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骨髓内植入联合富含血小板的纤维蛋白促进牙周组织再生:一项随机对照试验。

Intramarrow penetration synergized with advanced platelet-rich fibrin in periodontal regeneration: A randomized controlled trial.

作者信息

Sharma Parth, Manjunath Shiva R G, Gummaluri Shiva Shankar, Kunche Lavanya

机构信息

Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India.

Department of Periodontics, Sree Sai Dental College and Research Institute, Srikakulam, Andhra Pradesh, India.

出版信息

J Indian Soc Periodontol. 2023 May-Jun;27(3):301-307. doi: 10.4103/jisp.jisp_199_22. Epub 2023 May 1.

Abstract

BACKGROUND

Intramarrow penetration (IMP) is one of the recent treatment protocol where decortication is performed to stimulate osteogenic cells. IMP improves the blood supply and the inherent osteogenic properties of the vital bone and has the advantages of minimal surgical invasion, time, and cost. Incorporation of IMP in the regeneration of periodontal defects is very scarce. Hence, the present study aimed to evaluate the involvement of IMP and advanced platelet-rich fibrin (A-PRF) in the regenerative outcomes in the treatment of intrabony defects.

MATERIALS AND METHODS

In the present randomized controlled trial, 20 periodontitis patients with 20 defects were randomly allotted into two groups: group I open flap debridement (OFD) and A-PRF, group II OFD, intramarrow debridement, and A-PRF. Clinical parameters recorded were plaque index (PI), gingival index (GI), and clinical attachment level (CAL) probing depth. Radiographic parameters were defect depth, defect resolution, and change in alveolar crest height. Values were tabulated and subjected to statistical analysis. Paired and unpaired -tests were performed for intra and intergroup comparisons. <0.05 was set as statistically significant.

RESULTS

Intragroup comparisons showed a significant reduction ( < 0.05) in probing pocket depth, GI, PI, gain in CAL, and greater bone fill in both the groups from baseline to 6 months postoperative. Intergroup comparisons were not statistically significant ( > 0.05).

CONCLUSION

Within limitations, both treatment modalities stand good, but utilization of IMP along with A-PRF results in effective regenerative outcome in intrabony defects because of its stimulation of osteogenic properties.

摘要

背景

髓内穿刺(IMP)是最近的一种治疗方案,即通过进行去皮质术来刺激成骨细胞。IMP改善了重要骨组织的血液供应和固有的成骨特性,具有手术侵袭小、时间短和成本低的优点。将IMP应用于牙周缺损再生的研究非常少。因此,本研究旨在评估IMP和高级富血小板纤维蛋白(A-PRF)在治疗骨内缺损的再生效果中的作用。

材料与方法

在本随机对照试验中,将20例患有20处缺损的牙周炎患者随机分为两组:第一组为开放性翻瓣清创术(OFD)联合A-PRF,第二组为OFD、髓内清创术联合A-PRF。记录的临床参数有菌斑指数(PI)、牙龈指数(GI)和临床附着水平(CAL)探诊深度。影像学参数有缺损深度、缺损修复情况和牙槽嵴高度变化。将数据制成表格并进行统计分析。进行配对和非配对t检验以进行组内和组间比较。设定P<0.05为具有统计学意义。

结果

组内比较显示,两组从基线到术后6个月,探诊袋深度、GI、PI均显著降低(P<0.05),CAL增加,骨填充量增加。组间比较无统计学意义(P>0.05)。

结论

在一定限制范围内,两种治疗方式都有良好效果,但IMP联合A-PRF治疗骨内缺损能产生有效的再生效果,因为它能刺激成骨特性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dc5/10281316/13d149ce2da7/JISP-27-301-g001.jpg

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