Madokotala ochita opaleshoni m'kamwagwiritsani ntchito fibrin yolemera m'maselo oyera a magazi ndi mapulateleti (L-PRF) pochita opaleshoni yachipatala, kuphatikizapo kuika, kuika minofu yofewa, Kulumikiza mafupa ndi kuika zambiri.Anati L-PRF ndi "ngati mankhwala amatsenga".Mlungu umodzi pambuyo pa opaleshoni, malo opangira opaleshoni pogwiritsa ntchito L-PRF akuwoneka kuti achiritsidwa kwa milungu itatu kapena inayi, yomwe imakhala yofala kwambiri, "anatero Hughes. Imafulumizitsa kwambiri chithandizo chamankhwala.
Platelet rich fibrin (PRF)ndipo plasma wochuluka wa m’magazi (PRP) amaikidwa m’gulu la ma autologous blood concentrates, omwe ndi mankhwala opangidwa kuchokera ku mwazi wa odwala.Madokotala amachotsa magazi mwa odwala ndikugwiritsa ntchito chida cholumikizira kuti alikitse, ndikulekanitsa zigawo za magazi m'magulu osiyanasiyana omwe angagwiritsidwe ntchito ndi madokotala.Ngakhale kuti pali mitundu ingapo ya umisiri umenewu masiku ano imene imaika patsogolo zigawo zosiyanasiyana za magazi, lingaliro lonse la udokotala wa mano ndi lofanana - amagwiritsa ntchito mwazi wa wodwalayo kulimbikitsa machiritso pambuyo pa opaleshoni yapakamwa.
Hughes adanena kuti kuchira msanga ndi chimodzi mwamapindu ake.Pokambirana mwatsatanetsatane za L-PRF, adawonetsa zopindulitsa zingapo kwa odwala ndi mano: zimachepetsa kutuluka kwa magazi m'thupi ndikuchepetsa kutupa.Imawonjezera kutsekeka koyambirira kwa chiwombankhanga cha opaleshoni kuti tiyandikirenso.L-PRF ili ndi maselo oyera a magazi, motero amachepetsa chiopsezo cha matenda pambuyo pa opaleshoni.Chifukwa chakuti amapangidwa kuchokera m’mwazi wa wodwalayo, amachotsa chiwopsezo cha ziwengo kapena kukana chitetezo chathupi.Pomaliza, Hughes adanenanso kuti ndizosavuta kupanga.
'' M'zaka zanga za 30 zachipatala, palibe mankhwala ena, zipangizo, kapena matekinoloje omwe angathe kuchita zinthu zonsezi monga L-PRF, "Hughes adanena. Magazi a Autologous amathandizira odwala panthawi ndi pambuyo pa opaleshoni ya pakamwa, koma wamba. Madokotala a mano nthawi zambiri amakumana ndi zovuta powonjezera PRP/PRF pazochita zawo.Mavuto enieni owonjezera kugwiritsa ntchito magazi a autologous akuphatikizapo kuyang'anira msika wa zida zomwe zikukula, kumvetsetsa kusintha kosiyanasiyana ndi momwe angagwiritsire ntchito, komanso kufotokozera momwe amagwiritsidwira ntchito pamano.
PRP ndi PRF: Zosiyanasiyana Zofunika Zomwe Madokotala Amano Ambiri Ayenera Kumvetsetsa
PRP ndi PRF sali chinthu chomwecho, ngakhale akatswiri ndi ofufuza amasinthasintha kugwiritsa ntchito mawu awiriwa kwa mbadwo wotsatira wa biomaterials kwa mafupa ndi periodontal regeneration "ndi" Platelet wolemera fibrin mu regenerative mano: zamoyo maziko ndi zizindikiro zachipatala ". Miron adati PRP idagwiritsidwa ntchito koyamba mu opareshoni yapakamwa mu 1997. Imatanthawuza kuchulukira kwa mapulateleti osakanikirana ndi Anticoagulant.
'' Poyerekeza ndi PRP, deta yochokera m'madera ambiri azachipatala imasonyeza bwino zotsatira za PRF, monga coagulation ndizochitika zofunika kwambiri pakupanga machiritso a bala, "Miron adati. "Komabe, mkangano wakuti PRP" nthawi zonse "amagwiritsira ntchito Anticoagulant yayambitsa mkangano pakati pa Arun K. Garg, DMD, co-discoverer wa PRP.
"Kumayambiriro kwa kugwiritsa ntchito PRP, nthawi zina timasiya Anticoagulant tikangofunika kugwiritsa ntchito izi," adatero Garg."Kwa nthawi yayitali yogwira ntchito, tidawonjezera Anticoagulant kuti tisunge zomwe zimachokera ku mapulateleti mpaka titakonzeka kugwiritsa ntchito zinthuzi, ndiyeno tidzayambitsa kukomoka tikamazigwiritsa ntchito."Hughes makamaka amagwiritsa ntchito PRF muzochita zake, kuwonjezera kuti chimodzi mwa zifukwa zomwe zimafunika kuwongolera PRP ndi chifukwa chakuti zipangizo zoyambirira za PRP ndizokwera mtengo, ndipo luso lamakono ndi lovuta kwambiri komanso lowononga nthawi - PRP imafuna kusinthasintha kawiri mu centrifuge ndi kuwonjezera. a thrombin, pomwe PRF imangofunika kuzunguliridwa kamodzi popanda kufunikira kowonjezera.'' PRP poyamba inkagwiritsidwa ntchito kwambiri pazochitika zazikulu za opaleshoni yamlomo kapena pulasitiki m'zipatala, "anatero Hughes. PRP yasonyezedwa kuti sizingatheke kuti igwiritsidwe ntchito m'zipatala za mano.
