壳聚糖-胶原膜引导种植体颊侧骨缺损再生的实验  

Guided bone regeneration at a dehiscence-type defect using chitosan/collagen membranes in dogs

作　　者：李晓静[1] 王新木[2] 苗滪汶[1] 杨国利[3] 高波[1] 董研[1] 

机构地区：[1]浙江大学医学院附属第二医院口腔修复科,杭州310009 [2]杭州师范大学附属杭州牙科医院 [3]浙江大学医学院附属口腔医院口腔种植科

出　　处：《中华口腔医学杂志》2014年第4期204-209,共6页Chinese Journal of Stomatology

基　　金：卫生部科研基金（2003）;浙江省自然科学基金（Y2110260）;杭州市科技发展计划（20090833B02）

摘　　要：目的 研究用壳聚糖-胶原膜（chitosan-collagen membrane,CCM）引导种植体颊侧裂隙状缺损骨修复的效果.方法 壳聚糖与胶原以质量比40∶1和20∶1混合,经冻干得到CCM-1和CCM-2.比格犬10只,拔除下颌右侧4颗前磨牙和第一磨牙.4个月后,每只犬下颌骨右侧各植入4枚种植体,并在其颊侧制备裂隙状骨缺损,4个骨缺损处根据覆盖膜的种类及方式的不同,采用自身对照法分为4组：CCM-1组、CCM-2组、BG组及空白对照组,每组10只犬,各组观察样本量均为10个.术后4、8、12周各处死3、3、4只实验犬,取含种植体的标本,行组织学观察和硬组织形态学测量分析.结果 各实验组骨缺损区内均可见新生骨形成,随着时间延长逐渐增多、成熟.8周时,CCM-1组、CCM-2组和BG组的新生骨高度[（1.10 ±0.11） ～ （1.48 ±0.07） mm]均显著高于空白对照组[（0.74±0.12） mm]（P＜0.05）.12周时,CCM-1组新生骨高度[（1.91±0.25）mm]显著高于空白对照组[（1.20±0.34） mm] （P ＜0.05）.各组间骨-种植体接触率、新生骨面积差异无统计学意义.结论 CCM可促进种植体颊侧裂隙状缺损内的骨组织再生并与种植体表面结合良好.Objective To compare a developed absorbable chitosan/collagen membrane （CCM） with a standard biodegradable collagen membrane for the treatment of implant dehiscence-type defect in dog model.Methods The right four mandibular premolars and the first molar were extracted in each of 10 beagle dogs.Four months later,acute buccal dehiscence-type defects were surgically created following implant site preparation in each dog.Using self-control,defects were randomly assigned to four different groups：CCM-1 （with the ratio of chitosan and collagen of 40∶1）,CCM-2 （with the ratio of chitosan and collagen of 20∶1）,Bio-Gide collagen membrane （BG collagen）,control.The animals were sacrificed after 4 （3 animals）,8 （3 animals） and 12 （4 animals） weeks of healing interval for histological observation and histomorphometrical analysis including defect length（DL）,new bone height （NBH）,bone-to-implant contact （BIC） and area of new bone fill （BA）.Results Newly formed bone was observed in all the groups and became mature with time.At 8 weeks,increased mean NBH and BIC values were obtained for all the groups,the mean NBH values of the CCM-1,CCM-2 and BG groups[（1.1 0 ±0.11） ～ （1.48 ±0.07） mm] were significantly higher than that of the control [（0.74 ± 0.12）mm] （P ＜ 0.05）.At 12 weeks,the membranes treated groups obtained more mean NBH,BIC and BA values compared with the control.The CCM-1 groups showed the highest mean NBH value [（1.91 ± 0.25）mm],which was significantly higher than the control [（1.20 ± 0.34） mm] （P ＜ 0.05）.However,no statistically significant differences in BIC and BA were found between membrane groups and control and among the membranes treated groups.Conclusions The results of this study demonstrated that the developed CCM can enhance bone regeneration and obtaine similar amounts of newly formed bone compared with defects regenerated with a standard collagen membrane.

关 键 词：骨再生 牙种植体 壳聚糖-胶原膜 

分 类 号：R783.1[医药卫生—口腔医学]