富血小板血浆促进软组织损伤愈合的研究进展

富血小板血浆是全血经过离心获得的血小板浓缩物,已有研究证实其中含有多种与创伤愈合有关的生长因子。软组织损伤理想的愈合方式是快速及疤痕最少的愈合,近年来,有关富血小板血浆促进软组织损伤愈合、减少疤痕的研究逐渐增多,已成为医学研究的热点,本文就其促进软组织损伤愈合的机制及最新研究进展作一综述。     

富血小板血浆修复种植体周围骨缺损的实验研究

目的探讨富血小板血浆(platelet-rich plasma,PRP)修复种植体周围骨缺损的能力。方法Beagle犬4只,拔除单侧下颌1、2、4前磨牙作为实验牙位。3个月后植入种植体,其周围制备骨缺损并植入相应骨移植材料:实验组植入PRP/磷酸三钙(tricalcium phosphate,TCP);对照组植入TCP。8、16周分别处死动物2只,进行组织学、扫描电镜观察,观察新骨形成和种植体-新骨界面情况,能谱分析种植体-新骨界面Ca含量。结果8周及16周通过肉眼及组织学观察,实验组修复效果优于对照组,种植体-新骨界面Ca含量均高于对照组,差异有显著性(P<0.05)。结论PRP/TCP作为修复种植体周围骨缺损的骨移植材料具有可行性。     

富血小板血浆与骨修复

富血小板血浆（PRP）是全血经过离心分离而得到的血制品,含有全血中70％以上的血小板．现已知PRP是自体生长因子库．富含多种生长因子．如血小板源性生长因子（PDGF）、转化生长因子（TGF）、成纤维细胞生长因子（FGF）和胰岛素生长因子（IGF）等。这些生长因子对细胞的生长分化和组织的形成有着重要作用。近年来的研究表明,PRP能促进骨修复。在国外,PRP已逐步应用于口腔种植、颌面重建外科、牙周外科等领域。     

富血小板血浆促进骨缺损修复的研究进展

本文介绍了富血小板血浆的特点及在骨缺损修复中的研究进展,讨论了富血小板血浆促进骨组织缺损修复的可能机制,提出了富血小板血浆修复骨组织缺损目前还存在的问题.     

浓缩生长因子促进犬软组织损伤修复的实验研究

目的:研究浓缩生长因子(CGF)在促进软组织创伤愈合、减少愈合瘢痕方面的能力。方法 :健康雄性1岁龄杂种犬6只,体质量20～22 kg。选择实验犬双侧后腿的大腿内侧分别制作3个短径为2 cm、长径为3 cm、深及皮下筋膜层的椭圆形软组织缺损,其上分别覆盖CGF膜(实验组)、生物愈合膜(生物膜对照组)、不覆盖任何膜(空白对照组)。分别于术后7、14、21、28 d通过大体观察和组织学观察对比创面的生长愈合情况。结果:术后7 d时大体观察,肉芽组织生长的多少情况:实验组>生物膜对照组>空白对照组;炎症反应强度:实验组<生物膜对照组<空白对照组。术后7～28 d,3组的椭圆形创面均逐渐缩小,但实验组创面缩小较明显且无明显瘢痕。组织学观察,从14～21 d和21～28 d的结果来看,实验组创面愈合最快。结论:CGF能明显缩短软组织损伤愈合时间,减少瘢痕形成,提高愈合质量。     

富血小板血浆在种植体周围骨缺损修复中的实验研究

目的:探讨富血小板血浆(platelet-richplasma,PRP)、PRP复合骨诱导活性材料(osteoinduction active material,OAM)对种植体周围骨缺损修复的作用。方法:Beagle犬4只,拔除每只犬一侧下颌第一、二前磨牙及其双侧下颌第四前磨牙作为实验牙位。3个月后拔牙处植入种植体,每只犬共植入3颗种植体,第一、二前磨牙牙位植入1颗种植体为对照组,对侧第四前磨牙牙位植入1颗种植体为实验A组,同侧第四前磨牙牙位植入1颗种植体为实验B组。种植术中同期制备种植体周围骨缺损并植入相应骨移植材料:A组植入PRP/OAM;B组植入PRP/磷酸三钙;对照组植入磷酸三钙。种植术后8、16周处死动物,进行组织学观察,测量种植体周围骨密度,采用SPSS13.0软件对数据进行单因素方差分析。结果:8周时,实验A组新骨与种植体形成区段性骨结合;实验B组种植体边缘可见新骨形成,但量较少;对照组种植体边缘为纤维性界面。8周时骨密度测量,各组间骨密度差异无统计学意义。16周时,实验A组可见哈佛系统,实验A、B组新骨与种植体形成骨整合;对照组仅为纤维性结合。16周时骨密度测量,两实验组骨密度均显著高于对照组。结论:PRP及PRP/OAM可促进种植体周围骨缺损修复。     

