International Journal of Surgery Case Reports Platelet-rich Fibrin (prf) in Implant Dentistry in Combination with New Bone Regenerative Technique in Elderly Patients
International Journal of Surgery Case Reports Platelet-rich Fibrin (prf) in Implant Dentistry in Combination with New Bone Regenerative Technique in Elderly Patients
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国际外科杂志病例报告 种植牙中富含血小板的纤维蛋白 (prf) 与老年患者新骨再生技术相结合
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通讯作者：
Massimo Amato
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作者：
A. Cortese;Antonio Borri;Mario Caggiano;Massimo Amato
简介：一些研究表明，富血小板纤维蛋白（PRF）是一种具有巨大骨和软组织再生潜力的愈合生物材料，无任何炎症反应，可单独使用或与骨移植物联合使用，促进止血，骨生长和成熟。在老年患者的骨再生手术中，PRF似乎是一种天然和令人满意的辅助手段，具有良好的结果和低风险。目的：本研究旨在证明PRF与一种新的劈裂式牙槽嵴增强技术相结合如何能够极大地帮助种植体康复，特别是在需要骨再生的老年患者中。材料和方法：本研究共治疗10例患者，其中5例采用不翻瓣劈裂冠新术式，另5例采用传统术式不劈裂冠作为对照。选择平均年龄在50 - 60岁之间的5名患者采用劈裂嵴无翻瓣改良技术进行手术，以优化再生条件，在一个单一阶段手术中进行骨增强和植入物插入。对于所有患者，自体PRF已被用于填充分裂嵴间隙或简单地作为再生材料。治疗前及随访时除CT检查外，均行曲面体层摄影、口内X线摄影及CT DentaScan/CT Cone beam检查。结果：所有病例均获得成功，手术时间、术后和骨整合期均无问题。所有种植体均实现骨整合。这些结果是通过对所有手术病例术后即刻和晚期的准确管理而获得的。T1时两组患者的身高骨丢失平均差异为2.4 mm，T3时为2.2 mm。讨论内容：这种分裂牙嵴无瓣改良技术的原理是获得适当的颊侧皮质扩张，保留其血管供应，避免骨膜抬高，以更好地滋养皮质骨。此外，报告了与使用PRF相关的优点。PRF的有效性显示在促进手术伤口的愈合，事实上，它具有血小板生长因子，可以改善手术部位的血管形成，促进新血管生成。此外，通过简单地改变离心机的设置，如果必须将其用作再生和刺激材料，或者将更一致的物质用作裂缝顶部间隙中的填充物，则可以获得正常的胶凝。结论：应用该方法的主要优点是：
INTRODUCTION: Some studies have demonstrated that platelet rich fibrin (PRF) is a healing biomaterial with a great potential for bone and soft tissue regeneration, without any inflammatory reactions and may be used alone or in combination with bone grafts, promoting hemostasis, bone growth, and matu-ration. PRF appears as a natural and satisfactory aid in bone regenerative surgery in elderly patients with favorable results and low risks. AIM: This study wants to demonstrate how PRF in association with a new split crest augmentation technique can be a great aid in implant rehabilitation, especially in the elderly patients, when bone regeneration is required. MATERIALS AND METHODS: Ten patients were treated in this study, five following the flapless split crest new procedure and other five patients following traditional procedure without split crest as control. Five patients with an average age between 50 and 60 years were selected to be operated with a split crest flapless modified technique in order to optimize the regenerative conditions with a bone augmentation and implant insertion in one single stage procedure. For all the patients autologous PRF has been used to fill the split crest gap or simply as regenerative material. Orthopantomography, intraoral radiography and CT DentaScan/CT Cone beam were performed for every patient before the treatment and at follow-up time exeption made for CT. RESULTS: All cases were successful, there were no problems at surgery time, at post-operative and at osteointegration periods. All implants achieved osteointegration. These results were obtained by accurately managing immediate and late post operative period in all of the operated cases. Mean difference for height bone loss between the two groups of patients was 2.4 mm at T1 and 2.2 mm at T3. DISCUSSION: The rationale of this split crest flapless modified technique is to obtain a proper buccal cortex expansion preserving its vascular supply avoiding periosteal elevation for better cortical bone nourishing. Moreover, advantages are reported related to the use of PRF. The effectiveness of PRF is shown in promoting the healing of surgical wounds, it has, in fact, platelet growth factors that can improve the vascularisation of the surgical site, promoting neoangiogenesis. Furthermore, by simply changing the settings of the centrifuge, it is possible to obtain a normal gelling if it has to be used as regenerative and stimulating material, or more consistent substance to be used as a filler in the split crest gap. CONCLUSIONS: The main advantages in using …