Kemik İçi Defektlerin Tedavisinde Açık Flep Debridmanı ile Trombositten Zengin Fibrin Kullanımının Etkinliği: Bir Olgu Serisi

Abstract

Periodontitis diş kaybının önemli bir nedenidir ve bu durum bakteri iltihabı ve periodontal yıkımla karakterizedir. Periodontal tedavinin nihai amacı sadece periodontal hastalığın gelişimini yavaşlatmak değil, aynı zamanda yeni sement oluşumu ile birlikte yeni oluşan kemik ve sement arasında yeni bir bağ dokusu ataşmanı içeren periodontal kompleksin mimari ve fonksiyonel bütünlüğünü yeniden oluşturmaktır. Diş taşı ve granülasyon dokusunun tamamen çıkarılması, periodontitis tedavisinde açık flep debridman prosedürü ile elde edilen biyolojik olarak kabul edilebilir bir diş yüzeyi elde etmenin birincil parçasıdır. Cerrahi erişimin diş taşı temizliği ve kök yüzey düzleştirilmesi etkinliğini iyileştirdiği gösterilmiştir. Son zamanlarda büyüme faktörlerinden zengin ikinci nesil bir trombosit konsantresi olan trombositten zengin fibrin, periodontal rejenerasyon prosedüründe kullanılmaktadır. Bu vaka serisinin amacı, derin kemik içi defekt hastalarının tedavisinde trombositten zengin fibrin'in etkinliğini tanımlamaktır. Debridmanın ardından kemik defekti içine taze hazırlanmış bir otolog trombositten zengin fibrin pıhtısı yerleştirilmiştir. Klinik ve radyografik takipler, ağrı yokluğu, klinik ataşman seviyesinde artış, sondalama derinliğinde azalma ve başarılı sonucu gösteren kemik rejenerasyonu ortaya çıkaran düzenli aralıklarla gerçekleştirilmiştir.

Keywords

• Cerrahi flepler
• kemik rejenerasyonu
• trombositten zengin fibrin

The Effectiveness of Using Platelet Rich Fibrin with Open Flap Debridement in Treatment of Intra-Bony Defects: A Case Series

Abstract

Periodontitis, which is characterized by bacterial inflammation and periodontal damage, is a primary cause of tooth loss. The main objective of periodontal treatment is not only to slow down the progression of periodontal problem, but also to regenerate the architectural and functional integrity of the periodontal tissue, which includes the formation of new cementum together with a new connective tissue and newly formed bone. Thorough removal of calculus and granulation tissues is a critical part of obtaining a biologically appropriate tooth surface in the management of periodontitis, which is can achieved surgically by open flap debridement procedure. Surgical access has proved to improve the effectiveness of scaling and root planning procedure. Platelet-rich fibrin is a second-generation platelet concentrate which contains abundant amount of growth factors and can be used effectively in periodontal regeneration procedures. The goal of this case series is to show the efficiency of platelet-rich fibrin in the management of patients who have a deep intra-bony pocket by placing a freshly prepared platelet-rich fibrin clot inside intra-bony defect following open flap debridement. Clinical and radiographic follow-up were performed after a 2-year, and revealed a clinical attachment level gain, probing depth reduction, and bone fill indicating successful outcomes.

Keywords

• Bone regeneration
• platelet-rich fibrin
• surgical flaps

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