摘要
目的 探讨改良型富血小板纤维蛋白(advanced platelet-rich fibrin,A-PRF)作为骨移植材料在经牙槽嵴顶上颌窦底提升术中的骨再生效果。方法 选择2017年9月至2019年12月于大连医科大学附属口腔医院种植科拟行经牙槽嵴顶上颌窦底提升术同期行上颌后牙区种植的患者45例,共植入50枚种植体。随机分为3组:APRF组;A-PRF混合自体骨屑组;不使用骨移植材料组。每组15例,术后3个月及1年评估患者术后疼痛程度及种植体稳定性,再通过锥形束CT(cone beam CT,CBCT)观察上颌窦底种植体周围新生骨的高度变化,分析提升种植区域骨再生重建的效果。结果 3例A-PRF组、10例A-PRF混合自体骨屑组及3例不使用骨移植材料组的患者疼痛等级为1级,未出现2级和3级疼痛患者;术后即刻和术后3个月的种植体稳定系数(implant stability quotient,ISQ),3组间差异均无统计学意义(均P> 0.05);术后1年种植体近远中新生骨高度变化值,A-PRF混合自体骨屑组高于A-PRF组,A-PRF组高于不使用骨移植材料组,差异均具有统计学意义(均P <0.05)。结论 A-PRF膜联合自体骨屑在经牙槽嵴顶上颌窦底提升术中的骨再生效果最好,但单纯使用A-PRF膜也可以获得足够的骨量,且患者术后反应轻微。
Objective To investigate the osteogenic effects of advanced platelet-rich fibrin(A-PRF)as bone graft material in transalveolar maxillary sinus floor elevation. Methods From September 2017 to December 2019,45 patients who planned to undergo transalveolar maxillary sinus floor elevation and immediate implant placement in the maxillary posterior area at the Implantology Department of the Affiliated Stomatological Hospital of Dalian Medical University were selected,with a total of 50 implants placed. They were randomly divided into three groups:A-PRF group,A-PRF mixed with autologous bone debris group,and no bone graft group,with 15 cases in each group. At 3 months and 1 year after the operation,the postoperative pain of the patients and implant stability were evaluated,and then the height change of the new bone around the implant in the maxillary sinus floor was observed by cone beam CT(CBCT),and the effect of improving the bone regeneration and reconstruction in the implant area was analyzed. Results The pain grade of 3 patients in the A-PRF group,10 patients in the A-PRF mixed with autologous bone debris group and 3 patients in the no bone graft was grade 1,and there were no patients with grade 2 and grade 3 pain. The implant stability quotient(ISQ)immediately and 3 months after operation were of no statistical difference among the three groups(P > 0.05). One year after the operation,the height of new bone in the A-PRF mixed with autologous bone debris group was higher than that in the A-PRF group,and the A-PRF group was higher than no bone graft group,and the difference was statistically significant(P < 0.05). Conclusion APRF mixed with autologous bone debris achieves the best effect on bone regeneration in transalveolar maxilary sinus floor elevation,but using A-PRF membrane alone can also obtain sufficient bone with mild postoperative reaction.
作者
刘亮亮
王宁
仲维剑
马国武
LIU Liang-liang;WANG Ning;ZHONG Wei-jian;MA Guo-wu(Department of Oral Implantology,School and Hospital of Stomatology,Dalian Medical University,Dalian 116023,China)
出处
《中国实用口腔科杂志》
CAS
CSCD
2023年第1期76-81,共6页
Chinese Journal of Practical Stomatology
基金
辽宁省自然科学基金(2015020313)。
关键词
经牙槽嵴顶上颌窦底提升术
改良型富血小板纤维蛋白
骨再生
牙种植
transalveolar maxillary sinus floor elevation
advanced platelet-rich fibrin
bone regeneration
dental implant
