富血小板纤维蛋白结合引导骨组织再生在拔牙位点保存术中的应用

Application observation of platelet-rich fibrin combined with guided bone regeneration in the site preservation after tooth extraction

目的探讨富血小板纤维蛋白(platelet-rich fibrin,PRF)在拔牙后引导骨组织再生(guided bone regeneration,GBR)位点保存术中的应用。方法选取三亚市人民医院2015年1月至2017年1月期间收治的拔牙后行GBR位点保存术患者60例为研究对象,根据就诊顺序依次编号,采用数字表法随机分为观察组和对照组各30例。微创拔牙后,植入BioOss骨替代材料,观察组以PRF膜覆盖在其表面,对照组以海奥胶原膜覆盖在其表面。比较2组创面愈合时间、术后1周和术后2周创面愈合率,拔牙前和术后3个月牙槽骨高度和宽度,术后6个月组织学检查牙龈愈合情况和骨新生情况。结果观察组创面愈合时间为(11.87±3.85)d,显著短于对照组的(17.41±4.36)d(P<0.05);观察组术后1周和2周创面愈合率分别为(68.21±7.57)%和(96.17±3.38)%,显著高于对照组[(44.52±7.13)%和(78.35±3.04)%,P<0.05];观察组术后3个月牙槽骨宽度减少(0.58±0.12)mm,牙槽骨高度减少(0.81±0.17)mm,显著少于对照组[(0.92±0.22)mm和(1.15±0.26)mm,P<0.05];术后6个月,观察组牙龈组织排列以及牙龈成分较对照组愈合更好,观察组新生骨百分比为(37.32±11.87)%,显著高于对照组的(28.48±8.59)%,差异有统计学意义(P<0.05)。结论 PRF应用于拔牙后GBR位点保存术,可促进创面愈合,抑制牙槽骨吸收,促进新生骨形成。

Objective To explore the application of platelet-rich fibrin（ PRF） in the site preservation of guided bone regeneration（ GBR） after tooth extraction. Methods 60 cases of patients treated with GBR site preservation after tooth extraction in our hospital from January 2015 to January 2017 were selected for the study,and were numbered by the admission sequence and then divided into the observation group（ n = 30） and the control group（ n = 30） according to the random number table method. After the minimally invasive tooth extraction,Bio-Oss bone substitute material was implanted. The observation group was covered with PRF membrane on the surface and the control group was covered with sea oxide collagen membrane on its surface. The wound healing time,the healing rates at 1 week,2 weeks after operation,and the height and width of alveolar bone before tooth extraction and at 3 months after operation were compared between the two groups. Results The wound healing time was（ 11.87± 3.85） d in the observation group,which was significantly lower than that in the control group with（ 17.41± 4.36） d（ P〈0.05）. And the wound healing rates were（ 68. 21 ±7.57） % and（ 96.17± 3.38） % at 1 week,2 weeks after operation,which were significantly higher than those in the control group[（ 44. 52± 7.13） % and（ 78. 35 ± 3. 04） %,P〈0. 05]. The decreases of width and the height of alveolar bone at 3 months after operation were（ 0.58±0.12） mm and（ 0. 81 ± 0. 17） mm in the observation group,which were significantly lower than those in the control group [（ 0. 92 ± 0. 22） mm and（ 1. 15 ±0. 26） mm,P〈0.05]. At 6 months after operation,the gingival tissue of the observation group better than that of the control group,and the percentage of newborn bone in the observation group was significantly higher than that in the control group [（ 37.32±11.87） %vs（ 28.48±8.59） %,P〈0.05]. Conclusion PRF can promote wound healing and inhibit alveolar bone resorption in the GBR site preservation after tooth extraction.