Vanachiremba vezvemuromoshandisa fibrin yakapfuma mumasero machena eropa uye maplatelet (L-PRF) mukuvhiya kwekiriniki, kusanganisira kuisirwa, kutapurirana matishu akapfava, Bone grafting uye kunyanya kudyara.Akataura kuti L-PRF "yakafanana nemushonga wemashiripiti".Vhiki imwe mushure mekuvhiyiwa, nzvimbo yekuvhiya inoshandisa L-PRF inoratidzika kunge yakaporeswa kwemavhiki matatu kusvika mana, izvo zvinowanzoitika, "Hughes akati. Inokurumidza kukurumidza kurapa cascade reaction.''
Platelet rich fibrin (PRF)uye yakatangira iyo platelet rich plasma (PRP) inorongwa se autologous blood concentrates, izvo zvinhu zvinogadzirwa neropa zvinogadzirwa neropa romurwere pachake.Vanachiremba vanotora sampuli dzeropa kubva kuvarwere uye vanoshandisa centrifuge kuisa pfungwa pazviri, vachiparadzanisa zvikamu zveropa zvakasiyana-siyana muzvikamu zvakasiyana zvinogona kushandiswa navanachiremba.Kunyangwe paine misiyano yakati wandei yehunyanzvi uhu nhasi inoisa pamberi pezvikamu zveropa zvakasiyana, pfungwa yese yekurapa mazino yakafanana - vanoshandisa ropa remurwere kusimudzira kuporeswa mushure mekuvhiyiwa nemuromo.
Hughes akati kukurumidza kupora ingori imwe yemabhenefiti.Paakanga achinyatso kurukura L-PRF, akataura nhevedzano yemabhenefiti evarwere nemazino: inoderedza intraoperative kubuda ropa uye inoderedza kuzvimba.Iyo inosimudzira kuvharika kwekutanga kwekuvhiya flap yezve nzira.L-PRF yakapfuma mumasero machena eropa, nokudaro kuderedza ngozi yehutachiona hwepashure.Nemhaka yokuti inogadzirwa neropa romurwere pachake, inobvisa ngozi yokusawirirana nenyama kana kuti kurambwa kwomuviri.Pakupedzisira, Hughes akati zviri nyore kugadzira.
'' Mumakore angu makumi matatu ekudzidzira kliniki, hapana mimwe mishonga, zvigadzirwa, kana teknolojia inogona kuita zvinhu zvose izvi seL-PRF, "Hughes akati. Autologous blood concentrates inogona kubatsira varwere panguva uye mushure mekuvhiyiwa kwemuromo, asi zvakajairika. vanachiremba vemazino vanowanzosangana nematambudziko pavanenge vachiwedzera PRP/PRF kumaitiro avo.Matambudziko chaiwo ekuwedzera kushandiswa kwe autologous blood concentrates anosanganisira kutarisira musika wemidziyo iri kukura, kunzwisisa shanduko dzakasiyana uye mashandisiro azvo, uye kutsanangura mashandisiro azvo mukushandisa mazino.
PRP uye PRF: Misiyano Yakakosha Iyo General Dentist Vanofanira Kunzwisisa
PRP nePRF hazvisi chigadzirwa chimwe chete, kunyange zvazvo vashandi nevatsvakurudzi vanochinjanisa kushandiswa kwemashoko maviri aya kune chizvarwa chinotevera chebiomaterials yemapfupa uye periodontal regeneration "uye" Platelet rich fibrin mu regenerative dentistry: biological background uye kliniki zviratidzo ". Miron akadaro. kuti PRP yakatanga kushandiswa mukuvhiya nemuromo muna 1997. Inoreva platelet rich concentrate yakasanganiswa neAnticoagulant.PRF yakatangwa sechizvarwa chechipiri cheplatelet concentrate muna 2001, isina Anticoagulant.
"Kuenzaniswa nePRP, data kubva kune dzakawanda zvehutano hunoratidza zvakajeka migumisiro iri nani yePRF, sezvo coagulation chiitiko chinokosha mukugadzirisa maronda," akadaro Miron. "Zvisinei, nharo yokuti PRP" nguva dzose "inoshandisa Anticoagulant yakakonzera kukakavara pakati peArun K. Garg, DMD, co-discoverer yePRP.
"Mumazuva ekutanga ekushandisa PRP, dzimwe nguva tinosiya Anticoagulant patinenge tichida kushandisa zvinhu izvi," Garg akadaro."Kwenguva yakareba yekushanda, isu takawedzera Anticoagulant kuchengetedza platelet-inotorwa kukura chinhu kudzamara tagadzirira kushandisa chinhu ichi, uye isu tichazokonzera coagulation kana tichiishandisa."Hughes anonyanya kushandisa PRF mukuita kwake, achiwedzera kuti chikamu chechikonzero chekudiwa kwekuvandudza PRP ndechokuti yepakutanga PRP michina inodhura, uye teknolojia inonyanya kuoma uye inopedza nguva - PRP inoda kutenderera kuviri mu centrifuge nekuwedzera. yethrombin, nepo PRF ichingoda kutenderedzwa kamwe chete pasina chikonzero chekuwedzera.'' PRP pakutanga yainyanya kushandiswa mumatambudziko makuru emuromo kana epurasitiki muzvipatara, "Hughes akati. PRP yakaratidza kuti haigoneki kushandiswa mumakiriniki emazino chaiwo.
