| Objective: when the osteoconduction material and the platelet-rich fibrin are applied in the area of peri-implant mandibular defection in dental implant surgery,integration through to observe the situation of the osseointegration and the clinical effect of this operation type,to estimate the feasibility of the practical application in clinic.Material and Methods: Clinical cases were selected the patients came to my hospital from October 2014 to April 2016,and they were all informed consent and received dental implant surgery in this research program,including 6 women and 4men,a total of 10 patients are selected as the research object,the range of their age is from 27 to 64 years old,and the average is 45.5 years old.According to the amount of estimated required the predesign plan before the surgery,collecting venous blood of patients with 20 ml to 40 ml without adding any anticoagulant and biological agents,and used in sterile tubes immediately with PRF special centrifuge at 2700 speed/ min after 12 minutes,made the autologous blood preparations read to use.The Patients do the routine full mouth ultrasonic scaling first,and rinse with 0.12% chlorhexidine solution repeatedly for 10 minutes,20 ml and 2-3 minutes each time.After oral and maxillofacial disinfected with 0.5% iodophor,covered with sterile surgical towels in the operation erea at the part of the outside mouth.Block anesthesia used of compound articaine hydrochloride,local infiltration anesthesia used of mepivacaine hudrochloride in the surgical area.Make a full thickness incision in the crest of ridge,and flap with vertical releasing incision,exposure the intact alveolar bone in surgical field.Removal the inflammatory tissue and granulation tissue by scraping and treatingbone surface.According to the operation plan before the surgery,implant the implantation step by step after drilling and expansion the hole step by step in the predetermined position and direction,and ensure the torque value being controlled over 30 N.Filled up the bone defect with BonaGraft(60%HA/40%P-TCP),and covered up the surface with PRF of autologous blood preparation.Finally,the whole layer sutured with the non-absorbable suture.Follow up after surgery,take the X-ray was taken immediately after surgery as a benchmark.And though the comparative and observation of the X-ray to estimate the therapeutic effect.Results: follow up the first 3 months after implant surgery,the osseointegration of the peri-implant has good effect,and no case of implant was loosening,and no infection found at the meantime,no obvious pain and edema was found.6 cases had only mild pain after implantation.All of the patients reached the early healing,and no postoperative complications were found.Take the X-ray taken immediately after surgery as a benchmark,all of the osseointegration of peri-implant has good effect through the comparative and the observation of the X-ray of postoperative 3 months.The volume of bone in the bone defect area increased,and no absorption were found,and the density of the new bone was still lower than the surrounding bone.The imaging was taken at 6 months after operation displayed that the bone density was increased in the planting area.Conclusion: During the operation of the bone augmentation in the implant area,bone powder and PRF can be widely used in the most of clinical evidence,whereas the PRF derived from autologous,not only convenient preparation,but also low cost.In addition,PRF has the effect of promoting the osteogenesis and repair mucosal,also could be analgesic effect for implant area.Compared with use the PRF or the bone powder individually as the repair materials in the surge of osteogenesis,using these two kinds of materials at the same time has a higher value. |
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