The Clinical Observation On Platelet Rich Fibrin Repairing The Defection Of Gingival Softe Tissue

Objective:To observe the affection of PRF membrane and collagen membrane on gingival soft tissue healing, evaluate the ability of PRF to repair gingival defection.Methods:We select 30 patients at the Dentistry of the Chengdu Military Region Authorities Hospital from August 2013 to December 2014(22 men,8 women, aged 24-70 years, mean:47.67), we divide them into PRF group and collagen membrane group. There are 30 teeth including 28 molars and 2 premolars, needed to extracted. After operation of site preservation there are 30 gingival defections(PRF group has 16 areas,collagen membrane group has 14 areas).The two groups put Bio-Oss into extraction sockets.Then PRF group is covered by PRF membrane, while collagen membrane group is covered by collagen membrane. We evaluate the degree of healing to evaluate the ability of PRF to promote the healing of gums by questioning the postoperative pain, observing the color of mucous, touching bleeding, degree of swelling mucosa, degree of healing.Though the observation of 22 cases (12 cases in PRF group,10 cases in collagen membrane group) on healing time and the healing rate, we are able to compare the ability of PRF and collagen membrane to guide the gum renewable. By ELISA to detect 16 patients (8 cases of PRF group,8 cases of collagen membrane group) after 3,7,14,21 and 28 days the wound secretion of collagenase-1 and CR, we are able to evaluate the ability to promote the healing of the gum. By HE、Masson、CD31 staining the new bone and new gum which is from 15 patients (7 cases of PRF group,7 cases of collagen membrane group,1 case of natural healing) to observe the new bone and the gum of sit preservation,evaluating the ability of PRF to guide the formation of new bone and promote gum mature.Results:1.Two groups of postoperative pain after 24 hours have no difference(P> 0.05). The PRF group’gingival early healing is better than that of the collagen membrane group in 3days,7days,14days after the operation(P< 0.05).2.The time of the PRF group’s wound healing is 12.17±2.25 days,while the collagen membrane group is 17.30±2.58 days.The time of the PRF group’s wound healing is shorter than the collagen membrane group, there are significant statistically differences (P<0.05).The healing rate of PRF group is higher than that of collangen membrane group at 1 week and 2 weeks after the operation, there are significant statistically differences (P<0.05).3.Collagenase-1 of the wound secretion is increasing at first and then decreesing gradually. On the third day and seventh day, the PRF group’s collagenase-1 is higher than collangen membrane group, there are significant statistically differences (P<0.05).CR of the wound secretion is reducing slowly. On the third day and seventh day, the collangen membrane group’s CR is higher than PRF group, there are significant statistically differences (P< 0.05).4.Clinical observation:at the time of implanting surgery, we found the alveolar crest of PRF group is smooth, while that of collangen membrane group is roughness. Particle of Bio-Oss is obvious. HE staining:PRF group has intensive gingival connective tissue and rich blood vessels. Collagen membrane group has loose gingival connective tissue and the basement membrane of inflammatory cells infiltration. Masson staining:the collagen fiber of the PRF group is thicker and more neatly than that of collangen membrane group.CD31 staining:there is no difference in gingival connective tissue between two groups, but we can find many new blood vessels in the marrow cavity of PRF group.Conclusion:1.Based on the compration of the mucosa state of two groups at 3 days and 7 days after surgery,wound healing level at 14 days after surgery, we primarily proved that PRF’s ability to promote gingival soft tissue defect is better than collagen membrane.2.By comparing the gingival soft tissue defect healing time and healing rate, we find that the PRF can accelerate the wound healing.3.By comparing collagenase-1 and CR of the secretion of gingival tissue defect, we find that PRF promote the wound healing and reduce local inflammation at 1 week.4.To observe the new borne soft and hard tissue stained by HE、Masson  CD31, we find PRFcan accelerate the new bone of the alveolar ridge to form.