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在上颌窦提升中使用浓缩生长因子与同种异体移植物是否有辅助益处?

Does Concentrated Growth Factor Used With Allografts in Maxillary Sinus Lifting Have Adjunctive Benefits?

机构信息

Assistant Professor, Department Head, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Izmir Democracy University, Izmir, Turkey.

Research Assistant, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ege University, Izmir, Turkey.

出版信息

J Oral Maxillofac Surg. 2021 Jan;79(1):98-108. doi: 10.1016/j.joms.2020.07.217. Epub 2020 Aug 5.

Abstract

PURPOSE

Recent studies have shown that the use of platelet concentration products alone, or in combination with variable graft materials, accelerates the new bone formation associated with sinus augmentation. The aim of this study was to measure the adjunctive effects of concentrated growth factor (CGF) used with allograft on new bone formation and augmentation stability in sinus lifting.

MATERIALS AND METHODS

This randomized controlled study included patients who presented for dental implant placement in atrophic posterior maxilla at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ege University, and who needed maxillary sinus augmentation. All patients were treated with a 2-stage surgical technique using sinus lifting bilaterally and implant placement 6 months later. During sinus lifting surgery, one side was grafted with allograft (group 1) and the other side with allograft mixed CGF (group 2). Cone-beam computed tomography was carried out immediately postoperatively and also 6 months after the augmentation to evaluate vertical bone height and percentage of resorption. Bone specimens were obtained at the time of implant placement and evaluated histomorphometrically to analyze the percentage of new bone formation and residual graft particle. Statistical comparisons were conducted between groups for all these measurements.

RESULTS

A total of 10 patients (2 females and 8 males) with a mean age of 57 years (range, 39 to 72) were enrolled in the study. Cone-beam computed tomography analysis revealed a significantly higher percentage of bone height resorption at the sixth month in group 1 (median, 9.32%) compared with group 2 (median, 6.37%) (P < .05). According to the histomorphometric examination, the percentage of new bone formation in group 2 (median, 36.41%) was higher than group 1 (median, 35.49%), but this difference did not reach statistical significance.

CONCLUSIONS

Using CGF with allografts supports the stabilization of gained vertical bone height after sinus augmentation, but further research is needed to determine the accelerating effects of CGF on new bone formation.

摘要

目的

最近的研究表明,单独使用血小板浓缩物,或与不同移植物材料联合使用,可加速与鼻窦提升相关的新骨形成。本研究的目的是测量在鼻窦提升中使用同种异体移植物时浓缩生长因子(CGF)的附加作用对新骨形成和提升稳定性的影响。

材料和方法

这项随机对照研究纳入了在伊兹密尔埃格大学牙科学院口腔颌面外科就诊、因后牙上颌萎缩需行牙种植体植入的患者,所有患者均采用两阶段手术技术,双侧行鼻窦提升术,6 个月后行种植体植入术。在鼻窦提升术中,一侧用同种异体移植物(第 1 组)移植,另一侧用同种异体移植物混合 CGF(第 2 组)移植。术后即刻及提升后 6 个月行锥形束 CT 检查,以评估垂直骨高度和吸收率。在植入时获得骨标本,并进行组织形态计量学评估,以分析新骨形成百分比和剩余移植物颗粒。对所有这些测量值进行组间比较。

结果

共纳入 10 名患者(2 名女性,8 名男性),平均年龄 57 岁(范围,39 岁至 72 岁)。锥形束 CT 分析显示,第 1 组(中位数 9.32%)在第 6 个月时骨高度吸收率显著高于第 2 组(中位数 6.37%)(P<.05)。根据组织形态计量学检查,第 2 组(中位数 36.41%)的新骨形成百分比高于第 1 组(中位数 35.49%),但差异无统计学意义。

结论

在同种异体移植物中使用 CGF 可支持鼻窦提升后获得的垂直骨高度的稳定,但需要进一步研究来确定 CGF 对新骨形成的加速作用。

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