Kubva padzidziso yekuita: Ropa rinotarisa, PRF, uye PRP munzvimbo dzekiriniki yemazino inounganidzwa uye inogadzirwa nenzira yakafanana.Vanotsanangura kuti ropa rinotorwa kuvarwere roiswa mubhodhoro duku.Wobva watenderedza vial mu centrifuge panguva yakafanotemerwa kumhanya uye nguva yekuparadzanisa PRF kubva muropa panguva iyi.Iyo PRF yakawanikwa yero gel senge membrane, iyo inowanzo kudzvanywa kuita flatter membrane."Aya ma membrane anogona kubva agadziriswa kuBone grafting materials, akabatanidzwa neBone grafting materials, kana kuti akaiswa kumativi kana pamusoro pemazino emazino kuti ape biofilm inokurudzira kukura kwemapfupa uye inovandudza hutano hwemurwere. Keratized gingival tissue, "Kussek akati.PRF inogona zvakare kushandiswa seyo chete yekusimira zvinhu zvekuvhiya periodontal.Pamusoro pezvo, chinyorwa ichi chinobatsira zvikuru pakugadzirisa pakakoromoka panguva yekuwedzera sinus, kudzivirira utachiona, nekuvandudza mhedzisiro yekiriniki.''
'' Kushandiswa kwePRP kunosanganisira kuibatanidza nePRF uye mapfupa emapfupa kuti aite 'sticky' bone iyo iri nyore kugadzirisa uye kushanda mumuromo wemuromo panguva yekushandura, "Kusek akaenderera mberi. PRP zvinhu zvinogonawo kuiswa mujekiseni transplant area kuti uwedzere kugadzikana uye jekiseni mumatishu akapoteredza kuvandudza kupora.'' "Mukuita, anoshandiswa paBone grafting nekusanganisa PRP neBone grafting zvinhu nekuaisa, wozoisa PRF membrane pamusoro, uyezve nekuisa polytetrafluoroethylene membrane. pairi, "Rogge akati. Ndichiri kushandisa PRF sevhavha mushure mekubviswa kwezino - kusanganisira mazino ehuchenjeri - kubatsira kuderedza socket yakaoma uye kukurudzira kuporesa. Kutaura chokwadi, handina kumbova nesokisi yakaoma kubva pakuita PRF. Kubvisa socket yakaoma ndiko kwete chete kubatsira Rogge anoona.
''Handina kungoona kukurumidza kuporesa uye kuwedzera kukura kwepfupa, asi ndakaonawo kuderera kwemarwadzo epashure akataurwa pakushandisa PRP nePRF.'' '' Kana PRP/PRF isingashandisi, murwere achapora here?"Watts akati. Asi kana iwe uchigona kuita kuti zvive nyore uye nekukurumidza kwavari kuti vawane chigumisiro chekupedzisira, nezvinetso zvishomanana, sei iwe usingadaro?''
Mutengo wekuwedzera PRP/PRF unosiyana mune zvakajairika mazino maitiro, zvakanyanya nekuda kwekukura kuri kuita kwe autologous blood concentrates.Zvigadzirwa izvi zvakaburitsa indasitiri yemabhiriyoni akawanda emadhora, nevagadziri vakasiyana vachigadzira zvisingaoneki (dzimwe nguva zvevaridzi) zvakasiyana-siyana zvemacentrifuges nemabhodhoro madiki.'' Centrifuges ane maitiro akasiyana-siyana ekukurumidza akaiswa mumusika, uye kuchinja kwe centrifugation kunogona kukanganisa simba uye kushanda kwemasero mavari, "Werts akati. Icho chinoreva kliniki here? Handizivi kuti mumwe munhu achayera sei izvi.' Pamusoro pekudyara kwecentrifuge uye kudzidziswa kwephlebotomy, Werts akataura kuti mamwe mari inobatanidzwa mukushandisa PRP/PRF mukuita, senge vacuum sealed collection tubes, Winged infusion set uye suction chubhu, "zvishoma".
''Kushandiswa kwemembranes inonyura mukuvhiya munhu anogona kuita $50 kusvika ku $100 imwe neimwe, "Werts akadaro. Kusiyana neizvi, kushandisa PRF yemurwere pachake semutengo wekunze wemembrane uye nguva yako inogona kubhadharwa. Autologous blood products ane code yeinishuwarenzi. , asi inishuwarenzi haiwanzobhadhara mari iyi.
