Tiwari Urvashi Ojha, Chandra Ramesh, Tripathi Supratim, Jain Jyoti, Jaiswal Sanjay, Tiwari Rahul Kumar
Department of Conservative Dentistry and Endodontics, Career Post Graduate Institute of Dental Sciences, Lucknow, Uttar Pradesh, India.
Department of Radiodiagnosis, King George Medical University, Lucknow, Uttar Pradesh, India.
J Conserv Dent. 2020 Jul-Aug;23(4):348-353. doi: 10.4103/JCD.JCD_228_20. Epub 2021 Jan 16.
This clinical study was designed to evaluate the volumetric healing of periapical (PA) bone defect after PA surgery, using platelet-rich fibrin (PRF), and its combination with hydroxyapatite and alendronate.
Twenty male patients of age between 25 and 35 years, having PA pathology (>5 mm on intraoral periapical radiograph (IOPA)) with intraoral sinus opening, were included in this study. Cone-beam computed tomography (CBCT) imaging of all patients was done. Root canal treatment with PA surgery was done. Patients were divided into four groups (5 in each group), on the basis of material placed in PA bone defect. After 1 year, CBCT imaging was done. Linear measurement of maximal dimensions in all three orthogonal planes was done in both pre- and post-CBCT image. These measurements were used to estimate the volume of the lesion healed after 1 year of surgery.
Analysis of variance and Tukey's test were used for statistical analysis.
Change in volume were significantly different between Group 1 vs Group 3; Group 2 vs Group 3 and Group 3 vs Group 4. The Group Order for change in volume 1 year post surgery Group 3> Group 4 ≈ Group 2> Group 1.
PA bone healing after surgery is enhanced by placing combination of bone regenerative materials. PRF with hydroxyapatite provides best healing outcomes in comparison to PRF with alendronate or PRF alone.
本临床研究旨在评估根尖手术(PA)后,使用富血小板纤维蛋白(PRF)及其与羟基磷灰石和阿仑膦酸盐联合应用时根尖周(PA)骨缺损的容积性愈合情况。
本研究纳入了20名年龄在25至35岁之间、患有PA病变(口腔内根尖片(IOPA)上>5mm)且口腔内有窦口开放的男性患者。对所有患者进行了锥形束计算机断层扫描(CBCT)成像。进行了根管治疗及PA手术。根据置于PA骨缺损处的材料,将患者分为四组(每组5人)。1年后,进行了CBCT成像。在CBCT术前和术后图像中,对所有三个正交平面上的最大尺寸进行了线性测量。这些测量用于估计手术后1年愈合病变的体积。
采用方差分析和Tukey检验进行统计分析。
第1组与第3组、第2组与第3组以及第3组与第4组之间的体积变化存在显著差异。术后1年体积变化的组序为第3组>第4组≈第2组>第1组。
通过放置骨再生材料组合可增强PA手术后的骨愈合。与单独使用PRF或PRF与阿仑膦酸盐相比,PRF与羟基磷灰石联合应用可提供最佳愈合效果。