Cov kws phais qhov ncaujsiv fibrin nplua nuj nyob rau hauv cov qe ntshav dawb thiab platelets (L-PRF) hauv kev kho mob phais, suav nrog kev hloov pauv, hloov cov ntaub so ntswg, pob txha grafting thiab feem ntau implantation.Nws hais tias L-PRF yog "zoo li tshuaj muaj yees".Ib lub lis piam tom qab kev phais, qhov chaw phais siv L-PRF zoo li tau kho tau peb mus rau plaub lub lis piam, uas yog qhov tshwm sim heev, "Hughes tau hais. Nws ua rau cov tshuaj tiv thaiv cascade zoo heev."
Platelet nplua nuj fibrin (PRF)thiab nws cov thawj coj ntawm platelet nplua nuj plasma (PRP) yog cais raws li cov ntshav autologous concentrates, uas yog cov khoom siv ntshav ua los ntawm cov neeg mob cov ntshav.Cov kws kho mob muab cov ntshav kuaj los ntawm cov neeg mob thiab siv lub centrifuge kom mloog zoo rau lawv, sib cais cov ntshav sib txawv rau hauv cov txheej txheem sib cais uas tuaj yeem siv los ntawm cov kws kho mob.Txawm hais tias muaj ntau qhov sib txawv ntawm cov thev naus laus zis niaj hnub no uas muaj qhov tseem ceeb ntawm cov ntshav sib txawv, lub tswv yim ntawm kev kho hniav tag nrho yog tib yam - lawv siv tus neeg mob cov ntshav los txhawb kev kho mob tom qab phais qhov ncauj.
Hughes tau hais tias kev kho mob sai yog ib qho txiaj ntsig xwb.Thaum tham txog L-PRF tshwj xeeb, nws tau taw qhia txog cov txiaj ntsig zoo rau cov neeg mob thiab kws kho hniav: nws txo qis hauv kev ua haujlwm los ntshav thiab txo qhov mob.Nws txhim kho thawj qhov kaw ntawm lub qhov phais phais kom rov mus kom ze.L-PRF yog nplua nuj nyob rau hauv cov qe ntshav dawb, yog li txo qhov kev pheej hmoo ntawm kev mob tom qab phais.Vim tias nws yog tsim los ntawm tus neeg mob nws tus kheej cov ntshav, nws tshem tawm txoj kev pheej hmoo ntawm kev ua xua lossis kev tiv thaiv kab mob.Thaum kawg, Hughes tau hais tias nws kuj yog ib qho yooj yim ua.
"Hauv kuv 30 xyoo ntawm kev kho mob, tsis muaj lwm yam tshuaj, khoom siv, lossis cov thev naus laus zis uas tuaj yeem ua tiav txhua yam no zoo li L-PRF," Hughes tau hais. Cov kws kho hniav feem ntau ntsib cov teeb meem thaum ntxiv PRP / PRF rau lawv cov kev coj ua.Cov teeb meem tshwj xeeb ntawm kev siv cov ntshav autologous concentrates suav nrog kev tswj cov khoom lag luam loj hlob, nkag siab txog kev hloov pauv thiab siv lawv li cas, thiab piav qhia lawv siv hauv kev siv kho hniav.
PRP thiab PRF: Qhov txawv tseem ceeb uas cov kws kho hniav dav dav yuav tsum nkag siab
PRP thiab PRF tsis yog tib yam khoom, txawm hais tias cov kws kho mob thiab cov kws tshawb fawb hloov pauv kev siv ob nqe lus no rau tiam tom ntej ntawm biomaterials rau pob txha thiab periodontal regeneration "thiab" Platelet nplua nuj fibrin nyob rau hauv regenerative dentistry: biological keeb kwm yav dhau thiab soj ntsuam indications ". Miron hais. PRP tau siv thawj zaug hauv kev phais qhov ncauj hauv xyoo 1997. Nws yog hais txog platelet nplua nuj concentrate tov nrog Anticoagulant.PRF tau pib ua lub thib ob tiam platelet concentrate hauv 2001, tsis muaj Anticoagulant.
