平台转移设计种植体植入1年后下颌后牙区的骨丧失

背景：传统两段式种植体修复后种植体颈部牙槽骨的吸收一直被认为是种植术后的正常反应。 目的：评价下颌后牙区两段式种植体应用平台转移设计后周围骨丧失情况。 方法：50例患者共植入88颗种植体,实验组植入40颗Ankylos种植体,采用平台转移设计;对照组植入48颗3i种植体,采用传统对接设计。所有种植体均为潜入式植入,肩台均平齐牙槽嵴顶水平,3个月后完成最终修复。 结果与结论：所有种植体均完成骨结合。与种植体植入时相比,功能负重12个月后,实验组种植体周围骨丧失高度为(0.31± 0.39) mm,对照组种植体周围骨丧失高度为(0.94±0.43) mm,两者差异有非常显著性意义。随访期内,种植体无松动、脱落,牙龈组织健康,成功率为100%。结果显示种植体功能负重12个月后,平台转移设计可以减少种植体颈部骨吸收,保持种植体周围骨组织的稳定性。     

正畸应力刺激下纯钛微种植体周围炎模型及骨改建

背景：种植体周围炎是影响种植体稳定性的重要因素。目的：建立正畸应力刺激下比格犬微种植体周围炎动物模型,观察其骨改建过程。方法：采用助攻法将纯钛微种植钉随机植入Beagle犬双侧上颌第二,三,四前磨牙的根分叉区,将一侧植入3枚丝线结扎的微种植体,在丝线结扎诱导微种植体周围炎后加力,分别在微种植体周围炎的第1,2,3,4周即刻施加100 g拉力,持续加力1个月。处死动物后制备含微种植体的不脱钙硬组织切片,光学显微镜观察微种植体周围炎发展不同阶段受到持续正畸应力作用下的种植体-骨界面的改建过程。结果与结论：丝线颈部接扎的微种植体植入后,颈部组织内出现大量的梭形炎性细胞,随着时间的推移,炎症逐步扩散到微种植体的尖部,有大量胶原纤维,成骨活跃,出现新生骨进行改建;周围炎发生2周后扩散到微种植体尖部,出现深浅不一的新生骨小梁组成的编织骨,炎性细胞分散,可见胶原纤维吸收后留下的髓腔不规整,骨陷窝内可见排成三四层的成骨细胞,成骨活跃。说明实验成功构建了正畸应力刺激下Beagle犬纯钛微种植体周围炎模型,受力后约2周是该模型成骨的活跃期。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

骨引导再生术在牙种植术中的临床应用

目的评估Bio—Gide生物膜、Bio—oss骨粉引导骨组织再生修复种植床骨缺损的作用。方法选择种植区牙槽骨存在骨缺损的11例患者．其中男性9例．女性2例．年龄18～56岁。共计ll枚种植体。植入种植体后,在骨缺损处植入Bio～oss骨粉．并用Bio-Gide生物膜覆盖．术后、Ⅱ期手术前进行口腔临床检查和X射线检查。种植修复体完成后,分别于戴牙后6、12个月定期复诊．检查种植体周围骨组织的吸收及种植体周围软组织情况。结果术后2周内有1枚种植体覆盖黏膜少许裂开．Ⅱ期手术时,1枚种植体周围形成纤维愈合而失败,后经重新种植,所有种植体均顺利完成种植修复。修复后随访6～12个月．种植体均能成功地恢复咀嚼功能。结论Bio—Gide生物膜、Bio-oss骨粉可以引导骨组织再生,改善种植床骨增量效果。与正常骨组织中种植修复的1年成功率不存在明显差异。     

