富血小板纤维蛋白联合Bio-Oss骨粉植骨术治疗慢性牙周炎并发骨缺损的效果研究  

Effect of platelet-rich fibrin combined with Bio-Oss bone graft in the treatment of chronic periodontitis bone defect

作　　者：冯妍 郭建茹 王德伟 FENG Yan;GUO Jian-ru;WANG De-wei(Department of Prosthodontics,Affiliated Hospital of Tangshan Vocational and Technical College,Tangshan Hebei 063000,China)

机构地区：[1]唐山市职业技术学院附属医院口腔修复科,河北唐山063000

出　　处：《临床和实验医学杂志》2024年第15期1652-1655,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省医学科学研究课题计划(编号:20201544)。

摘　　要：目的探讨富血小板纤维蛋白(PRF)联合Bio-Oss骨粉植骨术治疗慢性牙周炎并发骨缺损的效果。方法前瞻性选取唐山市职业技术学院附属医院2019年8月至2021年2月收治的64例慢性牙周炎并发骨缺损患者为研究对象。按照随机数表法将其分为两组,每组各32例。对照组给予Bio-Oss骨粉植骨术治疗,观察组基于对照组条件施加PRF修补。记录并比较两组术前、术后1个月的炎症因子[白细胞介素(IL)-4、IL-6、肿瘤坏死因子α(TNF-α)、γ干扰素(IFN-γ)],术前、术后3个月的牙周相关指标[牙周探诊深度(PD)、附着水平(AL)及出血指数(BI)],及术前、术后1个月、术后3个月的菌落情况,术后3个月的创面愈合和咀嚼功能。结果观察组患者术后1个月的血清IL-4、IL-6、TNF-α、IFN-γ水平分别为(26.30±5.61)ng/L、(7.21±0.66)ng/L、(1.31±0.10)mg/L、(82.89±11.06)ng/L,均明显低于对照组[(34.42±6.97)ng/L、(11.32±1.07)ng/L、(1.75±0.13)mg/L、(90.12±13.87)ng/L],差异均有统计学意义(P<0.05)。观察组术后3个月的PD、AL值分别为(4.15±0.79)、(3.16±0.87)mm,均明显低于对照组[(5.09±1.01)、(4.56±1.12)mm],差异均有统计学意义(P<0.05);两组术后BI比较,差异无统计学意义(P>0.05)。观察组术后1、3个月的3种主要菌落的数量及占总菌落的百分率均明显低于对照组,差异均有统计学意义(P<0.05)。术后3个月,观察组创面甲级愈合率为87.50%,高于对照组(65.63%),差异有统计学意义(P<0.05)。术后3个月,观察组患者的咀嚼功能评分为(9.38±0.46)分,明显高于对照组[(7.12±0.39)分],差异有统计学意义(P<0.05)。结论PRF联合Bio-Oss骨粉植骨术治疗能够有效改善慢性牙周炎并发骨缺损患者的牙周状况,能显著降低患者血清炎症因子水平,能够更好地改善患者的牙周状况,并获得良好的创面愈合效果。Objective To study the effect of platelet rich fibrin(PRF)combined with Bio-Oss bone graft in the treatment of chronic periodontitis bone defect.Methods A total of 64 patients with chronic periodontitis complicated with bone defects admitted to the Affiliated Hospital of Tangshan Vocational and Technical College from August 2019 to February 2021 were prospectively selected as the research objects.According to the random number table method,they were divided into two groups,32 cases in each group.The control group was treated with Bio-Oss bone graft,and the observation group was treated with PRF based on the control group conditions.The inflammatory factors[interleukin(IL)-4,IL-6,tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)]before operation and 1 month after operation,periodontal related indexes[periodontal probing depth(PD),attachment level(AL)and bleeding index(BI)]before operation and 3 months after operation,colony status before operation,1 month after operation and 3 months after operation,wound healing and chewing function 3 months after operation were recorded and compared between the two groups.Results The serum levels of IL-4,IL-6,TNF-αand IFN-γin the observation group were(26.30±5.61)ng/L,(7.21±0.66)ng/L,(1.31±0.10)mg/L and(82.89±11.06)ng/L,respectively,which were significantly lower than those in the control group[(34.42±6.97)ng/L,(11.32±1.07)ng/L,(1.75±0.13)mg/L,(90.1±13.87)ng/L],the differences were statistically significant(P<0.05).The grade A wound healing rate in the observation group was 87.50%,which was higher than that in the control group(65.63%),the difference was statistically significant(P<0.05).The PD and AL values of the observation group at 3 months after operation were(4.15±0.79)and(3.16±0.87)mm,respectively,which were significantly lower than those of the control group[(5.09±1.01)and(4.56±1.12)mm],and the differences were statistically significant(P<0.05);there was no significant difference in BI between the two groups(P>0.05).The number of three main colonies an

关 键 词：富血小板纤维蛋白 Bio-Oss骨粉植骨术 慢性牙周炎 骨缺损 

分 类 号：R781.42[医药卫生—口腔医学] R782.4[医药卫生—临床医学]