硅橡胶膜对骨缺损愈合的影响

于骨膜下置入硅橡胶膜铺盖兔子胫骨缺损。结果表明,置膜8周后骨缺损形态结构已恢复接近正常。提示在愈合早期。硅橡胶膜承受和分散外力,保持成骨组织结构稳定,从而促进骨再生修复。     

冷冻异体骨膜引导即刻种植体周围骨缺损修复的临床研究

目的：观察机体对冷冻异体骨膜的反应及其引导骨组织再生的效果，方法：在实验研究成功的基础上，将冷冻异体骨膜作为引导组织再生膜性材料应用于引导即刻种植义齿植体周围骨缺损的修复。结果：临床观察证实机体对冷冻异体骨膜无排斥反应，膜无脱出，无感染，骨缺损修复率达到92．12％，结论：冷冻异体骨膜是一种理想的引导组织再生膜性材料。     

天然型无机骨骨膜下植入的实验研究

目的 观察天然型无机骨骨缺损内与骨膜下植入后在成骨能力,愈合过程上的差异。方法 将块状天然型无机骨植入兔下颌骨缺损内与骨膜下（骨皮质表面）,进行光镜及扫描电镜观察。结果 骨缺损组植入４周即有新骨向无机骨孔内长入,１２周无机骨少部分被吸收,新骨与无机骨间界面清晰,骨缺损被新骨完全修复。骨膜下组８周出现少量新骨,１２周大部分无机骨被纤维结缔组织包裹,与原骨床间主要为纤维性间隔,仅少部分与新骨组织结合。     

力学刺激下BMP信号通路影响成骨分化的研究进展

骨组织的再生和重塑涉及复杂的力学刺激,而机械性诱导骨改建是牵张成骨、骨缺损修复、正畸牙移动生物学的重要理论基础。骨形态发生蛋白(bone morphogenetic proteins,BMPs)是调控骨骼发育的关键信号分子,在骨组织的发生及再生中起着重要作用。研究表明,激活BMP信号可增强成骨相关标志性基因的表达,促进骨形成。本文就力学刺激下参与骨向分化的BMP信号通路的相关研究进行综述。     

引导骨再生屏障膜改良的研究进展

引导骨再生术是解决骨组织缺损问题的重要技术,引导骨再生屏障膜在其中发挥着不可替代的作用。引导骨再生膜是防止成纤维细胞进入骨缺损部位的屏障,同时可促进成骨细胞的黏附、增殖和骨组织再生。由于目前广泛应用于引导骨再生的胶原膜尚存在一些缺陷,探索具有更优良性质的引导骨再生屏障膜成为一个重要的课题。因此出现了从抗菌性的改良、成骨性的改良和新材料的研发等多方面的努力以改良引导骨再生膜。本文回顾了近年来引导骨再生膜改进的研究成果和进展,展望了未来相关研究的发展方向,为进一步展开骨再生及修复的相关研究工作提供参考。     

引导骨再生屏障膜改良的研究进展

引导骨再生术是解决骨组织缺损问题的重要技术,引导骨再生屏障膜在其中发挥着不可替代的作用。引导骨再生膜是防止成纤维细胞进入骨缺损部位的屏障,同时可促进成骨细胞的黏附、增殖和骨组织再生。由于目前广泛应用于引导骨再生的胶原膜尚存在一些缺陷,探索具有更优良性质的引导骨再生屏障膜成为一个重要的课题。因此出现了从抗菌性的改良、成骨性的改良和新材料的研发等多方面的努力以改良引导骨再生膜。本文回顾了近年来引导骨再生膜改进的研究成果和进展,展望了未来相关研究的发展方向,为进一步展开骨再生及修复的相关研究工作提供参考。     