Paulisick, Zechman, naKusek vanofungidzira kuti mutengo wekutanga wekuwedzera macentrifuges uye PRF membrane compressor mukuita kwavo unotangira pamadhora mazana maviri kusvika kumadhora mana, uye imwe chete mutengo uri wekiti yekuunganidza ropa inoraswa, kazhinji inodhura isingasviki madhora gumi pabhokisi.Nekuda kwemakwikwi eindasitiri uye huwandu hukuru hwemacentrifuges anowanikwa pamusika, vanachiremba vemazino vanofanirwa kuwana michina pamitengo yakasiyana siyana.Tsvagiridzo yakaratidza kuti chero protocol ichienderana, panogona kunge pasina misiyano yakakura mumhando yePRF inogadzirwa uchishandisa macentrifuges akasiyana.
'' Boka redu rekutsvakurudza munguva pfupi yapfuura rakabudisa kuongorora kwakarongeka umo takaona kuti PRF yakavandudza zvakanyanya migumisiro yekliniki mu periodontal uye kugadziriswa kwenyama yakapfava, "Miron akati. Kunyange zvakadaro, takagumisa kuti kuchine kushayikwa kwekutsvakurudza kwakanaka kuratidza zvinogutsa basa racho. yePRF mukukurudzira kuumbwa kwemapfupa (bone induction) Naizvozvo, vanachiremba vemakiriniki vanofanira kuziviswa kuti PRF ine simba rakasimba rokuvandudza matishu yakapfava kupfuura matishu akaoma.''
Tsvakurudzo zhinji dzesainzi dzinoita sedzinotsigira zvakataurwa naMiron.Pane humbowo hunoratidza kuti PRP/PRF inobatsira pakupora, kunyangwe iyo nhanho yekuvandudza haina kukosha.Kunyangwe paine humbowo hwakawanda hweAnecdotal, vaongorori vanotenda kuti humbowo hwakazara hunodiwa.Sezvo PRF yakatanga kushandiswa mukuvhiya nemuromo muna 2001, pane shanduko dzakawanda - L-PRF, A-PRF (advanced platelet rich fibrin), uye i-PRF (injectable platelet rich fibrin) fibrin).Sezvakataurwa naWerts, "zvakakwana kuti uite dzungu uye kuedza kudzidza uye kuzviyeuka."
'' Kunyanya, izvi zvose zvinogona kuteverwa kune pfungwa yepakutanga yePRP / PRF, "akadaro. Hongu, zvakanakira chimwe nechimwe chezvitsva izvi 'kuvandudzwa' zvinogona kupupurirwa nesayenzi, asi mumakiriniki maitiro, migumisiro yavo yose. zvakafanana - zvose zvinokurudzira kuporeswa.'' Hughes akabvumirana nazvo uye akataura kuti L-PRF, A-PRF, uye i-PRF zvose zvakasiyana-siyana zvePRF. Mhando idzi hadzidi midziyo yakakosha, asi kuti zvinoda kugadziriswa. kuchirongwa che centrifugal (nguva uye simba rekutenderera) '' Kuti ugadzire marudzi akasiyana ePRFs, zvakakosha kuchinja nguva yekutenderera kana kutenderera paminiti (RPM) yeropa panguva yekuita centrifugation," Hughes akatsanangura.
Musiyano wekutanga wePRF ndiL-PRF, uchiteverwa neA-PRF.Yechitatu yakasiyana-siyana, i-PRF, imvura, injectable fomu yePRF inopa imwe nzira kune PRP.'' Zvakakosha kunzwisisa kuti PRF inowanzotora maitiro e-clumps, "Hughes akati. '' Kana iwe uchida kuisa PRF, iwe unongoda kuchinja nguva ye centrifugation uye RPM kuti iite mufomu yemvura - iyi i- i- PRF.'' Kana pasina Anticoagulant, i-PRF haizogara iri mvura kwenguva yakareba. Hughes akati kana ikasabayiwa nekukurumidza, inonamira gel yecolloidal, asi chigadzirwa chacho chinobatsirawo. " chinhu chakanakisisa chekubatanidza kune granular kana guru Bone grafting, iyo inobatsira kudzikamisa nekugadzirisa girafu, "akadaro. ''Ndakaona kuti kuishandisa nenzira iyi kwakabudirira zvikuru.''
Kana zvakasiyana-siyana, zvipfupiso, uye zvibvumirano zvekupa mazita zvikavhiringa nyanzvi dzeindasitiri, vanachiremba vemazinowo zvavo vanofanira kutsanangura sei pfungwa yeropa re autologous rakanangana nevarwere?
(Zviri muchinyorwa ichi zvakadhindwa patsva, uye isu hatipe chero vimbiso yechokwadi, kuvimbika kana kuzara kwezviri muchinyorwa chino, uye hatina mhosva yemafungiro echinyorwa ichi, ndapota nzwisisa.)
Nguva yekutumira: Jul-24-2023