Department of Oral and Maxillofacial Surgery, School of Dentistry, Ege University, İzmir, Turkey.
Department of Oral and Maxillofacial Radiology, School of Dentistry, Mersin University, Mersin, Turkey.
Clin Oral Investig. 2021 Sep;25(9):5563-5575. doi: 10.1007/s00784-021-03987-5. Epub 2021 May 28.
To assess augmentation success after guided bone regeneration (GBR) carried out simultaneously with implant placement using bovine-derived xenograft alone and in combination with liquid platelet-rich fibrin (liquid-PRF).
This randomized controlled clinical trial was conducted on patients with horizontal bone deficiency in the posterior regions of the mandible. After implant placement, GBR procedures were randomly performed using liquid-PRF-enriched bovine-derived xenograft (for the test group) and with bovine-derived xenograft alone (for the control group). To assess the change in augmentation thickness, the primary outcome of the study, cone beam computed tomography was carried out at the implant sites on completion and 6 months after surgery. The secondary outcomes were marginal bone level and implant survival rate at prosthetic delivery and at 6 months, 1 year, and 2 years follow-up after loading. The significance level was set at p<0.05 for all analysis.
Twenty patients with 50 implants were analyzed for the test group and 20 patients with 48 implants for the control group. At 6 months postoperatively, the mean values of augmentation thickness were 1.63 ± 0.21 mm, 2.59 ± 0.34 mm, and 3.11 ± 0.36 mm for the test group and 1.34 ± 0.14 mm, 2.49 ± 0.24 mm, and 2.97 ± 0.24 mm for the control group at 2 mm, 4 mm, and 6 mm below to the implant shoulder (p < 0.001, p = 0.007, and p = 0.036, respectively). The mean marginal bone loss was found to be less than 1 mm for both study groups during the 2 years of follow-up after prosthetic loading. Implant survival rate was 100% for both study groups.
Bovine-derived xenograft alone and in combination with liquid-PRF are both successful in achieving bone augmentation around the implants and produce a small change in marginal bone level and a high implant survival rate after loading.
There is a lack of evidence in the literature regarding the augmentation success of liquid-PRF used in combination with bone graft substitutes. This study indicates that liquid-PRF could be used as a supportive material with bovine-derived xenograft in GBR procedures carried out simultaneously with implant placement.
评估单独使用牛源性异种骨和同时使用富含血小板的液体纤维蛋白（liquid-PRF）进行引导骨再生（GBR）后种植体植入的骨增量效果。
本随机对照临床试验纳入了下颌后区存在水平骨缺损的患者。在植入物放置后，随机采用富含血小板的液体纤维蛋白的牛源性异种骨（试验组）和单纯牛源性异种骨（对照组）进行 GBR 处理。为评估研究的主要结局（即骨增量厚度的变化），在术后即刻和 6 个月时，通过锥形束计算机断层扫描（CBCT）对种植体部位进行评估。次要结局为修复体植入时和植入后 6 个月、1 年和 2 年时的边缘骨水平和种植体存活率。所有分析的显著性水平均设定为 p<0.05。
试验组 20 名患者（50 个种植体）和对照组 20 名患者（48 个种植体）纳入分析。术后 6 个月时，在距种植体肩下 2mm、4mm 和 6mm 处，试验组的骨增量厚度平均值分别为 1.63±0.21mm、2.59±0.34mm 和 3.11±0.36mm，对照组分别为 1.34±0.14mm、2.49±0.24mm 和 2.97±0.24mm（p<0.001，p=0.007 和 p=0.036）。在修复体植入后 2 年的随访期间，两组的边缘骨平均丢失量均小于 1mm。两组的种植体存活率均为 100%。
单纯使用牛源性异种骨和同时使用富含血小板的液体纤维蛋白均可成功实现种植体周围的骨增量，并在负载后产生较小的边缘骨水平变化和较高的种植体存活率。
关于同时使用富含血小板的液体纤维蛋白和骨移植替代物的骨增量效果，文献中证据有限。本研究表明，液体-PRF 可作为一种支持材料，与牛源性异种骨一起用于同时进行的种植体植入的 GBR 处理。
