Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia.
Department of Oral & Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
J Dent. 2020 Oct;101:103455. doi: 10.1016/j.jdent.2020.103455. Epub 2020 Aug 21.
This clinical study assessed and compared the linear and volumetric changes of extraction sockets grafted with a combination of Platelet-Rich Fibrin (PRF) and Calcium Sulfate (CS) (PRF-CS), and extraction sockets grafted with a combination of PRF and xenograft (X) (PRF-X).
Five single maxillary premolar extraction sockets received PRF-CS grafts and five single maxillary premolar sockets received PRF-X grafts. Linear (horizontal and vertical) measurements were accomplished using Cone Beam Computed Tomography (CBCT) images and volumetric changes were assessed using MIMICS software. Soft tissue level changes were measured using Stonecast models. All measurements were recorded at baseline (before extraction) and at 5-months post-extraction.
Significant reduction in vertical and horizontal dimensions were observed in both groups except for distal bone height (DH = 0.44 ± 0.45 mm, p = 0.09) and palatal bone height (PH = 0.39 ± 0.34 mm, p = 0.06) in PRF-X group. PRF-CS group demonstrated mean horizontal shrinkage of 1.27 ± 0.82 mm (p = 0.02), when compared with PRF-X group (1.40 ± 0.85 mm, p = 0.02). Vertical resorption for mesial bone height (MH = 0.56 ± 0.25 mm, p = 0.008), buccal bone height (BH = 1.62 ± 0.91 mm, p = 0.01) and palatal bone height (PH = 1.39 ± 0.87 mm, p = 0.02) in PRF-CS group was more than resorption in PRF-X group (MH = 0.28 ± 0.14 mm, p = 0.01, BH = 0.63 ± 0.39 mm, p = 0.02 and PH = 0.39 ± 0.34 mm, p = 0.06). Volumetric bone resorption was significant within both groups (PRF-CS = 168.33 ± 63.68 mm, p = 0.004; PRF-X = 102.88 ± 32.93 mm, p = 0.002), though not significant (p = 0.08) when compared between groups. In PRF-X group, the distal soft tissue level (DH = 1.00 ± 0.50 mm, p = 0.03) demonstrated almost 2 times more reduction when compared with PRF-CS group (DH = 1.00 ± 1.00 mm, 0.08). The reduction of the buccal soft tissue level was pronounced in PRF-CS group (BH = 2.00 ± 2.00 mm, p = 0.06) when compared with PRF-X group (BH = 1.00 ± 1.50 mm, p = 0.05).
PRF-CS grafted sites showed no significant difference with PRF-X grafted sites in linear and volumetric dimensional changes and might show clinical benefits for socket augmentation. The study is officially registered with ClinicalTrials.gov Registration (NCT03851289).
本临床研究评估和比较了富血小板纤维蛋白（PRF）和硫酸钙（CS）（PRF-CS）组合与 PRF 和异种移植物（X）（PRF-X）组合移植的拔牙窝的线性和体积变化。
五例上颌单前磨牙拔牙窝接受 PRF-CS 移植，五例上颌单前磨牙拔牙窝接受 PRF-X 移植。使用锥形束 CT（CBCT）图像进行线性（水平和垂直）测量，使用 Mimics 软件评估体积变化。使用 Stonecast 模型测量软组织水平变化。所有测量均在基线（拔牙前）和拔牙后 5 个月进行记录。
两组均观察到垂直和水平尺寸的显著减小，除了 PRF-X 组的远中骨高度（DH=0.44±0.45mm，p=0.09）和腭骨高度（PH=0.39±0.34mm，p=0.06）外。与 PRF-X 组相比，PRF-CS 组的平均水平收缩为 1.27±0.82mm（p=0.02）。与 PRF-X 组相比，PRF-CS 组的近中骨高度（MH=0.56±0.25mm，p=0.008）、颊侧骨高度（BH=1.62±0.91mm，p=0.01）和腭骨高度（PH=1.39±0.87mm，p=0.02）的垂直吸收更多。PRF-CS 组的颊侧软组织水平（DH=1.00±0.50mm，p=0.03）比 PRF-X 组（DH=1.00±1.00mm，0.08）减少了近两倍。与 PRF-X 组相比，PRF-CS 组的颊侧软组织水平（BH=2.00±2.00mm，p=0.06）的减少更为明显。
PRF-CS 移植部位与 PRF-X 移植部位在线性和体积尺寸变化方面无显著差异，可能对拔牙窝增强具有临床益处。该研究已在 ClinicalTrials.gov 注册（NCT03851289）。
