インプラント周囲の骨欠損の再建における血小板リッチフィブリンとガイド付き骨再生の効果

Effects of platelet-rich fibrin combined with guided bone regeneration in the reconstruction of peri-implantitis bone defect.

抄録

目的:

インプラント周囲の骨欠損の再建において、多血小板リッチフィブリン（PRF）とガイド付き骨再生（GBR）の併用による臨床効果を検討すること。

OBJECTIVE: To investigate the clinical effect of platelet-rich fibrin (PRF) combined with guided bone regeneration (GBR) in the reconstruction of peri-implantitis bone defect.

研究方法:

本研究は、当院口腔外科でインプラント修復を行った80名のインプラント周囲炎患者を対象とした前向き研究である。対象となった患者は無作為に対照群と観察群に分けられ，各群に40例ずつが配置された．対照群の患者にはフラップ掻爬とGBRを併用した治療を行い、観察群の患者にはPRFと骨粉の混合物をGBRで埋入し、PRFバイオフィルムで覆った治療を行いました。術後24時間後の痛み、術後7日目の出血、術後60日目の骨欠損の程度の差を両群間で比較した。術後60日目と120日目に、両群の患者の再生骨密度を別々に測定し、分析して比較した。60日後の横方向と縦方向の再生骨欠損の程度を2つの再建方法で比較した。

METHODS: This prospective study included 80 patients with peri-implantitis who underwent implant restoration in the Department of Stomatology in our hospital. The eligible patients were randomly divided into control group and observation group, with 40 cases in each group. Patients in the control group were treated with flap curettage combined with GBR, while those in the observation group received a mixture of PRF and bone powder implanted with GBR and covered with PRF biofilm. The differences of pain 24 hours after surgery, bleeding at 7 days after surgery, and the degree of bone defect between the two groups at 60 days after surgery were compared. At 60 days and 120 days after surgery, separately, the regenerated bone density of patients in the two groups was measured, analyzed and compared. The degree of regenerated bone defect in transverse and longitudinal directions after 60 days was compared between the two reconstruction procedures.

結果:

観察群の術後24時間の痛みと術後7日の出血は、対照群よりも軽度であった（P<0.001）。術後60日目の骨欠損の程度には有意な差があった（P<0.05）。対照群と比較して、観察群の再生骨密度は術後60日目と120日目の両方で有意に高かった（P<0.001）。

RESULTS: The pain at 24 hours after surgery and the bleeding at 7 days after surgery in the observation group were milder than those in the control group (P<0.001). There was significant difference in the degrees of bone defect at 60 days after surgery (P<0.05). Compared with the control group, the regenerated bone density of the observation group was significantly higher both at 60 days and 120 days after surgery (P<0.001).

おわりに:

PRF法とGBR法の併用は，インプラント周囲炎患者の骨欠損の修復に明らかな効果があり，修復過程における患者の痛みを軽減することができる．

CONCLUSION: The combination of PRF and GBR technology has an obvious effect in repairing bone defects in patients with peri-implantitis, and can reduce the pain of patients during the repair process.