纳米羟基磷灰石/聚己内酯电纺支架修复种植体周围骨缺损

背景：牙齿缺失导致牙槽嵴骨质的改建和持续吸收,严重影响种植体植入的条件和种植区软硬组织的美观。目的：评价纳米羟基磷灰石/聚己内酯电纺支架促进即刻种植体周围骨缺损的成骨效果。方法：制作犬骨髓间充质干细胞复合纳米羟基磷灰石/聚己内酯电纺支架的组织工程化骨。拔除6只实验犬双侧下颌第二前磨牙,在其近中根牙槽窝处制备种植床,即刻植入种植体,在钛钉颊侧制作三壁骨缺损,两侧骨缺损处分别植入组织工程化骨与Bio-Oss小牛无机骨粉,并在材料表面覆盖Bio-Gide胶原膜。术后即刻、4周、8周、12周X射线测量种植体周围骨灰度值;12周后完整取出下颌骨,甲苯胺蓝染色观察骨缺损区的微观结构,新生骨量、形态结构及种植体-骨结合情况。结果与结论：两组间术后各时间点骨密度变化无明显差异,表明两组材料在促进骨再生过程中的成骨效果基本一致。组织工程化骨组骨缺损区内形成致密板状骨,可见成熟骨细胞,哈弗氏管,新生骨-种植体结合较紧密;Bio-Oss小牛无机骨粉组板层骨致密,新骨中有少量Bio-Oss颗粒分布,成骨细胞较组织工程化骨组少,部分哈弗管结构内可见到毛细血管,新骨与植入材料之间形成桥形连接,与种植体结合紧密。表明纳米羟基磷灰石/聚己内酯支架复合骨髓间充质干细胞、Bio-Gide胶原膜可促进种植体周围牙槽骨再生。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：     

新型种植体骨界面Ⅰ型胶原的表达

背景：刘福祥教授自行设计的新型种植体在较短种植体长度上给出了较大骨接触面积,同时考虑到种植体的抗扭转能力、抗侧向力能力,种植体与骨弹性模量的匹配及加工和植入、修复的便易度。 目的：观察自主设计的新型种植体植入颌骨后种植体-骨界面Ⅰ型胶原的表达变化,探讨新型种植体与牙槽骨的骨结合能力。 方法：拔除成年狼犬双侧下颌前磨牙3个月后,于两侧拔牙位点牙槽骨分别植入新型种植体和圆柱状种植体各2枚。 结果与结论：随时间增加两组周围骨组织密度逐渐升高,新型种植体组圆盘结构间出现密度逐渐升高的影像组织。两组种植体-骨界面均有Ⅰ型胶原表达,均于术后4周达高峰,且新型种植体组术后2,4周Ⅰ型胶原平均灰度值均高于圆柱状种植体组(P < 0.05)。表明新型种植体植入颌骨后能够取得生物性成功,种植体-骨界面成骨较圆柱状种植体更快,更活跃,骨结合能力更强。     

上颌窦内外提升不植骨替代材料同期种植牙：随访周围骨量及稳定性的变化

背景：研究已经证实,上颌窦黏膜具有促进成骨的能力,上颌窦内膜与种植体之间的空间随着时间的延长会有新生骨的形成。 目的：通过对两种上颌窦提升术不植骨同期种植牙的研究,明确不植骨对两种上颌窦提升后种植体成活状态的影响。 方法：将上颌后牙区骨量不足的50例患者随机分成上颌窦外提升和上颌窦内提升两组,分别在不植入骨替代材料的情况下同期进行种植体的植入,共植入种植体60个,外提升组25个植体,内提升组35个植体。 结果与结论：在不植骨的情况下,60个种植体经过12个月的观察,59个植体正常行使功能,1例外提升的种植体术后松动,治疗失败。内提升组手术时间和出血量均显著少于外提升组(P < 0.05)。两组患者的近期稳定性(术后12个月)比较差异无显著性意义(P > 0.05)。术后12个月外提升组种植体周围的骨量增加显著少于内提升组(P < 0.05)。结果说明不植骨在上颌窦的两种提升术中是可行的,而且能简化手术过程,减少治疗费用,但对种植体长期稳定性的影响有待进一步观察。 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：     