骨多肽生长素、珊瑚骨、地榆诱导鼠额面骨再生的研究

目的评价骨多肽生长素(BAP)应用于小白鼠额面骨缺损区诱导骨再生修复的效果。方法昆明小白鼠63只随机分为3组,实验组植入骨多肽生长素复合珊瑚骨,对照A组植入珊瑚骨,对照B组植入珊瑚骨复合地榆。观察骨组织形态变化和新生骨结构,计量每视野新生成骨细胞健康数;在透射电镜下观察再生骨的超微结构变化。结果术后7 d,骨缺损区周围有破骨细胞、间充质细胞和大量炎性细胞浸润,骨变性坏死。术后28 d,实验组可见成纤维细胞、毛细血管生长活跃,可见骨样组织和大量骨组织;对照A组可见骨缺损区周围有间充质细胞和成骨细胞;对照B组可见成纤维细胞、毛细血管生长活跃,骨缺损区周围有成骨细胞。术后90 d,实验组可见新生骨组织范围扩大,钙化程度加强,几乎接近正常骨质结构;对照A组、B组皆可见骨缺损边缘有较多新骨沉积。计量3组新生成骨细胞数,运用单因素方差分析及两两比较,实验组与各对照组差异有显著性。结论应用骨多肽生长素复合载体材料珊瑚骨可促进骨缺损的修复。     

兔下颌骨骨膜牵张成骨的实验研究

目的 探讨骨膜牵张成骨术的新方法。方法 将自制骨膜牵张器固定于3只兔的双侧下颌骨表面,左侧行骨膜牵张,右侧不牵张,作为对照。牵张过程结束后处死所有动物,标本进行X线和组织学检查。结果 3只动物术后情况良好,无明显并发症。在大体标本和X线片上表现出新骨形成。组织学检查显示牵张区有成骨样细胞浸润和骨组织形成。结论 骨膜牵张成骨技术能够为骨缺损的修复提供一种新的方法。     

可吸收膜在引导骨再生中的应用研究

引导骨再生（Guided Bone Regeneration，GBR）是指利用屏障膜引导骨组织再生防止周围纤维结缔组织过早长入骨缺损区，改变骨创愈合环境，从而促进骨组织再生修复。本文对临床常见的可吸收膜做一综述，研究其在引导骨再生中的作用。     

骨组织工程中壳聚糖支架材料的设计与改性

因外伤、肿瘤、组织感染坏死等多种原因造成的骨组织缺损无法或无法完全自行修复,需要良好的骨组织替代物帮助修复,因此学者们一直致力于研发与改性各种骨再生支架材料以更好地帮助修复骨缺损。壳聚糖因具有良好的生物可降解性、生物相容性等被视为骨组织工程支架材料绝佳原料。本文仅对近年来骨组织缺损修复与再生中学者们对壳聚糖支架材料改性设计与改性方法进行简要综述。     

Using the intact periosteum for horizontal bone augmentation of peri-implant defects: a retrospective cohort study

The objectives of this study were to observe hard tissue changes in guided bone regeneration (GBR) with intact periosteum and soft block deproteinised bovine bone mineral (DBBM), and evaluate whether the result of horizontal bone augmentation varied by initial peri-implant defect depth. Forty patients with a single missing tooth and contained peri-implant defect were categorised into three groups according to their presurgical defect depth (≤ 2, 2–4, and 4–6 mm). Cone-beam computed tomography (CBCT) images were collected and reconstructed preoperatively, postoperatively, and at six months’ follow up. The buccal bone width (BBW -0, -3, -5), alveolar bone width (ABW -0, -3, -5) and volume of augmented area were measured. At the six-month follow up the increase in BBW, ABW at all levels, and in bone volume, was statistically significant (all p < 0.001). No statistical significance in bone dimensions or bone resorption was found among groups (all p > 0.05). Histological analysis detected new bone formation in intimate contact with bone grafts underlying the periosteum. Within the limitations of this study, the insights gained may be of assistance to suggest that comparable and acceptable results of horizontal bone augmentation can be achieved in cases of peri-implant defect depth of ≤6 mm by means of GBR with intact periosteum.     

