富血小板血浆在治疗人类牙周骨内缺损中的作用。

Effect of platelet-rich plasma in the treatment of periodontal intrabony defects in humans.

作者信息

Ouyang Xiang-ying, Qiao Jing

机构信息

Department of Periodontology, School and Hospital of Stomatology, Peking University, Beijing 100081, China.

出版信息

Chin Med J (Engl). 2006 Sep 20;119(18):1511-21.

PMID:16996004

Abstract

BACKGROUND

Platelet-rich plasma (PRP) is a kind of natural source of autologous growth factors, and has been used successfully in medical community. However, the effect of PRP in periodontal regeneration is not clear yet. This study was designed to evaluate the effectiveness of PRP as an adjunct to bovine porous bone mineral (BPBM) graft in the treatment of human intrabony defects.

METHODS

Seventeen intrabony defects in 10 periodontitis patients were randomly treated either with PRP and BPBM (test group, n = 9) or with BPBM alone (control group, n = 8). Clinical parameters were evaluated including changes in probing depth, relative attachment level (measured by Florida Probe and a stent), and bone probing level between baseline and 1 year postoperatively. Standardized periapical radiographs of each defect were taken at baseline, 2 weeks, and 1 year postoperatively, and analyzed by digital subtraction radiography (DSR).

RESULTS

Both treatment modalities resulted in significant attachment gain, reduction of probing depth, and bone probing level at 1-year post-surgery compared to baseline. The test group exhibited statistically significant improvement compared to the control sites in probing depth reduction: (4.78 +/- 0.95) mm versus (3.48 +/- 0.41) mm (P < 0.01); clinical attachment gain: (4.52 +/- 1.14) mm versus (2.85 +/- 0.80) mm (P < 0.01); bone probing reduction: (4.56 +/- 1.04) mm versus (2.88 +/- 0.79) mm (P < 0.01); and defect bone fill: (73.41 +/- 14.78)% versus (47.32 +/- 11.47)% (P < 0.01). DSR analysis of baseline and 1 year postoperatively also showed greater radiographic gains in alveolar bone mass in the test group than in the control group: gray increase (580 +/- 50) grays versus (220 +/- 32) grays (P = 0.0001); area with increased gray were (5.21 +/- 1.25) mm(2) versus (3.02 +/- 1.22) mm(2) (P = 0.0001).

CONCLUSIONS

The treatment with a combination of PRP and BPBM led to a significantly favorable clinical improvement in periodontal intrabony defects compared to using BPBM alone. Further studies are necessary to assess the long-term effectiveness of PRP, and a larger sample size is needed.

摘要

背景

富血小板血浆（PRP）是一种自体生长因子的天然来源，已在医学界成功应用。然而，PRP在牙周组织再生中的作用尚不清楚。本研究旨在评估PRP作为牛多孔骨矿物质（BPBM）移植辅助材料治疗人类骨内缺损的有效性。

方法

10例牙周炎患者的17处骨内缺损被随机分为两组，分别接受PRP联合BPBM治疗（试验组，n = 9）或单纯BPBM治疗（对照组，n = 8）。评估临床参数，包括基线和术后1年时探诊深度、相对附着水平（用佛罗里达探针和定位支架测量）和骨探诊水平的变化。在基线、术后2周和1年时拍摄每个缺损的标准化根尖片，并通过数字减影放射摄影（DSR）进行分析。

结果

与基线相比，两种治疗方式在术后1年时均导致显著的附着增加、探诊深度降低和骨探诊水平降低。试验组在探诊深度降低方面与对照组相比有统计学显著改善：（4.78±0.95）mm对（3.48±0.41）mm（P < 0.01）；临床附着增加：（4.52±1.14）mm对（2.85±0.80）mm（P < 0.01）；骨探诊减少：（4.56±1.04）mm对（2.88±0.79）mm（P < 0.01）；以及缺损骨填充：（73.41±14.78）%对（47.32±11.47）%（P < 0.01）。基线和术后1年的DSR分析还显示，试验组牙槽骨量的影像学增加大于对照组：灰度增加（580±50）灰度对（220±32）灰度（P = 0.0001）；灰度增加区域为（5.21±1.25）mm²对（3.02±1.22）mm²（P = 0.0001）。