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目的探讨骨诱导活性材料(osteoinduction active material,OAM)复合富血小板纤维蛋白(platelet-rich fibrin,PRF)进行拔牙位点保存的修复效果。方法 12个月龄雄性beagle犬6只,微创拔除其上、下颌双侧第二侧切牙,将4个位点分为4组,分别为PRF+OAM组、PRF组、OAM组和对照组,分别填入PRF+OAM、PRF、OAM和不做处理。6只犬随机分别于术后4、12周各处死3只,取牙槽骨标本行形态学测量和组织学观察,采用锥形束CT(cone beam CT,CBCT)测量骨密度评价拔牙窝的愈合情况。结果4、12周时PRF+OAM组唇舌侧牙槽嵴宽度((-0.08±0.02)、(-0.09±0.02)mm)和高度((-0.53±0.07)、(-1.15±0.07)mm)均明显低于PRF组(牙槽嵴宽度(-0.15±0.03)、(-0.63±0.04)mm)和高度((-0.74±0.06)、(-1.51±0.05)mm)、OAM组(牙槽嵴宽度(-0.22±0.03)、(-0.08±0.05)mm和高度((-0.95±0.07)、(-1.51±0.06)mm)及对照组(牙槽嵴宽度(-0.35±0.08)、(-1.17±0.21)mm和高度((-1.27±0.12)、(-1.70±0.05)mm)(P均<0.05);析因分析结果显示,PRF组、OAM组存在交互作用,OAM与PRF混合使用效果优于分别单独使用;愈合期PRF+OAM组拔牙创CT差值(35.33±2.08)均高于PRF组(33.33±3.51)、OAM组(-80.67±2.08)和对照组(-153.33±2.88)(P<0.05);术后4、12周PRF+OAM组拔牙窝新生骨排列规则度及成骨情况明显优于PRF组、OAM组和对照组(P<0.05)。结论 PRF+OAM应用于拔牙位点保存中可减缓牙槽嵴吸收,促进组织修复,其效果明显优于单独使用PRF和OAM。
Objective To investigate the effect of osteoinduction active material (OAM) combined with platelet-rich fibrin (PRF) on the preservation of tooth extraction site. Methods Six male 12-month-old beagle dogs were randomly divided into four groups: PRF + OAM group, PRF group, OAM group and control group , Respectively, fill PRF + OAM, PRF, OAM and not dealt with. Six dogs were sacrificed at 4 and 12 weeks postoperatively, respectively. Three alveolar bone specimens were obtained for histomorphometry and histological observation. Bone mineral density (BMD) was measured by cone beam CT (CBCT) Healing situation. Results The width of the lingual alveolar crest of the PRF + OAM group (-0.08 ± 0.02, -0.09 ± 0.02) mm and the height (-0.53 ± 0.07) and (-1.15 ± 0.07) mm at 4 and 12 weeks Were significantly lower than those in PRF group (alveolar ridge width (-0.15 ± 0.03), (-0.63 ± 0.04) mm) and height (-0.74 ± 0.06), (-1.51 ± 0.05) mm, Crest width (-0.22 ± 0.03), (- 0.08 ± 0.05) mm and height (-0.95 ± 0.07) and (- 1.51 ± 0.06) mm respectively and control group (width of alveolar ridge -0.35 ± 0.08, -1.17 ± 0.21) mm and height (-1.27 ± 0.12) and (-1.70 ± 0.05) mm respectively (all P <0.05). The results of factorial analysis showed that there was interaction between PRF group and OAM group, OAM and PRF (P> 0.05). The difference between two groups was better than that of the PRF + OAM group (35.33 ± 2.08 vs. 33.33 ± 3.51, P <0.01), OAM group (-80.67 ± 2.08) and control group (-153.33 ± 2.88) (P <0.05). The regularity and osteogenesis of newborn bone in PRF + OAM group were significantly better than those in PRF group, OAM group and control group at 4 and 12 weeks after operation (P <0.05) .Conclusion PRF + OAM Applied to the extraction of tooth sites can reduce the alveolar ridge absorption and promote tissue repair, the effect was significantly better than the PRF and OAM alone.