A comparative study of barrier membranes as graft protectors in the treatment of localized bone defects. An experimental study in a canine model

Guided bone regeneration is a predictable and well-documented surgical approach for the treatment of deficient alveolar ridges prior to endosseous implant placement. The purpose of this study was to compare a new resorbable membrane (GORE RESOLUT ADAPT Regenerative Membrane, i.e. 67% glycolide (PGA) : 33% trimethyline carbonate (TMC)) with Bio-Gide, a resorbable collagen membrane. Five canines were used in the study. Three saddle-type osseous defects were created bilaterally in edentulous areas of the mandible. The defects were filled with assayed, canine demineralized freeze-dried bone (DFDB) in a thermoplastic gelatin matrix. Using a randomized block design, four sites were covered with PGA : TMC membranes of four different porosities, one site was covered with a collagen membrane and one site consisted of DFDB alone (control). At 3 months, the animals were euthanized and the mandibles were removed en bloc for laboratory processing. A total of 30 sites were reviewed microradiographically and underwent histomorphometric analysis for bone regeneration, soft tissue presence and remaining graft material. All sites exhibited uneventful healing. A significantly higher percentage of bone regeneration was seen in the sites protected by the PGA : TMC membrane. A higher component of soft tissue was visible beneath the collagen membrane as compared with the PGA : TMC membrane. The control sites exhibited noticeable deformation of the regenerated bone secondary to collapse of the overlying periosteum. The authors conclude that the PGA : TMC membrane protected the DFDB-filled defect and allowed a greater amount of bone regeneration than the defect protected by the collagen membrane or the control.     

小型猪骨膜成骨修复下颌骨节段性缺损的研究

目的:探讨原位骨膜成骨修复小型猪下颌骨节段性缺损的可行性。方法:选用13个月龄小型猪8只,雌雄不限,拔除右侧下颌前后磨牙3个月后,随机分为保留骨膜组(A组)和不保留骨膜组(B组),每组4只。再按骨缺损长度分为30 mm组和40 mm组,每组各2只。制备小型猪下颌骨体部30 mm和40 mm节段性骨缺损,利用钛板固定两侧骨断端,A组完整保留缺损区颊舌侧的骨膜并将其严密缝合形成一封套层,B组则不保留骨膜,术后4、8、12周进行影像学观察。结果:影像学观察保留骨膜组术后12周完成骨连接,新生骨形态规则,不保留骨膜组未完成骨连接,仅在骨断端有极少量新生骨,且形态不规则。结论:利用骨膜原位成骨可以修复下颌骨较大范围节段性骨缺损。     

Treatment of severe peri‐implant bone loss using autogenous bone and a resorbable membrane. Case report and literature review.

Clinical case reports and animal studies have demonstrated that the principle of guided bone regeneration can be applied for surgical treatment of moderate to profound peri‐implant bone loss (peri‐implantitis). However, the degree of bone regeneration within the peri‐implant osseous defect was reported to be variable depending on different clinical factors and on the postoperative course. Most papers dealing with surgical treatment of peri‐implantitis advocate the use of a non‐resorbable ePTFE membrane for secluding the peri‐implant bone defect enabling bone regeneration. Additionally some surgeons fill the defects with allografts or alloplasts. The present case report demonstrates another surgical approach by using autogenous cancellous bone for grafting into the peri‐implant bone defect and placing a bioresorbable polylactide membrane as a matrix barrier. The successful out‐come of this modified surgical approach enabled the patient to maintain the implant for prosthetic reconstruction after early but severe bone loss.     

GBR植骨效果的远期稳定性不优于自体骨移植

引导性骨再生术（GBR）的应用缺陷包括：屏障膜容易塌陷、吸收,不可吸收膜需要二次手术取出,容易早期暴露导致不理想的骨再生。膜的放置过程中容易导致颗粒状骨粉的移位和扩增位点凸度的丧失。尤其在不易维持成骨空间的骨缺损类型中,GBR在骨再生能力上往往具有不可预期性。因为传统的骨替代材料仅具有骨传导性而没有骨引导性,屏障膜在缺损形态不佳时难以维持一个稳定的骨再生空间。块状自体骨移植相对于使用颗粒状骨替代材料的引导性骨再生术的优势在于：具备良好的成骨特性和生物机械性能。即使在不易维持成骨空间的骨缺损类型中,块状自体骨移植能提供新骨形成改建所必需的骨源细胞,理想的外形重塑以及良好抗微动和抗吸收特性。我方观点：GBR植骨效果的远期稳定性不优于自体骨移植。     

