Sethi Alok Kumar, Kar Indu Bhusan, Mohanty Tanmoy, Mishra Niranjan, Singh Akhilesh Kumar
Department of Oral and Maxillofacial Surgery, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India.
Department of Oral and Maxillofacial Surgery, SCB Medical College and Hospital, Cuttack, Odisha, India.
Natl J Maxillofac Surg. 2018 Jul-Dec;9(2):174-183. doi: 10.4103/njms.NJMS_33_18.
The aim is to know the augmented new bone formation in postsurgical bony defects in the maxillofacial region when filled with plasma-enriched demineralized freeze-dried bone allograft (DFDBA).
The study group included 45 patients, selected randomly, and divided in three equated groups. In Group I (control) patients, the wound was closed primarily without incorporating any graft in the bony defect. In Group II, the defect was filled with DFDBA alone and in Group III with DFDBA enriched with platelet-rich plasma (PRP). The said graft material was procured from the (to be discarded) femur head, treated to get rid of its antigenicity, made suitable to be incorporated as a graft material, sterilized by gamma irradiation and then implanted into the jaw defects.
The results were evaluated and interpreted both clinically and radiographically by studying the changes post 1 week, 1 month, 3 months, and 6 months, respectively. Bone density was evaluated using computed tomography scan in addition to standard conventional radiographs. Evidence of trabecular formation and calcification were noted down. Measurements were recorded by taking note of Hounsfield units. Statistically, one-way ANOVA test followed by least significant difference test was done. Final results showed that the patients in the Group III had more bone density at the grafted site when compared to the Group II and I patients. These findings were significant.
PRP-enriched DFDBA is a superior grafting material in terms of other grafting materials available. It possesses both osteoconductive and osteoinductive properties and elicits the least immunological response, thereby making it one of the best effective combinations of grafting material to be used in oral and maxillofacial reconstructive purposes.
了解富含血浆的脱矿冻干骨同种异体移植物(DFDBA)填充颌面部手术后骨缺损时新骨形成增加的情况。
研究组包括45例随机选取的患者,分为三个相等的组。在第一组(对照组)患者中,伤口一期缝合,骨缺损处未植入任何移植物。在第二组中,缺损仅用DFDBA填充,在第三组中用富含血小板血浆(PRP)的DFDBA填充。所述移植物材料取自(待丢弃的)股骨头,经过处理以去除其抗原性,使其适合作为移植物材料,通过伽马射线照射灭菌,然后植入颌骨缺损处。
分别在术后1周、1个月、3个月和6个月研究变化,从临床和影像学两方面对结果进行评估和解读。除标准传统X线片外,还使用计算机断层扫描评估骨密度。记录小梁形成和钙化的证据。通过记录亨氏单位进行测量。统计学上,进行单因素方差分析,随后进行最小显著差检验。最终结果表明,与第二组和第一组患者相比,第三组患者移植部位的骨密度更高。这些发现具有显著性。
就现有的其他移植材料而言,富含PRP的DFDBA是一种优质的移植材料。它具有骨传导性和骨诱导性,引发的免疫反应最小,因此使其成为用于口腔颌面部重建目的的最佳有效移植材料组合之一。