富血小板血浆促进人牙髓细胞增殖的实验研究

目的探讨不同浓度富血小板血浆(Platelet rich plasma,PRP)对人牙髓细胞(human dental pulp cells,HDPCs)的增殖作用。方法两步离心法制备PRP,通过ELISA的方法测定PRP中两种主要生长因子血小板源性生长因子(PDGF-AB)和转化生长因子(TGF-β1)的浓度;用四唑盐比色法(MTT)观察5%、10%、20%PRP在2d、4d时对牙髓细胞的增殖作用,并探讨这种作用是否依赖于胎牛血清(FBS)的存在。结果所制备的PRP中血小板的浓度大于1000×109个/L,为全血中的4倍以上,经ELISA的方法测定PRP及贫血小板血浆(Platelet poor plasma,PPP)中PDGF-AB、TGF-β1的浓度分别增加4倍以上。MTT法测定不同浓度组的PRP对牙髓细胞均有增殖作用,以10%PRP增殖效应最明显,P值均<0.05;4d时PRP对细胞的增殖作用明显强于2d时,P值<0.05;10%PRP组较10%胎牛血清组增殖作用明显,P值<0.05。结论本实验制备的PRP含有较高浓度的PDGF-AB及TGF-β1,不同浓度的PRP均能有效促进牙髓细胞增殖,以10%PRP浓度增殖效应最明显;并且这种增殖作用并不依赖于胎牛血清的存在;随着时间延长,PRP对细胞增殖作用增加。     

富血小板血浆制备方法的研究进展

血小板除具有凝集作用外,还含有较多特别是与创伤愈合和骨再生相关的多种生长因子,而浓缩后的富血小板血浆(PRP)中所富含的高质量分数的生长因子对创伤局部组织的修复和骨再生有着重要的作用.目前,PRP的应用已成为一项重要的外科技术,但其最佳的制各方法、最准确的血小板计数和相关的实验研究尚无统一的标准,因此其临床应用价值尚无令人满意的诠释.笔者下面就PRP的制备原理和制备方法的研究进展作一综述.     

富血小板血浆在修复牙周组织缺损中的应用研究

目的：建立富血小板血浆（PRP）提取方法,以探讨作为自身复合生长因子来源的可行性,并研究其在修复牙周组织缺损中的作用。方法：利用二次离心法（1000 rpm×15 min;3000 rpm×8 min）分离全血,获得PRP。将PRP设3个浓度组（5%,10%,30%）,比较各浓度PRP＋植骨术与单纯植骨术治疗牙周骨内袋缺损的效果,以评价PRP在牙周组织再生治疗中的作用。结果：所获得的血小板浓度均超过全血的4倍,实验组各浓度的PRP＋植骨术均可促进牙周组织的再生,实验组与对照组相比差异具有显著性（P〈0.01）。当PRP浓度在5%～30%时促再生作用呈剂量依赖性。结论：二次离心法是一种简单易行的提取PRP的方法。PRP可促进牙周组织的再生。     

富血小板血浆与富血小板纤维蛋白在牙周组织再生中的应用

富血小板血浆(platelet-rich plasma,PRP)与富血小板纤维蛋白(platelet-rich fibrin,PRF)因其促进组织再生的能力,在临床口腔创伤及缺损的修复中逐渐被重视及应用,并取得了令人较为满意的效果,鉴于PRP与PRF的制作较简便,且不易出现疾病传染及免疫排斥的不良反应,两者在口腔临床中...     

