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牙周组织再生中生长因子促使牙周膜细胞向损伤部位的趋化、黏附并诱导牙周膜成体干细胞增殖和分化。很多学者将富血小板血浆(platelet rich plasma,PRP)应用于牙周组织再生,有研究显示PRP能有效促进牙周组织再生,也有报道无明显作用。     

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富血小板纤维蛋白（PRF）是自体全血离心的产物,含有大量的生长因子,同时为组织细胞提供迁移、增殖和分化的场所,利于组织的再生和重建。近年来有学者将PRF用于牙周植骨术,获得良好的效果。本文就PRF及其在牙周植骨术中应用进展做一综述。     

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??Abstract: Platelet-rich ?brin (PRF) is regarded as a new type of platelet concentrate??which can be isolated from autologous venous blood. After blood sample centrifugation?? PRF is in the state of gel?? located in the middle part between the red corpuscles at the bottom and acellular plasma at the top. The PRF??which contains high concentration of platelets?? a variety of growth factors?? fibrinogen and leukocytes??could promote the restoration and regeneration of bone and soft tissue. And it also has the ability of resisting infection. The aim of this article is to review the research progress of the mechanism of PRF and the application of PRF to oral and maxillofacial tissue regeneration.     

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??Platelet-rich plasma has ??PRP?? been widely used in sports medicine and oral and maxillofacial surgery for the past few decades owing to its potential ability in regenerative medicine.In recent years??more and more studies have focused on the cartilage repair of PRP in osteoarthritis??such as knee joint and temporomandibular joint. However??temporomandibular joint and knee joint are not the same??so the purpose of this paper is to summarize some of the controversies in PRP and the mechanism and application of PRP in temporomandibular joint osteoarthritis.     

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??Platelet-rich fibrin??PRF????the second generation of platelet concentrate??is defined as an autologous leukocyte- and platelet-rich fibrin biomaterial. High quantities of growth factors in PRF provide biological environment for mesenchymal stem cells to participate in tissue regeneration??and the fibrin in PRF is used as a biological scaffold. This article summaries the research progress on platelet-rich fibrin in oral tissue regeneration.     

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??Objective??An animal model of condylar cartilage and subchondral bone injury during growing period is established??and three-dimensional measurement of mandibular was performed with Materialise Proplan CMF 3.0 software to investigate the effect of PRP on repairing condylar cartilage and maintaining mandibular growth in growing period. Methods??Thirty growing New Zealand white rabbits were randomly divided into three groups. The PRP group animals ??10?? were implanted in activated PRP after the establishment of the animal model of condylar cartilage and subchondral bone injury.The condylar cartilage and subchondral bone injury models were established in the operation group ??10??. The sham operation group ??10?? was similar to the operation group except for the condylar cartilage and subchondral bone injury. At 6 and 12 weeks after surgery the animals received spiral computed tomography??and SPCC data were collected.Maxillary and mandibular three-dimensional reconstruction was performed using Materialise Proplan CMF 3.0. The upper and lower jaws were separated and the morphology of condylar was completely revealed. The result of measurement are analysed with statistical method after the determining the marking points??reference planes and corresponding measurement indexes. Results??The indexes of the operation group were all smaller than those of the sham operation group and the PRP group at each time point??P < 0.05????6 weeks after surgery??the height of mandibular ramus??the length of condyle and the width of condyle in PRP group were less than those in sham operation group??P < 0.05??. There was no significant difference in mandibular length or condylar height between PRP group and sham operation group ??P > 0.05??. The mandibular ramus height and mandibular body length in PRP group were less than those in sham operation group at 12 weeks after operation??P < 0.05??. There was no significant difference in condylar height??length or width between PRP group and sham operation group ??P > 0.05??. Conclusion??After the injury of mandibular condylar cartilage??the growth and development of mandibular are relatively stagnant??and the mandibular condyle is absorbed. Activated PRP can effectively repair the injury of condylar cartilage during growing period??promote the normal growth and development of mandible and condyle??and maintain the normal shape of mandible.     

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??Platelet-rich fibrinogen??PRF??is considered to be a safe??simple??efficient and predictable graft biomaterial with multiple functions. In recent years??studies concerning the application of PRF in maxillary sinus augmentation have been conducted. However??there is still no consensus on the effect of platelet-derived growth factor on maxillary sinus elevation. Our article is a review regarding the clinical application and research advancement of maxillary sinus lift with PRF.     

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富血小板纤维蛋白(platelet-rich fibrin,PRF)被誉为新一代血小板浓缩制品,最早由法国科学家Choukroun等[1]于2001年报道。PRF制备简单,不需添加任何人工制剂,避免了交叉感染的风险及伦理道德的争议。此外,其具有良     

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目的评价自体富血小板血浆应用于颌骨囊肿手术的临床疗效。方法将2007年8月至2008年8月浙江嘉兴医学院附属第二医院口腔科收治的颌骨囊肿患者30例随机分成试验组和对照组各15例。颌骨囊肿摘除后骨腔用含自体富血小板血浆的数字纱布充填为试验组,术后骨腔只用数字纱布充填为对照组。比较两组术后10d创口愈合情况和术后6个月骨缺损区骨密度的变化。结果术后10d创口软组织愈合和术后6个月骨缺损区骨密度的变化,试验组优于对照组。结论富血小板血浆局部应用能促进软硬组织的生长。     

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血小板浓缩制品富含多种生长因子,是自身生长因子的主要来源之一,在牙周组织缺损修复的临床治疗和实验研究中被广泛应用,其中富血小板血浆、富血小板纤维蛋白和浓缩生长因子较为常见。文章对自身生长因子在重度牙周炎中的应用做一简要介绍。     

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.     

