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富血小板血浆与牛多孔骨矿物质联合引导组织再生治疗人类骨内缺损。

Platelet-rich plasma and bovine porous bone mineral combined with guided tissue regeneration in the treatment of intrabony defects in humans.

作者信息

Camargo Paulo M, Lekovic Vojislav, Weinlaender Michael, Vasilic Nikola, Madzarevic Miroslav, Kenney E Barrie

机构信息

Division of Associated Clinical Specialties, Section of Periodontics, UCLA School of Dentistry, Periodontics CHS 63048, Los Angeles, CA 90095, USA.

出版信息

J Periodontal Res. 2002 Aug;37(4):300-6. doi: 10.1034/j.1600-0765.2002.01001.x.

Abstract

BACKGROUND

A combination of platelet-rich plasma (PRP), bovine porous bone mineral (BPBM) and guided tissue regeneration (GTR) has been shown to be effective in promoting clinical signs of periodontal regeneration in intrabony defects. As an initial attempt to clarify the role played by each of the three treatment components, this study was performed to compare the clinical effectiveness of two regenerative techniques for intrabony defects in humans: a combination of PRP/BPBM/GTR vs. GTR.

MATERIAL AND METHODS

Eighteen patients participated in the study. Using a split-mouth design, interproximal bony defects were surgically treated with either an absorbable membrane made of polylactic acid for GTR or a combination of PRP/BPBM/GTR. Changes in pocket depth, attachment level and defect fill as revealed by 6-month reentry surgeries were evaluated.

RESULTS

Both treatment modalities resulted in significant pocket depth reduction and clinical attachment gain as compared to baseline values. Pocket depth reduction was 4.98 +/- 0.96 mm on buccal and 4.93 +/- 0.92 mm on lingual sites of the PRP/BPBM/GTR group and 3.62 +/- 0.81 mm on buccal and 3.54 +/- 0.88 mm on lingual sites of the GTR group. The gain in clinical attachment observed was 4.37 +/- 1.31 mm on buccal and 4.28 +/- 1.33 mm on lingual sites of the PRP/BPBM/GTR group and 2.62 +/- 1.23 mm on buccal and 2.44 +/- 1.21 mm on lingual sites of the GTR group. The amount of defect fill observed was 4.78 +/- 1.26 mm on buccal and 4.66 +/- 1.32 mm on lingual sites of the PRP/BPBM/GTR group and 2.31 +/- 0.76 mm on buccal and 2.26 +/- 0.81 mm on lingual sites of the GTR group. All differences between the two groups were statistically significant in favor of the PRP/BPBM/GTR group.

CONCLUSIONS

The results of this study suggest that PRP and BPBM provide an added regenerative effect to GTR in promoting the clinical resolution of intrabony defects on patients with severe periodontitis.

摘要

背景

富含血小板血浆(PRP)、牛多孔骨矿物质(BPBM)和引导组织再生(GTR)联合使用已被证明可有效促进骨内缺损牙周再生的临床症状。作为初步尝试以阐明三种治疗成分各自所起的作用,本研究旨在比较两种用于人类骨内缺损的再生技术的临床效果:PRP/BPBM/GTR联合治疗与GTR治疗。

材料与方法

18名患者参与了本研究。采用分口设计,用聚乳酸制成的可吸收膜进行GTR手术治疗邻间骨缺损,或采用PRP/BPBM/GTR联合治疗。通过6个月后的再次手术评估牙周袋深度、附着水平和缺损填充情况的变化。

结果

与基线值相比,两种治疗方式均使牙周袋深度显著降低,临床附着增加。PRP/BPBM/GTR组颊侧牙周袋深度降低4.98±0.96mm,舌侧降低4.93±0.92mm;GTR组颊侧降低3.62±0.81mm,舌侧降低3.54±0.88mm。PRP/BPBM/GTR组颊侧临床附着增加4.37±1.31mm,舌侧增加4.28±1.33mm;GTR组颊侧增加2.62±1.23mm,舌侧增加2.44±1.21mm。PRP/BPBM/GTR组颊侧缺损填充量为4.78±1.26mm,舌侧为4.66±1.32mm;GTR组颊侧为2.31±0.76mm,舌侧为2.26±0.81mm。两组之间的所有差异均具有统计学意义,PRP/BPBM/GTR组更具优势。

结论

本研究结果表明,在促进重度牙周炎患者骨内缺损的临床恢复方面,PRP和BPBM为GTR提供了额外的再生效果。

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