Clinical outcome of autogenous bone blocks or guided bone regeneration with e‐PTFE membranes for the reconstruction of narrow edentulous ridges

The aim of this study was to analyse the clinical outcome of two different surgical methods for the reconstruction of narrow edentulous ridges before implant installation: guided bone regeneration with e-PTFE membranes and autologous bone chips or grafting of autologous bone blocks without e-PTFE membranes. Thirty partially edentulous patients, presenting insufficient bone width (less than 4 mm) in the edentulous sites for installation of screw-type titanium implants, were selected and assigned to two different treatment modalities. Fifteen patients (group 1) were treated by means of guided bone regeneration with e-PTFE membranes supported by stainless steel screws and autologous bone chips taken from intraoral sites. Fifteen patients (group 2) were treated by means of autologous bone blocks taken from intraoral or extraoral sites (anterior iliac crest and calvaria) and stabilized with titanium microscrews. Six to 8 months later, during re-entry for implant insertion, the gain of ridge width obtained was measured. In group 1 the average amount of bone gain was 2.7 mm, whereas in group 2 the value was 4.0 mm. Five to 6 months after implant placement prosthetic rehabilitation was started. The mean follow-up after prosthetic load has been 22.4 months. Success rates of implants according to Albrektsson criteria has been 93.3% in group 1, and 90.9% in group 2. Although a statistical comparison between the two treatment modalities may not be feasible, due to the bias resulting from the choice of treatment by the clinician and from the differences in donor sites and defect extension, some considerations can be made: 1) both methods are a reliable means for the correction of narrow edentulous ridges; 2) both techniques necessitate overcorrection of the defect because of interposition of connective tissue beneath the membrane in the first group and bone resorption in the second one; 3) the use of semipermeable barriers increases the costs of the surgical procedure, as compared to bone grafting without membranes; 4) guided bone regeneration presents a higher risk of infection because of wound dehiscence and membrane exposure. Therefore, in case of wide edentulous areas, reconstruction of narrow ridges should be performed with bone blocks without membranes.     

Spontaneous regeneration of the mandible after hemimandibulectomy: report of a case

Mandibular defects may result from many conditions such as trauma, inflammatory diseases and tumors. There are rare cases reported in the literature that have demonstrated spontaneous bone regeneration after resection of the mandible. Several factors such as age, preservation of the periosteum and genetics seem to influence spontaneous bone regeneration capacity in individuals. Evaluation of these factors may lead to a better understanding of the mechanism of spontaneous bone regeneration and also help to create new methods for bone reconstruction. The purpose of this article was to describe the spontaneous regeneration of the hemi-mandible with a well shaped condyle and coronoid after resecting a mandibular pathologic lesion in a young man.     

组织工程修复髁突软骨-骨复合体缺损研究进展

髁突缺损的修复重建方法很多,组织工程技术是最近发展起来的一项新技术,目标是髁突的再生修复。现就目前组织工程修复髁突软骨-骨复合体缺损的研究进展做一综述。     

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??There are a lot of methods for condylar reconstruction?? among which?? tissue engineering is a novel technique for condyle regeneration. The aim of the article is to review the research progress in the repair of the defect of condylar cartilage and bone unit by tissue engineering technique.     

Bone formation in rat calvaria ceases within a limited period regardless of completion of defect repair

A bone defect that is not repaired with bone completely is designated a non-union defect or a critical-size defect. The biological mechanism that regulates the process of bone repair of the critical-size defect remains unknown. The present study was designed to investigate bone repair in a critical-size defect compared with that in a smaller or non-critical-size defect. Our original standardized rat calvarial bone defect model was used for the experiment. The rate of bone formation was examined with X-ray morphometry and the bone production of osteoblasts and osteocytes was assessed by molecular histology with in situ hybridization for type I collagen and osteocalcin. Formation of repaired bone ceased within 24 weeks in both critical- and non-critical-size defects i.e. regardless of completion of the defect repair. The results suggested that osteoblasts and osteocytes cease bone formation, and the differentiation of osteoblast progenitors declines in 24 weeks. Also, bone repair proceeds from the periosteum on both sides of the parietal bone but not from the surface of the bony edge around the original defect. The results could provide useful information for clinical research on bone repair.