骨膜下植骨技术修复兔口腔种植体颊侧骨缺损的实验研究  

Experimental study on repairing buccal bone defect of rabbit oral implant with sub-periosteal peri-implant augmented layer technique

作　　者：于海洋 杨晶[2] Yu Haiyang;Yang Jing(Tianjin Hospital,Tianjin 300211,China;Tianjin Stomatological Hospital,Tianjin 300041,China)

机构地区：[1]天津市天津医院,天津300211 [2]天津市口腔医院,天津300041

出　　处：《齐齐哈尔医学院学报》2024年第21期2012-2019,共8页Journal of Qiqihar Medical University

基　　金：天津市卫生健康委员会科技自筹项目(ZC20039)。

摘　　要：目的探究骨膜下植骨(Sub-periosteal Peri-implant Augmented Layer,SPAL)技术对于修复种植体颊侧骨缺损的组织学可靠性。方法选取20只日本大耳白兔,应用随机数表法将其分为引导骨再生(Guided bone regeneration,GBR)组(A组)和SPAL组(B组)两组,每组各10只。拔除兔下颌切齿同期植入种植体建立骨缺损模型。骨增量A组采用GBR技术,B组采用SPAL技术。术后即刻、1个月、3个月、6个月取材进行Micro CT扫描及组织学观察。结果实验操作可实现理想骨充填,术后1个月时,B组种植体颊侧多个水平层面骨壁厚度及整体骨体积均明显高于A组。术后3个月时,B组种植体颊侧骨量高于A组,差异具有统计学意义(P<0.05)。术后6个月时,两组种植体颊侧最终骨量趋于等量。组织学观察可知,两组种植体颊侧均可实现成熟板层骨结构。结论SPAL骨增量术后无纤维组织长入成骨区,术后6个月可实现种植体骨结合及颊侧骨再生,效果与传统GBR技术无显著差异。且骨膜替代人工屏障膜有利于维持原始骨壁,具有更好的空间维持作用。Objective To investigate the histological reliability of the sub-periosteal peri-implant augmented layer(SPAL)technique for repairing buccal bone defects of implants.Methods Twenty Japanese big-eared white rabbits were selected and divided into guided bone regeneration(GBR)group(Group A)and SPAL group(Group B)by the random number table method,with 10 rabbits in each group.The bone defect model was established by extracting the mandibular incisors and simultaneously implanting to create bone defects.Bone augmentation in Group A was performed using GBR technology,while Group B used the SPAL technique.Samples were taken immediately after surgery,and at 1,3,and 6 months postoperatively for Micro CT scanning and histological observation.Results The experimental procedures achieved ideal bone filling.One month postoperatively,the buccal bone wall thickness at multiple horizontal levels and overall bone volume around the implants in Group B were significantly higher than those in Group A.Three months postoperatively,the buccal bone volume in Group B was greater than that in Group A,with a statistically significant difference.Six months postoperatively,the final buccal bone volume in both groups tended to be equivalent.Histological observations revealed that both groups could achieve a mature lamellar bone structure on the buccal side of the implants.Conclusions There is no fibrous tissue growth into the osteogenic area after the SPAL bone augmentation.Six months postoperatively,osseointegration and buccal bone regeneration are achieved,with results not significantly different from those of the traditional GBR technique.Moreover,the periosteum,as a substitute for artificial barrier membranes,is beneficial for maintaining the original bone walls and has a better space-retention effect.

关 键 词：骨膜 屏障膜 骨再生 种植体 

分 类 号：R78[医药卫生—口腔医学]