Ibrahim Almusi Blend J, Al-Kamali Reiadh K
Department of Oral Surgery, Khanazad Teaching Center, Erbil Health Care Institute, Ministry of Health, Erbil, IRQ.
Department of Oral and Maxillofacial Surgery, College of Dentistry, Hawler Medical University, Erbil, IRQ.
Cureus. 2024 Jul 16;16(7):e64651. doi: 10.7759/cureus.64651. eCollection 2024 Jul.
The goal was to evaluate the effect of the combined growth factor of hyaluronic acid (HA) and advanced platelet-rich fibrin (A-PRF) on acceleration and maturation of bone formation around titanium dental implants in the bone-free space (jumping distance) of an over-preparation socket.
Thirty-two titanium dental implants were placed in four sheep and distributed into one control group (A) and three experimental groups (B, C, and D) in two different time periods. Each sheep received eight implants. The eight implants in each sheep were distributed into four groups. The first period was one month after the initial placement, 16 implants were used in two sheep. The second period was three months after the initial placement; another 16 implants were used in the other two sheep. All implants were placed in over-prepared implant sockets, resulting in minimal primary stability. In Group A: the space between the dental implant and the bone of the inner wall of the socket was left without a growth substrate material. In Group B: we added HA between the dental implant and the bone of the inner wall of the socket. In Group C: we added A-PRF between the dental implant and the bone of the inner wall of the socket. In Group D: we added a combination of HA and A-PRF between the dental implant and the bone of the inner wall of the socket. Data was collected for each group at one month and three months at the same time. A high-resolution, desktop micro-CT system (Bruker Skyscan 1275, Kontich, Belgium) was used to scan the specimens. The NRecon software (ver. 1.6.10.4, SkyScan) and CTAn (SkyScan) were used for the visualization and quantitative measurement of the samples. One-way analysis of variance (ANOVA) was used to compare the means of the four study groups in the same period. A post hoc test was used after ANOVA to compare the means of two samples at the same time. A p-value of ≤ 0.05 was considered statistically significant.
After one month and three months of using combined HA and A-PRF on Group D, significant acceleration was observed in bone formation in all tests around dental implants compared with other groups, while no significant acceleration was observed when they were used separately; all three study groups showed significant results when compared with the control group.
Our data showed that using a combination of HA and A-PRF had a significant effect on the acceleration of the bone formation and ossification process when added to bone-free space (jumping distance) around implants while leaving space without any growth substrates might delay the bone ossification process.
本研究旨在评估透明质酸（HA）和高级富血小板纤维蛋白（A-PRF）联合生长因子对钛牙种植体周围骨形成在过度预备牙槽窝无骨空间（跳跃间隙）中的加速和成熟作用。
将32枚钛牙种植体植入4只绵羊体内，并在两个不同时间段分为1个对照组（A组）和3个实验组（B组、C组和D组）。每只绵羊植入8枚种植体。每只绵羊体内的8枚种植体分为4组。第一个时间段为初次植入后1个月，在2只绵羊中植入16枚种植体。第二个时间段为初次植入后3个月，在另外2只绵羊中植入另外16枚种植体。所有种植体均植入过度预备的种植窝内，初始稳定性最小。A组：牙种植体与牙槽窝内壁骨之间的间隙不放置生长基质材料。B组：在牙种植体与牙槽窝内壁骨之间添加HA。C组：在牙种植体与牙槽窝内壁骨之间添加A-PRF。D组：在牙种植体与牙槽窝内壁骨之间添加HA和A-PRF的组合。在1个月和3个月时同时收集每组的数据。使用高分辨率台式微型CT系统（布鲁克Skyscan 1275，比利时孔蒂奇）扫描标本。使用NRecon软件（版本1.6.10.4，SkyScan）和CTAn（SkyScan）对样本进行可视化和定量测量。采用单因素方差分析（ANOVA）比较同一时期4个研究组的均值。方差分析后使用事后检验同时比较两个样本的均值。p值≤0.05被认为具有统计学意义。
D组使用HA和A-PRF联合制剂1个月和3个月后，与其他组相比，种植体周围所有测试中的骨形成均观察到显著加速，而单独使用时未观察到显著加速；与对照组相比，所有三个研究组均显示出显著结果。
我们的数据表明，在种植体周围无骨空间（跳跃间隙）中添加HA和A-PRF的组合对骨形成和骨化过程的加速有显著影响，而留出无任何生长基质的空间可能会延迟骨化过程。
