自体富血小板血浆联合牙周引导组织再生技术对齿槽嵴裂患者修复效果影响及应用价值分析

Effect of platelet rich plasma combined with periodontal guided tissue regeneration technology on the tepair effect of patients with alveolar ridge and its application value analysis

目的探讨自体富血小板血浆(PRP)联合牙周引导组织再生(GTR)技术对齿槽嵴裂患者修复效果影响及应用价值。方法前瞻性选择2018年9月至2021年2月在北京市大兴区人民医院口腔科进行齿槽嵴裂修复治疗的单侧齿槽嵴裂患者36例。根据随机数字表法将受试者分为GTR组(n=18)和PRP+GTR组(n=18)。术后观察2组患者植骨区有无感染、暴露、植骨坏死和口鼻瘘复发;拍摄颌骨曲面断层片观察植骨生长情况;术后4周参考Bergland评价标准对植骨高度进行判断并进行比较。结果术后2周内所有患者植骨区无感染、植骨暴露、植骨坏死和口鼻瘘复发;术后4周,植入骨与齿槽骨间已建立骨小梁,但形态尚与齿槽骨有所不同。术后4周GTR组植入骨高度Ⅰ级7例,Ⅱ级8例,Ⅲ级3例,Ⅳ级0例,治疗成功率83.33%;术后4周GTR+PRP组植入骨高度Ⅰ级16例,Ⅱ级1例,Ⅲ级1例,Ⅳ级0例,治疗成功率94.44%;GTR+PRP组Bergland分级优于GTR组,差异有统计学意义(P<0.05)。结论PRP的应用可以使骨组织获得良好再生,重建齿槽裂隙处部位的骨缺损,有利于提高GTR联合植骨术的临床修复效果。

Objective To explore the effect and application value of autologous platelet rich plasma(PRP)combined with periodontal guided tissue regeneration(GTR)technology on the repair effect of patients with alveolar cleft.Methods A total of 36 patients with unilateral alveolar cleft who underwent alveolar cleft repair in the Department of Stomatology of Beijing Daxing District People's Hospital from September 2018 to February 2021 were prospectively selected.According to the random number table method,subjects were divided into two groups:GTR group(n=18)and PRP+GTR group(n=18).The two groups of patients for infection,exposure,bone graft necrosis,and recurrence of oral and nasal fistulas after operation were observed;the growth of the bone graft was observed by taking a slice of the jawbone;4 weeks after operation,the height of the bone graft was judged and compared according to the Bergland evaluation standard.Results All patients had no infection,bone graft exposure,bone graft necrosis and recurrence of oral and nasal fistula within 2 weeks after surgery;4 weeks after operation,trabecular bone had been established between the implanted bone and the alveolar bone,but the shape was still different with Groove bones.In the GTR group 4 weeks after operation,7 cases of implanted bone height were gradeⅠ,8 cases were gradeⅡ,3 cases were gradeⅢ,and 0 cases were gradeⅣ,the treatment success rate was 83.33%;In the PRP+GTR group 4 weeks after operation,there were 16 cases of bone height gradeⅠ;1 case of gradeⅡ;1 case of gradeⅢ;0 cases of gradeⅣ;the treatment success rate was 94.44%.The Bergland classification of GTR+PRP group was better than that of GTR group,and the difference was statistically significant(P<0.05).Conclusion The application of PRP can make bone tissue regenerate well,reconstruct the bone defect in the alveolar fissure,and help to improve the clinical repair effect of GTR combined with bone grafting.