离体时间对非血管化游离骨移植同期种植体骨内固位影响的实验观察  

An experimental research on effect of off-body time for fixation of simultaneously dental implant in nonvascularized free bone graft transplantation

作　　者：韩泽民[1] 于开涛[1] 刘宝林[1] 孙沫逸[1] 

机构地区：[1]第四军医大学口腔医学院颌面外科,陕西西安710032

出　　处：《临床口腔医学杂志》2006年第9期517-519,共3页Journal of Clinical Stomatology

基　　金：国家自然科学基金(30471901)

摘　　要：目的：研究非血管化游离骨移植同期种植的种植体固位力与游离骨块离体时间的关系,判断游离骨块离体时间对其存活和成骨的影响。方法：16只实验犬分为A、B两组,A组为非血管化游离骨块离体30min组；B组为非血管化游离骨块离体90min组。制作下颌骨节段性缺损的动物模型,取与缺损大小相当的自体非血管化全层游离髂骨,分别在30 min和90 min内植入纯钛金属种植体,用于修复下颌骨缺损处,牢固内固定。手术当时和术后3d、1周、2周、4周测量从骨内拉出种植体所用力的大小。HE和三色染色观察植骨块内骨成活和骨质变化状况。结果：A组,在种植体植入当时和骨移植后3d、1周、2周、4周各时间点,拔出种植体的力分别为144±13 N、140±15 N、134±9 N、137±13 N、146±7 N；骨块未见明显吸收,组织切片HE染色,骨块中央部位的骨陷窝内可见骨细胞,骨块中央部位可见成形骨小梁,部分骨陷窝空虚,但破骨现象不明显。改良Mallory染色,部分区域的骨密度有降低。B组在骨移植后3 d、1周、2周、4周,拔出种植体的力分别为143±14 N、140±7 N、133±11 N、130±7 N、136±2 N；骨块部分区域可见明显吸收,见到破骨细胞及明确的破骨现象；较多的骨陷窝空虚,成活的骨细胞较少,部分骨小梁有密度减低现象。结论：非血管化游离骨块的离体时间与移植后的骨成活密切相关,也就影响到了种植体的骨结合,因此,在临床应用时应尽量缩短非血管化游离骨的离体时间,以减少移植后的骨吸收。Objective：Our aim is to investigate the relation between fixation force of simultaneously dental implant in nonvaseularized free bone graft and its off- body time, furthermore, to analyze effect on the bone block survival and osteogenesis caused by bone block off- boy time. Method： 16 experimental dogs were divided into two groups （group A and group B） randomly, average 8 animals in each group, the off- body time of nonvascularized free bone graft was 30 minutes in group A , 90 minutes in group B. the animal model of mandible segmental was made , cutting the two- double ilium block without blood vessel and any soft tissue, implanting the titanium dental implant in it and repairing the mandible defect within 30 and 90 minutes in group A and group B respectively. The force of pulling dental implants out and osteanabrosis and osteogenesis around implant were investigated at that time, after operation 3 days and 1, 2, 4 weeks. Re. suit： In group A , at that very day, 3d, lw, 2w, 4w five time point after the compound bone graft transplantation, the pulling dental implant force value were 144± 13 N, 140 ± 15 N, 134 ± 9 N, 137±13 N, 146 ± 7 N respetively and present a special curve;that of group B were143 ± 14 N,140 ± 7 N,133± 11 N,130± 7 N,136± 2 N respectively and showed a similar curve to that of group A, but less pulling force value at 2w time point. Tissue sections HE staining shows that more osteocytes occupying Howship＇s fossa in group A than that of group B. The graft bone density of group A has no different changes compare with that before the bone grafts transplanted, but the density of parts spongy bone of group B was reduced. Bone absorption in group B was more serious than that of group A. Conclusion：The survival of transplantated nonvascularized free bone graft inside body is closed related to it＇s off- body time, even effect the dental implant osteointegration. In the clinical practice, for a free nonvascuarized bone graft, the shorter it＇s off- body time, the higher survival r

关 键 词：非血管化骨 种植体 颌骨缺损 骨结合 

分 类 号：R782.2[医药卫生—口腔医学]