摘要
背景:自体骨和自体牙本质均可作为骨移植材料应用于骨缺损的再生重建中,但异种或异体的牙本质能否作为骨移植替代材料,仍有待研究。目的:评价未脱矿异种牙本质颗粒作为骨移植材料的可行性,同时比较骨髓浓缩物和富血小板纤维蛋白在牙本质颗粒骨再生重建中的作用。方法:将临床获得的牙齿经过清洁、粉碎、煮沸、脱脂、消毒等步骤制成牙本质颗粒。取12只1岁龄雄性比格犬,进行双侧上颌窦提升手术,随机分3组进行窦腔内黏膜下植骨,A组植入未脱矿的异种牙本质颗粒,B组植入未脱矿的异种牙本质颗粒与自体富血小板纤维蛋白混合物,C组植入未脱矿的异种牙本质颗粒和自体骨髓浓缩物混合物。植入后3个月取材,进行植骨区X射线检查和组织学观察分析。结果与结论:(1)X射线检查:A组骨移植区可见密度较高的牙本质颗粒影像,与邻近正常骨组织界限较明显;B组、C组骨移植区可见大量密度较低的阻射影,与邻近正常骨组织界限不明显;(2)组织学观察:A组骨移植区牙本质颗粒周围有少量多核巨噬细胞,新骨生成量较少;B组、C组骨移植区牙本质颗粒外形呈虫蚀状,新骨生成的量均较多,且骨小梁排列较规则;A、B、C组的新骨生成率分别为(13.61±8.57)%,(32.28±4.85)%和(36.85±9.70)%,B组、C组新骨生成率显著高于A组(P<0.05),B组与C组新骨生成率无差异;(3)结果表明:经过处理的未脱矿异种牙本质颗粒具有良好的骨传导作用,骨髓浓缩物或富血小板纤维蛋白均能有效促进未脱矿异种牙本质颗粒周围的新骨生成,骨髓浓缩物的作用略优于富血小板纤维蛋白。
BACKGROUND:Autologous bone and dentin can be used as bone grafting materials for bone regeneration and reconstruction,but it is unclear whether heterogeneous dentin particles can be processed as bone substitutes to facilitate the bone regeneration.OBJECTIVE:To investigate the feasibility of undemineralized heterogeneous dentin particles to be used as bone grafting materials,and to compare the effects of bone marrow concentrate and platelet-rich fibrin on bone regeneration in combination with dentin particles.METHODS:The extracted human teeth were harvested and prepared to be dentin particles for bone grafting through cleaning,crushing,boiling,degreasing and disinfection.Twelve healthy male Beagle dogs,1 year of age,were selected to create the animal models of bilateral maxillary sinus lift and were then randomly divided into three groups.The maxillary sinus surgery was performed on both sides of each dog.In group A,only implantation of heterogeneous dentine particles was given;in group B,implantation of the mixture of rich platelet fibrin and heterogeneous dentine particles was performed;and in group C,the mixture of bone marrow concentrate and heterogeneous dentine particles was implanted.The specimens from each animal were harvested after 3 months of implantation.Gross observation,X-ray examination and histological analysis were used to evaluate bone regeneration effects.RESULTS AND CONCLUSION:No inflammatory signs were found in the bone grafting areas of each group.X-ray results showed that dentin particles with high density were detected in the bone graft area of group A,with the clear boundary with the adjacent bone tissue.However,lower density and unclear border of the graft area were detected in the groups B and C.Histological observation revealed that there was less new bone formation with a few multinucleated macrophages around the dentin particles in group A,while in groups B and C,dentin particles with worm-eaten shape was visible,and there was more new bone formation with regular trabecular alignment.The new bone formation rates were(13.61±8.57)%,(32.28±4.85)%and(36.85±9.70)%in groups A,B and C,respectively.Significantly higher new bone formation rate was found in groups B and C than group A(P<0.05),but there was no significant difference between groups B and C.Experimental findings show that the undemineralized heterogeneous dentin particles possess good biocompatibility and bone conduction capacity.In combination with bone marrow concentrate and platelet-rich fibrin,the new bone formation around the grafted dentin granules can be effectively promoted.Moreover,bone marrow concentrates have a slightly better effect than platelet-rich fibrin.
作者
崔婷婷
邱泽文
邵阳
仲维剑
Cui Ting-ting;Qiu Ze-wen;Shao Yang;Zhong Wei-jian(Department of Oral and Maxillofacial Surgery,School of Stomatology,Dalian Medical University,Dalian 116023,Liaoning Province,China;Animal Laboratory Center,Dalian Medical University,Dalian 116044,Liaoning Province,China;Department of Oral and Maxillofacial Surgery,Ningbo Dental Hospital,Ningbo 315000,Zhejiang Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2018年第30期4806-4811,共6页
Chinese Journal of Tissue Engineering Research
基金
辽宁省自然科学基金(2015010313-301)~~
作者简介
崔婷婷,女,1993年生,辽宁省铁岭市人,汉族,大连医科大学口腔医学院在读硕士,主要从事种植牙和骨再生技术的研究。;通讯作者:仲维剑,副教授,硕士生导师,大连医科大学口腔医学院口腔颌面外科,辽宁省大连市116023。
