钛网成形自体颗粒骨修复下颌骨缺损并同期种植的实验研究  

Experimental study of the shaped titanium mesh combined with autogenous particulate bone graft and simultaneous implant for reconstructing segmental mandibular defect

作　　者：陈宁[1] 郭吉来 张双越[1] 陶江丰[3] 杜一飞[1] 

机构地区：[1]南京医科大学口腔医学研究所南京医科大学附属口腔医院口腔颌面外科,江苏南京210029 [2]山东省青岛市口腔医院种植科 [3]江苏省江阴市人民医院口腔科

出　　处：《中华口腔医学杂志》2009年第6期360-364,共5页Chinese Journal of Stomatology

基　　金：江苏省科技厅社会发展项目（BS2006062）;江苏省卫生厅科研基金（H20037）.

摘　　要：目的观察犬钛网成形自体颗粒骨移植修复下颌骨节段性缺损并同期植入钛种植体后的骨愈合和骨结合情况。方法5只Beagle犬，一侧下颌骨制备长40mm的节段性缺损；钛网成形修复下颌骨缺损。将切除后的下颌骨和自体髂骨剪成直径约2mm颗粒，骨皮质、骨松质体积比3：1混合，紧密充填在钛网内，将2枚纯钛种植体埋置于颗粒骨内，术后6个月处死动物。用下颌骨X线片、组织学切片、扫描电镜以及能谱分析观察钛网内颗粒骨愈合以及种植体骨结合的情况。结果钛网成形自体颗粒骨移植重建后的下颌骨外形满意，功能正常、颗粒骨成骨良好、结构优良，未见明显骨吸收。同期植入的种植体能够与周围骨组织形成良好的骨结合，并有促进邻近骨组织结构优化的趋势。结论钛网成形自体颗粒骨移植是一种修复下颌骨节段性缺损的好方法，当修复后下颌骨形态良好、骨质优良、骨量充足时可以同期植入种植体。Objective To observe the healing and bone formation of the autogenous particulate bone graft and osseointegration of the implants in shaped titanium mesh with autogenous particulate bone graft and simultaneous implant for reconstructing segmental mandibular defect in dogs. Methods Five Beagle dogs were prepared with unilateral 40 mm segmental mandibular defect. Titanium mesh was shaped according to the mandibular defect and was fixed with titanium screws. The ablated mandibular bone and iliac bone were crashed to approximately 2 mm particulates which then filled the titanium mesh tightly （cortical bone：cancellous bone, 3：1 ）. Two implants were placed in the autogenous particulate bone graft. The dogs were sacrificed after six months. X-ray films, histological sections, Scanning electron microscopy（SEM） and Energy disperse analysis of the reconstructed mandibles were examined to evaluate the bone formation of the bone graft and osseointegration of the implants. Results The outline of the reconstructed mandible was satisfactory and its function was excellent. The ossific fusion among the particulate bone grafts was fine and no resorption was found. All implants showed excellent osseointegration with the bone graft. The bone near the implant was more compact than the bone away from it. The structure of the bone near implant was optimized because of simultaneous implant in shaped titanium mesh. Conclusions The shaped titanium mesh with autogenous particulate bone graft is a good method for reconstructing segmental mandibular defect, and simultaneous implant is feasible in the reconstructed mandible in dogs.

关 键 词：下颌骨 移植 自体 牙种植体 

分 类 号：R686[医药卫生—骨科学]