"Piv rau PRP, cov ntaub ntawv los ntawm ntau qhov chaw kho mob kom meej meej pom cov txiaj ntsig zoo dua rau PRF, vim tias kev coagulation yog ib qho xwm txheej tseem ceeb hauv cov txheej txheem kho qhov txhab," Miron hais. rov tsim dua tshiab ntawm tus nqi qis. "Txawm li cas los xij, kev sib cav hais tias PRP" ib txwm "siv Anticoagulant tau ua rau muaj kev tsis sib haum xeeb ntawm Arun K. Garg, DMD, tus co-discoverer ntawm PRP.
"Thaum ntxov ntawm kev siv PRP, qee zaum peb tshem tawm Anticoagulant sai li sai tau thaum peb yuav tsum siv cov khoom no," Garg hais."Rau lub sijhawm ua haujlwm ntev dua, peb ntxiv Anticoagulant los khaws cov platelet-derived kev loj hlob kom txog thaum peb npaj siv cov khoom no, thiab tom qab ntawd peb yuav ua kom coagulation thaum siv nws."Hughes tshwj xeeb siv PRF hauv nws qhov kev coj ua, ntxiv tias ib feem ntawm qhov kev xav tau los txhim kho PRP yog vim cov khoom siv PRP qub kim, thiab cov cuab yeej siv ntau dua thiab siv sij hawm siv - PRP xav tau ob qhov kev sib hloov hauv lub centrifuge nrog qhov sib ntxiv. ntawm thrombin, thaum PRF tsuas yog yuav tsum tau tig ib zaug yam tsis tas yuav tsum tau ntxiv."PRP yog thawj zaug feem ntau siv rau hauv qhov ncauj loj lossis phais mob hauv tsev kho mob," Hughes tau hais.
Los ntawm txoj kev xav mus rau kev xyaum: Cov ntshav concentrates, PRF, thiab PRP nyob rau hauv chaw kho hniav ib puag ncig yog sau thiab tsim nyob rau hauv ib tug zoo sib xws.Lawv piav qhia tias cov ntshav tau muab los ntawm cov neeg mob thiab muab tso rau hauv lub raj mis me me.Tom qab ntawd tig lub vial nyob rau hauv ib lub centrifuge ntawm lub predetermined ceev thiab lub sij hawm cais PRF los ntawm cov ntshav thaum lub sij hawm tus txheej txheem no.PRF tau txais yog daj gel zoo li daim nyias nyias, uas feem ntau yog compressed rau hauv daim nyias nyias."Cov daim nyias nyias no tuaj yeem hloov mus rau pob txha grafting cov ntaub ntawv, ua ke nrog pob txha grafting cov ntaub ntawv, los yog nyob ib ncig ntawm los yog nyob rau sab saum toj ntawm cov hniav cog hniav los muab ib tug biofilm uas txhawb cov pob txha maturation thiab txhim kho cov neeg mob noj qab haus huv. Keratized gingival ntaub so ntswg," Kussek hais.PRF tseem tuaj yeem siv los ua cov khoom hloov pauv nkaus xwb rau kev phais mob.Tsis tas li ntawd, cov khoom no muaj txiaj ntsig zoo rau kev kho cov perforations thaum lub qhov txhab loj, tiv thaiv kev kis kab mob, thiab txhim kho cov txiaj ntsig kho mob.
"Kev siv PRP feem ntau suav nrog kev sib txuas nrog PRF thiab cov pob txha pob txha los tsim cov pob txha ' nplaum' uas yooj yim rau kev hloov kho thiab ua haujlwm hauv qhov ncauj kab noj hniav thaum lub sijhawm hloov pauv, "Kusek txuas ntxiv. PRP cov ntaub ntawv tseem tuaj yeem raug txhaj rau hauv Hloov chaw kom muaj kev ruaj ntseg thiab txhaj rau hauv cov ntaub so ntswg ib puag ncig kom kho tau zoo.'' "Hauv kev xyaum, lawv tau siv rau pob txha grafting los ntawm kev sib xyaw PRP nrog cov pob txha grafting cov ntaub ntawv thiab muab tso rau lawv, ces muab PRF daim nyias nyias rau saum, thiab tom qab ntawd muab polytetrafluoroethylene membrane. ntawm nws, "Rogge hais tias, Kuv tseem siv PRF ua cov pob txha tom qab tshem tawm cov hniav - suav nrog cov hniav ntse - los pab txo cov qhov (socket) qhuav thiab txhawb kev kho mob. tsis yog qhov txiaj ntsig xwb Rogge pom.
