富血小板纤维蛋白在正畸减数拔牙中对拔牙位点保存的应用研究
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摘要
目的:研究富血小板纤维蛋白(platelet-rich fibrin,PRF)对减数拔牙后的牙槽窝进行位点保存,及减数后正畸提供足够骨量的临床效果。方法:选取正畸需拔除4颗第一前磨牙的安氏Ⅰ类成年患者28例,年龄范围18～25岁;并将每例患者拔牙窝左右分为对照组与实验组。实验组拔牙后于拔牙窝内充填PRF凝胶并以PRF膜覆盖;对照组拔牙后使拔牙窝内滞留血凝块,不做其他处理。观测分析上颌牙槽骨高度、上颌牙槽窝骨密度指标及正畸治疗尖牙远移到位后的牙龈折痕出现情况。结果:术后1个月、术后2个月实验组BCH、MCH、CCH、DCH、P/LCH测量值明显小于对照组,差异均有统计学意义; BMH、BDH、P/LMH、P/LDH测量值差异将均无统计学意义。实验组牙龈折痕出现数量少于对照组,差异有统计学意义。结论:PRF应用于拔牙位点保存可加速牙槽窝新骨形成,增加牙槽窝骨密度,同时可有效减少牙龈折痕的出现。
Objective: To study the effect of platelet-rich fibrin( PRF) on the location preservation of alveolar fossa after subtractive extraction,so as to provide sufficient bone for orthodontics after subtractive extraction. Methods: Twentyeight adult Angle class I patients( 18 ～ 25 years old) with 4 first premolars to be extracted during orthodontic treatment were divided into control group and experimental group. In the experimental group,PRF gel was filled in the extraction socket and covered with PRF film. After extraction,the control group retained blood clot in the extraction cavity without any other treatment. The height of maxilla,bone mineral density of alveolar fossa of maxilla and the occurrence of gingival creases after orthodontic treatment of canines were recorded and analyzed. Results: The BCH,MCH,CCH,DCH,P/LCH measurements in the experimental group were significantly smaller than those in the control group at 1 month and 2 months after operation,and the difference was statistically significant. The BMH,BDH,P/LMH,P/LDH measurements were not significant,but there was no significant difference. The number of gingival creases in the experimental group was less than that in the control group,and the difference was statistically significant. Conclusion: PRF can accelerate the formation of new bone in alveolar fossa,increase the bone density of alveolar fossa,and effectively reduce the occurrence of gingival creases.
Objective: To study the effect of platelet-rich fibrin( PRF) on the location preservation of alveolar fossa after subtractive extraction,so as to provide sufficient bone for orthodontics after subtractive extraction. Methods: Twentyeight adult Angle class I patients( 18 ～ 25 years old) with 4 first premolars to be extracted during orthodontic treatment were divided into control group and experimental group. In the experimental group,PRF gel was filled in the extraction socket and covered with PRF film. After extraction,the control group retained blood clot in the extraction cavity without any other treatment. The height of maxilla,bone mineral density of alveolar fossa of maxilla and the occurrence of gingival creases after orthodontic treatment of canines were recorded and analyzed. Results: The BCH,MCH,CCH,DCH,P/LCH measurements in the experimental group were significantly smaller than those in the control group at 1 month and 2 months after operation,and the difference was statistically significant. The BMH,BDH,P/LMH,P/LDH measurements were not significant,but there was no significant difference. The number of gingival creases in the experimental group was less than that in the control group,and the difference was statistically significant. Conclusion: PRF can accelerate the formation of new bone in alveolar fossa,increase the bone density of alveolar fossa,and effectively reduce the occurrence of gingival creases.
引文
[1]Proff P,Bayerlein T,Fanghnel J,et al.The application of bone graft substitutes for alveolar ridge preservation after orthodontic extractions and for augmentation of residual cleft defects[J].Folla Morphol,2006,65(1):81-83.
