富血小板纤维蛋白在GTR联合植骨术中促进牙周组织再生作用的临床研究

目的：牙周引导组织再生术（guided tissue regeneration，GTR）联合植骨材料治疗骨内缺损是目前l临床上能获满意效果的一种常用治疗手段。本研究目的在于评价富血小板纤维蛋白对GTR联合植骨术的治疗效果的影响。同时通过术后6个月的观察评估此项手术技术应用于临床是否具有稳定的优越性。方法：选取20例慢性牙周炎牙槽骨垂直吸收的患牙，共计60个位点，随机分为实验组（PRF＋GTR联合植骨术组）和对照组（单纯GTR联合植骨术组）各30个位点。分别在术前和术后6个月拍摄CBCT确定术区骨密度，同时记录探诊深度（PD）、附着丧失（CAL）、出血指数（BI）并进行比较。在此期间，测量术前、术后1、2周、1、3、6个月时的角化龈宽度（Keratinizedgingival width，KTW），观察其变化。结果：实验组与对照组的PD、CAL、BI的均值在术前与术后6个月时的差别具有统计学意义（P〈o．05），其中实验组CAL的改善方面要优于对照组（P〈o．05）。术后1个月时，实验组与对照组在角化龈宽度变化程度的差异有统计学意义（P〈O．05）。而对于骨密度值的变化，两组差别则没有显著性差异。结论：PRF的应用有利于提高GTR联合植骨术的临床疗效，在恢复牙周附着丧失方面具有更明显的效果。

Effects of PRF on GTR and Bone Graft in the Treatment of Intrabony Defects.

Objective： To evaluate the effect of PRF on GTR＋ bone graft in the treatment of intrabony defects. Meanwhile, we also evaluate whether this technique has stable superiority. Methods： 20 intrabony defects of chronic periodontitis were selected. A total of 60 sites were divided randomly into the test group （PRF＋GTR） and the con trol group with （GTR） 30 sites each. CBCT was used to determine bone mineral density preoperatively and 6 months postoperatively. At the same time, probing depth （PD）, clinical attachment loss （CAL） and bleeding index （BI） were recorded and compared. During this period, keratinized gingival width （KTW） were recorded and corn pared on baseline and 1 week, 2 weeks, 1 month, 3 months, 6 months postoperatively. Results： A statistically sig nificant difference was found between two groups in the mean changes for PD, CAL and BI at baseline and 6 months. CAL gain was greater in the test group compared to control sides, and a statistically significant difference was found between two groups. Compared with that on baseline, the reduction of KTW of the control group and test group after 1 month was statistically significant. However, there＇s no statistically significant difference be tween two groups in the changes of bone density. Conclusion： Treatment of intrabony defects with PRF results in clinical improvement of curative effect, significantly greater mean CAL gain was found in experimental group.