Research And Application Of PRF Combined With GBR Technique In Preservation Of Alveolar Ridge

Objective:After tooth extraction,platelet-rich fibrin(PRF)combined with Guided Bone Regeneration(GBR)technique comparing with the simple GBR technique was used to the preservation of alveolar ridge site,to analyze the effect of PRF on osteogenesis of bone substitute materials and the promotion of tissue regeneration by observing the effect of PRF composite GBR technique in the preservation of alveolar ridge site and bone regeneration.Methods:5 cases(crown,root fold and crown and root combined fold,tooth can not be retained or other forms of repair)were selected from the Oral clinic of the First Hospital of Shanxi Medical University,including 3 males and 2 females,Aged 21-72 years,with an average age of 34.4 years.Control group(Bio-Oss Bone Powder + Heal-All Oral repair membrane)and the experimental group(PRF membrane + Bio-Oss bone substitute + Heal-All Oral repair membrane)was stored.Patients phlebotomized elbow shallow vein blood 15 ml preparation PRF in preoperative 10 min.Minimally invasive removal of bilateral trauma teeth and broken roots.Selected experimental group to implement PRF membrane + Bio-Oss bone substitute+ Heal-All Oral repair membrane to site preservation.The control group implemented Bio-Oss bone substitute+ Heal-All Oral repair membrane to site preservation.The experimental group and the control group's 2 weeks,4 weeks,6 weeks,8 weeks and 12 weeks' X-ray after surgery were used to measure the gray value of the by MATLAB software.The half-hour,6-week and 12-week's CBCT of the control group and experimental group was measured by simplant software to observe width,height and bone density of the alveolar bone at the 2mm,4mm,6mm three points under the alveolar ridge.Results: 1.5 cases of patients during the observation of soft and hard tissue healing is good,no infection and delayed healing phenomenon,patients with good compliance,timely follow-up parallel imaging examination.2.radiology observation(1)the socket X-ray radiographs: 2 weeks postperative the bone substitute material showed high-density granular images,the experimental group of the apical area slightly blurred border,the control group of tooth socket clear boundary;There was no significant change compared with 4 weeks after operation and 2 weeks after operation;6 weeks after surgery,the density of bone meal granules in the control group was significantly higher than experimental group;The density of bone meal granules in the experimental group was significantly lower than that in the control group at 2 weeks after operation and the control group had no significant change in the control group;At the 12 th week after operation,the 2/3 border blossom of the extraction group was blurred,the area of high density of bone meal particles decreased,the root tip 1/2 of the control group was unclear,the density of bone meal particles was more decreased than the 2ed week after operation,and the high density area of bone meal particles did not decrease.(2)CBCT images: CBCT images showed that the density of the experimental group and the control group were both not lower than that of immediately after surgery,but the density of the experimental group was lower than that of the control group.3.the statistical analysis of measurement data.(1)The value of gray value of apical X-ray was measured by SPSS 21.0 software at 2 weeks,4 weeks,6 weeks,8 weeks and 12 weeks by paired t test(P < 0.05),the difference was statistically significant.(2)The difference of the gray value of the apical X-ray was analyzed by LSD-t(P <0.01),and the difference was significant(P <0.01).The difference was correlated with the rank correlation test(Spearman correlation test)between the gray value difference and the postoperative two factors(P <0.01),which was statistically significant.(3)Simplant software was used to measure the CBCT image of the effect of alveolar ridge site preservation: Simplant software was used to measure the CBCT images of patients at different stages.Compare with the width of 2mm,4mm,6mm under the alveolar ridge,the difference was no significant by paired t test(P> 0.05),width and height changes were significantly less than the absorption of alveolar ridge by simple tooth extraction.(4)Analysis of bone mineral density in CBCT imaging by simplant software:5 cases' bone mineral density in CBCT during different postoperative was analyzed by paired t test(P <0.05),and the difference was statistically significant.LSD-t test was performed between the control group and the experimental group,compare with the immediately and the 12 th week after surgery(P>0.01),and compare with the immediately and the 6th week,the 6th week and the 12 th week after surgery after surgery(P<0.01).The difference of bone mineral density between different stage of postoperative has relevance by Spearman correlation test(P <0.01).Conclusion: 1.PRF with GBR technology and the simple use of GBR technology for site preservation can effectively reduce the absorption of alveolar bone width and height after tooth extraction.2.PRF can promote the new bone formation and artificial bone meal to the new bone transformation,the speed of bone formation faster than the simple GBR technology same period.