PRF、胶质银及Bio-Oss骨粉在凹面型上颌窦底提升术中的应用效果对比

Comparison on the Application of PRF,Colloidal Silver and Bio-Oss Bone Meal in Maxillary Sinus Floor Lifting with Concave Maxillary Sinus Floor Morphology

目的:对比富血小板纤维蛋白(Platelet-rich fibrin,PRF)、胶质银及Bio-Oss骨粉在凹面型上颌窦底提升术中的应用。方法:选取2015年1月-2021年11月在承德市口腔医院就诊的上颌后牙区骨量不足需行上颌窦底提升术的90例患者(共136颗磨牙),按照上颌窦内移植材料不同分为PRF组、胶质银组、Bio-Oss骨粉组,每组30例。采用VAS评分评估术后疼痛度,画线测量法测量患者术后面部肿胀度,使用EasyDent测量骨密度,采用Osstell Mentor分析仪检测种植体ISQ值,采用口腔健康相关生活质量评分表(Oral health-related quality of life,OHRQOL)评估患者生活质量,记录三组患者术后并发症发生情况。结果:三组患者手术疼痛程度和术后面部肿胀比较,显著无统计学意义(P>0.05);各时间段PRF组患者骨密度比较,差异无统计学意义(P>0.05);术后4个月,胶质银组和PRF组患者骨密度均显著低于Bio-Oss骨粉组,胶质银组患者骨密度显著低于PRF组,差异有统计学意义(P<0.05);术后三组患者颊侧、舌侧、近中侧、远中侧4个方向ISQ值有明显差异,PRF组术后ISQ值明显高于胶质银组和Bio-Oss骨粉组,差异有统计学意义(P<0.05)。同型植体相同时间点,颊侧、舌侧、近中侧、远中侧4个方向的ISQ值比较,差异无统计学意义(P>0.05)。术后三组患者生活质量无明显差异(P>0.05);术后PRF组并发症发生率为6.67%、胶质银组为10.00%、Bio-Oss骨粉组为36.67%,差异有统计学意义(P<0.05)。结论:PRF、胶质银及Bio-Oss骨粉均能发挥促进上颌窦内新骨形成的作用,PRF成骨速度快、较稳定、术后并发症少,值得临床广泛使用。

Objective To compare the application of platelet-rich fibrin (PRF),colloidal silver and Bio-Oss bone meal in maxillary sinus floor lifting with concave maxillary sinus floor morphology.Methods A total of 90 patients (136 molars) with concave maxillary sinus floor morphology undergoing maxillary sinus floor lifting due to bone insufficiency at maxillary posterior dental area in Chengde Stomatological Hospital were enrolled between January 2015 and November 2021.According to different intrasinus graft materials,they were divided into PRF group,colloidal silver group and Bio-Oss bone meal group,30 cases in each group.The postoperative pain was evaluated by Visual Analogue Scale (VAS).The postoperative facial swelling was measured by scribing method.The bone mineral density was measured by EasyDent.The implant stability quotient (ISQ) was measured by Ostell Mentor analyzer.The quality of life in patients was assessed by oral health-related quality of life scale (OHRQOL).The occurrence of postoperative complications in the three groups was recorded.Results There was no significant difference in surgical pain or postoperative facial swelling among the three groups (P>0.05).There was no significant difference in bone mineral density at different time periods in PRF group (P>0.05).At 4 months after surgery,bone mineral density was the highest in Bio-Oss bone meal group,followed by PRF group and colloidal silver group (P<0.05).After surgery,there were significant differences in ISQ values in buccal,lingual,mesial and distal directions among the three groups.After surgery,ISQ value in PRF group was significantly greater than that in colloidal silver group and Bio-Oss bone meal group (P<0.05).At the same time point,there was no significant difference in ISQ values of buccal,lingual,mesial and distal directions among patients with the same type of implants (P>0.05).There was no significant difference in postoperative quality of life among the three groups (P>0.05).The incidence rates of postoperative complications in PRF group,colloidal silver group and Bio-Oss bone meal group were 6.67%,10.00% and 36.67%,respectively (P<0.05).Conclusion PRF,colloidal silver and Bio-Oss bone meal can promote formation of new bones in maxillary sinus.PRF has fastest osteogenesis,with relatively higher stability and fewer postoperative complications.