富血小板凝胶与拔牙窝新骨形成和骨量保持

Effect of platelet-rich gel on new bone formation and bone maintenance following tooth extraction

背景:富血小板血浆能否促进骨组织的修复再生存在一定的争议。目的:研究富血小板血浆/凝胶对拔牙窝骨愈合过程中新骨形成和骨量保持的可能调节作用,探讨富血小板血浆/凝胶与骨愈合的相互关系。方法:通过拔牙建立Beagle犬拔牙窝骨缺损模型,同期在拔牙窝导入富血小板血浆或复血小板凝胶,并设计对照组。术后2,4,8,12周分别进行大体观察、放射影像学检查、三维CT平扫+重建、组织学检查拔牙窝颊舌侧牙槽嵴高度差、CT值以及新生骨面积。结果与结论:与富血小板血浆组和对照组比较,影像学结果表明富血小板凝胶组在第2,4,8周新骨形成的面积最大(P<0.01);组织学结果表明富血小板凝胶组在第2,4周新骨形成面积最大(P<0.05);在所有时间点上富血小板凝胶组颊舌侧牙槽嵴高度差值最小(P<0.05)。在第12周,富血小板凝胶组颊舌侧牙槽嵴高度仍有2mm差值。提示,富血小板凝胶具有促进牙槽窝早期愈合的能力,但其单独使用时促进牙槽窝骨量保持的效能有限。

BACKGROUND：Whether platelet-rich plasma can promote bone tissue regeneration or not is controversial.OBJECTIVE：To explore the effect of platelet-rich plasma（PRP）/platelet-rich gel（PRG） on bone healing after tooth extraction by an animal model of denervation.METHODS：The premolars of both sides were extracted from Beagle dogs,then a filling socket with PRP or PRG was introduced.The Beagle dogs were sacrificed at 2,4,8,12 weeks.X-ray,CT scan,hematoxylin-eosin staining were used to detect the effect of PRP or PRG on the new bone formation and maintenance after tooth extraction.RESULTS AND CONCLUSIOU：CT scan convinced that compared with group PRP and control,group PRG had more new bone at 2,4,8 weeks.While,histological analysis showed that only at 2,4 weeks,group PRG had the advantage of osteogenesis.At all time points,group PRG showed the lest difference of buccal-lingual height.At 12 weeks,the difference of buccal and lingual height in group PRG was still 2mm.PRG had the ability to promote early phase healing of extraction sockets.PRG showed the limited efficiency in bone maintenance when used exclusively after extraction.