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注射用富血小板纤维蛋白联合自体脱矿牙本质能否增强牙槽嵴保存效果?一项随机对照试验。

Does Injectable Platelet-Rich Fibrin Combined With Autogenous Demineralized Dentine Enhance Alveolar Ridge Preservation? A Randomized Controlled Trial.

作者信息

Amer Odai, Shemais Nesma, Fawzy El-Sayed Karim, Saleh Heba Ahmed, Darhous Mona

机构信息

Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.

Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany.

出版信息

Clin Oral Implants Res. 2025 Feb;36(2):166-177. doi: 10.1111/clr.14372. Epub 2024 Oct 21.

Abstract

OBJECTIVE

The present trial evaluated the first-time application of autogenous demineralized dentin graft with injectable platelet-rich fibrin (ADDG + i-PRF) versus autogenous demineralized dentin graft (ADDG), in alveolar ridge preservation (ARP) in the maxillary aesthetic zone.

MATERIAL AND METHODS

Twenty-two maxillary (n = 22) non-molar teeth indicated for extraction were randomized into two groups (n = 11/group). Extracted teeth were prepared into ADDG, implanted into extraction sockets with or without i-PRF amalgamation and covered by collagen sponge. Cone-beam computed tomography scans at baseline and 6 months were compared to assess ridge-dimensional changes. Keratinized tissue width, patient satisfaction, pain score and chair time were recorded. In the course of dental implant placements at 6 months, bone core biopsies of engrafted sites were obtained and analysed histomorphometrically.

RESULTS

Reduction in ridge width was 1.71 ± 1.08 and 1.8 ± 1.35 mm, while reduction in ridge height was 1.11 ± 0.76 and 1.8 ± 0.96 mm for ADDG + i-PRF and ADDG, respectively (p > 0.05). Significant differences in keratinized tissue width reduction were notable between ADDG + i-PRF and ADDG (0.12 ± 0.34 and 0.58 ± 0.34 mm respectively; p = 0.008). Postoperative pain scores were significantly lower in ADDG + i-PRF (p = 0.012). All patients in the two groups were satisfied with no differences in chair time (p > 0.05). No differences in total percentage area of newly formed bone, soft tissue or graft particles were observed between the groups (p > 0.05).

CONCLUSIONS

ADDG alone or in combination with i-PRF yields similar results regarding ARP clinically, quality of the formed osseous tissues, as well as patients' satisfaction. Yet, the addition of i-PRF to ADDG tends to preserve the keratinized tissue and lessen postoperative pain.

摘要

目的

本试验评估了自体脱矿牙本质移植物联合可注射富血小板纤维蛋白(ADDG+i-PRF)与自体脱矿牙本质移植物(ADDG)在上颌美学区牙槽嵴保存(ARP)中的首次应用。

材料与方法

将22颗上颌(n=22)需拔除的非磨牙随机分为两组(每组n=11)。将拔除的牙齿制备成ADDG,植入拔牙窝,分别联合或不联合i-PRF,并覆盖胶原海绵。比较基线和6个月时的锥形束计算机断层扫描,以评估牙槽嵴尺寸变化。记录角化组织宽度、患者满意度、疼痛评分和椅旁时间。在6个月进行牙种植时,获取植入部位的骨芯活检标本并进行组织形态计量学分析。

结果

ADDG+i-PRF组和ADDG组的牙槽嵴宽度减少分别为1.71±1.08和1.8±1.35mm,牙槽嵴高度减少分别为1.11±0.76和1.8±0.96mm(p>0.05)。ADDG+i-PRF组和ADDG组在角化组织宽度减少方面存在显著差异(分别为0.12±0.34和0.58±0.34mm;p=0.008)。ADDG+i-PRF组术后疼痛评分显著更低(p=0.012)。两组所有患者均满意,椅旁时间无差异(p>0.05)。两组之间新形成骨、软组织或移植颗粒的总面积百分比无差异(p>0.05)。

结论

单独使用ADDG或与i-PRF联合使用在临床上对于ARP、形成的骨组织质量以及患者满意度方面产生相似的结果。然而,在ADDG中添加i-PRF倾向于保留角化组织并减轻术后疼痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75e7/11810550/9e34237086d5/CLR-36-166-g002.jpg

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