Fang Dongdong, Long Zhangbiao, Hou Jun
Associate Chief Doctor, Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Attending Doctor, Department of Hematology, First Affiliated Hospital of Anhui Medical University, Hefei, China.
J Oral Maxillofac Surg. 2020 Jun;78(6):882-892. doi: 10.1016/j.joms.2020.01.037. Epub 2020 Feb 8.
We investigated the promoting effect of concentrated growth factor (CGF) fibrin on the repair of jaw bone defects.
We designed a clinical trial composed of patients with jaw defects. Forty patients were divided into the test and control groups. CGF fibrin combined with Bio-Oss bone powder (Giestlich Pharma, Wolhusen, Switzerland) was used in the test group. Bio-Oss bone powder alone was used in the control group. The concentration of vascular endothelial growth factor (VEGF) and transforming growth factor (TGF)-β in the red blood cell (RBC) layer and CGF gel was measured. At different time points before and after surgery, the serum bone alkaline phosphatase (BAP), osteocalcin, and bone mineral density levels were measured. Regular examinations and computed tomography scans were also performed in the follow-up period.
The CGF fibrin available for clinical use was obtained by centrifugation. One day after preparation by centrifugation, the VEGF and TGF-β concentration in the CGF gel was 2.57-fold and 3.4-fold greater than the concentration in the RBC layer, respectively. The BAP and osteocalcin levels increased at 1 and 12 weeks postoperatively in both groups. Furthermore, the BAP and osteocalcin levels in the test group were significantly greater than those in the control group at 1 and 12 weeks postoperatively (P < .05 for all). The bone mineral density in the bone defect area of the test group was also significantly greater than that of the control group at 6 months postoperatively (P < .05). Evaluation of the regular radiographic scans revealed that the effects in the test group were better than those in the control group.
CGF fibrin could promote new bone formation in jaw defects, with benefit to the healing of bone tissue and, thus, is a promising bone repair material.
我们研究了浓缩生长因子(CGF)纤维蛋白对颌骨缺损修复的促进作用。
我们设计了一项针对颌骨缺损患者的临床试验。40例患者被分为试验组和对照组。试验组使用CGF纤维蛋白联合Bio-Oss骨粉(瑞士沃胡森的吉斯特利希制药公司)。对照组仅使用Bio-Oss骨粉。测量红细胞(RBC)层和CGF凝胶中血管内皮生长因子(VEGF)和转化生长因子(TGF)-β的浓度。在手术前后的不同时间点,测量血清骨碱性磷酸酶(BAP)、骨钙素和骨密度水平。在随访期间还进行了定期检查和计算机断层扫描。
通过离心获得了可用于临床的CGF纤维蛋白。离心制备后一天,CGF凝胶中VEGF和TGF-β的浓度分别比RBC层中的浓度高2.57倍和3.4倍。两组术后1周和12周时BAP和骨钙素水平均升高。此外,试验组术后1周和12周时BAP和骨钙素水平显著高于对照组(所有P<0.05)。试验组骨缺损区域的骨密度在术后6个月时也显著高于对照组(P<0.05)。定期X线扫描评估显示试验组的效果优于对照组。
CGF纤维蛋白可促进颌骨缺损处新骨形成,有利于骨组织愈合,因此是一种有前景的骨修复材料。