Zhou Tian, Yang Hua-Wei, Tian Zhuo-Wei, Wang Yang, Tang Xiao-Shan, Hu Jing-Zhou
Resident, Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
Associate Chief Physician, Department of Stomatology, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China.
J Oral Maxillofac Surg. 2018 Jan;76(1):221-228. doi: 10.1016/j.joms.2017.05.031. Epub 2017 Jun 2.
The aim of this study was to explore the effect of Choukroun platelet-rich fibrin (PRF) combined with autologous micro-morselized bone on the repair of mandibular defects in rabbits.
Thirty-six healthy New Zealand rabbits were selected for the present study. After models of mandibular defects were established, rabbits were randomly divided into Choukroun PRF, autologous micro-morselized bone (autologous), Choukroun PRF combined with autologous bone (combined) and model groups. After the rabbits were sacrificed at 2, 8, and 12 weeks postoperatively, their bone formation was assessed by x-ray and scanning electron microscopy, and the histologic changes of the mandibular defect area were detected by hematoxylin and eosin staining. Cone-beam computed tomography was used to observe the size of the change of the mandibular defect area. Bone mineral density (BMD) was analyzed by dual-energy x-ray absorptiometry.
The bone defect in the combined group showed better repair, increased bone mineral content, and denser callus than the other groups, and the defect area was filled with mature trabecular bone. In the Choukroun PRF and autologous groups, the defect area was smaller and filled with osteoporotic trabecular bone. A clear mandibular defect area was still observed in the model group. Compared with the other groups, the combined group showed more bone regeneration, more fibrous tissue regeneration, and greater bone maturity at all time points. The combined group had the highest BMD, there was no relevant difference in BMD between the Choukroun PRF and autologous groups, and the model group had the lowest BMD. BMD in all 4 groups increased with time.
These findings indicate that Choukroun PRF combined with autologous micro-morselized bone can substantially improve the repair of mandibular defects in rabbits, and the effect is superior to Choukroun PRF or autologous micro-morselized bone alone.
本研究旨在探讨乔克鲁恩富血小板纤维蛋白（PRF）联合自体微小颗粒骨对兔下颌骨缺损修复的影响。
选取36只健康的新西兰兔进行本研究。建立下颌骨缺损模型后，将兔随机分为乔克鲁恩PRF组、自体微小颗粒骨组（自体组）、乔克鲁恩PRF联合自体骨组（联合组）和模型组。术后2周、8周和12周处死兔后，通过X线和扫描电子显微镜评估其骨形成情况，并用苏木精-伊红染色检测下颌骨缺损区域的组织学变化。采用锥形束计算机断层扫描观察下颌骨缺损区域大小的变化。通过双能X线吸收法分析骨密度（BMD）。
联合组的骨缺损修复效果优于其他组，骨矿物质含量增加，骨痂更致密，缺损区域充满成熟的小梁骨。在乔克鲁恩PRF组和自体组中，缺损区域较小，充满骨质疏松的小梁骨。模型组仍可观察到明显的下颌骨缺损区域。与其他组相比，联合组在所有时间点均显示出更多的骨再生、更多的纤维组织再生和更高的骨成熟度。联合组的BMD最高，乔克鲁恩PRF组和自体组之间的BMD无显著差异，模型组的BMD最低。所有4组的BMD均随时间增加。
这些结果表明，乔克鲁恩PRF联合自体微小颗粒骨可显著改善兔下颌骨缺损的修复，其效果优于单独使用乔克鲁恩PRF或自体微小颗粒骨。
