【摘要】 在上颌后牙区骨量不足时，常采用上颌窦底提升术获得充足的骨量，随着研究的不断深入，现普遍认为上颌窦底黏膜本身具备成骨潜力，术后的成骨模式为通过植骨材料维持稳定的空间，来自创面和窦底黏膜的间充质干细胞黏附、迁移并成骨分化，形成新骨。常规应用的植骨材料普遍缺乏骨诱导性，使得术后成骨效率低、术后反应明显，因此加速术后的骨再生并减轻患者负担是当前临床研究的热点。富血小板纤维蛋白（platelet-rich fibrin,PRF）是第二代自体血小板浓缩制品，作为组织工程材料最初被用于修复软组织损伤，现已被广泛应用于口腔种植领域。近期研究发现PRF可诱导间充质干细胞成骨分化。通过标准化流程制备的PRF具有一定的骨诱导性，同时可促进血管形成，在上颌窦底提升术中能够调控其成骨模式中的各项因素。另外，PRF制成膜使用可依靠其机械强度维持提升后的窦底黏膜。但迄今为止PRF促进骨再生的机制研究仍有欠缺，是否应该在上颌窦底提升术中常规应用PRF仍存争议。文章重点介绍PRF促进上颌窦底提升术后的骨再生机制以及PRF在不同术式中的临床应用方式及效果，旨在为临床决策及进一步研究提供参考。更多还原

【Abstract】 Maxillary sinus floor elevation(SFE)is often used to obtain sufficient bone mass when the bone mass in the posterior maxillary region is insufficient. With the development of the research,it is generally believed that Schneiderian membrane itself has the potential of osteogenesis,the mode of osteogenesis after operation is to maintain a stable space by means of bone graft material,and to form new bone by adhesion,migration and differentiation of mesenchymal stem cells(MSCs)from wound surface and Schneiderian membrane. Conventional bone graft materials lack osteoinductive ability,which leads to low osteogenic efficiency and obvious postoperative response. Therefore,accelerating bone regeneration and reducing the burden of patients are the hot spots of clinical research. Platelet-rich fibrin(PRF)is the second generation of autologous platelet concentrate. As a tissue engineering material,PRF was originally used to repair soft tissue injury,and now it has been widely used in oral implant field. Recent studies have shown that PRF can induce osteogenic differentiation of MSCs. PRF prepared through the standardized process has certain osteoinductive and play a role in angiogenesis. When using in SFE,PRF can regulate various factors in its osteogenic mode and promote new bone formation. PRF membrane can rely on its mechanical strength to maintain the raised sinus floor mucosa. However,there is still a lack of research in the mechanism of PRF promoting bone regeneration. Whether PRF should be routinely applied in SFE is still controversial. This paper mainly reviews the mechanism of PRF promoting bone regeneration after SFE and the clinical application and effect of PRF in different surgical methods,which is aimed to provide reference for clinical decision and further studies.更多还原