上颌外侧窦底抬高,或者外鼻窦抬高,是牙科领域广泛的外科手术。在上颌骨的后部区域中插入植入物通常需要重建具有不足体积的剩余天然骨。
■发表的大部分研究涉及使用人造产品,比如异种移植和可吸收的胶原膜,在先前的锥形束计算机断层摄影(CBCT)调查之后。如今,更多的访问,更少的财务成本,生物学方法,和更快的愈合是围绕这个过程的目标。富含纤维蛋白的白细胞和血小板(L-PRF)是具有高浓度生长因子的天然组分。由于其再生特性和缺乏并发症,它被用于多个医疗领域,比如骨科,皮肤病学,口腔手术。这项回顾性研究旨在比较通过外鼻窦提升获得的骨高度和体积的结果。通过使用异种移植物或富含纤维蛋白的自体血浆,通过从放射学角度评估新骨形成的数量。
■58名白种人患者被纳入这项回顾性研究;48名患者接受了异种移植手术,选择10个用于同时植入的L-PRF移植材料。缺乏对L-PRF手术患者进行的临床和组织学研究限制了我们选择更大的组进行放射学分析。术前和术后6个月进行CBCT评估。所有入选本研究的患者均表现出良好的总体和口腔健康。急性口腔和鼻窦感染除外;吸烟和牙周病也是排除标准。两个操作员在不同的时间范围内在预先建立的地标中执行测量。采用Wilcoxon秩和检验比较两组的定量数据。定性特征被描述为计数和百分比。所有分析均在R环境中进行,用于统计计算和图形。
■异种移植组的平均骨高度增加如下:前标志为7.44,中位数为12.14,远端为8.28。L-PRF组增加的平均组高是向前0.1,-0.18用于中位数测量,远端0.23.对于两个操作员之间的所有高度测量,我们获得了出色的整体可靠性。
■必须进行进一步的研究,以建立新的手术方案,以防发现仅L-PRF是可靠的,稳定,在外部鼻窦提升中,有文献记载的异种移植物的生物学替代品。放射学结果,虽然很有希望,必须进一步应用于移植部位植入物的长期临床存活。此外,L-PRF联合异种移植的研究可能在减少术后并发症和加速愈合方面带来改善的临床结果.
Maxillary lateral sinus floor elevation, or external sinus lift, is a widespread surgical intervention in the dental field. Insertion of implants in the posterior region of the maxilla often requires reconstruction of the remaining native bone that has insufficient volume.
UNASSIGNED: Much of the research published involves using artificial products, like xenografts and resorbable collagen membranes, after a prior Cone Beam Computer Tomography (CBCT) investigation. Nowadays, more accessible access, less financial costs, a biological approach, and faster healing are objectives that surround this procedure. Leucocytes and platelets rich in Fibrin (L-PRF) are a natural component with a high concentration of growth factors. Due to its regenerative properties and lack of complications, it is used in several medical fields, like orthopedics, dermatology, and oral surgery. This retrospective study aims to compare results in bone height and volume obtained through external sinus lift, either by using xenografts or autologous plasma rich in fibrin, by evaluating the quantity of new bone formation from a radiological point of view.
UNASSIGNED: Fifty-eight Caucasian patients were included in this retrospective study; 48 were submitted to xenograft procedure, and 10 were selected for L-PRF grafting material with simultaneous implant placement. Lack of clinical and histological studies performed on patients with L-PRF surgeries limited us in choosing a larger group for the radiological analysis. CBCT evaluation was performed before surgery and 6 months after. All patients selected for the study presented good general and oral health, acute oral and sinus infections excluded; smoking and periodontal disease were also criteria of exclusion. Two operators performed the measurements in pre-established landmarks in different time frames. The two independent groups were compared with the Wilcoxon rank-sum test for quantitative data. Qualitative characteristics were described as counts and percentages. All analyses were performed in an R environment for statistical computing and graphics.
UNASSIGNED: Mean bone height gain in the xenograft group in the regions was as follows: 7.44 for the anterior landmark, 12.14 for the median and 8.28 for the distal. The mean group height gained for the L-PRF group was 0.1 anteriorly, -0.18 for the median measurement, and 0.23 distally. We obtained excellent overall reliability for all the height measurements between the two operators.
UNASSIGNED: Further studies must be conducted to establish new sets of surgical protocols in case L-PRF alone is found to be a reliable, stable, biological alternative to the well-documented xenografts in external sinus lifts. Radiological results, although promising, must be further applied in long term clinical survival of the implants in the grafted sites. Also, studies combining L-PRF in conjunction with xenograft might bring improved clinical results in terms of reduced postoperative complications and accelerated healing.