''Tsis yog kuv tau pom kev kho mob sai dua thiab nce pob txha loj dua, tab sis kuv kuj pom qhov txo qis ntawm qhov mob tom qab kev phais thaum siv PRP thiab PRF.'' ''Yog tias tsis siv PRP / PRF, tus neeg mob puas yuav zoo dua?"Watts tau hais. Tab sis yog tias koj tuaj yeem ua kom yooj yim dua thiab sai dua rau lawv kom ua tiav qhov kawg tshwm sim, nrog cov teeb meem tsawg dua, vim li cas koj tsis ua?'
Tus nqi ntawm kev ntxiv PRP / PRF sib txawv hauv kev kho hniav dav dav, feem ntau vim yog kev loj hlob ntawm autologous ntshav concentrates.Cov khoom lag luam no tau tsim kev lag luam ntau lab daus las, nrog cov tuam txhab sib txawv tsim cov kev hloov maj mam (qee zaum muaj tswv) txawv ntawm cov centrifuges thiab lub raj mis me me.Werts tau hais tias "Centrifuges nrog cov kev sib txawv ceev tau qhia hauv khw, thiab kev hloov pauv hauv centrifugation tuaj yeem cuam tshuam qhov tseem ceeb thiab kev ua haujlwm ntawm cov hlwb hauv lawv," Werts tau hais. ' Ntxiv rau kev nqis peev centrifuge thiab kev cob qhia phlebotomy, Werts tau hais tias lwm cov nqi koom nrog kev siv PRP / PRF hauv kev xyaum, xws li lub tshuab nqus tsev ntim cov raj, Winged infusion teeb thiab nqus cov raj, yog "tsawg kawg".
Werts tau hais tias "Kev siv cov ntaub so ntswg absorbable hauv kev phais yuav raug nqi $ 50 txog $ 100 txhua," Werts hais tias, piv txwv li, siv tus neeg mob tus kheej PRF raws li tus nqi sab nraud ntawm daim nyias nyias ntxiv rau koj lub sijhawm tuaj yeem raug them. , tab sis qhov kev pov hwm them nqi kho mob tsis tshua them tus nqi no. Kuv feem ntau them rau kev phais thiab muab khoom plig rau tus neeg mob.'
Paulisick, Zechman, thiab Kusek kwv yees tias tus nqi pib ntawm kev ntxiv cov centrifuges thiab PRF membrane compressors hauv lawv cov kev coj ua yog li ntawm $ 2000 txog $ 4000, nrog rau tus nqi ntxiv xwb yog cov khoom siv ntshav pov tseg, feem ntau raug nqi tsawg dua $ 10 ib lub thawv.Vim muaj kev sib tw hauv kev lag luam thiab ntau cov centrifuges muaj nyob rau hauv kev ua lag luam, cov kws kho hniav yuav tsum muaj peev xwm nrhiav tau cov cuab yeej ntawm ntau lub ntsiab lus.Kev tshawb fawb tau pom tias ntev npaum li cov txheej txheem zoo ib yam, yuav tsis muaj qhov sib txawv tseem ceeb hauv qhov zoo ntawm PRF uas siv cov centrifuges sib txawv.
"Peb pab neeg tshawb fawb tsis ntev los no tau tshaj tawm cov kev tshuaj xyuas zoo uas peb pom tias PRF tau txhim kho cov txiaj ntsig zoo hauv kev kho cov nqaij mos thiab cov nqaij mos," Miron tau hais. ntawm PRF nyob rau hauv inducing pob txha tsim (pob txha induction). Yog li ntawd, cov kws kho mob yuav tsum tau ceeb toom tias PRF muaj zog cov ntaub so ntswg regeneration muaj peev xwm tshaj cov ntaub so ntswg.
