自体骨髓浓缩物修复种植体周围的骨缺损  

Autologous bone marrow aspirate concentrate repairs peri-implant bone defect

作　　者：杨颖[1] 仲维剑[2] 刘国[3] 马国武[2] 

机构地区：[1]温州医科大学附属口腔医院种植科,浙江省温州市325027 [2]大连医科大学口腔医学院口腔颌面外科,辽宁省大连市116085 [3]温州医科大学附属口腔医院牙体牙髓科,浙江省温州市325027

出　　处：《中国组织工程研究》2014年第11期1653-1658,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:目前,自体骨髓浓缩物主要应用于骨科、重症肢体缺血患者,其在口腔颌面外科尤其是种植外科应用较少,在种植体周围促进新骨再生的效果也有待研究。目的:评价自体骨髓浓缩物在种植体周围骨缺损修复中的作用。方法:于实验犬髂后上棘处抽取骨髓5 mL,对浓缩前后的骨髓进行细胞计数。在实验犬的双侧下颌前磨牙区植入种植体,并于近中制作4 mm×4 mm×4 mm的骨缺损,随机植入骨髓浓缩物混合明胶海绵、自体骨、明胶海绵。术后4,12周对骨缺损标本进行组织学观察分析,并计算新骨生成率和新骨密度。结果与结论:骨髓细胞平均浓缩倍数为(2.78±0.22)倍。浓缩骨髓中,可观察到更多和更大的克隆单位。组织学分析发现,4周时骨髓浓缩物明胶海绵组的新骨生成率和密度均明显高于自体骨组和明胶海绵组(P<0.05),12周时骨髓浓缩物明胶海绵组新骨生成率明显低于自体骨组,但高于明胶海绵组(P<0.05),3组新骨密度差异无显著性意义(P>0.05)。结果显示自体骨髓浓缩物能够显著提高种植体周围骨缺损内早期新生骨的质量。BACKGROUND：Autologous bone marrow aspirate concentrate is often applied in patients from Department of Orthopedics and those with severe limb ischemia, but rarely applied in Department of Oral and Maxil ofacial Surgery, especial y in Department of Oral Implantology. The effect of autologous bone marrow aspirate concentrate on promoting peri-implant bone regeneration deserves further studies. OBJECTIVE：To evaluate the effect of bone marrow aspirate concentrate in the repair of peri-implant bone defect. METHODS：Bone marrow 5 mL was extracted from posterior superior iliac spine of experimental dogs and bone marrow cel s were counted before and after concentration. Bone defect （4 mm ×4 mm×4 mm） was prepared in the middle of bilateral mandibular premolar, which was randomly implanted with gelatin sponge plus bone marrow aspirate concentrate, autologous bone and gelatin sponge. At 4 and 12 weeks after surgery, bone defect specimens were histological y observed. The new bone formation rate and new bone mineral density were calculated. RESULTS AND CONCLUSION：After centrifugation, the concentrations of nucleated cel s in bone marrow aspirate concentrate were increased by （2.78±177;0.22） times. More colony-forming units were found after cel culture. Histological analysis showed that, significantly higher new bone formation rate and new bone mineral density occurred in gelatin sponge plus bone marrow aspirate concentrate group, compared with autologous bone group and gelatin sponge group at 4 weeks （P〈0.05）. The new bone formation rate in gelatin sponge plus bone marrow aspirate concentrate group was significantly lower than that of autologous bone group, and higher than that of gelatin sponge group at 12 weeks （P〈0.05）. However, the difference of new bone mineral density in the three groups was not significant （〈0.05）. Autologous bone marrow aspirate concentrate can significantly＆amp;nbsp;improve new bone mineral density and quantity in the pre-implant bone defect.

关 键 词：组织构建 骨组织构建 种植体 骨缺损 骨髓浓缩物 骨再生 

分 类 号：R318[医药卫生—生物医学工程]