Lee C, Nishihara K, Okawachi T, Iwashita Y, Majima H J, Nakamura N
Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan.
Int J Oral Maxillofac Surg. 2009 Feb;38(2):117-25. doi: 10.1016/j.ijom.2008.11.019. Epub 2009 Jan 14.
This longitudinal study evaluated the outcomes of secondary autogenous bone graft combined with platelet-rich plasma (PRP) in the alveolar cleft. Thirty-five alveolar clefts in 30 patients with grafted autogenous bone and PRP (PRP group), and 36 clefts in 30 patients with grafted autogenous bone alone (non-PRP group) were enrolled. PRP was extracted from autogenous blood using a plasma centrifuge system (SmartPReP SMP-1000). The density and resorption of grafted bone were evaluated at 1 week, and 1, 3, 6 and 12 months postoperatively. Bone density was quantitatively assessed as an aluminum-equivalence (Al-Eq) value. Moreover, relationships between bone resorption rate and prognostic factors were discussed. Al-Eq values decreased significantly until 3 months, and then increased up to 12 months in both groups. The Al-Eq rate in the PRP group was significantly smaller than that in the non-PRP group at 3 months. No significant differences were observed in the bone resorption rate between the groups. Regarding prognostic factors, continuous mechanical stress affected bone resorption with or without PRP. The authors suggest that PRP may enhance bone remodeling in the early phase, however, PRP seems to be insufficient as a countermeasure against bone resorption following secondary bone graft in the long term.
这项纵向研究评估了自体骨移植联合富血小板血浆(PRP)治疗牙槽嵴裂的效果。纳入了30例接受自体骨和PRP移植的患者的35处牙槽嵴裂(PRP组),以及30例仅接受自体骨移植的患者的36处牙槽嵴裂(非PRP组)。使用血浆离心系统(SmartPReP SMP - 1000)从自体血液中提取PRP。在术后1周、1、3、6和12个月评估移植骨的密度和吸收情况。骨密度通过铝当量(Al - Eq)值进行定量评估。此外,还讨论了骨吸收速率与预后因素之间的关系。两组的Al - Eq值在3个月前均显著下降,然后在12个月时上升。PRP组在3个月时的Al - Eq速率显著低于非PRP组。两组之间的骨吸收速率未观察到显著差异。关于预后因素,持续的机械应力无论有无PRP都会影响骨吸收。作者认为,PRP可能在早期促进骨重塑,然而,从长期来看,PRP似乎不足以作为对抗二次骨移植后骨吸收的对策。