即刻种植中异体脱细胞真皮基质引导的骨组织再生*

背景：脱细胞真皮基质可作为软组织支架使成纤维细胞和上皮细胞在其中增殖,并最终成为宿主组织的一部分。 目的：观察异体脱细胞真皮基质引导即刻植入种植体周围骨组织再生的效果。 方法：选择口腔修复行即刻种植患者15例,使用异体脱细胞真皮基质行骨组织引导再生,种植体植入后,测量术中、植入后6,12个月唇侧骨壁厚度,同时观察种植体周围软组织愈合情况。 结果与结论：6个月后均完成最终修复,无感染及明显并发症。异体脱细胞真皮基质有效关闭了即刻种植位点的软组织创口,6个月内逐渐与种植体周软组织发生整合。植入后6,12个月种植位点唇侧骨壁厚度与唇侧骨量高于术中测量值(P < 0.05),植入后6,12个月组间骨壁厚度及骨量变化不明显(P > 0.05)。说明异体脱细胞真皮基质作为屏障膜能有效引导骨组织再生,降低即刻种植术中关闭创口的难度,短期临床结果满意。关键词：异体脱细胞真皮基质;牙种植体;即刻种植;引导骨组织再生技术;组织膜 缩略语注释：GBR：guided bone regeneration,骨组织再生技术;ADM：acellular dermal matrix,异体脱细胞真皮基质 doi:10.3969/j.issn.1673-8225.2012.16.002     

在复合移植的上颌窦中圆柱形种植体的保存

本文回顾性研究报告骨内种植体植入用自体骨和HA复合移植物增高的上颌窦中的保存情况。种植体平均负载时间为55个月,77个病人的上颌窦用髂骨嵴松质骨和HA(2∶1混合)加高,种植体植入前允许它愈合3～4个月。11例患者加高与植入一期进行。移植的上颌窦内共植入388个HA涂层的圆柱形种植体。82个种植体植入用复合移植物加高的尖牙区。植入后种植体负载3～4个月。植入加高上颌窦中388个种植体中46个失败(12%)。到70个月,植入加高上颌窦种植体总保存率为82%。植入2个不同临床区域种植体保存率有显著差异。作者发现,加高前上颌窦底残余骨厚度超过…     

应用浓缩生长因子行上颌窦内提升后种植体周围骨变化

背景：许多实验和临床研究报道不使用植骨材料而单纯采用患者静脉血、可吸收胶原海绵、富纤维蛋白凝块等均可促进新骨形成,那么只移植浓缩生长因子在上颌窦内提升中是否也能有效地促进骨再生？目的：以浓缩生长因子作为移植材料行上颌窦内提升,观察种植体周围骨水平的改变。方法：纳入26例患者,其中男14例,女12例,年龄35-73岁,均以自体浓缩生长因子作为移植材料行上颌窦内提升,同期植入Astra Tech种植体。按随访时间分为6-12个月组、13-18个月组与18个月以上组,按术前剩余牙槽骨高度分为≤5 mm组、5-7 mm组与≥7 mm组,按术后上颌窦提升高度分为≤2 mm组、2.0-3.0 mm组与≥3 mm组,随访观察种植体存留率与边缘骨水平变化。结果与结论：共植入种植体44 枚,修复后随访6-18个月,43枚种植体修复成功,种植体存留率为98%。不同随访时间组间近、远中边缘骨水平改变比较差异无显著性意义,显示以浓缩生长因子作为移植材料行上颌窦内提升在随访6-18个月内能形成良好骨结合。不同剩余牙槽骨高度组间的近、远中边缘骨水平改变比较差异无显著性意义,不同窦底提升高度组间的近、远中边缘骨水平改变比较差异无显著性意义,说明剩余牙槽骨高度与上颌窦提升高度对种植体周骨组织形成无明显影响。表明在上颌窦内提升时使用浓缩生长因子移植材料同期植入种植体存留率高,种植体周围牙槽骨稳定,长期效果有待进一步观察。 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

