富血小板纤维蛋白膜对延迟再植牙牙周愈合影响的实验研究

摘要/Abstract

摘要： 目的：探讨局部应用富血小板纤维蛋白（PRF）膜对全脱位延迟再植牙牙周愈合的影响。方法：25只6周龄Wistar雄性大鼠，进行同颌左右对照实验。拔除双侧上颌第一磨牙，体外干燥保存30 min后，将自制的PRF膜置于一侧拔牙窝内，干燥保存的牙齿原位再植，作为PRF膜组，对侧拔牙窝内不添加PRF膜，脱位牙原位再植作为对照组。分别于术后1、3、7、14、28 d处死大鼠，制作石蜡切片，HE染色，对再植牙牙周愈合情况进行组织形态学评价，并对结果进行统计学分析。结果：所有再植牙无脱落。再植术后1 d，牙周炎症细胞浸润，PRF膜组牙周炎性改变发生率显著高于对照组（P<0.01）；术后3 d，PRF膜组牙周炎性改变发生率仍较对照组高（P<0.01）；术后7 d，两组中牙周膜愈合发生率无统计差异（P>0.05），PRF膜组表面吸收发生率显著低于对照组（P<0.05），炎症性吸收发生率与对照组无统计差异（P>0.05）；术后14 d，PRF膜组表面吸收发生率显著高于对照组（P<0.05），炎症性吸收发生率显著低于对照组（P<0.01）；术后28 d，两组中各类牙周愈合表现发生率无统计差异（P＞0.05）。结论：全脱位牙延迟再植术中，应用PRF膜不影响再植牙就位、愈合，早期能够控制再植牙牙根吸收的发生、发展，但远期效果尚不稳定，有待进一步研究。

Abstract: Objectives：To investigate the effect of platelet rich fibrin (PRF) membrane on periodontal healing of delayed replanted avulsed teeth. Methods：Twenty-five six-week-old male Wistar rats were used for split mouth design. After bilateral maxillary first molars extracted, dried for 30 min, self-made PRF membrane was placed in one side of the extraction socket and the avulsed teeth replanted as PRF membrane group, without PRF membrane at contra-lateral, avulsed teeth replanted as control group. On 1, 3, 7, 14 and 28 days after tooth replantation, the rats were sacrificed. Paraffin specimens of maxillary bone were prepared, sliced. HE staining was used to observe the periodontal healing of the replanted teeth and the results were statistically analyzed. Results：All the replanted teeth did not fall off. One d after tooth replantation, inflammatory infiltrate could be found in both groups, the incidence rate of periodontal inflammatory change was significantly higher in PRF membrane group than that of control group (P<0.01); After 3 days, the incidence rate of periodontal inflammatory change was still higher in PRF membrane group (P<0.01); After 7 days, the incidence rate of periodontal membrane healing was consistent in both groups(P>0.05), incidence rate of surface resorption was significantly lower in PRF membrane group than in control group (P<0.05), inflammatory resorption was consistent in both groups(P>0.05),14 days after operation, incidence rate of surface resorption was significantly higher in PRF membrane group than that of control group (P<0.05) while inflammatory resorption was significantly lower in PRF membrane group (P<0.01); 28 days after operation, periodontal healing pattern in the two groups were similar. Conclusions：In delayed avulsion teeth replantation， the application of PRF membrane did not affect the reposition and healing of replanted teeth, and could control the occurrence and development of root resorption at the initial stage. However, the long-term effect is not stable, and needs further study.

汪俊兰刘茜夏烨鹏曹灵杨颜菁梅予锋. 富血小板纤维蛋白膜对延迟再植牙牙周愈合影响的实验研究[J]. , 2017, 8(2): 95-99.

