Dhondt Rutger A L, Quirynen Marc, Lahoud Pierre, Cortellini Simone, Temmerman Andy
Int J Oral Maxillofac Implants. 2025 Sep 26;40(5):579-590. doi: 10.11607/jomi.11095.
To assess the differences between using leukocyte- and platelet-rich fibrin (L-PRF) with a deproteinized bovine bone mineral block versus a combination of 50% autogenous bone (AB) and 50% deproteinized bovine bone mineral (DBBM) as grafting material for horizontal guided bone regeneration (GBR).
This randomized double-blind split-mouth clinical trial included 13 patients requiring bilateral horizontal bone augmentation. Each patient received both treatment modalities: one side of the jaw was treated via GBR with L-PRF and deproteinized bovine bone mineral block, and the other side was treated with a 50/50 mixture of AB and DBBM. CBCT scans were used to evaluate horizontal bone width (HBW) and buccal bone thickness (BBT) at the following time points: baseline (T0), immediately post-augmentation (T1), at implant placement (T2), and 1 year after abutment connection (T4). Bone sounding (BS) was also used to verify CBCT measurements.
No statistically significant differences were found in HBW gain between test (L-PRF) and control (AB/DBBM) sites at any time point. Both sites showed significant HBW loss after implant placement, with more bone volume lost at higher crestal levels (at the implant shoulder level [Sh0], > 2 mm from the implant shoulder [Sh2], and > 4 mm from the implant shoulder [Sh4]). At the Sh2 level, 48.8% of the HBW gain at T1 was lost by T4 in test sites, and 46.2% of HBW gain was lost at the same time point in control sites. Similarly, BBT at Sh2 reduced from 4.7 ± 1.0 mm to 1.3 ± 1.5 mm in test sites and from 2.1 ± 1.0 mm to 0.9 ± 0.8 mm in control sites. Both groups of sites had one complication, resulting in a 91.6% success rate for both treatments. The cumulative survival rate of implants was 100% at 16 months, with a mean interproximal bone level (IBL) loss of 0.2 ± 0.9 mm and 0.1 ± 0.6 mm for test and control sites, respectively.
No statistically significant differences were found between the AB/DBBM composite graft and the L-PRF and bovine bone mineral block for horizontal GBR. Significant resorption of grafted volume occurs within 25 months, continuing after implant placement. Further research with larger sample sizes is needed to confirm these findings and optimize GBR techniques.
评估富含白细胞和血小板的纤维蛋白（L-PRF）与脱蛋白牛骨矿物质块联合使用，与50%自体骨（AB）和50%脱蛋白牛骨矿物质（DBBM）的组合作为水平引导骨再生（GBR）移植材料之间的差异。
这项随机双盲分口临床试验纳入了13例需要双侧水平骨增量的患者。每位患者均接受两种治疗方式：一侧颌骨通过GBR联合L-PRF和脱蛋白牛骨矿物质块进行治疗，另一侧则采用AB和DBBM的50/50混合物进行治疗。在以下时间点使用锥形束计算机断层扫描（CBCT）评估水平骨宽度（HBW）和颊侧骨厚度（BBT）：基线（T0）、增量后即刻（T1）、种植体植入时（T2）以及基台连接后1年（T4）。还使用骨探测（BS）来验证CBCT测量结果。
在任何时间点，试验组（L-PRF）和对照组（AB/DBBM）部位的HBW增加量均未发现统计学上的显著差异。两个部位在种植体植入后均出现了显著的HBW丢失，在更高的嵴顶水平（种植体肩部水平[Sh0]、距种植体肩部>2 mm[Sh2]以及距种植体肩部>4 mm[Sh4]）骨量丢失更多。在Sh2水平，试验组在T1时HBW增加量的48.8%在T4时丢失，对照组在同一时间点HBW增加量的46.2%丢失。同样，试验组Sh2处的BBT从4.7±1.0 mm降至1.3±1.5 mm，对照组从2.1±1.0 mm降至0.9±0.8 mm。两组部位均发生了1例并发症，两种治疗的成功率均为91.6%。种植体在16个月时的累积生存率为100%，试验组和对照组的平均邻间骨水平（IBL）丢失分别为0.2±0.9 mm和0.1±0.6 mm。
对于水平GBR，AB/DBBM复合移植材料与L-PRF和牛骨矿物质块之间未发现统计学上的显著差异。移植骨量在25个月内发生显著吸收，种植体植入后仍在继续。需要进行更大样本量的进一步研究来证实这些发现并优化GBR技术。
