Elgendy Enas Ahmed, Abo Shady Tamer Elamer
Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, October 6 University, Giza, Egypt.
Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Tanta University, Tanta, Egypt.
J Indian Soc Periodontol. 2015 Jan-Feb;19(1):61-5. doi: 10.4103/0972-124X.148639.
Nano-sized ceramics may represent a promising class of bone graft substitutes due to their improved osseointegrative properties. Nanocrystalline hydroxyapatite (NcHA) binds to bone and stimulate bone healing by stimulation of osteoblast activity. Platelet-rich fibrin (PRF), an intimate assembly of cytokines, glycan chains, and structural glycoproteins enmeshed within a slowly polymerized fibrin network, has the potential to accelerate soft and hard tissue healing. The present study aims to explore the clinical and radiographical outcome of NcHA bone graft with or without PRF, in the treatment of intrabony periodontal defects.
In a split-mouth study design, 20 patients having two almost identical intrabony defects with clinical probing depth of at least 6 mm were selected for the study. Selected sites were randomly divided into two groups. In Group I, mucoperiosteal flap elevation followed by the placement of NcHA was done. In Group II, mucoperiosteal flap elevation, followed by the placement of NcHA with PRF was done. Clinical and radiographic parameters were recorded at baseline and at 6-month postoperatively.
Both treatment groups showed a significant probing pocket depth (PPD) reduction, clinical attachment gain, increase bone density 6-month after surgery compared with baseline. However, there was a significantly greater PPD reduction and clinical attachment gain when PRF was added to NcHA.
The NcHA bone graft in combination with PRF demonstrated clinical advantages beyond that achieved by the NcHA alone.
纳米级陶瓷因其改善的骨整合特性,可能代表一类有前景的骨移植替代物。纳米晶羟基磷灰石(NcHA)与骨结合并通过刺激成骨细胞活性来促进骨愈合。富血小板纤维蛋白(PRF)是一种由细胞因子、聚糖链和结构糖蛋白紧密组装在缓慢聚合的纤维蛋白网络中的物质,有加速软组织和硬组织愈合的潜力。本研究旨在探讨使用或不使用PRF的NcHA骨移植治疗骨内牙周缺损的临床和影像学结果。
采用分口研究设计,选择20例有两个几乎相同的骨内缺损且临床探诊深度至少为6mm的患者进行研究。将选定部位随机分为两组。第一组,进行粘骨膜瓣翻起,随后植入NcHA。第二组,进行粘骨膜瓣翻起,随后植入含PRF的NcHA。在基线和术后6个月记录临床和影像学参数。
与基线相比,两个治疗组在术后6个月时均显示探诊深度(PPD)显著降低、临床附着增加、骨密度增加。然而,当NcHA添加PRF时,PPD降低和临床附着增加更为显著。
NcHA骨移植联合PRF显示出比单独使用NcHA更大的临床优势。