Froum Stuart J, Wallace Stephen, Cho Sang-Choon, Rosenburg Edwin, Froum Scott, Schoor Robert, Mascarenhas Patrick, Tarnow Dennis P, Corby Patricia, Elian Nicolas, Fickl Stefan, Ricci John, Hu Bin, Bromage Timothy, Khouly Ismael
Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY 10019, USA.
Int J Periodontics Restorative Dent. 2013 May-Jun;33(3):269-79. doi: 10.11607/prd.1614.
The purpose of this study was to assess vital bone formation at 4 to 5 months and 7 to 9 months following sinus augmentation with anorganic bovine bone matrix (ABBM) with and without recombinant human platelet-derived growth factor (rhPDGF). Twenty-four subjects received bilateral sinus elevation surgery with ABBM on one side and ABBM and rhPDGF on the contralateral side. Twelve patients had core sampling at 4 to 5 months and 12 patients at 7 to 9 months postoperatively. In subjects with cores taken at 4 to 5 months, mean vital bone, connective tissue, and residual graft were 11.8%, 54.1%, and 33.6%, respectively, with ABBM alone. Cores of sinuses filled with ABBM and rhPDGF showed mean 21.1% vital bone, 51.4% connective tissue, and 24.8% residual graft. Paired t test showed a statistically significant difference in vital bone. In cores taken at 7 to 9 months, the values for ABBM alone and ABBM + rhPDGF were 21.4% vs 19.5% vital bone, 28.4% vs 44.2% connective tissue, and 40.3% residual graft vs 35.5%. There was no statistically significant difference in vital bone at 7 to 9 months after surgery. Test and control groups showed clinically acceptable levels of vital bone both at 4 to 5 months and 7 to 9 months postsurgery. However, vital bone formation was significantly greater in the 4- to 5-month sections of ABBM + rhPDGF vs the Bio-Oss alone. In the 7- to 9-month specimens, this difference disappeared. More rapid formation of vital bone with the addition of rhPDGF may allow for earlier implant placement.
本研究的目的是评估在使用和不使用重组人血小板衍生生长因子(rhPDGF)的情况下,采用无机牛骨基质(ABBM)进行鼻窦增高术后4至5个月以及7至9个月时的活性骨形成情况。24名受试者接受了双侧鼻窦提升手术,一侧使用ABBM,另一侧使用ABBM和rhPDGF。12名患者在术后4至5个月进行了岩心取样,12名患者在术后7至9个月进行了岩心取样。在4至5个月进行岩心取样的受试者中,单独使用ABBM时,活性骨、结缔组织和残余移植物的平均比例分别为11.8%、54.1%和33.6%。填充有ABBM和rhPDGF的鼻窦岩心显示,活性骨平均为21.1%,结缔组织为51.4%,残余移植物为24.8%。配对t检验显示活性骨存在统计学上的显著差异。在7至9个月进行岩心取样时,单独使用ABBM和ABBM + rhPDGF的活性骨值分别为21.4%和19.5%,结缔组织分别为28.4%和44.2%,残余移植物分别为40.3%和35.5%。术后7至9个月时活性骨无统计学上的显著差异。试验组和对照组在术后4至5个月以及7至9个月时的活性骨水平均在临床可接受范围内。然而,与单独使用Bio-Oss相比,ABBM + rhPDGF在4至5个月切片中的活性骨形成明显更多。在7至9个月的标本中,这种差异消失。添加rhPDGF后活性骨形成更快,可能允许更早植入种植体。