口腔组织补片和富血小板血浆处理拔牙创的临床研究

目的：观察口腔组织补片和富血小板血浆（PRP）处理阻生齿拔牙创的临床疗效。方法：将200例拔除下牙阻生齿的患者随机分为甲、乙、丙、丁四组。完成拔除术后,甲组：口腔组织补片置入拔牙创;乙组：PRP置入拔牙创;丙组：口腔组织补片＋PRP置入拔牙创;丁组：空白对照组。术后观察四组并发症发生情况。并于术后3个月观察x线结果,以Digra分析比较牙槽窝愈合情况。结果：与对照组比较,补片＋PRP组对于预防术后出血、干槽症的发生以及促进牙槽骨的生长有意义（P〈0．05）。结论：口腔组织补片和PRP联合应用对于阻生齿拔除后预防术后出血以及干槽症有一定疗效,同时对牙槽骨生长有促进作用。     

牛血小板衍化生长因子促进小鼠伤口愈合的研究

切除小白鼠北部皮肤制作创伤模型，人造皮肤覆盖伤口，并在人造皮肤下注射牛血小板衍化生长因子２μｇ／ｄ，共注射３ｄ。然后于术后３、７、１０ｄ对伤口新生上皮、肉芽组织生长情况进行观察，结果表明牛ＰＤＧＦ能促进肉芽组织生长，上皮再生，使伤口加速愈合，提示牛ＰＤＧＦ可应用于临床创伤治疗。     

富血小板血浆促进口腔种植骨再生的临床应用研究

目的 探讨与评估富血小板血浆促进口腔种植骨缺损区骨组织再生的临床作用和效果。方法 口腔种植骨缺损病例共10例,男6例,女4例,平均年龄49.6岁;上颌窦提升植骨7例,种植体周围骨缺损植骨3例。病例分为2组,对照组6例,单纯植入骨替代品β相磷酸三钙,实验组4例,植入β相磷酸三钙与富血小板血浆混合物。术前、术后1周、3个月、6个月行X线检查;每组各有3例在术后4-6个月的二期手术中取得植骨标本,行组织学观察。结果 10例均未出现植骨感染,愈合良好。影像学观察显示植骨材料与周围骨组织结合良好。组织学观察可见各组中β相磷酸三钙颗粒为胶原纤维样组织或蓝染的新生骨组织包绕,无炎症细胞浸润表现。实验组与对照组相比,植骨颗粒周围包绕着较为稠密的蓝染组织,新形成的编织骨排列更为整齐有序,并可见大量蓝染组织侵入β相磷酸三钙颗粒微孔内部,颗粒吸收改建明显。结论 富血小板血浆具有促进口腔种植骨缺损区骨组织再生的作用。     

Effects of leukocyte- and platelet-rich fibrin alone and combined with hyaluronic acid on early soft tissue healing after surgical extraction of impacted mandibular third molars: A prospective clinical study

Purpose

In this prospective, randomized, double-blind, controlled study, we evaluated the effects of leukocyte- and platelet-rich fibrin (L-PRF) alone and combined with hyaluronic acid (HA) sponge on early healing of soft tissue after mandibular third molar (M3) surgery.

Effect of platelet-rich plasma on temporomandibular joint cartilage wound healing: Experimental study in rabbits

Purpose

The aim of the study is to evaluate the effect of platelet-rich plasma (PRP) injection on temporomandibular joint (TMJ) cartilage and subchondral bone healing.

富血小板纤维蛋白对软组织修复与再生影响的研究进展

近年来随着组织工程的不断发展,关于损伤组织修复与再生的研究层出不穷,其中富血小板纤维蛋白（PRF）用于软组织修复及再生的问题成为研究热点。PRF是一种自体血来源的富含细胞生长因子的新型生物材料,被誉为第二代血小板浓缩物。本文就PRF对软组织修复及再生影响的体内研究,体外研究及临床研究作一综述。     

