NISHIHARA Kazuhide Kagoshima University, University Hospital, Faculty of Medicine and Dentistry, Assistant Professor, 医学部・歯学部附属病院, 講師 (30253892)
MIMURA Tamotsu Kagoshima University, Graduate School of Medical and Dental Sciences, Professor, 大学院・医歯学総合研究科, 教授 (70028760)
NOZOE Etsuro Kagoshima University, Graduate School of Medical and Dental Sciences, Associate Professor, 大学院・医歯学総合研究科, 助教授 (40208351)
|Budget Amount *help
¥2,800,000 (Direct Cost : ¥2,800,000)
Fiscal Year 2004 : ¥1,300,000 (Direct Cost : ¥1,300,000)
Fiscal Year 2003 : ¥1,500,000 (Direct Cost : ¥1,500,000)
The postoperative changes in the grafted bone were evaluated in 28 patients with cleft lip and palate (34 clefts) who had undergone iliac bone grafting in the alveolar cleft using platelet rich plasma(PRP)(PRP group), and compared to those in 17 patients with cleft lip and palate(17 clefts) who had undergone grafting without PRP(non-PRP group).
Dental X-ray with an aluminum wedge was taken in the grafted bone in the alveolar cleft, 1 week, and 1,3, and 6 months postoperatively, and the levels of the upper and lower margins of the bone bridge in the alveolar cleft was measured. The bone density on the dental X-ray film was also measured on an aluminum-equivalence(Al-Eq) value based on aluminum wedge with a thickness of 0 to 16 mm was mounted on the film holder. The surgical outcome was regarded as good when the level of the upper margin of the bone bridge was 1.0 or less and that of the lower margin was 3.0 or more 6 months postoperatively and as failure otherwise, and was evaluated on b
The postoperative change of the bone grafting by iliac block bone and the distraction osteogenesis using PRP in alveolar cleft was evaluated in a patient with unilateral cleft lip and palate.
The results were as follows :
1.Preoperatively, the mean number of platelets in the plasma was 27.7×10^4/μl, and that in the PRP was 86.8×10^4/μl, showing a concentration rate of 319.9%. The mean amount of TGF-β1 in the plasma was 4.4 ng/ml, and that in the PRP was 191.7 ng/ml, which was 51.5-fold higher than in the former. It was confirmed that the number of platelets and the amount of TGF-β1 in the PRP were increased.
2.The Al-Eq rapidly decreased up to 3 months postoperatively in the PRP group, and slightly increased 6 months postoperatively. In the non-PRP group, the Al-Eq gradually decreased up to 6 months postoperatively. Bone regeneration was slightly more rapid in the PRP group than in the non-PRP group.
3.The lower margin of the bone bridge was slightly reduced between 1 week and 6 months postoperatively in the PRP and non-PRP groups, but the differences were not significant. The upper margin of the bone bridge was rapidly absorbed up to 1 month postoperatively in both groups, and then remained almost unchanged. Good outcomes 6 months postoperatively were observed in 12 of the 17 patients in the PRP group (70.6%), and in 9 of the 17 patients in the non-PRP group (52.9%), the difference being significant.
4.The rate of change in the bone bridge width between 1 week and 6 months postoperatively was 77.2% in the PRP group and 71.7% in the non-PRP group, indicating that bone absorption was slightly lower in the former than in the latter.
5.In grafted bone by iliac block bone, the Al-Eq rapidly decreased up to 3 months postoperatively, and the rate of change in Al-Eq value width between 1 week and 1 year postoperatively was 90.7%.
These findings suggested that PRP enhanced bone regeneration by acting on the autogenous iliac bone, resulting in good outcomes of iliac bone grafting. Less