Application of advanced platelet-rich fibrin for through-and-through bony defect during endodontic surgery:Three case reports and review of the literature

BACKGROUND The use of advanced platelet-rich fibrin(A-PRF)membranes for guided bone and tissue regeneration in through-and-through defects after endodontic surgery was explored in three cases.CASE SUMMARY Herein,three patients presented to the endodontic clinic suffering from apical periodontitis,associated with large bone resorption and related to previously endodontically treated teeth.Periapical surgery was indicated in these cases and the osteotomy site was covered by A-PRF membrane.Cone-beam computed tomography(CBCT)was used to assess the cases before and after the surgery.CONCLUSION Four months post-surgery,the recall CBCT scan showed complete obliteration of the osteotomy with newly formed bone.A-PRF membrane showed promising results and was an advantageous addition to surgical endodontic treatment.

富血小板纤维蛋白在口腔再生领域中的应用

许多医学领域都在研究富血小板纤维蛋白(platelet-rich fibrin,PRF)与其他生物性材料结合应用在再生治疗中的临床优势。尽管如此,PRF在组织修复和再生方面的实际临床作用还存在许多问题。该文就当前PRF在口腔领域内再生性治疗的临床潜能作一综述。

Minimally invasive maxillary sinus augmentation with simultaneous implantation on an elderly patient:A case report

BACKGROUND In this case study,a minimally invasive transalveolar approach using platelet-rich fibrin and bone substitute with simultaneous implantation was carried out in an elderly patient.We analyzed the cone-beam computed tomography(CBCT)findings to evaluate bone regeneration.CASE SUMMARY A 65-year-old female with no contraindications for dental implants and loss of maxillary bilateral molars is described.Examination by CBCT showed the available vertical bone height in the bilateral posterior maxilla was 0.5-6.8 mm in the left and 2.8-6.5 mm in the right.The patient underwent a transalveolar approach using platelet-rich fibrin and bone substitute with simulataneous placement of an implant 10 mm in length.Six months post-surgery,the implant showed excellent osseointegration with the bone graft.Thereafter,full-ceramic crowns were fitted.Follow-up at 2 years demonstrated satisfactory prognosis.CONCLUSION Platelet-rich fibrin and bone substitute can be used to augment the maxillary sinus with a vertical bone height less than 4 mm.

口腔种植上颌窦提升术临床要点(英文)

严重牙周病导致的上颌后牙缺失常伴有严重的牙槽嵴低平。因此,缺少足够的骨高度通常是在这个区域做牙种植的主要困难。1985年Boyne与James首先提出经上颌窦侧壁开窗的上颌窦底提升术,以提升足够的骨高度来进行上颌后牙种植修复。1998年,Summers提出了另外一种窦底提升方法,即从上颌牙槽嵴顶垂直向牙根方向,对上颌窦进行窦底提升,称为垂直提升技术或者牙槽嵴入路上颌窦提升术。本文将结合相关文献及我们的临床经验,叙述这两种手术方式的特点、适应证与禁忌证、临床步骤以及可能的并发症和处理方法。希望对读者理解上颌窦提升术有所帮助。

浓缩血小板制品在面部皮肤软组织年轻化中应用的专家共识(2020版)

面部皮肤软组织年轻化的治疗方式包括手术和非手术治疗两大类,其中非手术治疗近年来发展迅猛。以浓缩血小板生物制品为代表的面部年轻化生物治疗受到人们的关注,但由于在制备的质量控制、使用方式等方面的不统一,也有一些不一致观点。本次通过复习大量文献,筛选出高质量的证据文章,结合面部年轻化领域专家反复的研讨,形成具有指导意义的专家共识,为从事面部年轻化的医护人员科学、规范地使用浓缩血小板治疗技术。

重度牙周炎患者双侧后牙牙周牙髓联合病变累及下颌管的位点保存后种植修复1例报告

种植手术作为一种修复方式,因其临床效果稳定,已经成为临床常用的修复牙列缺损或缺失方法。在种植手术中,种植区足够的骨量支持是保证种植体正常功能的必要条件。在临床工作中,很多患者在拔牙术后,牙齿缺失致使牙槽骨失去刺激,而失去正常牙槽骨丰满度和牙龈外形轮廓,这种情况在牙周病患者中尤甚。有研究表明,在拔牙后前6个月,牙槽骨吸收速度最快,平均水平向骨吸收4.56 mm,垂直向骨吸收1.5 mm[1]。

富血小板纤维蛋白促进上颌窦底提升术后骨再生研究进展

在上颌后牙区骨量不足时,常采用上颌窦底提升术获得充足的骨量,随着研究的不断深入,现普遍认为上颌窦底黏膜本身具备成骨潜力,术后的成骨模式为通过植骨材料维持稳定的空间,来自创面和窦底黏膜的间充质干细胞黏附、迁移并成骨分化,形成新骨。常规应用的植骨材料普遍缺乏骨诱导性,使得术后成骨效率低、术后反应明显,因此加速术后的骨再生并减轻患者负担是当前临床研究的热点。富血小板纤维蛋白(platelet-rich fibrin,PRF)是第二代自体血小板浓缩制品,作为组织工程材料最初被用于修复软组织损伤,现已被广泛应用于口腔种植领域。近期研究发现PRF可诱导间充质干细胞成骨分化。通过标准化流程制备的PRF具有一定的骨诱导性,同时可促进血管形成,在上颌窦底提升术中能够调控其成骨模式中的各项因素。另外,PRF制成膜使用可依靠其机械强度维持提升后的窦底黏膜。但迄今为止PRF促进骨再生的机制研究仍有欠缺,是否应该在上颌窦底提升术中常规应用PRF仍存争议。文章重点介绍PRF促进上颌窦底提升术后的骨再生机制以及PRF在不同术式中的临床应用方式及效果,旨在为临床决策及进一步研究提供参考。