低功率激光对Beagle犬胫骨种植体周骨愈合的影响

背景：低功率激光照射对种植体周骨愈合及骨结合的影响尚无确切的结论。 目的：探讨低功率氦氖激光局部照射对骨内种植体周骨愈合的影响。 方法：取6只Beagle犬,每只犬两侧胫骨分别植入3枚种植体,植入后分别采用低功率氦氖激光局部照射1周,2周或不照射。分别于第4,8,12周随机处死2只Beagle犬取材。 结果与结论：亚甲基蓝-酸性品红染色显示,给予低功率氦氖激光局部照射的种植体周骨组织愈合优于未照射者。骨形态计量学分析结果显示,随着种植体植入时间的延长,种植体-骨结合率逐渐增高;在相同时间点,种植体-骨结合率以照射2周组最高,照射1周组次之。提示低功率氦氖激光局部照射能显著促进种植体周骨组织愈合及其改建成熟,同时增加种植体骨结合面积。     

种植体不同基台连接方式对上颌单个前牙种植修复美学的影响

BACKGROUND: Implant-abutment connection has become a key factor in the success of implant restoration, but  the effects of different implant-abutment connections on peri-implant tissues is unclear. OBJECTIVE: To compare the effects of three different implant-abutment connections on the alveolar bone and peri-implant soft tissues at the maxillary esthetic zone. METHODS: Sixty patients undergoing aesthetic restoration of single maxillary anterior tooth were enrolled randomly, including 20 cases of Bego Replace system, 20 of Osstem Replace system, and 20 cases of ITI Replace system. All the patients had a follow-up of 3 to 6 months after the surgery, and then received the two-stage surgery. Radiographic and clinical examinations were made at the same time. Peri-implant bone height measured was used as the reference line. The final crowns were made after 2 weeks, and the peri-implant bone resorption and pink esthetic scores were evaluated after 12 months shown through X-ray films. RESULTS AND CONCLUSION: There were significant differences in peri-implant marginal bone loss and pink esthetic scores among different groups after implant restoration. The amount of marginal bone loss around implants using platform switching was significantly less than that using platform butt-joint (P < 0.0.5), and the pink esthetic scores of the former group was higher than the later one (P < 0.05). These findings indicate that aesthetic restoration of a single maxillary tooth implant using platform switching is able to preserve better marginal bone and acquire better aesthetic effects.       

不同牙种植体系统对种植体周围骨组织吸收的影响

BACKGROUND: The peri-implant bone absorption is closely related to the repair effect. OBJECTIVE: To compare the effects of three kinds of dental implant systems on the peri-implant bone absorption. METHODS: 116 patients who underwent the dental implant systems were collected, including 46 cases with 3I implant system, 40 cases with ITI implant system and 30 cases with BLB implant system. The peri-implant bone absorption, sulcus bleeding index and periodontal probing depth of three groups were detected at 1, 3, 6, 9 and 12 months after implantation, respectively. RESULTS AND CONCLUSION: The peri-implant bone absorption of three groups within 1 year after implantation was in a rise, and the bone absorption of BLB group was significantly higher than that of ITI and 3I groups at 3 and 12 months after implantation (P < 0.05). Compared with the natural teeth, the gingival sulcus bleeding index of three groups were all increased at different time points after implantation; the gingival sulcus bleeding index of BLB group was significantly higher than that of natural teeth at 6 months after implantation (P < 0.05); the gingival sulcus bleeding index of three groups were significantly higher than that of natural teeth at 9 months after implantation (P < 0.05). The periodontal probing depth of three groups showed an ascending trend at 6 months after implantation; the periodontal probing depth of three groups was higher than that of natural teeth at different time points after implantation, which exhibited significant differences at 6 and 9 months after implantation (P < 0.05). In conclusion, three kinds of dental implant systems exhibit differet effects on the peri-implant bone absorption, but all achieve excellent clinical efficacies.     

