富血小板纤维蛋白膜对延迟再植牙牙周愈合影响的实验研究

Effect of platelet rich fibrin membrane on periodontal healing of delayed replantedrat tooth

目的:探讨局部应用富血小板纤维蛋白(PRF)膜对全脱位延迟再植牙牙周愈合的影响。方法:25只6周龄Wistar雄性大鼠,进行同颌左右对照实验。拔除双侧上颌第一磨牙,体外干燥保存30 min后,将自制的PRF膜置于一侧拔牙窝内,干燥保存的牙齿原位再植,作为PRF膜组,对侧拔牙窝内不添加PRF膜,脱位牙原位再植作为对照组。分别于术后1、3、7、14、28 d处死大鼠,制作石蜡切片,HE染色,对再植牙牙周愈合情况进行组织形态学评价,并对结果进行统计学分析。结果:所有再植牙无脱落。再植术后1 d,牙周炎症细胞浸润,PRF膜组牙周炎性改变发生率显著高于对照组(P<0.01);术后3 d,PRF膜组牙周炎性改变发生率仍较对照组高(P<0.01);术后7 d,两组中牙周膜愈合发生率无统计差异(P>0.05),PRF膜组表面吸收发生率显著低于对照组(P<0.05),炎症性吸收发生率与对照组无统计差异(P>0.05);术后14 d,PRF膜组表面吸收发生率显著高于对照组(P<0.05),炎症性吸收发生率显著低于对照组(P<0.01);术后28 d,两组中各类牙周愈合表现发生率无统计差异(P>0.05)。结论:全脱位牙延迟再植术中,应用PRF膜不影响再植牙就位、愈合,早期能够控制再植牙牙根吸收的发生、发展,但远期效果尚不稳定,有待进一步研究。

Objectives To investigate the effect of platelet rich fibrin （PRF） membrane on periodontal healing of delayed replanted avulsed teeth. Methods ： Twenty-five six-week-old male Wistar rats were used for split mouth design. After bilateral maxillary first mo-lars extracted,dried for 30 min, self-made PRF membrane was placed in one side of the extraction socket and the avulsed teeth replan-ted as PRF membrane group,without PRF membrane at contra-lateral,avulsed teeth replanted as control group. On 1,3,7 , 14 and 28 days after tooth replantation, the rats were sacrificed. Paraffin specimens of maxillary bone were prepared, sliced. HE staining was used to observe the periodontal healing of the replanted teeth and the results were statistically analyzed. Results ： All the replanted teeth did not fall off. One day after tooth replantation,inflammatory infiltrate could be found in both groups,the incidence rate of periodontal inflammatory change was significantly higher in PRF membrane group than that of control group （P〈0.01）; After 3 days,the incidence rate of periodontal inflammatory^ change was still higher in PRF membrane group （P〈0.01） ; After 7 days,the incidence rate of perio-dontal membrane healing was consistent in both groups（ P〉0.05）,incidence rate of surface resorption was significantly lower in PRF membrane group than in control group （P〈0.05）,inflammatory^ resorption was consistent in both groups（P〉0.05）, 14 days after opera-tion, incidence rate of surface resorption was significantly higher in PRF membrane group than that of control group （ P 〈0.05） while inflammatory resorption was significantly lower in PRF membrane group （P〈0.01）; 28 days after operation,periodontal healing pattern in the two groups were similar. Conclusions： In delayed avulsion teeth replantation,the application of PRF membrane did not affect the reposition and healing of replanted teeth, and could control the occurrence and development of root resorption at the initial stage. However, the long-term effect is not stable, and needs further study.