Effect of platelet-rich plasma in the treatment of periodontal intrabony defects in humans
Effect of platelet-rich plasma in the treatment of periodontal intrabony defects in humans
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DOI：
10.1097/00029330-200609020-00003
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发表时间：
2006-09-20
影响因子：
6.1
通讯作者：
Qiao Jing
中科院分区：
文献类型：
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作者：
Ouyang Xiang-ying;Qiao Jing
背景富含血小板血浆(PRP)是一种天然的自体生长因子来源，已在医学界得到成功应用。然而，PRP在牙周再生中的作用尚不清楚。方法随机选择10例牙周炎患者17个骨内缺损，随机分为试验组(9例)和对照组(8例)。评估临床参数，包括探查深度、相对附着水平(用佛罗里达探头和支架测量)和骨探查水平从基线到术后1年的变化。分别于术前、术后2周、术后1年拍摄标准化根尖周片，并进行数字减影摄影(DSR)分析。结果术后1年，两种治疗方法均较术前显著增加附着体，减少探诊深度，降低骨探查水平。在探诊深度减少方面，试验组较对照组有显著改善，分别为(4.78±0.95)mm和(3.48±-0.41)mm。临床附着增加：(4.52+/-1.14)mm对(2.85+/-0.80)mm(P<；0.01)；骨探查减少：(4.56+/-1.04)mm对(2.88+/-0.79)mm(P<；0.01)；骨缺损率：(73.41+/-14.78)%对(47.32+/-11.47)%(P<；0.01)。治疗前和术后1年的牙槽骨密度测量结果显示，试验组牙槽骨骨密度较对照组有明显改善：灰阶增加(580±-50)mm(P=0.0001)，灰阶增加面积为(5.21+/-1.25)mm(2)对(3.02+/-1.22)mm(2)(P=0.0001)。需要进一步的研究来评估PRP的长期有效性，并且需要更大的样本量。
Background Platelet-rich plasma (PRP) is a kind of natural source of autologous growth factors, and has been used successfully in medical community. However, the effect of PRP in periodontal regeneration is not clear yet. This study was designed to evaluate the effectiveness of PRP as an adjunct to bovine porous bone mineral (BPBM) graft in the treatment of human intrabony defects.Methods Seventeen intrabony defects in 10 periodontitis patients were randon-fly treated either with PRP and BPBM (test group, n=9) or with BPBM alone (control group, n=8). Clinical parameters were evaluated including changes in probing depth, relative attachment level (measured by Florida Probe and a stent), and bone probing level between baseline and 1 year postoperatively. Standardized periapical radiographs of each defect were taken at baseline, 2 weeks, and 1 year postoperatively, and analyzed by digital subtraction radiography (DSR).Results Both treatment modalities resulted in significant attachment gain, reduction of probing depth, and bone probing level at 1-year post-surgery compared to baseline. The test group exhibited statistically significant improvement compared to the control sites in probing depth reduction: (4.78 +/- 0.95) mm versus (3.48 +/- 0.41) mm. (P < 0.01); clinical attachment gain: (4.52 +/- 1.14) mm versus (2.85 +/- 0.80) mm (P < 0.01); bone probing reduction: (4.56 +/- 1.04) mm versus (2.88 +/- 0.79) mm (P < 0.01); and defect bone fill: (73.41 +/- 14.78)% versus (47.32 +/- 11.47)% (P < 0.01). DSR analysis of baseline and 1 year postoperatively also showed greater radiographic gains in alveolar bone mass in the test group than in the control group: gray increase (580 +/- 50) grays versus (220 +/- 32) grays (P=0.0001); area with increased gray were (5.21 +/- 1.25) mm(2) versus (3.02 +/- 1.22) mm(2) (P=0.0001).Conclusions The treatment with a combination of PRP and BPBM led to a significantly favorable clinical improvement in periodontal intrabony defects compared to using BPBM alone. Further studies are necessary to assess the long-term effectiveness of PRP, and a larger sample size is needed.