实验性骨质疏松对种植体周自体骨移植愈合影响的研究  

The effect of experimental osteoporosis on bone healing of autologous iliac crest graft around implants

作　　者：李剑平[1] 张望群[1] 于静[1] 戚孟春[1] 胡静[2] 王东胜[3] 

机构地区：[1]华北煤炭医学院口腔系,河北唐山063000 [2]四川大学华西口腔医学院口腔颌面外科学教研室,四川成都610041 [3]解放军总医院口腔科,北京100039

出　　处：《华西口腔医学杂志》2010年第4期435-438,共4页West China Journal of Stomatology

基　　金：河北省科技厅基金资助项目(08276101D-73);河北省教育厅基金资助项目(2008322)

摘　　要：目的研究实验性骨质疏松(OP)对兔种植体周自体骨移植愈合的影响。方法将20只雌性日本大耳白兔随机分成对照组和实验组,实验组行双侧卵巢切除术,对照组接受假手术。术后12周测量股骨骨密度(BMD),证实OP状态。同时在2组家兔左侧胫骨近中干骺端制备骨缺损,行自体髂骨移植和同期种植体植入手术。植骨术后第8、12周分2批处死动物,切取标本制作不脱钙硬组织切片,进行组织形态学观察和骨计量学检测。结果实验组BMD显著低于对照组(P<0.001),证实OP造模成功。植骨术后第8、12周,种植体在2组植骨区均达到了骨结合。然而,实验组植骨区内骨皮质厚度(TCB)、松质骨区骨量(BVC)、种植体骨结合率(IBCR)均显著低于对照组(P<0.01),且新生骨量也明显少于对照组。结论实验性OP虽然不会延迟自体骨移植内种植体骨结合,但可促进植骨吸收,减少BVC,降低IBCR。因而,对于行自体骨移植同期牙种植的患者,OP是一个重要的危险因素。Objective To investigate the influences of experimental osteoporosis（OP） on bone healing of autologous iliac crest graft around dental implants in rabbits.Methods Twenty Japanese rabbits were randomly divided into two groups.Bilaterally ovariectomy was performed on experimental group and control group received sham-operation.Twelve weeks later,femoral bones were examined for bone mineral density（BMD） to verify OP status.Then bone defects were made in the proximal metaphysis of the tibiae and autologous iliac crest grafts with simultaneous implant placement were performed.The animals were killed at 8 and 12 weeks after bone graft surgery.Undecalcified sections were prepared and examined histologically and histomorphometrically.Results Osteoporotic status caused by ovariectomy was verified by significantly decreased BMD in experimental group（P〈0.001）.At 8 and 12 weeks after bone graft surgery,osseointegration was observed in both groups.However,thickness of cortical bone（TCB）,bone volume in cancellous area（BVC）,implant-bone contact rate（IBCR） at bone graft area all significantly decreased in experimental group when compared with control group（P〈0.01）.Newly formed bone was also less in experimental group than that in control group.Conclusion Although experimental OP may not delay osseointegration of dental implants in autologous iliac crest graft,it certainly promotes resorption of bone grafts,decreases cancellous bone volume and implant-bone contact rate.Therefore it may be an important risk factor for patients receiving autologous bone graft with simultaneous implant placement.

关 键 词：种植牙 自体髂骨移植 骨质疏松 骨结合 

分 类 号：R687.3[医药卫生—骨科学]