富血小板纤维蛋白的研究及在组织修复中的应用

富血小板纤维蛋白(PRF)是含有丰富的细胞因子和生长因子等类似天然血凝块的浓缩体。因有助于修复组织缺损,在实验和临床应用研究中得到了广泛的认可。该文就PRF的制备、生理特性、组织修复的应用等研究进展作一综述。     

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.     

富血小板血浆在颌骨再生方面的应用

富血小板血浆(platelet-rich plasma,PRP)是全血经过密度梯度离心分离产生的血小板浓缩物,富含多种自源性生长因子,不仅具有促进组织愈合和骨再生的作用,而且还避免了免疫原性和疾病传播等缺点。迄今为止,国内外学者对PRP已进行了大量的基础和临床研究,该文就其生物学特性、在颌骨再生和其他方面的应用研究作一综述。     

光遗传学技术在口腔医学中的应用进展

光遗传学技术是指利用光控蛋白对特定基因进行光学控制的一种技术,具有高度的时间和空间特异性。光遗传学技术在心血管疾病、视听障碍、代谢性疾病和神经系统疾病等临床治疗研究中均有广泛的应用,在基础医学的研究中也逐渐成为热点技术。近年来,光遗传学技术在口腔医学领域中的应用也逐渐增多,如味觉系统的研究、三叉神经痛的治疗、颌面部肌肉神经支配的研究等。本文就光遗传学技术在口腔医学中的应用作一综述。     

Analysis of rat calvaria defects implanted with a platelet-rich plasma preparation: histologic and histometric observations

OBJECTIVES: It has been suggested that degranulating platelet alpha-granules release growth factors having a potential to modulate bone formation. The objective of this study was to evaluate the osteoconductive potential of a platelet-rich plasma (PRP) preparation. METHODS: Thirty adult male Sprague-Dawley rats were used. The PRP preparation was obtained from 10 ml of whole blood drawn from one age-matched donor rat. The preparation was processed by gradient density centrifugation and stored at -80 degrees C until use. Using aseptic techniques, the PRP preparation soak loaded onto an absorbable collagen sponge (ACS) or ACS alone was surgically implanted into contralateral critical size 6-mm calvaria osteotomies in 18 animals. Twelve animals received ACS versus sham surgery in contralateral defects. Animals were sacrificed at 4 and 8 weeks when biopsies were collected for histologic and histometric analysis. RESULTS: The animals were maintained without adverse events. Bone formation was highly variable in sites receiving PRP and control treatments. Defect bone fill at 4 weeks averaged (+/-SD) 28.8+/-27.4% (PRP/ACS) versus 39.1+/-24.4% (ACS; p=0.2626) and 62.0+/-20.0% (ACS) versus 71.6+/-32.2% (sham surgery; p=0.1088), and at 8 weeks 81.0+/-12.9% (PRP/ACS) versus 64.5+/-28.1% (ACS; p=0.2626) and 75.6+/-34.1% (ACS) versus 74.1+/-24.2% (sham surgery; p=0.7353). Remnants of the ACS biomaterial were observed at both 4 and 8 weeks in sites implanted with PRP/ACS or ACS. CONCLUSIONS: The results suggest that the PRP preparation has a limited potential to promote local bone formation.     

富血小板血浆影响正畸牙齿移动效率的研究进展

富血小板血浆(PRP)是一种从自体血液中提取的血小板浓缩物,含有丰富的细胞因子和生长因子,其中血小板衍生生长因子、转化生长因子β、血管内皮生长因子主要对成骨细胞和破骨细胞的活性产生影响,促进骨重建过程。正畸牙的移动效率受到骨重建的影响,故局部注射PRP将是加速正畸牙齿移动效率的新方向。该文主要对PRP在正畸治疗中加速正畸牙移动效率的相关实验及其基础研究进行了综述,有助于进一步探讨PRP应用于临床治疗中加速正畸牙移动效率的可行性。     

Use of platelet-rich plasma under autogenous onlay bone grafts

OBJECTIVES: To analyze the healing of autogenous onlay bone grafts in three different situations, focusing on the interface area. MATERIAL AND METHODS: Sixteen rabbits underwent autogenous bone graft surgeries in the calvaria. The block bone grafts were positioned in three different situations: direct contact between bone graft and receptor bed, graft interposed by particulate bone, and graft interposed by platelet-rich plasma (PRP). After 7, 15, 30, and 60 days, the specimens were retrieved for histological and morphometric evaluation. RESULTS: All groups healed uneventfully and presented incorporation of the grafts after 30 days. A slightly more evident new bone formation could be observed in the PRP group in the first analyzed period, and an earlier maturation of bone in the last period, although no statistically significant differences were achieved. CONCLUSION: The use of additional material between the bone graft and the receptor bed when using the onlay technique must be carefully considered, taking into account the size of the reconstruction and the cost/benefit relation. The addition of PRP in between autogenous bone blocks and the receptor bed did not confer significant benefit for the new bone formation and healing on the calvaria of bone of rabbits.