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下颌骨嵴骨碎片联合富含血小板的血浆凝胶治疗骨内骨缺损:临床和影像学评价。

Torus mandibularis bone chips combined with platelet rich plasma gel for treatment of intrabony osseous defects: clinical and radiographic evaluation.

机构信息

Department of Preventive Dental Sciences, Division of Periodontics, College of Dentistry, University of Dammam, Saudi Arabia.

出版信息

Int J Oral Maxillofac Surg. 2012 Dec;41(12):1519-26. doi: 10.1016/j.ijom.2012.02.009. Epub 2012 Apr 6.

Abstract

The use of platelet rich plasma (PRP) gel in combination with torus mandibularis offers a potentially useful treatment for periodontal osseous defects. Whether this combination enhances the outcome of periodontal regenerative therapy is not known. This study compared the effectiveness of torus mandibularis bone chips alone and when combined with autogenous PRP gel in treating periodontal osseous defects. 24 sites from 12 patients were selected using a split mouth design and determined by a double-blind, randomized, controlled clinical trial. Both sites received a full-thickness mucoperiosteal flap; one intrabony defect was filled with torus mandibularis bone chips alone and the other with torus mandibularis bone chips mixed with PRP gel. There was a 57% gain in the clinical attachment level and 60% reduction in the probing depth for torus mandibularis alone compared to 72% and 68% for sites treated with torus mandibularis and PRP gel (p ≤ 0.01). There was a statistically significant difference in the bone dentistry and the marginal bone loss at sites with PRP gel compared to those without gel (p ≤ 0.01). The use of mandibular tori as autogenous bone graft combined with PRP gel showed a significant improvement in the clinical outcome of periodontal therapy than mandibular tori alone.

摘要

富血小板血浆 (PRP) 凝胶与下颌隆凸联合应用为牙周骨缺损的治疗提供了一种潜在的有效方法。但这种联合应用是否能提高牙周再生治疗的效果尚不清楚。本研究比较了下颌隆凸骨块单独应用和与自体 PRP 凝胶联合应用治疗牙周骨缺损的效果。采用分口设计,从 12 名患者中选择了 24 个位点,通过双盲、随机、对照临床试验进行了评估。两个位点均采用全厚黏骨膜瓣;一个骨内缺损部位仅填充下颌隆凸骨块,另一个部位填充下颌隆凸骨块和 PRP 凝胶混合物。与单独使用下颌隆凸相比,下颌隆凸单独使用时临床附着水平增加了 57%,探诊深度减少了 60%;而与下颌隆凸和 PRP 凝胶联合使用的位点相比,临床附着水平增加了 72%,探诊深度减少了 68%(p≤0.01)。与无凝胶的位点相比,使用 PRP 凝胶的位点在骨量和边缘骨丧失方面有统计学上的显著差异(p≤0.01)。与单独使用下颌隆凸相比,将下颌隆凸作为自体骨移植与 PRP 凝胶联合使用可显著改善牙周治疗的临床效果。

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