Flow cytometric and morphological characterization of platelet-rich plasma gel

BACKGROUND OF PROBLEMS: Platelet-rich plasma (PRP) gel is derived from an autogenous preparation of concentrated platelets and is widely used in implant dentistry as a vector for cell growth factors. However, limited data are available on its structure and composition. The present study was aimed at providing a flow cytometric and ultrastructural characterization of PRP gel. MATERIALS AND METHODS: Twenty PRP gel samples were obtained from healthy volunteers. These PRP gel specimens were prepared for transmission (TEM) and scanning electron microscopy (SEM) examination of their morphological ultrastructure. Flow cytometry with CD41-PE monoclonal antibody was used to detect platelet cells, as this antibody recognizes human-platelet-specific antigen CD41. RESULTS: Both SEM and TEM showed that PRP gel contains two components: a fibrillar material with striated band similar to fibrin filaments, and a cellular component that contains human platelet cells. Both techniques indicated that no morphological elements were bound between the cellular component and the fibrillar material. The cells were confirmed as platelet cells by flow cytometric study after incubation with specific monoclonal antibody CD41-PE. CONCLUSION: PRP gel contains a fibrillar and a cellular (largely human platelet cell) component. This unique structure may be capable of acting as a vehicle for carrying of cells that are essential for soft/hard tissue regeneration.     

富血小板血浆对牙周膜成纤维细胞损伤模型影响的研究

目的：探讨应用富血小板血浆（PRP）对狗牙周膜成纤维细胞（PDLFs）损伤模型的愈合有无影响.方法：采用组织块法培养狗牙周膜成纤维细胞,取第四代细胞接种于12孔板,待细胞融合后制作直径约8 mm的损伤模型.用含1%PRP和10%PRP的培养液继续培养,于损伤后第1、4、7、9、11天分别检测各组细胞数量及细胞覆盖损伤区的情况.结果：1%PRP和10%PRP均可促进损伤PDLFs的移行和增殖.结论：1%PRP和10%PRP均可促进牙周膜成纤维细胞损伤模型的愈合.     

The use of leukocyte- and platelet-rich fibrin in the management of soft tissue healing and pain in post-extraction sockets: A randomized clinical trial

This study aimed to evaluate the clinical effect of leukocyte- and platelet-rich fibrin (L-PRF) to improve epithelialization and decrease postoperative pain in post-extraction sockets. Thirty two participants requiring extractions of posterior teeth were randomized into two groups: 1) extractions and socket filling with L-PRF membrane (test group) and 2) extraction with spontaneous healing (control group). One week after extraction, an assessment of soft tissue healing around the sockets was performed using the healing index. Also, postoperative pain by visual analog scale (VAS) and number of consumed analgesic tablets were recorded. In the first week, the sockets of the test group presented a significantly (mean of 3.81 ± 0.54; p = 0.0138) higher level of healing when compared to the sockets of the control group (mean of 3.18 ± 0.65). The participants of control group reported a significantly (mean of 5.12 ± 1.08; p = 0.0128) higher level of postoperative pain when compared to the test group (mean of 4 ± 1.15). Also, the control group consumed a greater number of analgesics (mean of 1.75 ± 0.85; p = 0.0136) when compared to the test group (mean of 1 ± 1.15). The results of the present study demonstrate that whenever improved healing of the extraction socket is needed, the use of L-PRF should be considered. In addition, the use of L-PRF decreases postoperative pain and discomfort.     

Sinus floor elevation applied tissue-engineered bone. Comparative study between mesenchymal stem cells/platelet-rich plasma (PRP) and autogenous bone with PRP complexes in rabbits

In the present study, we compared bone regeneration ability in sinus floor elevation between a tissue engineering method using mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP), and a promising new method using particulate cancellous bone and marrow (PCBM) and PRP. Bilateral sinus floor elevation procedures were performed in 18 adult Japanese white rabbits. MSCs/PRP or PCBM/PRP complexes were grafted to each maxillary sinus in the same rabbits. The MSCs were isolated from rabbit iliac crest marrow, and PRP was obtained from peripheral blood. PCBM were collected from the rabbit iliac crest and mixed with PRP. The animals were sacrificed at 2, 4, and 8 weeks after transplantation, and the bone formation ability of each implant was evaluated histologically and histometrically. According to the histological observations, both sites (MSCs/PRP and PCBM/PRP) showed well newly formed bone and neovascularization at 2 and 4 weeks. However, at 8 weeks, the lamellar bone was observed to be occupied by fatty marrow in large areas in both sites. There was no significant difference in bone volume or augmented height between MSCs/PRP and PCBM/PRP groups each week, but there were significant differences in bone volume and augmented height between 2 and 8 weeks in PCBM/PRP or MSCs/PRP groups and in bone volume between 4 and 8 weeks in the PCBM/PRP group (P<0.05). These results suggest that the MSCs/PRP complex may well be used for bone regeneration in sinus floor elevation, compared with the PCBM/PRP complex.