种植体周围骨缺损修复的组织学观察  

Histological evaluation of bone regeneration after repair of peri-implant bone defect

作　　者：陈建钢[1] 曾凯[1] 张伟[1] 陈新明[2] 赵怡芳[2] 

机构地区：[1]武汉大学中南医院,湖北武汉430071 [2]武汉大学口腔医学院

出　　处：《临床口腔医学杂志》2004年第11期648-650,共3页Journal of Clinical Stomatology

基　　金：湖北省科技攻关项目 (2 0 0 3AA30 4 1 30 8)

摘　　要：目的 :观察脱钙冻干骨移植物 (DFDBA)在种植体周骨缺损的诱导成骨活性以及重组人骨形成蛋白 -2 (rhBMP -2 )和钛膜对DFDBA成骨作用的影响。方法 :犬股骨植入种植体周围 ,制造 4mm× 3mm× 3mm骨缺损 ,分别采用DFDBA、DFDBA +rhBMP -2和DFDBA +钛膜三种不同方法修复种植体周骨缺损 ,术后 4、8、12周 ,组织学观察种植体周骨缺损修复情况。结果 :三组实验动物中 ,植骨创均愈合良好 ,种植体无松动 ,未见种植体周围炎发生。①DFDBA组 :术后 4周即有新生骨小梁形成 ,术后 12周修复骨缺损 ,但新骨组织与宿主骨之间仍见明显分界 ;②DFDBA +rhBMP -2组 :成骨过程较早 ,术后 4周即有较多新生骨组织出现 ,术后 8周 ,成骨细胞较为丰富 ,术后 12周新骨组织与宿主骨完全融合 ;③DFDBA +钛膜 :术后 4周即见新生骨小梁沿钛膜生长 ,至术后 12周 ,完全覆盖骨缺损。结论 :DFDBA具有良好的骨诱导和骨引导作用 ,可用于修复种植体周骨缺损 ;rhBMP -2复合DFDBA ,可增强骨诱导作用 ,加速成骨过程 ;钛膜有助于维持骨再生空间 ,阻隔软组织长入 ,引导新骨生长 ,缩短修复过程。Objective:To observe the osteoinductive a ctivity of DFDBA in the per i-implant bone defect and evaluate the effect of rhBMP-2 and titanium membrane e ach combining with DFDBA for bone regeneration.Method: 3 dogs we re adopted eac h for 3 CDIC threaded implants placing operation in the femur, and made a 4 mm× 3 mm× 3 mm cortical bone defect around every implant. Simultaneously, 3 bone defects i n each dog were treated with DFDBA or DFDBA+rhBMP-2 or DFDBA+titanium membrane. Animals were sacrificed at 4, 8, 12 weeks post-operation. All specimens were obs erved by histological methods.Result: All bone defects recovered normally. Non e of the implants has loosed, no peri-implantitis has occurred. DFDBA group: At 4 weeks post-operation, new trabecular bone formed. In 8-12 weeks, newly formed bone was increasing with time and repaired the bone defect. But at 12 weeks ther e's still a definite gap between the new bone and host bone. DFDBA+ rhBMP-2 grou p: At 4,8 weeks post-operation, more new bone formed than that of DFDBA group. A t 12 weeks, the bone defect was obliterated with newly formed bone. DFDBA+ titan ium membrane group: At 4 weeks post-operation, new trabecular bone formed along the titanium membrane. At 12 weeks, new bone repaired the bone defect.C onclusion: DFDBA possesses osteoinductivity and osteoconductive activiti es, and can be a pplied to bone defect in implant operation. DFDBA combined with rhBMP-2 will inc rease its osteoinductive activity and shorten the period of bone repairing. Tita nium membrane help keep the space of bone regeneration, protect new bone from so ft tissue, conduct bone formation and shorten the process of bone repairing. [

关 键 词：脱钙冻干骨移植物 人重组骨形成蛋白-2 钛膜 种植义齿 骨缺损 

分 类 号：R782.2[医药卫生—口腔医学]