[2]Wehrbein,Heinrich,Fuhrmann,et al.Human histologic tissue response after long-term orthodontic tooth movement[J].AM J Orthod Dentofac,1995,107(4):360-371.
[3]Kim TS,Caruso JM,Christensen H,et al.A comparison of cone-beam computed tomography and direct measurement in the examination of the mandibular canal and adjacent structures[J].J Endodont,2010,36(7):1191-1194.
[4]Chackartchi T,Stabholz A.[Ridge preservation after tooth extraction:what do we know today][J].Refuat Hapeh Vehashinayim,2013,30(2):65-75.
[5]Ten HJ,Slot DE,Van der Weijden GA.Effect of socket preservation therapies following tooth extraction in non-molar regions in humans:a systematic review[J].Clin Oral Impl An Bes,2011,22(8):779-788.
[6]Avila-Ortiz G,Elangovan S,Kramer KW,et al.Effect of alveolar ridge preservation after tooth extraction:a systematic review and meta-analysis[J].J Dent Bes,2014,93(10):950-958.
[7]Scantlebury TV.1982-1992:A decade of technology development for guided tissue regeneration[J].J Periodontol,1993,64(Suppl 11):1129.
[8]Chen FM,Zhang J,Zhang M,et al.A review on endogenous regenerative technology in periodontal regenerative medicine[J].Biomaterials,2010,31(31):7892-7927.
[9]孙晓琳,翟婧捷,孙悦,等.PRF联合GBR在前牙即刻种植中的应用1例[J].口腔医学研究,2017,33(1):106-107.
[10]Dohan Ehrenfest DM,de Peppo GM,Doglioli P,et al.Slow release of growth factors and thrombospondin-1 in Choukroun's platelet-rich fibrin(PRF):a gold standard to achieve for all surgical platelet concentrates technologies[J].Growth Factors,2009,27(1):63-69.
[11]Choukroun J,Adda F,Schoeffler C,et al.Une opportunite paro-implantologie:le PRF[J].Implantodontie,2000,42:55-62.
[12]李一鸣,尼加提·吐尔逊,周晶.RANKL和OPG在不同骨移植材料拔牙位点保存区的表达[J].北京口腔医学,2015,23(2):80-84.
[13]van Hinsbergh VW,Collen A,Koolwijk P.Role of fibrin matrix in angiogenesis[J].Ann Ny Acad Sci,2001,936(1):426-437.
[14]Dohan Ehrenfest DM,Diss A,Odin G,et al.In vitro effects of Choukroun's PRF(platelet-rich fibrin)on human gingival fibroblasts,dermal prekeratinocytes,preadipocytes,and maxillofacial osteoblasts in primary cultures[J].Or Surg Or Med Or Pa,2009,108(3):341-352.
[15]Dohan DM,Choukroun J,Diss A,et al.Platelet-rich fibrin(PRF):a second-generation platelet concentrate.Part I:technological concepts and evolution[J].Or Surg Or Med Or Pa,2006,101(3):e37-44.
[16]He L,Lin Y,Hu X,et al.A comparative study of platelet-rich fibrin(PRF)and platelet-rich plasma(PRP)on the effect of proliferation and differentiation of rat osteoblasts in vitro[J].Or Surg Or Med Or Pa,2009,108(5):707-713.
[17]Rivera Circuns AL,Tulloch JF.Gingival invagination in extraction sites of orthodontic patients:their incidence,effects on periodontal health,and orthodontic treatment[J].AM J Orthod Dentofac,1983,83(6):469-476.
[18]Reichert C,G9lz L,Dirk C,et al.Retrospective investigation of gingival invaginations:Part I:Clinical findings and presentation of a coding system[J].J Oroeac Orthop,2012,73(5):387-396.
[19]Reichert C,Kutschera E,Nienkemper M,et al.Influence of time after extraction on the development of gingival invagination:study protocol for a multicenter pilot randomized controlled clinical trial[J].Trials,2013,14(1):1-5.