The influence of Young's modulus of loaded implants on bone remodeling: an experimental and numerical study in the goat knee

The aim of this study was to examine the influence of the Young's modulus of the implant material on the bone remodeling in a loaded condition. A combined animal experimental and computational study was set up. The animal experimental group comprised of 16 Saanen goats, each receiving one titanium implant (Young's modulus 110 GPa) and one high-density polyethylene (HDPE) implant (Young's modulus 1 GPa) in the left femoral condyle. Both types of implants received a titanium coating of 100 nm thickness. The implants protruded in the knee joint space and were directly weight bearing. The first group of eight goats was sacrificed after 6 weeks of loading and the second group of eight goats after 6 months of loading. The 16 femoral condyles with the 32 implants were prepared for microfocus computed tomography (micro-CT) scanning and histological sectioning. Three-dimensional trabecular bone parameters were calculated on the micro-CT images for the zones neck, middle, and apex of the implant. The percent of bone contact with the implant was measured on longitudinal histological sections. An axisymmetric finite element (FE) model was created to compare peri-implant bone strains and relative motion between a titanium and a HDPE implant for the experimental loading condition, and to assess the influence of different bone-implant interface (contact) conditions. From the statistical analysis of the 3D bone parameters, the difference between the titanium and HDPE implants was not significantly different (p > 0.05) between the zones (neck, middle, and apex) for both groups of goats. The implants could be considered in their entirety. After 6 weeks of loading, the PE implant presented lower connectivity and smaller marrow spaces in the circular region of 0-500 microm. In the region 500-1500 microm more bone volume was present for the PE implant. After 6 months, the PE implants showed more bone volume and thicker trabeculae than the titanium implants for the entire length of the implant. This effect was already present in the smallest region of interest, 0-500 microm. After 6 months more fibrous encapsulation was found around titanium implants. FE results demonstrated a substantial influence of the interface conditions on peri-implant strains and relative motion. For interface conditions that were representative for the early postoperative situation (involving press-fit and friction), differences in peri-implant bone strain distributions between titanium and HDPE could be related to the experimentally observed differences in amounts of bone and fibrous encapsulation. In contrast, differences in relative motion did not seem to play a role. Both the experimental and computational results suggest that implant stiffness can affect the peri-implant tissue response, which may be related to differences in peri-implant strains.     

In vivo behaviour of hydroxyapatite coatings on titanium implants: a quantitative study in the rabbit

The aim of this study was to evaluate quantitatively the behaviour of in vivo hydroxyapatite coated implants (HA) in the rabbit over time, and to compare the results with observations made on titanium plasma spray implants (TPS). Results were analysed according to the percentage of bone contact. Eighteen HA cylindrical implants (3.25 x 8 mm) and 6 TPS cylindrical implants from Steri-Oss were placed in the epiphysis of the femur in 24 white rabbits. Each rabbit received one implant. Three rabbits with one HA implant (n = 3) and 1 rabbit with one TPS implant (n = 1) were sacrificed after implantation periods of 2, 4, 6, 8, 10 and 12 months. Implants were cut along the long axis and prepared for histological and histomorphometrical evaluations. Measurements of coating thickness and percentage of bone contact were performed with scanning electron microscopy analysis on the sides of the implant, in 3 different types of bone, namely cortical, trabecular and marrow. In cortical bone, dense bone was apposed to the HA implants: from 92.3 +/- 5.5% at 2 months to 89.6 +/- 6.5% at 1 year, with no significant regression of HA thickness (P = 0.37). TPS coating showed less bone contact, but thickness was stable (P = 0.46). In trabecular zone, where bone contact was less pronounced, a significant regression of HA coatings thickness (P < 0.05) was observed. Nevertheless TPS coatings were stable (P = 0.81). Histomorphometrical results demonstrated that a highly significant regression (P < 0.0001) of HA thickness was observed in the marrow area, where the bone-to-implant contact never exceeded 7.6% from 2 to 12 months. TPS coating did not reveal any sign of resorption (P = 0.88), despite a rare bone contact. Histological analysis revealed inflammatory and giant cells, principally in the marrow area in contact with HA coating, but always in restrictive numbers. We conclude that bone contact protected the HA coating from resorption.     

