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使用单纯β-磷酸三钙或联合富血小板血浆进行上颌窦底提升的锥形束计算机断层扫描评估:一项随机临床试验

Cone Beam Computed Tomography Assessment of Maxillary Sinus Floor Augmentation Using Beta-Tricalcium Phosphate Alone or in Combination with Platelet-Rich Plasma: A Randomized Clinical Trial.

作者信息

Kiliç Songül Cömert, Güngörmüş Metin

出版信息

Int J Oral Maxillofac Implants. 2016 Nov/Dec;31(6):1367-1375. doi: 10.11607/jomi.5205.

Abstract

PURPOSE

The aim of this study was to evaluate and compare the long-term clinical and radiographic outcomes between a bone graft substitute mixture (beta-tricalcium phosphate [β-TCP] and plateletrich plasma [PRP]) and β-TCP bone graft substitute alone used for sinus floor elevation.

MATERIALS AND METHODS

This randomized clinical trial included patients with an atrophic maxilla referred for maxillary sinus floor elevation. The elevated sinus cavities of patients were randomly filled with β-TCP plus PRP (study group) or β-TCP alone (control group). Residual bone crest height, vertical bone height gain, and bone graft resorption were measured on cone beam computed tomography (CBCT) images at 10 days and 6 months postoperatively. Incidence of sinus membrane perforations and maxillary sinus infections were recorded. Paired t and Student t tests were used for intragroup and intergroup comparisons, respectively.

RESULTS

The sample was composed of 18 subjects: nine subjects in the control group (mean age, 31.51 years) and nine subjects in the study group (mean age, 34.01 years). The mean residual bone crest height was found to be < 5 mm in both groups (4.88 mm in the control group and 2.70 mm in the study group, with no significant difference). From the 10-day to 6-month postoperative visit, mean vertical bone height gains were changed from 12.48 to 11.59 mm in the study group and from 14.77 to 13.19 mm in the control group, with no significant difference. The mean vertical bone graft resorption was -1.58 mm in the study group and -0.89 mm in the control group, with no significant difference. Sinus membrane perforation was observed in 3 of 18 patients.

CONCLUSION

In this study, PRP plus β-TCP graft substitute did not produce significantly more vertical bone height gain or significantly less vertical bone graft resorption compared with β-TCP graft substitute alone. Within the limitations of this study, however, it can be concluded that both grafting materials produced sufficient vertical bone height gain for safe implant placement.

摘要

目的

本研究旨在评估和比较用于上颌窦底提升的骨移植替代物混合物(β-磷酸三钙[β-TCP]和富血小板血浆[PRP])与单独使用β-TCP骨移植替代物的长期临床和影像学结果。

材料与方法

这项随机临床试验纳入了因上颌窦底提升而转诊的萎缩性上颌患者。患者提升后的上颌窦腔被随机填充β-TCP加PRP(研究组)或仅填充β-TCP(对照组)。在术后10天和6个月时,通过锥形束计算机断层扫描(CBCT)图像测量剩余牙槽嵴高度、垂直骨高度增加量和骨移植吸收情况。记录上颌窦黏膜穿孔和上颌窦感染的发生率。分别使用配对t检验和学生t检验进行组内和组间比较。

结果

样本由18名受试者组成:对照组9名受试者(平均年龄31.51岁),研究组9名受试者(平均年龄34.01岁)。两组的平均剩余牙槽嵴高度均<5mm(对照组为4.88mm,研究组为2.70mm,无显著差异)。从术后10天到6个月的随访,研究组的平均垂直骨高度增加量从12.48mm变为11.59mm,对照组从14.77mm变为13.19mm,无显著差异。研究组的平均垂直骨移植吸收量为-1.58mm,对照组为-0.89mm,无显著差异。18例患者中有3例观察到上颌窦黏膜穿孔。

结论

在本研究中,与单独使用β-TCP移植替代物相比,PRP加β-TCP移植替代物并没有显著增加更多的垂直骨高度,也没有显著减少更少的垂直骨移植吸收。然而,在本研究的局限性内,可以得出结论,两种移植材料都产生了足够的垂直骨高度增加,以安全地植入种植体。

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