在牙科种植学中,牙槽嵴保留(ARP)已成为解决牙齿脱落后影响牙槽嵴形态的尺寸变化的标准技术。各种替代移植材料,包括异种移植物,异形体,和同种异体移植,已有效地用于ARP的新鲜提取场所。目前的证据表明,这些材料主要用作生物支架,慢慢合并,因此,在植入前需要至少4-6个月的等待期。因此,ARP技术将植入治疗的总持续时间延长了几个月.最近,掺入一种形式的自体血小板浓缩物,称为富血小板纤维蛋白(PRF),已被提倡与ARP结合作为软硬组织愈合和再生的生物增强方法。PRF含有血小板源性生长因子,荷尔蒙,和生物活性成分,如细胞因子,已经证明了在伤口愈合的所有阶段刺激血管生成和组织再生的能力。此外,作为骨免疫应答的一部分,PRF基质中存在的白细胞的浓度在组织愈合和再生中起着至关重要的作用。据报道,在ARP期间掺入自体PRF血小板浓缩物的优势包括缩短愈合时间,改善血管生成和骨再生,通过纤维蛋白基质的插座密封,抗菌性能,并降低拔牙后疼痛和感染风险。因此,本文的目的是回顾有关PRF在拔牙后牙槽脊保存(ARP)中应用的现有证据。提出了两个临床案例研究,其中ARP用PRF增强,然后在相对较短的8周内植入。这些病例作为支持辅助使用PRF以增强愈合并加速ARP后植入物放置的概念的进一步证明。
In dental implantology, alveolar ridge preservation (ARP) has emerged as a standard technique to address dimensional changes that affect alveolar ridge morphology following tooth loss. Various alternative graft materials, including xenografts, alloplasts, and allografts, have been effectively employed in fresh extraction sites for ARP. Current evidence suggests that these materials primarily serve as bio-scaffolds, which are slowly incorporated, thus necessitating a waiting period of at least 4-6 months before implant placement. Consequently, the ARP technique extends the overall duration of implant treatment by several months. Recently, the incorporation of a form of autologous platelet concentrate, known as platelet-rich fibrin (PRF), has been advocated in conjunction with ARP as a method of bioenhancement of soft- and hard-tissue healing and regeneration. PRF contains platelet-derived growth factors, hormones, and bioactive components like cytokines that have demonstrated the ability to stimulate angiogenesis and tissue regeneration throughout all phases of wound healing. Additionally, the concentration of leukocytes present in the PRF matrix plays a vital role in tissue healing and regeneration as part of the osteoimmune response. The reported advantages of incorporating autogenous PRF platelet concentrates during ARP encompass reduced healing time, improved angiogenesis and bone regeneration, socket sealing through the fibrin matrix, antibacterial properties, and decreased post-extraction pain and infection risk. Therefore, the objective of this paper is to review the existing evidence regarding the application of PRF in alveolar ridge preservation (ARP) following tooth extraction. Two clinical
case studies are presented, wherein ARP was enhanced with PRF, followed by implant placement within a relatively short period of 8 weeks. These cases serve as further proof of concept for supporting the adjuvant use of PRF to enhance healing and accelerate implant placement after ARP.