Nadon Florian, Chaput Benoit, Périssé Jean, de Bérail Ambre, Lauwers Frédéric, Lopez Raphaël
*Maxillofacial and Facial Plastic Unit, University Toulouse Purpan †Plastic and Reconstructive Surgery Unit, Faculty of Medicine, University Toulouse Rangueil, Toulouse, France.
J Craniofac Surg. 2015 Oct;26(7):2148-51. doi: 10.1097/SCS.0000000000001951.
The authors describe a new material termed mineralized plasmatic matrix (MPM), a combination of platelets, fibrin concentrate, and autogenous bone to repair alveolar cleft defects. Autogenous cancellous bone is widely used to this end because such bone affords the functionalities (osteogenesis, osteoinduction, and osteoconduction) required for successful outcomes. To optimize these features, autologous blood products high in platelet concentrations have recently been developed. On the basis of our experience with PRP (platelet-rich plasma) and PRF (platelet-rich fibrin), we developed MPM, which contains platelets and fibrin concentrate in a liquid state; these materials can become bound to bone particles. The filling material is easy to shape and a PRF-type membrane is also generated. Ten patients with cleft lips and alveoli, with or without cleft palates (median, or uni- or bilateral) benefited from secondary bone grafts placed using our new material. We transferred autogenous bone from the iliac crest, an abundant source of cancellous bone associated with a high success rate. The 6-month outcomes of all patients were excellent in terms of both bone graft stability and closure of the oronasal fistulae. The preparation procedure is simple and the technical requirements minimal. Upon further optimization, MPM may serve as a third-generation platelet concentrate with potential applications in various fields.
作者描述了一种名为矿化血浆基质(MPM)的新型材料,它是血小板、纤维蛋白浓缩物和自体骨的组合,用于修复牙槽嵴裂缺损。自体松质骨为此被广泛使用,因为这种骨具备成功治疗所需的功能(成骨、骨诱导和骨传导)。为优化这些特性,最近已研发出高血小板浓度的自体血制品。基于我们对富血小板血浆(PRP)和富血小板纤维蛋白(PRF)的经验,我们研发了MPM,它含有液态的血小板和纤维蛋白浓缩物;这些材料可与骨颗粒结合。填充材料易于塑形,还会生成PRF型膜。10例唇腭裂患者(有或无腭裂,中位、单侧或双侧)接受了使用我们新材料进行的二期骨移植,效果良好。我们从髂嵴转移自体骨,髂嵴是松质骨的丰富来源,成功率高。所有患者6个月时在骨移植稳定性和口鼻瘘闭合方面的结果均极佳。制备过程简单,技术要求极低。经过进一步优化,MPM可能成为第三代血小板浓缩物,在各个领域具有潜在应用价值。