富血小板血浆在移植上颌骨中的疗效：一项随机临床试验。

The efficacy of platelet-rich plasma in grafted maxillae. A randomised clinical trial.

作者信息

Badr Mohamed, Coulthard Paul, Alissa Rami, Oliver Richard

机构信息

Oral and Maxillofacial Surgery, School of Dentistry, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.

出版信息

Eur J Oral Implantol. 2010 Autumn;3(3):233-44.

PMID:20847993

Abstract

PURPOSE

The aim of this randomised, controlled, parallel-group clinical trial was to evaluate the clinical effect of platelet-rich plasma (PRP) on bone graft healing and implant integration in iliac crest grafted maxillae.

MATERIALS AND METHODS

Twenty-two consenting patients were randomised to PRP (13 patients) and control (9 patients) groups. Both groups received onlays and 16 patients had their maxillary sinus grafted with particulate bone (lateral window approach) with iliac crest bone grafts. Autologous platelet concentrates were prepared from the patients' blood and autologous thrombin was produced. PRP was mixed with the test group bone grafts. Outcome measures were implant integration, implant stability, soft tissue healing, graft resorption, and donor and recipient site complications. Implant stability measurements were recorded at placement and exposure using a resonance frequency analysis device. Patients were followed up to abutment connection. Multiple linear regression analyses using robust standard error were performed, taking the patient as the unit of measurement. The t test was also used where appropriate.

RESULTS

One bone graft failed in the PRP group and regrafting was required. No statistically significant differences were observed for soft tissue healing indices (P = 0.4) and mean graft resorption (P = 0.5) between groups. All implants were found clinically integrated at time of exposure. No statistically significant differences in implant stability were observed between groups at implant placement (P = 0.059) and exposure (P = 0.1). Using a post-hoc analysis, posterior implants in the PRP group showed statistically significantly higher stability values (61 ± 2.6) than anterior implants (60 ± 2.4) at implant placement (mean difference -0.95, P = 0.04). However, this difference was not clinically significant.

CONCLUSION

No appreciable clinical effect could be observed when using PRP with autologous iliac crest bone graft in the maxilla.

摘要

目的

本随机、对照、平行组临床试验旨在评估富血小板血浆（PRP）对上颌骨髂嵴移植骨愈合及种植体植入的临床效果。

材料与方法

22名同意参与的患者被随机分为PRP组（13例患者）和对照组（9例患者）。两组均接受覆盖义齿修复，16例患者接受上颌窦颗粒骨移植（侧窗入路）及髂嵴骨移植。从患者血液中制备自体血小板浓缩物并产生自体凝血酶。PRP与试验组骨移植材料混合。观察指标包括种植体植入、种植体稳定性、软组织愈合、移植骨吸收以及供体和受体部位并发症。使用共振频率分析装置在种植体植入和暴露时记录种植体稳定性测量值。患者随访至基台连接。以患者为测量单位，采用稳健标准误差进行多元线性回归分析。在适当情况下也使用t检验。

结果

PRP组有1例骨移植失败，需要再次移植。两组间软组织愈合指数（P = 0.4）和平均移植骨吸收（P = 0.5）无统计学显著差异。所有种植体在暴露时均实现临床整合。两组在种植体植入时（P = 0.059）和暴露时（P = 0.1）的种植体稳定性无统计学显著差异。采用事后分析，PRP组后部种植体在植入时的稳定性值（61±2.6）在统计学上显著高于前部种植体（60±2.4）（平均差异-0.95，P = 0.04）。然而，这种差异在临床上并不显著。