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富血小板血浆、富含血小板的纤维蛋白和贫血小板血浆对犬颊侧骨开窗拔牙窝愈合的影响。

Effects of platelet-poor plasma, platelet-rich plasma, and platelet-rich fibrin on healing of extraction sockets with buccal dehiscence in dogs.

机构信息

Oral and Maxillofacial Surgery, Division of Oral Health Sciences, Department of Oral Restitution, Tokyo Medical and Dental University Graduate School , Tokyo, Japan .

出版信息

Tissue Eng Part A. 2014 Feb;20(3-4):874-82. doi: 10.1089/ten.TEA.2013.0058. Epub 2013 Nov 27.

Abstract

Alveolar bone resorption generally occurs during healing after tooth extraction. This study aimed to evaluate the effects of platelet-poor plasma (PPP), platelet-rich plasma (PRP), and platelet-rich fibrin (PRF) on healing in a ridge-augmentation model of the canine socket with dehiscence of the buccal wall. The third mandibular premolars of 12 beagle dogs were extracted and a 3 mm buccal dehiscence from the alveolar crest to the buccal wall of the extraction socket was created. These sockets were then divided into four groups on the basis of the material used to fill the sockets: PPP, PRP, PRF, and control (no graft material) groups. Results were evaluated at 4 and 8 weeks after surgery. The ultrastructural morphology and constructs of each blood product were studied by a scanning electron microscope (SEM) or calculating concentrations of platelets, fibrinogen, platelet-derived growth factor, and transforming growth factor-β. A total of five microcomputed tomography images of specimens were selected for measurement, and the area occupied by the newly formed bone as well as the horizontal bone width were measured. Moreover, decalcified tissue specimens from each defect were analyzed histologically. The median area of new bone at 4 and 8 weeks and median horizontal bone width at 8 weeks were the highest in the PPP group. However, bone maturation in the PRF and the PRP groups was more progressed than that in the PPP and control groups. By SEM findings, the PRF group showed a more highly condensed fibrin fiber network that was regularly arranged when compared with the PPP and PRP groups. The growth factors released from platelets in PRP indicated higher concentrations than that in PRF. Under more severe conditions for bone formation, as in this experiment, the growth factors released from platelets had a negative effect on bone formation. This study showed that PPP is an effective material for the preservation of sockets with buccal dehiscence.

摘要

牙槽骨吸收通常发生在拔牙后愈合过程中。本研究旨在评估贫血小板血浆(PPP)、富血小板血浆(PRP)和富血小板纤维蛋白(PRF)对颊侧壁骨开窗犬牙槽嵴增量模型愈合的影响。12 只比格犬的第三下颌前磨牙被拔出,并在牙槽窝的颊侧嵴到颊侧壁形成 3mm 的颊侧开窗。根据用于填充牙槽窝的材料,这些牙槽窝被分为四组:PPP 组、PRP 组、PRF 组和对照组(无移植物材料)。术后 4 周和 8 周评估结果。通过扫描电子显微镜(SEM)或计算血小板、纤维蛋白原、血小板衍生生长因子和转化生长因子-β的浓度来研究每种血液制品的超微结构形态和结构。共选择了五个标本的微计算机断层扫描图像进行测量,测量了新形成骨的面积和水平骨宽度。此外,对每个缺陷的脱钙组织标本进行了组织学分析。PPP 组在 4 周和 8 周时新骨面积的中位数和 8 周时水平骨宽度的中位数最高。然而,PRF 和 PRP 组的骨成熟度比 PPP 和对照组进展得更快。通过 SEM 观察结果,与 PPP 和 PRP 组相比,PRF 组的纤维蛋白纤维网络更加致密,排列规则。PRP 中血小板释放的生长因子浓度高于 PRF。在更严重的成骨条件下,如本实验中,血小板释放的生长因子对成骨有负面影响。本研究表明,PPP 是保存颊侧开窗牙槽窝的有效材料。

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