Abstract:

Objective　To investigate the effect of platelet-rich fibrin (PRF) in promoting bone tissue regeneration in patients undergoing external maxillary sinus lifting without bone graft concurrent implantation. Methods　A prospective study method was adopted in this study, and 40 patients(40 teeth) who underwent external maxillary sinus lifting without bone graft concurrent implantation in Fujian Provincial Hospital from November 2020 to November 2021 were selected as the study objects, including 22 males and 18 females, aged (29.28±2.63) years. According to the patients' outpatient number after admission, under the guidance of random numbers, the above patients were randomly divided into a study group and a control group, with 20 cases in each group. The control group was filled with Bio-oss bone meal, and the study group was filled with Bio-oss bone meal mixed with PRF. Independent sample t test was used to compare the alveolar bone height, implant stability, and gingival crevicular fluid inflammatory factors between the study group and the control group, and χ² test was used to compare the difference of adverse reactions. Results　There were no statistically significant differences in the alveolar bone height between the two groups before and immediately after surgery (both P>0.05); the alveolar bone height of the study group was higher than that of the control group 6 and 12 months after surgery [(8.70±0.54) mm vs. (6.63±0.84) mm, (7.96±0.97) mm vs. (6.32±1.15) mm] (both P<0.05). The implant stability of the study group was higher than that of the control group 6 and 12 months after surgery [(55.55±5.37) vs. (50.52±5.75), (73.56±2.65) vs. (71.66±2.99)] (both P<0.05). Six months and 12 months after surgery, the levels of tumor necrosis factor (TNF-α) and nuclear factor κB (NF-κB) of the study group were (30.42±3.21) ng/L, (25.03±3.18) ng/L, (29.09±2.80) ng/L, and (28.79±2.67) ng/L, those of the control group were (35.70±3.07) ng/L, (28.34±3.73) ng/L, (46.01±2.50) ng/L, and (30.72±2.61) ng/L, with statistically significant differences between the two groups (all P<0.05). There were no statistically significant differences in the risk of local swelling and bleeding between the two groups (both P>0.05). Conclusion　In patients undergoing external maxillary sinus lifting without bone graft concurrent implantation, PRF treatment shows significant bone tissue regeneration in bone defects around the implant, and the implant shows high height of new bone and stability, suggesting clinical promotion.

Key words:

Maxillary sinus, Implant, Bone defect, Bone tissue regeneration

摘要：

目的　研究富血小板纤维蛋白（PRF）促进行上颌窦外提升不植骨同期种植术患者种植体周围骨缺损中骨组织再生的作用。方法　本研究采用前瞻性研究方法，以福建省立医院2020年11月至2021年11月行上颌窦外提升不植骨同期种植术患者40例（40颗）作为研究对象，其中男性22例，女性18例，年龄（29.28±2.63）岁，按照患者入院后的门诊编号，在随机数字的引导作用下，将以上患者随机分为对照组及研究组，各20例。对照组患者采取Bio-oss骨粉进行填充，研究组患者采取Bio-oss骨粉混合PRF进行填充。采用独立样本t检验比较两组患者的牙槽骨高度、种植体稳定性、龈沟液炎性因子之间的差异，采用χ²检验比较两组不良反应之间的差异。结果　两组患者术前和术后即刻的牙槽骨高度比较差异均无统计学意义（均P>0.05）；研究组术后6个月、12个月的牙槽骨高度均高于对照组［（8.70±0.54）mm比（6.63±0.84）mm、（7.96±0.97）mm比（6.32±1.15）mm］（均P<0.05）。研究组患者术后6个月、12个月的种植体稳定性均高于对照组［（55.55±5.37）比（50.52±5.75）、（73.56±2.65）比（71.66±2.99）］（均P<0.05）。术后6个月、12个月，研究组患者的龈沟液肿瘤坏死因子（TNF-α）分别为（30.42±3.21）ng/L、（25.03±3.18）ng/L，核因子κB（NF-κB）分别为（29.09±2.80）ng/L、（28.79±2.67）ng/L，对照组分别为（35.70±3.07）ng/L、（28.34±3.73）ng/L、（46.01±2.50）ng/L、（30.72±2.61）ng/L，两组比较差异均有统计学意义（均P<0.05）。两组患者发生局部肿胀以及渗血的风险比较差异均无统计学意义（均P>0.05）。结论　行上颌窦外提升不植骨同期种植术患者中采取PRF进行治疗，种植体周围骨缺损中骨组织再生作用显著，种植体的新生骨高度以及稳定性较高，建议临床推广。

关键词:

上颌窦, 种植体, 骨缺损, 骨组织再生