参考文献

[1]Günday M, Sazak H, Türkmen C.A scanning electron microscopic study of external root resorption in replanted dog teeth[J].J Endod, 1995, 21(5):269-271
[2]ANDREASEN J O, ANDREASEN F M, ANDERSSON L, et al.Textbook and color atlas of traumatic injuries to the teeth[M]. 4th. City: Blackwell Munksgaard, 2007.
[3]Dohan DM, Choukroun J, Diss A, et al.Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 101(3):e45-e50
[4]Choukroun J, Diss A, Simonpieri A, et al.Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 101(3):e56-e60
[5]Choukroun J, Diss A, Simonpieri A, et al.Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part V: histologic evaluations of PRF effects on bone allograft maturation in sinus lift[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 101(3):299-303
[6]Agarwal A, Gupta ND, Jain A.Platelet rich fibrin combined with decalcified freeze-dried bone allograft for the treatment of human intrabony periodontal defects: a randomized split mouth clinical trail[J].Acta Odontol Scand, 2016, 74(1):36-43
[7]Borie E, Oliví DG, Orsi IA, et al.Platelet-rich fibrin application in dentistry: a literature review[J].Int J Clin Exp Med, 2015, 8(5):7922-7929
[8]Zhao YH, Zhang M, Liu NX, et al.The combined use of cell sheet fragments of periodontal ligament stem cells and platelet-rich fibrin granules for avulsed tooth reimplantation[J].Biomaterials, 2013, 34(22):5506-5520
[9]Johns DA, Shivashankar VY, Maroli RK, et al.Novel management of avulsed tooth by pulpal and periodontal regeneration[J].J Endod, 2013, 39(12):1658-1662
[10]王伟, 黄超, 刘艳丽, 等.恒牙撕脱性损伤临床特征的回顾性分析[J].牙体牙髓牙周病学杂志, 2016, 26(4):245-249
[11]Andreasen JO, Hjorting-Hansen E.Replantation of teeth. I. Radiographic and clinical study of 110 human teeth replanted after accidental loss[J].Acta Odontol Scand, 1966, 24(3):263-286
[12]Andreasen JO, Hjorting-Hansen E.Replantation of teeth. II. Histological study of 22 replanted anterior teeth in humans[J].Acta Odontol Scand, 1966, 24(3):287-306
[13]钟声, 闫福华, 卢友光, 等.富血小板血浆对脱位再植牙牙周组织愈合影响的研究[J].实用口腔医学杂志, 2008, 24(5):659-664
[14]明盛金, 李俊, 尹雏笳, 等.一种改良大鼠心脏采血方法的探讨[J].吉林医药学院学报, 2012, 33(2):86-87
[15]Hammarstr?m L, Bloml?f L, Lindskog S.Dynamics of dentoalveolar ankylosis and associated root resorption[J].Endod Dent Traumatol, 1989, 5(4):163-175
[16]Maslamani M, Almusawi A, Joseph B, et al.An experimental model for studies on delayed tooth replantation and ankylosis in rabbits[J].Dent Traumatol, 2016, 32(6):443-449
[17]Andreasen JO.Effect of extra-alveolar period and storage media upon periodontal and pulpal healing after replantation of mature permanent incisors in monkeys[J].Int J Oral Surg, 1981, 10(1):43-53
[18]Pettiette M, Hupp J, Mesaros S, et al.Periodontal healing of extracted dogs' teeth air-dried for extended periods and soaked in various media[J].Endod Dent Traumatol, 1997, 13(3):113-118
[19]姜沙沙.实验性大鼠完全脱位牙即刻与延迟再植术的实验研究[D].南京：南京医科大学, 2013.
[20]Andreasen JO.Analysis of topography of surface- and inflammatory root resorption after replantation of mature permanent incisors in monkeys[J].Swed Dent J, 1980, 4(4):135-144
[21]Andreasen JO.Experimental dental traumatology: development of a model for external root resorption[J].Endod Dent Traumatol, 1987, 3(6):269-287
[22]Bastos JV, Ilma de Souza C?rtes M, Andrade Goulart EM, et al.Age and timing of pulp extirpation as major factors associated with inflammatory root resorption in replanted permanent teeth[J].J Endod, 2014, 40(3):366-371
[23]Woo SM, Kim WJ, Lim HS, et al.Combination of Mineral Trioxide Aggregate and Platelet-rich Fibrin Promotes the Odontoblastic Differentiation and Mineralization of Human Dental Pulp Cells via BMP/Smad Signaling Pathway[J].J Endod, 2016, 42(1):82-88
[24]Dohan DM, Choukroun J, Diss A, et al.Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part III: leucocyte activation: a new feature for platelet concentrates?[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 101(3):e51-e55
[25]Andreasen JO, Andreasen FM, Andersson L.Textbook and color atlas of traumatic injuries to the teeth [M]. 4th. Hoboken: Wiley-Blackwell, 2007
[26]Mar?o HF, Mao JJ, Casatti CA, et al.Effects of ovariectomy on periodontal tissues following tooth replantation[J].Arch Oral Biol, 2016, 65:9-16
[27]Ahn HJ, Nam OH, Lee HS, et al.Expression of inflammatory cytokines and MMPs on replanted teeth at different extra-alveolar time: an ex vivo and in vivo study[J].Int J Paediatr Dent, 2015, 26(4):301-309
