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富血小板血浆对临界尺寸骨缺损自体骨移植骨愈合的影响。

Effect of platelet-rich plasma on bone healing of autogenous bone grafts in critical-size defects.

作者信息

Nagata Maria J H, Melo Luiz G N, Messora Michel R, Bomfim Suely R M, Fucini Stephen E, Garcia Valdir G, Bosco Alvaro F, Okamoto Tetuo

机构信息

Department of Surgery and Integrated Clinic, Division of Periodontics, Dental School of Araçatuba, São Paulo State University - UNESP, São Paulo, Brazil.

出版信息

J Clin Periodontol. 2009 Sep;36(9):775-83. doi: 10.1111/j.1600-051X.2009.01450.x. Epub 2009 Jul 14.

Abstract

AIM

This study histologically analysed the effect of autogenous platelet-rich plasma (PRP), prepared according to a new semiautomatic system, on healing of autogenous bone (AB) grafts placed in surgically created critical-size defects (CSD) in rabbit calvaria.

MATERIAL AND METHODS

Sixty rabbits were divided into three groups: C, AB and AB/PRP. A CSD was created in the calvarium of each animal. In Group C (control), the defect was filled by blood clot only. In Group AB (autogenous bone graft), the defect was filled with particulate autogenous bone. In Group AB/PRP (autogenous bone graft with platelet-rich plasma), it was filled with particulate autogenous bone combined with PRP. All groups were divided into subgroups (n=10) and euthanized at 4 or 12 weeks post-operatively. Histometric and histologic analyses were performed. Data were statistically analysed (anova, t-test, p<0.05).

RESULTS

Group C presented significantly less bone formation compared with Group AB and AB/PRP in both periods of analysis (p<0.001). At 4 weeks, Group AB/PRP showed a statistically greater amount of bone formation than Group AB (64.44 +/- 15.0%versus 46.88 +/- 14.15%; p=0.0181). At 12 weeks, no statistically significant differences were observed between Groups AB and AB/PRP (75.0 +/- 8.11%versus 77.90 +/- 8.13%; p>0.05). It is notable that the amount of new bone formation in Group AB/PRP at 4 weeks was similar to that of Group AB at 12 weeks (p>0.05).

CONCLUSION

Within its limitation, the present study has indicated that (i) AB and AB/PRP significantly improved bone formation and (ii) a beneficial effect of PRP was limited to an initial healing period of 4 weeks.

摘要

目的

本研究通过组织学分析,探讨根据一种新型半自动系统制备的自体富血小板血浆(PRP)对植入兔颅骨手术造成的临界尺寸缺损(CSD)处自体骨(AB)移植物愈合的影响。

材料与方法

60只兔子分为三组:C组、AB组和AB/PRP组。在每只动物的颅骨上制造一个CSD。C组(对照组)仅用血凝块填充缺损;AB组(自体骨移植组)用颗粒状自体骨填充缺损;AB/PRP组(自体骨移植加富血小板血浆组)用颗粒状自体骨与PRP联合填充缺损。所有组再分为亚组(n = 10),并在术后4周或12周实施安乐死。进行组织计量学和组织学分析。对数据进行统计学分析(方差分析、t检验,p < 0.05)。

结果

在两个分析时间段内,C组的骨形成均显著少于AB组和AB/PRP组(p < 0.001)。在4周时,AB/PRP组的骨形成量在统计学上高于AB组(64.44±15.0%对46.88±14.15%;p = 0.0181)。在12周时,AB组和AB/PRP组之间未观察到统计学上的显著差异(75.0±8.11%对77.90±8.13%;p > 0.05)。值得注意的是,AB/PRP组在4周时的新骨形成量与AB组在12周时的相似(p > 0.05)。

结论

在其局限性范围内,本研究表明:(i)AB和AB/PRP显著改善了骨形成;(ii)PRP的有益作用仅限于最初4周的愈合期。

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