Torul Damla, Bereket Mehmet Cihan, Onger Mehmet Emin, Altun Gamze
Research Assistant, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey.
Associate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey.
J Oral Maxillofac Surg. 2018 Aug;76(8):1823.e1-1823.e12. doi: 10.1016/j.joms.2018.04.012. Epub 2018 Apr 20.
The aim of this study was to investigate the effects of platelet-rich fibrin (PRF) and plasma rich in growth factors (PRGF) on peripheral nerve injury in the early period of healing.
Thirty Wistar albino rats were used in this study. Rats were divided into control (C), damaged (D), PRF, and PRGF groups. The left sciatic nerves of each group were identified as group C. Crush-type injury was performed on the right sciatic nerves of the D, PRF, and PRGF groups. In the PRF and PRGF groups, blood 2 mL was obtained to prepare the PRF and PRGF and the biomaterials were applied to the injured nerve area. After 8 weeks, functional, electrophysiologic, and stereological evaluations were performed.
For the electrophysiologic evaluation, the latency and amplitude values in the D, PRF, and PRGF groups were significantly lower than those in the C group (P > .05). According to the sciatic functional index result, there were significant differences between groups D and PRF and between groups D and PRGF (P = .000). For the stereological evaluations, although no significant difference was observed between the PRGF and C groups (P > .05), a significant difference was observed among the D, PRF, and PRGF groups for myelinated axon number. There were significant differences between groups D and PRF and between groups D and PRGF for axon area (P = .021 and .001, respectively). No significant difference was observed among the D, PRF, and PRGF groups for myelin sheath thickness and ratio of axon area to myelin sheath thickness (P > .05).
The results of this study suggest that PRGF increases nerve regeneration in the early period of healing and that the limited early action of PRF should be re-evaluated in the late period.
本研究旨在探讨富血小板纤维蛋白（PRF）和富含生长因子的血浆（PRGF）在愈合早期对周围神经损伤的影响。
本研究使用了30只Wistar白化大鼠。大鼠被分为对照组（C）、损伤组（D）、PRF组和PRGF组。每组大鼠的左侧坐骨神经作为C组。对D组、PRF组和PRGF组大鼠的右侧坐骨神经进行挤压型损伤。在PRF组和PRGF组中，采集2 mL血液制备PRF和PRGF，并将生物材料应用于损伤的神经区域。8周后，进行功能、电生理和体视学评估。
对于电生理评估，D组、PRF组和PRGF组的潜伏期和波幅值显著低于C组（P >.05）。根据坐骨神经功能指数结果，D组与PRF组之间以及D组与PRGF组之间存在显著差异（P =.000）。对于体视学评估，虽然PRGF组与C组之间未观察到显著差异（P >.05），但在有髓轴突数量方面，D组、PRF组和PRGF组之间存在显著差异。在轴突面积方面，D组与PRF组之间以及D组与PRGF组之间存在显著差异（分别为P =.021和.001）。在髓鞘厚度以及轴突面积与髓鞘厚度之比方面，D组、PRF组和PRGF组之间未观察到显著差异（P >.05）。
本研究结果表明，PRGF在愈合早期可促进神经再生，而PRF的早期作用有限，后期应重新评估。
