Department of Conservative Dentistry and Endodontics, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India.
Faciomaxillary Surgeon, Department of Dentistry, Government Doon Medical College (Hospital), Dehradun, Uttarakhand, India, Phone: +91 9410558642, e-mail:
J Contemp Dent Pract. 2022 Mar 1;23(3):337-342.
To compare different combinations of alendronate, platelet-rich fibrin (PRF), and hydroxyapatite in bone regeneration in endodontic surgeries using cone-beam computed tomography (CBCT).
During this study, 28 patients were selected who were found to have pathology in the periapical area in the anterior region, The study subjects were categorized into four categories, each consisting of seven subjects, Category one-there was no placement of any material; category two-PRF; category three-hydroxyapatite along with PRF; category four-alendronate along with PRF, Root canal treatment followed by endodontic surgery in each patient was carried out, Volumetric analysis of the lesions was carried out before surgery and 12 months after surgery using CBCT, Analysis of variance (ANOVA) test and Tukey test were used for statistical analysis.
There was a maximum change in the volume of lesions in the study subjects in which PRF was used along with hydroxyapatite in comparison to other combination of materials, There was no significant difference when PRF was placed along with alendronate in comparison to study subjects when PRF was placed alone, The difference was not significant when PRF was placed in defects of bone in comparison to study subjects when no materials were placed in the defects of bone.
It can be concluded from the current research that PRF along with hydroxyapatite is a better option for the healing of defects of bone in surgeries performed in the area around the root apex in endodontic patients, But further studies should be carried out with a large sample size and for a longer duration.
It is a very important consideration that there should be healing of the lesion after surgery around the root apex by actual bone regeneration, The healing of the larger lesions does not take place easily as compared with the lesions having a small size, This is because there is healing by secondary intention where there is formation of scar instead of actual healing by formation of bone, There are several methods by which proper bone regeneration can be obtained.
使用锥形束计算机断层扫描 (CBCT) 比较不同组合的阿伦膦酸钠、富血小板纤维蛋白 (PRF) 和羟基磷灰石在根管手术中的骨再生效果。
本研究共选择 28 例前牙区根尖区有病变的患者。研究对象分为 4 组,每组 7 例。第 1 组不放置任何材料;第 2 组为 PRF;第 3 组为 PRF 加羟基磷灰石;第 4 组为 PRF 加阿伦膦酸钠。每位患者均进行根管治疗和根管手术后,使用 CBCT 分别在术前和术后 12 个月对病变进行容积分析。采用方差分析 (ANOVA) 检验和 Tukey 检验进行统计学分析。
在研究中,与其他材料组合相比,使用 PRF 加羟基磷灰石的研究对象病变体积变化最大。与单独使用 PRF 的研究对象相比,使用 PRF 加阿伦膦酸钠的研究对象差异无统计学意义。与不放置材料的研究对象相比,PRF 放置在骨缺损处的差异无统计学意义。
从目前的研究可以得出结论,在根管患者根尖周围区域手术中,PRF 加羟基磷灰石是治疗骨缺损的更好选择。但需要进行更大样本量和更长时间的研究。
根尖周围手术后病变的实际骨再生愈合是非常重要的考虑因素。与小病变相比,大病变的愈合不易发生。这是因为存在由瘢痕形成的二期愈合,而不是由骨形成的实际愈合。有几种方法可以获得适当的骨再生。