微渠多孔羟基磷灰石支架修复犬下颌骨大面积缺损后与种植体的骨结合  

Osseointegration of micro-grooved patterns of porous hydroxyapatite scaffolds with implants after repairing large-area canine mandibular defects

作　　者：李静 陈争晖 凯迪丽娅·亚力坤 刘畅 江思婧 牟雁东 Li Jing;Chen Zhenghui;Kaidiliya·Yalikun;Liu Chang;Jiang Sijing;Mu Yandong(Affiliated Stomatology Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China;Sichuan Academy of Medical Sciences·Sichuan Provincial People’s Hospital,Chengdu 610072,Sichuan Province,China;Nanbu County People’s Hospital,Nanchong 637000,Sichuan Province,China)

机构地区：[1]西南医科大学附属口腔医院,四川省泸州市646000 [2]四川省医学科学院·四川省人民医院,四川省成都市610072 [3]南部县人民医院,四川省南充市637000

出　　处：《中国组织工程研究》2023年第12期1920-1926,共7页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金面上项目(82071168),项目负责人:牟雁东;四川省科技厅重点研发项目(2021YFS0009),项目负责人:牟雁东;四川省科技厅项目(2016TD0008),项目负责人:牟雁东。

摘　　要：背景:前期研究显示,微渠多孔羟基磷灰石具有良好骨诱导性、生物相容性、骨传导性,为临床修复颌骨缺损扩大种植适应证提供了新思路。目的:观察微渠多孔羟基磷灰石修复犬下颌骨大面积缺损后与牙种植体骨结合的情况。方法:制作微渠多孔羟基磷灰石支架。将8只比格犬随机分为实验组和对照组,每组4只,拔除犬双侧下颌前磨牙,拔牙3个月后,在双侧前磨牙处各制造2个近远端为8 mm、颊舌侧为10 mm、冠根方向为8 mm的圆柱型骨缺损,实验组植入微渠多孔羟基磷灰石支架,对照组植入自体骨;3个月后于骨缺损修复区植入直径4 mm、高度10 mm的Dentium种植体。种植体植入4,12周后取材,进行锥形束CT、Micro-CT、组织学与种植体共振频率分析。结果与结论:①锥形束CT:植入4周后,两组种植体与周围骨界面处有部分低密度影;12周后,两组种植体与骨结合的面积增加,种植体与植入材料结合紧密,无明显暗影;②Micro-CT检测:实验组植入4周后的植体表面被覆骨量小于对照组(P<0.05),植入12周后的植体表面被覆骨量比较差异无显著性意义(P>0.05);③组织学形态:苏木精-伊红、Masson与亚甲基蓝-酸性品红染色显示,两组植入4周后术区均可见新骨形成,实验组种植体-骨结合率低于对照组(P<0.05);12周后两组植体周围骨量明显增加,两组种植体-骨结合率比较差异无显著性意义(P>0.05);④种植体共振频率分析:实验组植入4,12周后的种植体稳定系数均低于对照组(P<0.05),但两组种植体在各时间段均有良好的稳定性;⑤结果表明:微渠多孔羟基磷灰石支架能修复犬颌骨大面积缺损,诱导新生骨形成,与种植体形成良好的骨结合。BACKGROUND:Preliminary studies have shown that micro-grooved patterns of porous hydroxyapatite have good osteoinductivity,biocompatibility,and osteoconductivity,which provides a new idea for clinical repair of jaw defects and expansion of implantation.OBJECTIVE:To observe the osseointegration of the micro-grooved patterns of porous hydroxyapatite with the dental implant after repairing large-area defect of the canine mandible.METHODS:Micro-grooved patterns of porous hydroxyapatite were made.Eight beagle dogs were randomly divided into experimental group and control group(n=4 per group).Bilateral mandibular premolars of the dogs were extracted.Three months later,two cylindrical bone defects of 8 mm×10 mm were fabricated.The experimental group was implanted with micro-grooved patterns of porous hydroxyapatite and the control group was implanted with autologous bone.Three months later,a 4 mm×10 mm Dentium implant was implanted in the bone defect repair area.Samples were taken at 4 and 12 weeks after implantation.Cone beam CT examination,Micro-CT scan,histological examination,and implant resonance frequency analysis were performed.RESULTS AND CONCLUSION:(1)Cone beam CT showed that there were some low-density shadows at the implant-osseointegration interface between the experimental group and the control group 4 weeks after the operation.At 12 weeks after the operation,the area of the implant-osseointegration surface increased in the experimental group and the control group.The implant was closely combined with the implant material,and there was no obvious shadow.(2)Micro-CT data analysis showed that the amount of bone covered on the implant surface in the experimental group was less than that in the control group 4 weeks after operation(P<0.05).There was no significant difference in the amount of bone covered on the implant surface between the two groups at 12 weeks(P>0.05).(3)Histological morphology:Hematoxylin-eosin,Masson and methylene blue-acid fuchsin staining showed that new bone formation was seen in both gr

关 键 词：羟基磷灰石 种植体 骨缺损 骨结合 支架 下颌骨 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R783.6