背景:富含白细胞血小板的纤维蛋白(L-PRF)的创新对伤口愈合动力学,尤其是牙周再生领域增加了巨大的影响。生长因子(GF)的释放被认为可以改善先天性缺陷的临床结果。这项研究的目的是评估用胶原膜(CM)覆盖含L-PRF的次生缺损的临床效果,并将其GF释放曲线与未发现的L-PRF缺损和开放皮瓣清创(OFD)进行比较。
方法:将30名非吸烟患者的无缺陷口袋随机分配到OFD组(n=10),L-PRF组(n=10),或L-PRF保护的CM基团(n=10)。斑块指数(PI),牙龈指数(GI),探测深度(PD),在基线和手术干预后6个月测量临床附着水平(CAL)和影像学缺损基底填充(DBF).在手术后第1、3、5、7、14、21和30天获得龈沟液样品,用于血小板衍生生长因子-BB(PDGF-BB)和血管内皮生长因子(VEGF)释放曲线评估。
结果:对于所有患者,PI有统计学意义(P≤0.05)的降低,GI,在整个研究期间报告PD和CAL。三种治疗方式之间的差异无统计学意义。在随访时,与OFD和L-PRF组相比,PRF+CM显示统计学上显著的DBF。PDGF-BB和VEGF水平的定量分析显示所有组的测量间隔之间的统计学显著(P<0.001)下降,三组之间没有统计学显著差异。
结论:在本研究的局限性内,用CM覆盖L-PRF可通过其机械保护作用增加缺损基底填充,而不增强VEGF和PDGF的释放曲线。非显著的组间差异质疑由L-PRF收获物提供的声称的GF的额外生理浓度的有效性。
背景:本研究已在ClinicalTrials.gov(NCT05496608)注册,(2022年8月11日)。
The innovation of leukocyte platelet-rich fibrin (L-PRF) has added enormous impact on wound healing dynamics especially the field of periodontal regeneration. The release of growth factors (GF) is thought to improve the clinical outcomes in infrabony defects. The aim of this
study was to evaluate the clinical effect of covering L-PRF contained infrabony defects with collagen membranes (CM), and to compare their GF release profile to uncovered L-PRF defects and open flap debridement (OFD).
Thirty non- smoking patients with infrabony pockets participated to be randomly assigned to OFD group (n = 10), L-PRF group (n = 10), or L-PRF protected CM group (n = 10). Plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL) and the radiographic defect base fill (DBF) were measured at baseline and at 6 month following surgical intervention. Gingival crevicular fluid samples were obtained on days 1, 3, 5, 7, 14, 21 and 30 days following surgery for the Platelet Derived Growth Factor-BB (PDGF-BB) and Vascular Endothelial Growth Factors (VEGF) release profile evaluation.
For all patients, a statistically significant (P ≤ 0.05) reduction in PI, GI, PD and CAL were reported throughout the
study period. Differences between the three treatment modalities were not statistically significant. PRF + CM showed a statistically significant DBF compared to OFD and L-PRF groups at follow up. Quantitative analysis of PDGF-BB and VEGF levels demonstrated a statistically significant (P < 0.001) decline between measurement intervals for all groups with no statistically significant differences between the three groups.
Within the limitations of this
study, L-PRF coverage with CM may augment defect base fill through its mechanical protective effect without enhancement in the release profile of VEGF and PDGF. The non-significant intergroup differences question the validity of the claimed extra physiologic concentration of GF offered by L-PRF harvests.
The present
study was registered at ClinicalTrials.gov (NCT05496608), (11/08/2022).