邓丽　张敬雷　苏晓平　张雪容　黄丽云

[摘要]目的：探討富血小板纤维蛋白（Platelet-rich fibrin，PRF）在促进牙周炎患者牙周组织再生和骨缺损修复中的作用。方法：纳入2017年9月-2019年5月笔者科室收治的60例重度牙周炎伴骨缺损患者，按照随机数字表法分为观察组和对照组，每组30例。对照组采用引导骨再生技术（Guided bone regeneration，GBR）+Bio-oss人工骨粉植骨术，观察组采用富血小板纤维蛋白+引导骨再生技术（Guided bone regeneration，GBR）+Bio-oss人工骨粉植骨术;随访6个月，比较两组患者牙槽骨指标[唇侧根尖1/3牙槽骨厚度（AAHBT）、唇侧根中1/3牙槽骨厚度（AMHBT）、唇侧根冠1/3牙槽骨厚度（ACHBT）、牙根长度（RL）、唇侧牙槽嵴顶的垂直向水平（AVBL）]、牙周指标[临床附着丧失（CAL）、牙龈萎缩深度（GRD）、探诊深度（PD）]、牙龈健康指标[牙龈指数（GI）、龈沟出血指数（SBI）]，评估患者咬合度、咀嚼功能、固位能力及整体美观度。结果：在牙槽骨指标方面，观察组AAHBT、AMHBT、ACHBT、RL水平高于对照组，AVBL低于对照组，差异具有统计学意义（P<0.05）;牙周指标方面，观察组PD、CAL、GRD水平低于对照组，差异具有统计学意义（P<0.05）;牙龈健康指标方面，观察组GI、SBI低于对照组，差异具有统计学意义（P<0.05）;观察组牙齿咬合度、咀嚼功能、固位能力及整体美观度评分均高于对照组，差异具有统计学意义（P<0.05）。结论：PRF能够促进牙周炎伴骨缺损患者牙周组织再生，促进骨缺损修复，具有较好的临床应用价值。

[关键词]富血小板纤维蛋白;牙周炎;组织再生;骨缺损;骨再生技术

[中图分类号]R781.4+2    [文献标志码]A    [文章编号]1008-6455（2021）09-0150-04

Study on the Role of PRF in Promoting Periodontal Tissue Regeneration and Bone Defect Repair in Patients with Periodontitis

DENG Li，ZHANG Jing-lei，SU Xiao-ping，ZHANG Xue-rong，HUANG Li-yun

[Department of Stomatology， the 909 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army （Southeast Hospital Affiliated to Xiamen University），Zhangzhou 363000，Fujian，China]

Abstract：Objective  To explore the role of platelet-rich fibrin in promoting periodontal tissue regeneration and bone defect repair in patients with periodontitis. Methods  From September 2017 to May 2019， 60 patients with severe periodontitis and bone defects were admitted to the Department of Stomatology， our Hospital. They were divided into observation group and control group according to random number table method， 30 cases each. The observation group used platelet-rich fibrin + guided bone regeneration （GBR） + Bio-oss artificial bone powder bone grafting， and the control group used guided bone regeneration （GBR） + Bio-oss artificial bone powder grafting Bone surgery.Followed up for 6 months and compared the alveolar bone indexes of the two groups of patients [Lip apical 1/3 alveolar bone thickness （AAHBT）， labial root middle 1/3 alveolar bone thickness （AMHBT）， labial root crown 1/3 alveolar Bone thickness （ACHBT）， root length （RL）， vertical level of labial crest （AVBL）]， periodontal index [clinical attachment loss （CAL）， depth of gingival atrophy （GRD）， depth of exploration （PD）]， Gum health indicators [gingival index （GI）， sulcus bleeding index （SBI）].Evaluate the patient's bite degree， chewing function， retention ability， and overall aesthetics. Results  In terms of alveolar bone indexes， the levels of AAHBT， AMHBT， ACHBT， and RL in the observation group were higher than those in the control group， and AVBL was lower than the control group， the difference was statistically significant （P<0.05）. In terms of periodontal indicators， the levels of PD， CAL and GRD in the observation group were lower than those in the control group， and the difference was statistically significant （P<0.05）.In terms of gum health indicators， the GI and SBI of the observation group were lower than those of the control group， the difference was statistically significant （P<0.05）.The observation group's teeth bite degree， chewing function， retention ability， and overall aesthetic score were higher than the control group， the difference was statistically significant （P<0.05）. Conclusion  PRF can promote periodontal tissue regeneration of patients with periodontitis and bone defects， and promote the repair of bone defects.

Key words： platelet-rich fibrin; periodontitis; tissue regeneration; bone defect;bone regeneration technology

牙周病的治疗及技术正朝着可视化、精细化及微创化的方向发展，再生性修复的研究也在持续推进中[1]。国内外在对缺损组织的修复再生方面，除了目前在临床使用的植骨和屏障膜材料外，生物活性蛋白产物的联合应用也越来越多，目前牙周领域应用最多的是血小板衍生物和釉基质蛋白衍生物[2-3]。传统的植骨术+生物膜屏障对于骨缺损的修复效果尚未达到临床医生满意的程度，部分骨缺损未能完全修复。……