部分脱矿自体牙本质颗粒在种植位点保存术中的成骨效能  

Osteogenic effects of partially demineralized autogenous dentin particles in implant site preservation

作　　者：梁韩莹 马云豪 李涵 李东阳 仲维剑[1] 马国武[1] Liang Hanying;Ma Yunhao;Li Han;Li Dongyang;Zhong Weijian;Ma Guowu(School of Stomatology,Dalian Medical University,Dalian 116044,Liaoning Province,China)

机构地区：[1]大连医科大学口腔医学院,辽宁省大连市116044

出　　处：《中国组织工程研究》2023年第16期2488-2492,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:自体牙本质颗粒被越来越多地应用于各种骨增量手术中。适度的脱矿处理可以使牙本质表面的胶原和生长因子暴露,促进骨再生,但脱矿程度如何控制尚无明确报道。目的:评价不同程度脱矿的自体牙本质颗粒作为骨移植材料,在牙槽骨位点保存术中的促进骨再生效能。方法:选取比格犬6只,均拔除双侧下颌第二、三、四前磨牙,经过打磨、粉碎、筛选、浸酸、消毒、清洗等处理制成直径0.5-1.0 mm的牙本质颗粒,浸入2%硝酸中不同时间进行不脱矿(0 min)、轻度(1 min)、中度(10 min)及重度(40 min)脱矿处理,将4种自体牙本质颗粒随机植入4个拔牙窝内,未植入牙本质颗粒的拔牙窝为空白对照。移植后6个月对植骨区进行大体观察、影像学检查和组织学观察。结果与结论:(1)大体观察:植入牙本质颗粒组牙槽嵴顶丰满,空白对照组牙槽嵴顶凹陷不连续;(2)锥形束CT检测显示,植入牙本质颗粒组牙槽嵴连续平整,空白对照组嵴顶不连续且牙槽窝内密度较低,未脱矿组、轻度脱矿组牙槽窝内密度不均,可见散在的高密度影;中度脱矿组牙槽窝充实,密度均匀;重度脱矿组牙槽窝内大面积空虚,呈低密度影象;(3)组织学观察:未脱矿组仍有较多的牙本质颗粒残余,颗粒内可见虫噬状缺损,颗粒外围被排列散乱的新生骨组织包裹;轻度脱矿组残余少量牙本质颗粒且被新生骨包裹;中度脱矿组牙本质颗粒零星残余,骨细胞排列规律有序;重度脱矿组无牙本质颗粒残余,骨细胞成熟,排列规律;空白对照组牙槽窝内骨小梁排列紊乱,骨髓腔内含较多纤维结缔组织;(4)结果表明:不同程度脱矿的自体牙本质颗粒在牙槽骨保存术中均可以引导新骨生成,其中脱矿10 min的牙本质颗粒促骨再生效果更好。BACKGROUND:Autogenous dentin particles are increasingly used in various bone augmentation surgeries.Moderate demineralization may expose collagen and growth factors on the dentin surface and promote bone regeneration,but the degree of demineralization has not been clearly reported.OBJECTIVE:To evaluate the efficacy of autogenous dentin particles demineralized with different degrees as bone graft materials on promoting bone regeneration in alveolar bone site preservation.METHODS:Six beagles were selected and the second,third and fourth premolars of bilateral mandible were extracted.After grinding,crushing,sifting,pickling,disinfection and cleaning,dentin particles with a diameter of 0.5-1.0 mm were prepared.According to the time of pickling in 2%nitric acid,the samples received undemineralized(0 minute),demineralized for 1 minute(mild),demineralized for 10 minutes(moderate)and demineralized for 40 minutes(severe).The prepared dentin particles were filled into the tooth socket respectively,and the extraction socket without implanted dentin particles was a blank control.At 6 months after surgery,the bone graft area was observed by gross inspection,radiographic examination,and histological observation.RESULTS AND CONCLUSION:(1)Gross observation:The crests of alveolar ridge in the dentin particle groups were full and discontinuous crest with depressions was found in blank control group.(2)Cone beam CT showed that continuous alveolar ridge was formed in the dentin particle groups,discontinuous alveolar ridge and low density in the center of alveolar bone in the blank control group,and uneven density in alveolar socket in the undemineralized and mild demineralized groups with scattered high density image.Uniform and higher density was displayed in alveolar sockets of the moderate demineralized group and the alveolar sockets in the severe demineralized group were empty with low density images.(3)Histological observation:A large amount of dentin particles and insect phagocytic defects in the particles of the undemineraliz

关 键 词：骨 种植位点保存 牙本质颗粒 骨移植 骨再生 动物实验 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学] R782.13