Kuchokera kumaganizo kuti azichita: Magazi amaika, PRF, ndi PRP m'malo azachipatala a mano amasonkhanitsidwa ndikupangidwa mofananamo.Amalongosola kuti magazi amatengedwa mwa odwala n’kuikidwa m’botolo laling’ono.Kenako tembenuzani vial mu centrifuge pa liwiro lodziwikiratu ndi nthawi kuti mulekanitse PRF ndi magazi panthawiyi.PRF yopezedwa ndi gel wachikasu ngati nembanemba, yomwe nthawi zambiri imapanikizidwa kukhala nembanemba yosalala."Zizindikirozi zimatha kusinthidwa kuti zikhale ndi zipangizo zopangira mafupa, kuphatikizapo Bone grafting materials, kapena kuziyika mozungulira kapena pamwamba pa mano opangira mano kuti apereke biofilm yomwe imalimbikitsa kukula kwa mafupa ndikukhala ndi thanzi la odwala. Keratized gingival minofu, "anatero Kussek.PRF itha kugwiritsidwanso ntchito ngati chinthu chokhacho chosinthira pa opaleshoni ya periodontal.Kuonjezera apo, nkhaniyi ndi yothandiza kwambiri pokonza zobowola panthawi ya kukula kwa sinus, kuteteza matenda, ndi kupititsa patsogolo zotsatira zachipatala.''
'' Kugwiritsiridwa ntchito kwa PRP kumaphatikizapo kuphatikiza ndi PRF ndi fupa la mafupa kuti apange fupa 'lomata' lomwe limakhala losavuta kusintha ndikugwira ntchito m'kamwa pakamwa panthawi ya kuyika, "Kusek anapitiriza. kumuika malo kuti achulukitse komanso kubaya minyewa yozungulira kuti machiritso achiritsidwe.'' "Pochita izi, amagwiritsidwa ntchito kulumikiza mafupa posakaniza PRP ndi zida zolumikizira mafupa ndikuziyika, kenako ndikuyika nembanemba ya PRF pamwamba, ndikuyika nembanemba ya polytetrafluoroethylene. pa izo, "adatero Rogge. Ndikugwiritsabe ntchito PRF monga chotchinga pambuyo pochotsa dzino - kuphatikizapo mano anzeru - kuthandiza kuchepetsa socket youma ndikulimbikitsa machiritso. Kunena zowona, sindinakhalepo ndi socket youma kuyambira kukhazikitsa PRF. Kuchotsa socket youma ndikosavuta. osati phindu lokhalo lomwe Rogge amawona.
''Sikuti ndinangowona machiritso ofulumira komanso kukula kwa mafupa, koma ndinawonanso kuchepa kwa ululu wopweteka pambuyo pogwiritsira ntchito PRP ndi PRF.'' ''Ngati PRP/PRF sichigwiritsidwa ntchito, kodi wodwalayo adzachira?"Watts adati. Koma ngati mungathe kukhala kosavuta komanso mofulumira kuti akwaniritse zotsatira zomaliza, ndi zovuta zochepa, bwanji osatero?'
Mtengo wowonjezera PRP/PRF umasiyanasiyana m'machitidwe a mano, makamaka chifukwa chakukula bwino kwamagazi a autologous.Zogulitsa izi zadzetsa bizinesi ya madola mabiliyoni ambiri, opanga osiyanasiyana akupanga mitundu yobisika (nthawi zina eni) ya ma centrifuge ndi mabotolo ang'onoang'ono.'' Ma centrifuges okhala ndi maulendo osiyanasiyana othamanga adayambitsidwa pamsika, ndipo kusintha kwa centrifugation kungakhudze mphamvu ndi mphamvu za maselo mwa iwo, "adatero Werts. Kodi ndi tanthauzo lachipatala? ' Kuphatikiza pa maphunziro a centrifuge ndi maphunziro a phlebotomy, Werts adanena kuti ndalama zina zomwe zimagwiritsidwa ntchito pogwiritsira ntchito PRP / PRF muzochita, monga machubu otsekedwa otsekedwa, mapiko olowetsera mapiko ndi machubu oyamwa, ndi "ochepa".
''Kugwiritsiridwa ntchito kwa nembanemba koyamwa m'maopaleshoni oika munthu wina kungawononge $50 mpaka $100 iliyonse, "adatero Werts. Mosiyana ndi zimenezo, kugwiritsa ntchito PRF ya wodwala mwiniyo monga mtengo wakunja wa nembanemba kuphatikizapo nthawi yanu ikhoza kulipiritsidwa. , koma ndalama za inshuwalansi sizilipira kaŵirikaŵiri ndalama zimenezi.
