presencia de Sangrado al Sondaje (SS), fue similar en los sitios experimentales y en los sitios sin L-PRF.
Conclusiones: Al finalizar el estudio se evalúo que terapia fue más efectiva en términos de tiempo de regeneración, es decir, la terapia convencional o la terapia con L-PRF. Según los resultados obtenidos, se observa una mejoría en los grupos experimentales con L-PRF, frente a los sitios control, en base a los parámetros clínicos periodontales evaluados.
Background: Periodontal disease is one of the major causes of tooth loss worldwide. Therefore, the management of patients diagnosed with chronic periodontitis is critical and currently continues to remain under investigation by using new techniques, such as the application of platelet rich in fibrin and leukocytes (L -PRF), with excellent results. Nevertheless, literature only provides the application of L -PRF in surgical therapies and not in non-surgical therapies, reason that encouraged the realization of this research. Justification: The effect of L -PRF nonsurgical therapies applied in the dental area was evaluated , the study was based on the lack of research that include this platelet concentrate in nonsurgical procedures. Therefore, this innovative and impact research through a new noninvasive technique generated new data and results support earlier findings and poses a new treatment protocol for non - surgical phase of the treatment of chronic periodontitis. Purpose: Determine the effect of platelet rich fibrin and leukocytes on insertion tissues used as alternative or adjunctive therapy in periodontal treatment of chronic periodontitis in non-surgical phase in patients treated at the Dental Clinic of the University Andres Bello during the year 2015. Material and Methods: Field study with a quantitative approach and whose design is experimental, within subjects, longitudinal, prospective and analytical clinical trial. The sample consisted of 19 patients and in those sites periodontally compromised in each sextant (to be addressed for purposes of study, like sextants, where there was a sextant control and other experimental sextant, both showing moderate to severe chronic periodontitis was evaluated and who meet the inclusion criteria.) A control sites were applied conventional periodontal scaling and root planing non-surgical therapy (RAR), while the pilot sites, were applied therapy unconventional, scraping surgical and root planing, with subsequent insertion of a piece of membrane of fibrin rich in platelets and leukocytes (L-PRF) in the same place and at the end, were sealed with surgical cement. The results of the experimental groups were obtained at three weeks after treatment, while the control group results at the fourth week post treatment of RAR. The results of both groups were compared and analyzed using SPSS version 22 program, using a statistical, descriptive and inferential analysis. Normality was first evaluated in the distribution of variables and according to presence or absence of this , the paired Wilcoxon test was applied. Outcomes: The results in terms of clinical parameters evaluated in this study , improved significantly with the use of L -PRF . As for the regeneration times , scarring and inflammation of the tissues affected by chronic periodontitis , were better in therapy with L -PRF was applied. Like, that clinical measurements such as Clinical Attachment Level ( NIC) and probing depth (PS ) were better in therapy with L -PRF compared to sites without the application of L -PRF . However, in the presence of bleeding on probing (SS ) was similar in the experimental sites and sites without L -PRF . Conclusions: Upon completion of the study was evaluated to therapy was more effective in terms of time of regeneration , ie conventional therapy or therapy with L -PRF . According to the results, an improvement is observed in the experimental groups with L -PRF compared to control sites , based on clinical periodontal parameters evaluated.
Background: Periodontal disease is one of the major causes of tooth loss worldwide. Therefore, the management of patients diagnosed with chronic periodontitis is critical and currently continues to remain under investigation by using new techniques, such as the application of platelet rich in fibrin and leukocytes (L -PRF), with excellent results. Nevertheless, literature only provides the application of L -PRF in surgical therapies and not in non-surgical therapies, reason that encouraged the realization of this research. Justification: The effect of L -PRF nonsurgical therapies applied in the dental area was evaluated , the study was based on the lack of research that include this platelet concentrate in nonsurgical procedures. Therefore, this innovative and impact research through a new noninvasive technique generated new data and results support earlier findings and poses a new treatment protocol for non - surgical phase of the treatment of chronic periodontitis. Purpose: Determine the effect of platelet rich fibrin and leukocytes on insertion tissues used as alternative or adjunctive therapy in periodontal treatment of chronic periodontitis in non-surgical phase in patients treated at the Dental Clinic of the University Andres Bello during the year 2015. Material and Methods: Field study with a quantitative approach and whose design is experimental, within subjects, longitudinal, prospective and analytical clinical trial. The sample consisted of 19 patients and in those sites periodontally compromised in each sextant (to be addressed for purposes of study, like sextants, where there was a sextant control and other experimental sextant, both showing moderate to severe chronic periodontitis was evaluated and who meet the inclusion criteria.) A control sites were applied conventional periodontal scaling and root planing non-surgical therapy (RAR), while the pilot sites, were applied therapy unconventional, scraping surgical and root planing, with subsequent insertion of a piece of membrane of fibrin rich in platelets and leukocytes (L-PRF) in the same place and at the end, were sealed with surgical cement. The results of the experimental groups were obtained at three weeks after treatment, while the control group results at the fourth week post treatment of RAR. The results of both groups were compared and analyzed using SPSS version 22 program, using a statistical, descriptive and inferential analysis. Normality was first evaluated in the distribution of variables and according to presence or absence of this , the paired Wilcoxon test was applied. Outcomes: The results in terms of clinical parameters evaluated in this study , improved significantly with the use of L -PRF . As for the regeneration times , scarring and inflammation of the tissues affected by chronic periodontitis , were better in therapy with L -PRF was applied. Like, that clinical measurements such as Clinical Attachment Level ( NIC) and probing depth (PS ) were better in therapy with L -PRF compared to sites without the application of L -PRF . However, in the presence of bleeding on probing (SS ) was similar in the experimental sites and sites without L -PRF . Conclusions: Upon completion of the study was evaluated to therapy was more effective in terms of time of regeneration , ie conventional therapy or therapy with L -PRF . According to the results, an improvement is observed in the experimental groups with L -PRF compared to control sites , based on clinical periodontal parameters evaluated.
Notas
Tesis (Cirujano Dentista, Grado de Magíster en Ciencias Odontológicas)
Palabras clave
Plasma rico en plaquetas, Periodontitis Crónica, Regeneración Tisular Guiada Periodontal, Leucocitos, Chile