PRF复合GBR技术在牙槽嵴位点保存中的应用研究

Research and application of PRF combined with GBR technique in preservation of alveolar ridge

目的:观察富血小板血纤维蛋白(PRF)复合引导骨再生(GBR)技术在牙槽嵴位点保存中的应用效果及骨再生情况。方法:选取本院口腔科就诊上前牙外伤患者5例,分为对照组和实验组,二组分别为同一患者双侧对称同名牙,实验组行PRF膜+Bio-Oss骨粉+海奥生物膜位点保存术,对照组行Bio-Oss骨粉+海奥生物膜位点保存术。术后2周、4周、6周、8周、12周X线片应用MATLAB软件进行术区灰度值测量,术后半小时、6周及12周锥形束CT(CBCT)应用simplant软件行牙槽嵴顶下2mm、4mm、6mm三个位点牙槽骨宽度、高度及术区骨质密度测量。结果:二组X线片灰度值差异有统计学意义(P<0.01),二组各时期X线片灰度值的差值差异均有统计学意义(P<0.01),相关性检验示与时间有相关性(P<0.01),二组术后即刻及术后12周牙槽嵴顶下2mm、4mm、6mm宽度、牙槽嵴顶到对颌牙切端平面高度差异无统计学意义(P>0.05),CBCT术区骨密度值差异有统计学意义(P<0.05),相关性检验示与时间有相关性(P<0.01)。结论:PRF配合GBR技术与单纯使用GBR技术进行位点保存术均能有效减少牙拔除术后牙槽骨宽度及高度的吸收,并且PRF可以促进新骨生成以及人工骨粉向新骨转化,同时期较单纯GBR技术成骨速度快。

Objective： To observe the effect of platelet-rich fibrin（PRF） combined with guided bone regeneration（GBR） in the preservation of alveolar ridge sites and bone regeneration. Methods： Five patients were divided into control group and experimental group, and two groups were the one patient bilateral symmetry of the same name teeth. The experimental group were treated with PRF membrane＋Bio-Oss bone meal＋Haiao biological membrane to site preservation, the control group with Bio-Oss bone meal＋sea Austrian biological membrane to site preservation. 2 weeks, 4 weeks, 6 weeks, 8 weeks and 12 weeks after surgery, the X-ray was used matlab software to measure the gray value of the operation area. The half-hour, 6-week and 12-week cone beam CT（CBCT） was used simplant software to measure the width, height and bone density of under the alveolar ridge at 2mm, 4mm and 6mm. Results： The differences of gray values between the two groups were statistically significant（P0.01）. The difference of the differences of gray values between the two groups was statistically significant（P0.01）, and the correlation test showed that has a correlation with time（P0.01）. There was no significant difference between the two groups of the width, height and bone density of under the alveolar ridge at 2mm, 4mm and 6mm.（P0.05）. The difference of bone mineral density measured by CBCT was statistically significant（P 0.05）, and the correlation test showed that has a correlation with time（P 0.01）. Conclusion：PRF with GBR technique and simple use of GBR technique can effectively reduce the the absorption of alveolar bone width and height after tooth extraction, and PRF can promote the new bone formation and artificial bone meal to the new bone transformation, the speed of bone formation faster than the simple GBR technology same period.