Paulisick, Zechman, ndi Kusek akuyerekeza kuti mtengo woyamba wowonjezera ma centrifuge ndi ma compressor membrane a PRF muzochita zawo umachokera ku $ 2000 mpaka $ 4000, ndipo mtengo wowonjezera womwe ndi zida zosonkhanitsira magazi, zomwe zimawononga ndalama zosakwana $10 pabokosi lililonse.Chifukwa cha mpikisano wamakampani komanso kuchuluka kwa ma centrifuge omwe amapezeka pamsika, madokotala a mano ayenera kupeza zida pamitengo yosiyanasiyana.Kafukufuku wasonyeza kuti malinga ngati ndondomekoyi ikugwirizana, sipangakhale kusiyana kwakukulu pa khalidwe la PRF lopangidwa pogwiritsa ntchito ma centrifuges osiyanasiyana.
'' Gulu lathu lofufuza posachedwapa linasindikiza ndondomeko yowonongeka yomwe tidapeza kuti PRF idasintha kwambiri zotsatira zachipatala mu periodontal ndi kukonza minofu yofewa, "Miron adati. ya PRF poyambitsa mapangidwe a mafupa (kulowetsa mafupa) Choncho, madokotala achipatala ayenera kudziwitsidwa kuti PRF ili ndi mphamvu yowonjezereka ya minofu yofewa kuposa minofu yolimba.'
Kafukufuku wambiri wasayansi akuwoneka kuti akugwirizana ndi zomwe Miron adanena.Pali umboni wosonyeza kuti PRP/PRF imathandizira kuti machiritso achiritsidwe, ngakhale pamene kusintha sikuli kofunikira.Ngakhale pali umboni wochuluka wa Anecdotal, ofufuza amakhulupirira kuti umboni wotsimikizirika ukufunika.Popeza PRF idagwiritsidwa ntchito koyamba pa opaleshoni yapakamwa mu 2001, pakhala zosintha zingapo - L-PRF, A-PRF (advanced platelet rich fibrin), ndi i-PRF (injection platelet rich fibrin) fibrin).Monga momwe Werts ananenera, “ndizokwanira kukuchititsani chizungulire ndi kuyesetsa kuphunzira ndi kuzikumbukira.’’
'' Kwenikweni, zonsezi zikhoza kubwereranso ku lingaliro loyambirira la PRP / PRF, "adatero. Inde, ubwino wa 'zotukuka' zatsopanozi zikhoza kutsimikiziridwa mwasayansi, koma muzochita zachipatala, zotsatira zake ndizo zonse. chimodzimodzi - onse amalimbikitsa machiritso.'' Hughes adavomereza ndipo adanenanso kuti L-PRF, A-PRF, ndi i-PRF zonse ndi mitundu "yaing'ono" ya PRF. ku dongosolo la centrifugal (nthawi ndi mphamvu yozungulira). '' Kuti apange mitundu yosiyanasiyana ya PRFs, m'pofunika kusintha nthawi yozungulira kapena kusintha kwa mphindi imodzi (RPM) ya magazi panthawi ya ndondomeko ya centrifugation, "Hughes anafotokoza.
Mtundu woyamba wa PRF ndi L-PRF, wotsatiridwa ndi A-PRF.Mitundu yachitatu, i-PRF, ndi yamadzimadzi, yojambulidwa ya PRF yomwe imapereka m'malo mwa PRP."Ndikofunikira kumvetsetsa kuti PRF nthawi zambiri imatenga mawonekedwe a clumps," adatero Hughes. '' Ngati mukufuna jekeseni PRF, mumangofunika kusintha nthawi ya centrifugation ndi RPM kuti ikhale yamadzimadzi - izi ndi- i- PRF.'' Ngati palibe Anticoagulant, i-PRF sikhala yamadzimadzi kwa nthawi yaitali. Hughes adanena kuti ngati siibayidwa mwamsanga, idzakhala gel yomata ya colloidal, koma mankhwalawa ndi othandiza kwambiri. " ndi njira yabwino kwambiri yolumikizirana ndi granular kapena yaikulu ya Bone, yomwe imathandiza kukhazikika ndi kukonza zitsulo," adatero.
Ngati mitundu yosiyanasiyana, mawu achidule, ndi katchulidwe ka mayina zimasokoneza akatswiri a m’mafakitale, kodi madokotala wamba angafotokoze bwanji mfundo yakuti magazi a autologous ndi ofunika kwambiri kwa odwala?
(Zomwe zili m'nkhaniyi zidasindikizidwanso, ndipo sitikupereka chitsimikizo chotsimikizika kapena chotsimikizika pakulondola, kudalirika kapena kukwanira kwa zomwe zili m'nkhaniyi, ndipo sitili ndi udindo pamalingaliro ankhaniyi, chonde mvetsetsani.）
Nthawi yotumiza: Jul-24-2023