Kev tshawb fawb feem ntau zoo li txhawb nqa Miron qhov kev thov.Muaj pov thawj los qhia tias PRP / PRF pab txhawb rau txoj kev kho mob, txawm tias qhov kev txhim kho qib tsis tseem ceeb.Txawm hais tias muaj ntau cov pov thawj Anecdotal, cov kws tshawb fawb ntseeg tias yuav tsum muaj pov thawj ntxiv.Txij li thaum PRF tau siv thawj zaug hauv kev phais qhov ncauj hauv xyoo 2001, muaj ntau qhov kev hloov pauv - L-PRF, A-PRF (advanced platelet nplua nuj fibrin), thiab i-PRF (injectable platelet nplua nuj fibrin) fibrin).Raws li Werts tau hais, nws yog "yuav ua rau koj kiv taub hau thiab siv zog kawm thiab nco ntsoov lawv."
Nws hais tias, "Qhov tseem ceeb, txhua qhov no tuaj yeem taug qab rov qab mus rau lub tswv yim qub ntawm PRP / PRF," nws hais. Yog lawm, qhov zoo ntawm txhua qhov kev txhim kho tshiab no tuaj yeem ua pov thawj tshawb fawb, tab sis hauv kev kho mob, lawv cov teebmeem yog tag nrho. Ib yam - lawv txhua tus txhawb kev kho kom zoo.'' Hughes pom zoo thiab taw qhia tias L-PRF, A-PRF, thiab i-PRF yog txhua yam "me" ntawm PRF. Cov ntau yam no tsis tas yuav tsum muaj cov cuab yeej tshwj xeeb, tab sis yuav tsum tau hloov kho. mus rau lub tswv yim centrifugal (lub sij hawm thiab lub zog rotational). 'To tsim ntau hom PRFs, nws yog tsim nyog los hloov lub sij hawm tig los yog revolutions ib feeb (RPM) ntawm cov ntshav thaum lub sij hawm centrifugation txheej txheem, "Hughes piav qhia.
Thawj qhov txawv ntawm PRF yog L-PRF, ua raws li A-PRF.Qhov thib peb ntau yam, i-PRF, yog kua, txhaj tshuaj ntawm PRF uas muab lwm txoj hauv kev rau PRP."Nws yog ib qho tseem ceeb kom nkag siab tias PRF feem ntau siv cov kab mob," Hughes tau hais. "Yog tias koj xav tau txhaj tshuaj PRF, koj tsuas yog yuav tsum tau hloov lub sijhawm centrifugation thiab RPM los ua kua hauv daim ntawv - qhov no yog i- PRF.'' Yog tias tsis muaj Anticoagulant, i-PRF yuav tsis nyob twj ywm rau lub sijhawm ntev, Hughes tau hais tias yog tias nws tsis txhaj tshuaj sai, nws yuav dhau los ua cov nplaum nplaum colloidal gel, tab sis cov khoom siv kuj tseem siv tau. "Nws yog ib qho zoo heev ntxiv rau granular los yog loj pob txha grafting, uas yuav pab kom ruaj khov thiab kho cov graft, "Kuv tau pom tias siv nws nyob rau hauv lub peev xwm no tau txais txiaj ntsig zoo heev."
Yog tias muaj ntau yam, cov ntawv luv luv, thiab kev sau npe cov rooj sib tham ua rau cov kws tshaj lij hauv kev lag luam, cov kws kho hniav zoo li yuav piav qhia lub ntsiab lus ntawm cov ntshav autologous rau cov neeg mob li cas?
(Cov ntsiab lus ntawm tsab xov xwm no tau luam tawm dua, thiab peb tsis muab ib qho kev qhia lossis kev lees paub rau qhov raug, kev ntseeg tau lossis ua tiav ntawm cov ntsiab lus muaj nyob rau hauv tsab xov xwm no, thiab tsis muaj lub luag haujlwm rau cov kev xav ntawm tsab xov xwm no, thov nkag siab.)
Post lub sij hawm: Lub Xya hli ntuj-24-2023