Biodegradable magnesium scaffolds: Part II: peri-implant bone remodeling

In this study, histomorphometrical parameters of the peri-implant bone remodeling around degrading open-porous scaffolds made of magnesium alloy AZ91D were investigated and compared with the peri-implant bone remodeling around an autologous bone transplant in the contralateral side in a rabbit model after 3 and 6 months. Osteoblast activity was displayed by collagen I (alpha 2) mRNA in situ hybridization. Major scaffold degradation was completed within 3 months after implantation showing no osteolysis around the scaffolds, both after 3 and 6 months. Enhanced formation of unmineralized extracellular matrix and an enhanced mineral apposition rate adjacent to the degrading magnesium scaffolds were accompanied by an increased osteoclastic bone surface, which resulted in higher bone mass and a tendency to a more mature trabecular bone structure around the magnesium scaffolds compared to the control. These results show that even fast-degrading magnesium scaffolds induce extended peri-implant bone remodeling with a good biocompatibility. In summary, this study shows that degrading magnesium scaffolds promote both bone formation and resorption in a rabbit model and are therefore very promising candidates for the development of novel implants in musculoskeletal surgery.     

Effect of umbilical cord mesenchymal stem cell in peri-implant bone defect after immediate implant: an experiment study in beagle dogs

Background: For the sake of reducing post extraction resorption, getting optimal positioning of the implant and shortening treatment time, immediate implant placement following tooth extraction has been proposed as a treatment option. However, the large bone defect peri-implant has a negative influence on the process of bone healing. In this study, umbilical cord mesenchymal stem cells (UCMSCs) were transplanted into the bone defect peri-implant inbeagle dogs and the effect of UCMSCs on bone regeneration in peri-implant were assessed. Methods: The mandibular second, third and fourth premolars of 8 beagle dogs were extracted bilaterally. The defects in one side were filled with platelet-rich fibrin (PRF) and then UCMSCs were injected into the defect area, while the defects in the other side were filled with PRF only as control group. The titanium implant was placed into the distal root socket of each extracted tooth. The animals were sacrificed at week 2, 4 and 8 post operative. The bone defects adjacent to the implant which are 4 mm in height, 4 mm in the mesio-distal direction and 3.5 mm in the bucco-lingual direction were made after immediate implant. Histomorphometric analysis was performed using methylene blue-fuchsin acid staining and hematoxylin and eosin (HE) staining to evaluate bone regeneration. Results: The direct bone-to-implant contact (BIC) in the experiment after 4 and 8 weeks was 56.47±1.18% and 76.23±2.08%; and in the control group was40.79±0.65% and 61.17±2.79%, respectively. The percentage of newly formed bone after 2, 4 and 8 weeks was 17.60±1.5%, 49.82±4.02% and 67.16±2.1% in experiment group; and in control group 14.30±1.25%, 37.04±2.29% and 58.83±3.36%, respectively. These results represented significant differences statistically. Conclusion: Intra-bone marrow injection of UCMSCs can promote new bone formation. UCMSCs can be used to as excellent seed cells to repair the large defect peri-implant after immediate implant.     