[2]Wehrbein,Heinrich,Fuhrmann,et al.Human histologic tissue response after long-term orthodontic tooth movement[J].AM J Orthod Dentofac,1995,107(4):360-371.
[3]Kim TS,Caruso JM,Christensen H,et al.A comparison of cone-beam computed tomography and direct measurement in the examination of the mandibular canal and adjacent structures[J].J Endodont,2010,36(7):1191-1194.
[4]Chackartchi T,Stabholz A.[Ridge preservation after tooth extraction:what do we know today][J].Refuat Hapeh Vehashinayim,2013,30(2):65-75.
[5]Ten HJ,Slot DE,Van der Weijden GA.Effect of socket preservation therapies following tooth extraction in non-molar regions in humans:a systematic review[J].Clin Oral Impl An Bes,2011,22(8):779-788.
[6]Avila-Ortiz G,Elangovan S,Kramer KW,et al.Effect of alveolar ridge preservation after tooth extraction:a systematic review and meta-analysis[J].J Dent Bes,2014,93(10):950-958.
[7]Scantlebury TV.1982-1992:A decade of technology development for guided tissue regeneration[J].J Periodontol,1993,64(Suppl 11):1129.
[8]Chen FM,Zhang J,Zhang M,et al.A review on endogenous regenerative technology in periodontal regenerative medicine[J].Biomaterials,2010,31(31):7892-7927.
[9]孙晓琳,翟婧捷,孙悦,等.PRF联合GBR在前牙即刻种植中的应用1例[J].口腔医学研究,2017,33(1):106-107.
[10]Dohan Ehrenfest DM,de Peppo GM,Doglioli P,et al.Slow release of growth factors and thrombospondin-1 in Choukroun's platelet-rich fibrin(PRF):a gold standard to achieve for all surgical platelet concentrates technologies[J].Growth Factors,2009,27(1):63-69.
[11]Choukroun J,Adda F,Schoeffler C,et al.Une opportunite paro-implantologie:le PRF[J].Implantodontie,2000,42:55-62.
[12]李一鸣,尼加提·吐尔逊,周晶.RANKL和OPG在不同骨移植材料拔牙位点保存区的表达[J].北京口腔医学,2015,23(2):80-84.
[13]van Hinsbergh VW,Collen A,Koolwijk P.Role of fibrin matrix in angiogenesis[J].Ann Ny Acad Sci,2001,936(1):426-437.
[14]Dohan Ehrenfest DM,Diss A,Odin G,et al.In vitro effects of Choukroun's PRF(platelet-rich fibrin)on human gingival fibroblasts,dermal prekeratinocytes,preadipocytes,and maxillofacial osteoblasts in primary cultures[J].Or Surg Or Med Or Pa,2009,108(3):341-352.
[15]Dohan DM,Choukroun J,Diss A,et al.Platelet-rich fibrin(PRF):a second-generation platelet concentrate.Part I:technological concepts and evolution[J].Or Surg Or Med Or Pa,2006,101(3):e37-44.
[16]He L,Lin Y,Hu X,et al.A comparative study of platelet-rich fibrin(PRF)and platelet-rich plasma(PRP)on the effect of proliferation and differentiation of rat osteoblasts in vitro[J].Or Surg Or Med Or Pa,2009,108(5):707-713.
[17]Rivera Circuns AL,Tulloch JF.Gingival invagination in extraction sites of orthodontic patients:their incidence,effects on periodontal health,and orthodontic treatment[J].AM J Orthod Dentofac,1983,83(6):469-476.
[18]Reichert C,G9lz L,Dirk C,et al.Retrospective investigation of gingival invaginations:Part I:Clinical findings and presentation of a coding system[J].J Oroeac Orthop,2012,73(5):387-396.
[19]Reichert C,Kutschera E,Nienkemper M,et al.Influence of time after extraction on the development of gingival invagination:study protocol for a multicenter pilot randomized controlled clinical trial[J].Trials,2013,14(1):1-5.