[28]Saito CT, Gulinelli JL, Panzarini SR, et al.Effect of low-level laser therapy on the healing process after tooth replantation: a histomorphometrical and immunohistochemical analysis[J].Dent Traumatol, 2011, 27(1):30-39
[29]Toffler M.Guided bone regeneration (GBR) using cortical bone pins in combination with leukocyte- and platelet-rich fibrin (L-PRF)[J].Compend Contin Educ Dent, 2014, 35(3):192-198
[30]Bai MY, Wang CW, Wang JY, et al.Three-dimensional structure and cytokine distribution of platelet-rich fibrin[J].Clinics (Sao Paulo), 2017, 72(2):116-124
[31]Pruthi PJ, Yadav N, Nawal RR, et al.Novel Use of PRF and PDT in the Management of Trauma Induced Root Resorption and Infrabony Defect[J].J Clin Diagn Res, 2015, 9(5):ZD26-ZD28
[32]Johns DA, Shivashankar VY, Krishnamma S, et al.Use of photoactivated disinfection and platelet-rich fibrin in regenerative Endodontics[J].J Conserv Dent, 2014, 17(5):487-490
[33]Moraschini V, Barboza Edos S.Use of Platelet-Rich Fibrin Membrane in the Treatment of Gingival Recession: A Systematic Review and Meta-Analysis[J].J Periodontol, 2016, 87(3):281-290
[34]Kumar YR, Mohanty S, Verma M, et al.Platelet-rich fibrin: the benefits[J].Br J Oral Maxillofac Surg, 2016, 54(1):57-61
[35]Zhao YH, Zhang M, Liu NX, et al.The combined use of cell sheet fragments of periodontal ligament stem cells and platelet-rich fibrin granules for avulsed tooth reimplantation[J].Biomaterials, 2013, 34(22):5506-5520
[36]Johns DA, Shivashankar VY, Maroli RK, et al.Novel management of avulsed tooth by pulpal and periodontal regeneration[J].J Endod, 2013, 39(12):1658-1662
[37]王伟, 黄超, 刘艳丽.自体富血小板纤维蛋白用于延迟牙再植例[J].口腔医学, 2016, 36(5):449-452
[38]王伟, 黄超, 刘艳丽, 等.自体富血小板纤维蛋白用于延迟牙再植1例[J].口腔医学, 2016, 36(5):449-452
[39]Schwartz O, Andreasen FM, Andreasen JO.Effects of temperature, storage time and media on periodontal and pulpal healing after replantation of incisors in monkeys[J].Dent Traumatol, 2002, 18(4):190-195
[40]Dohan DM, Choukroun J, Diss A, et al.Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 101(3):e37-e44
[41]DOHAN D M, CHOUKROUN J, DISS A, et al.Platelet-rich fibrin (PRF): a second-generation platelet concentratePart I: technological concepts and evolution[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 101(3):e37-44
[42]明盛金, 李俊, 尹雏笳, 等.一种改良大鼠心脏采血方法的探讨[J].吉林医药学院学报, 2012, 33(2):86-87
[43]Dohan DM, Choukroun J, Diss A, et al.Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 101(3):e45-e50
[44]De Pascale MR, Sommese L, Casamassimi A, et al.Platelet derivatives in regenerative medicine: an update[J].Transfus Med Rev, 2015, 29(1):52-61
[45]Dohan DM, Choukroun J, Diss A, et al.Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part III: leucocyte activation: a new feature for platelet concentrates?[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 101(3):e51-e55
[46]Chignon-Sicard B, Georgiou CA, Fontas E, et al.Efficacy of leukocyte- and platelet-rich fibrin in wound healing: a randomized controlled clinical trial[J].Plast Reconstr Surg, 2012, 130(6):819e-829e
[47]Choukroun J, Diss A, Simonpieri A, et al.Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 101(3):e56-e60
[48]Panda S, Sankari M, Satpathy A, et al.Adjunctive Effect of Autologus Platelet-Rich Fibrin to Barrier Membrane in the Treatment of Periodontal Intrabony Defects[J].J Craniofac Surg, 2016, 27(3):691-696
[49]Andersson L, Bodin I, S?rensen S.Progression of root resorption following replantation of human teeth after extended extraoral storage[J].Endod Dent Traumatol, 1989, 5(1):38-47
[50]Gomes WD, Silva CA, Melo ME, et al.Delayed tooth replantation in rats: effect of systemic antibiotic therapy with amoxicillin and tetracycline[J].Dent Traumatol, 2015, 31(6):448-456
[51]白洁, 秦满, 赵玉鸣.儿童恒牙全脱出牙髓组织预后的回顾性研究[J].北京大学学报（医学版）, 2015, 47(1):140-144
[52]Andreasen JO.Experimental dental traumatology: development of a model for external root resorption[J].Endod Dent Traumatol, 1987, 3(6):269-287
[53]Cunha RS, Abe FC, Araujo RA, et al.Treatment of inflammatory external root resorption resulting from dental avulsion and pulp necrosis: clinical case report[J].Gen Dent, 2011, 59(3):e101-e104
[54]Esteves JC, Mar?o HF, Silva PI, et al.Delayed tooth replantation following root canal filling with calcium hydroxide and MTA: Histomorphometric study in rats[J].Arch Oral Biol, 2015, 60(9):1254-1262
[55]Bastos JV, Ilma de Souza C?rtes M, Andrade Goulart EM, et al.Age and timing of pulp extirpation as major factors associated with inflammatory root resorption in replanted permanent teeth[J].J Endod, 2014, 40(3):366-371