Mohammed F.a ALKHATIB, Hacer ŞAHİN AYDINYURT, Nasser SHOSHAA

Kemikiçi Defektin Trombositten Zengin Fibrin ile Tedavisi: 2 Yıllık Takip Vaka Raporu

Periodontitis, dişi destekleyen dokuların ileri derecede yıkımına neden olan bir hastalıktır. Klinik ataşman kaybı, radyografik alveolar kemik kaybı, periodontal cepler ve diş eti kanaması periodontitisin semptomlarındandır. Tedavi edilmediğinde diş kaybına yol açabilen inflamatuar yükü olan polimikrobiyal bir hastalıktır. Periodontitisin altın standart tedavisi diş taşı temizliği ve kök yüzeyi düzleştirmesidir, hem başlangıç aşamalarında hem de bakım fazında periodontal tedavinin amacı, bağ dokusunun mümkün olan en büyük ölçüde bağlanmasını sağlayan biyolojik olarak kabul edilebilir diş yüzeyleri oluşturmaktır. Derin cepler genellikle enfleme kök yüzeyine ulaşabilmek ve enfekte dokuları uzaklaştırmak adına cerrahi müdahaleye ihtiyaç duymaktadır, açık flep debridmanı ile otolog veya sentetik rejeneratif materyallerin kullanımı daha iyi sonuç vermektedir. Trombositten zengin fibrin (TZF), çok çeşitli uygulamalara sahip yeni nesil otolog trombosit tedavisidir. Fibrin matrisi, hücresel bileşenleri ve büyüme faktörlerinin sürekli salınımı nedeniyle, TZF yara iyileşmesinde birincil veya yardımcı bir yaklaşım olarak kullanılabilir. Büyüme faktörlerinin A-TZF'den daha yavaş salınması nedeniyle L-TZF kullanıldı. Ayrıca orijinal L-TZF protokolü, A-TZF protokolünden daha büyük pıhtıların/membranların üretilmesine ve büyüme faktörlerinin daha yoğun salınmasına izin vermektedir. TZF'nin elde edilmesi kolaydır, ucuzdur ve topikal olarak veya diğer cerrahi prosedürlerle birlikte kullanılabilir. Bu vaka çalışmasında açık flep debridmanı ile birlikte TZF kullanılmış ve 2 yıllık takip sonucu bu tedavi protokolünün etkinliğini göstermiştir.

Anahtar Kelimeler:

Kemikiçi defektler, rejenerasyon, trombositten zenginleştirilmiş fibrin

Treatment of Intra-bony Defect Using Platelet Rich Fibrin: A 2 Years Follow-Up Case Report

Periodontitis is a disease that causes progressive destruction of the tooth-supporting tissues. Clinical attachment loss, radiographic alveolar bone loss, periodontal pockets, and gingival bleeding are all symptoms of periodontitis. It is a poly-microbial disease with an inflamatory burden which can lead to tooth loss in the absence of proper treatment. The gold standard treatment of periodontitis is scaling and root planning, the purpose of periodontal therapy, both during the initial phases and during maintenance stages, is to make biologically acceptable tooth surfaces through subgingival and supragingival cleaning, which enables binding of the connective tissue to the biggest extent possible. Deep pockets usually need surgical intervention to provide a sufficient and enough cleaning to the root surface, open flap debridement along with the use of regenerative materials whether it is autologous or synthetized have given better results. Platelet-rich fibrin (PRF) is a next-generation autologous platelet treatment with a wide range of applications. Because of its fibrin matrix, cellular components, and sustained release of growth factors, PRF can be used as a primary or auxiliary approach in wound healing. Also the original L-PRF protocol allowed making larger clots / membranes and a more intensive releasing of growth factors than the modified A-PRF protocol. L-PRF is easy to get, can be used topically or in combination with other surgical procedures. In this case study open flap debridement along with L-PRF had been used and a 2 years follow up result showed the effectiveness of this treatment protocol.

Keywords:

Intrabony defects, platelet rich fibrin, regeneration,

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