两种改进的自体骨融合方式在后路腰椎融合术中的应用研究

目的　回顾研究两种改进的自体骨融合方案(自体颗粒骨打压植骨、自体骨cage植骨)与PEEK cage植骨在腰椎后路融合手术中的临床疗效差异,旨在证实其临床价值。 方法　收集2010年6月至2016年6月因退行性腰椎疾患在我科行腰椎融合术的患者,根据腰椎融合的采用情况将患者分为自体骨打压组36例、自体骨cage组35例、PEEK cage组39例。观察手术前后的 VAS、ODI评分,并在影像学资料上计算术后24h、术后6月、术后12月的椎间隙高度丢失度及椎体融合率。术前患者一般资料无统计学差异,资料可比性良好。 结果　三组术后均未发生严重的手术相关并发症。影像学结果示术后6月、12月的椎体高度丢失度分别为：打压植骨组(6.1±2.5、6.5±3.8)%;自体骨cage组(5.6±2.9、5.8±3.7)%;PEEK cage 组(5.4±3.3、5.9±4.1)%。术后6月、12月的椎间相对融合率为：打压植骨组(27.5±10.5、26.5±9.1)%;自体骨cage组(31.2±8.7、28.1±8.7)%;PEEK cage 组(28.4±7.1、29.3±8.2)%。各组结果均无统计学差异(P＞0.05)。术后三组的ODI、VAS评分亦无统计学差异(P＞0.05)。 结论　三组术后的临床疗效及术后融合率无明显差异,自体颗粒骨打压植骨、自体骨cage植骨融合效果良好。     

Bone turnover markers correlate with implant fixation in a rat model using LPS-doped particles to induced implant loosening

Revision surgery for particle-induced implant loosening in total joint replacement is expected to increase dramatically over the next few decades. This study was designed to investigate if local tissue and serum markers of bone remodeling reflect implant fixation following administration of lipopolysaccharide (LPS)-doped polyethylene (PE) particles in a rat model. Twenty-four rats received bilateral implantation of intramedullary titanium rods in the distal femur, followed by weekly bilateral intra-articular injection of either LPS-doped PE particles (n = 12) or vehicle that contained no particles (n = 12) for 12 weeks. The group in which the particles were injected had increased serum C-terminal telopeptide of type I collagen (CTX-I), decreased serum osteocalcin (OC), increased peri-implant eroded surface, decreased peri-implant bone volume, and decreased mechanical pull-out strength compared to the controls. Implant fixation strength was positively correlated with peri-implant bone volume and serum OC and inversely correlated with serum CTX-I, while energy to yield was positively correlated with serum OC and inversely correlated with the number of tartrate-resistant acid phosphatase positive cells at the interface and the amount of peri-implant eroded surface. There was no effect on trabecular bone volume at a remote site. Thus, the particle-induced impaired fixation in this rat model was directly associated with local and serum markers of elevated bone resorption and depressed bone formation, supporting the rationale of exploring both anticatabolic and anabolic strategies to treat and prevent particle-related implant osteolysis and loosening, and indicating that serum markers may prove useful in tracking implant fixation.     

选择性连续三节段Solis融合器置入对颈椎曲度的长期影响

背景：随着对颈椎疾病病理过程认识的深入,颈椎曲度日渐成为评价长期临床疗效的重要指标之一。恢复及保持颈椎正常生理曲度对维持颈椎远期稳定性及颈椎生物力学环境有重要意义。 目的：评价选择性颈椎前路连续三节段Solis椎间融合器治疗脊髓型颈椎病对颈椎曲度的长期影响。 方法：2008年6月至2010年12月应用Solis融合器行选择性连续三节段颈前路手术治疗脊髓型颈椎病共22例,男14例,女8例,年龄26-73岁,平均45.1岁。C2/3/4/5,C3/4/5/6,C4/5/6/7,C5/6/7/T1分别为2,7,12,1例,共66个椎间隙。所有患者均随访2年以上。 结果与结论：平均出血量40 mL (20-80 mL),平均手术时间121 min(100-175 min)。平均随访30.7个月,手术节段均骨性融合,无植入物移位或椎体塌陷。置入前JOA评分为11.94±3.61,置入后6个月为15.56±1.13,置入后2年为15.21±1.85;置入前颈椎曲度为(1.86±3.24) mm,置入后6个月为(4.83±1.78) mm,置入后2年为(4.44±3.36) mm。以上各组数据置入前与置入后6个月,置入前与置入后2年间差异均有显著性意义(P < 0.05),置入后6个月与置入后2年间差异均无显著性意义(P > 0.05)。结果显示行颈椎前路连续三节段椎间融合器置入治疗脊髓型颈椎病可有效改善颈椎曲度并长期维持,有良好的临床疗效。