骨多肽生长素与珊瑚骨诱导鼠额面骨再生的研究

我们以探讨骨多肽生长素 (ｂｏｎｅａｃｔｉｖｅｐｏｌｙｐｅｐｔｉｄｅ,ＢＡＰ)和珊瑚骨的应用前景为研究目的。1 .材料和方法 :体重 2 5ｇ昆明小鼠 48只 ,雌雄各半。随机分 2组 ,均在小鼠额面骨制成 3ｍｍ× 2ｍｍ× 1ｍｍ骨缺损区。实验组置放ＢＡＰ和珊瑚骨 ,对照组置放珊瑚骨。术后 7、2 8、90ｄ分批处死并取材作切片 ,ＨＥ染色 ,光镜观察。每组各术后期用 1只 ,分别取材 ,以 4 %多聚甲醛与 5 %戊二醛混合液固定 2 4ｈ ,1 0 %ＥＤＴＡ Ｎａ2 脱钙。ＬＫＢ ＩＩＩ型超薄切片机作超薄切片 ,铅铀染色 ,置日产Ｈ 60 0透射电镜下观察再生骨…     

骨多肽生长素与珊瑚骨诱导鼠额面骨再生的研究

目的 :探讨骨多肽生长素 (boneactivingpolypeptide)对小鼠额面骨缺损再生修复的诱导作用 ,比较骨多肽素与珊瑚骨联用和单独用珊瑚骨的差异。方法 :实验用 42只昆明小白鼠 ,雌雄各半 ,体重 2 5g ,随机分为实验组和对照组。手术制备额面骨 3mm× 2mm× 1mm骨缺损区 ,实验组骨缺损区填入多肽类骨生长素与珊瑚骨 ,对照组只填入珊瑚骨。术后 7、2 8、90d分别取材 ,进行组织学和透射电镜观察。图像软件分析 ,t检验。结果 :实验组 :术后7d ,骨缺损区周围有炎性细胞浸润 ,可见额面骨变性坏死 ;术后 2 8d ,炎性渗出明显吸收 ,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 ;术后 90d ,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。通过透射电镜观察 ,得到进一步证明。对照组 :术后 90d ,骨缺损边缘有较多新骨沉积。并对间充质细胞、破骨细胞、成骨细胞进行数据处理 ,两组间成骨细胞数有显著差异 (P <0 .0 1)。结论 :骨多肽生长素是一种分子生物活性物质 ,可诱导小鼠额面骨再生 ,用骨多肽生长素与珊瑚骨比单独用珊瑚骨诱导额面骨再生修复效果显著     

重组人骨形成蛋白-2、胶原、珊瑚复合人工骨异位诱导成骨的实验研究

目的 采用珊瑚作为载体,胶原作为缓释系统,制血出重组人骨形成蛋白－２（ｒｈＢＭＰ－２）胶原／珊瑚复合人工骨,并评价其骨诱导活性。方法 ｒｈＢＭＰ－２、胶原和珊瑚以一定的方式复合后,植入小鼠股部肌袋内,以单纯珊瑚植入用对照,术后不同取材,通过组织学方法检测骨诱导活性。结果 复合人工骨植入１周诱导软骨形成,２周形成编织骨,４周形成含骨髓的板层骨,同时珊瑚被降解吸收。结果 胶原、珊瑚是ｒｈＢＭＰ－２较理     

珊瑚人工骨的研究现况

珊瑚的主要成份是碳酸钙、具有类似人类骨骼的多孔结构。近年来人们将其作为一种新种植材料进行了不少实验和临床应用研究，证实了珊是一种较为理想的生物活性材料。本文就珊瑚的种类、结构与理化特性，瑚的生物学特性，实验研究和临床应用作了综述。     

珊瑚人工骨的实验研究

研究珊瑚人工骨在成骨过程中所起作用、其生物降解与新骨形成的关系。方法选用６只杂交狗,将珊瑚人工骨植入下颌下缘,以对侧作为对照,采用Ｘ线片、扫描电镜及能谱分析进行观察。结果术后第四、第五个月,实验侧下缘有纤维钙结构和新骨形成,很少有珊瑚人工骨残留,能谱分析钙盐含量很高。     

珊瑚人工骨的研究现况

珊瑚的主要成份是碳酸钙,具有类似人类骨骼的多孔结构。近年来人们将其作为一种新型种植材料进行了不少实验和临床应用研究,证实了珊瑚是一种较为理想的生物活性材料。本文就珊瑚的种类、结构与理化特性,珊瑚的生物学特性,实验研究和临床应用作了综述。     

珊瑚人工骨的生物相容性研究

将珊瑚人工骨材料作生物相容性研究,结果显示:珊瑚人工骨和组织间有良好的生物相容性,不含有对人体有害的成份,具有天然骨的类似结构和同样的元素,可为新生血管、血管周围组织、新骨的形成和长入提供适宜的生理基质。在骨损修复中起到骨引导作用。     

重组人骨形成蛋白-2/珊瑚复合人工骨的研制及其诱导成骨的实验研究

目的：制备珊瑚（ｃｏｒａｌ）与重组人骨形成蛋白－２（ｒｈＢＭＰ－２）复合人工骨并测试其骨诱导活性。方法：将ｒｈＢＭＰ－２与珊瑚复合后植入鼠肌袋内。６６只小鼠随机分为３组：第１组为复合骨（１∶２０ｗ／ｗ）；第２组为复合骨（１∶４０ｗ／ｗ）；第３组为单独珊瑚。术后１、３、６周处死动物，光镜下观察，并用图象分析法作成骨定量测定，结果：术后１周，可见复合材料表面及孔洞内有软骨形成。３周出现编织骨。６周形成含骨髓的板层骨。珊瑚被部分吸收。诱导成骨的量有时间依赖性和ｒｈＢＭＰ－２剂量依赖性。结论：ｒｈＢＭＰ－２／ｃｏｒａｌ复合人工骨具有良好的诱导成骨能力；珊瑚可能是目前能使用的ｒｈＢＭＰ－２最合适的缓释载体。     

珊瑚、异体脱钙骨、自体骨髓复合可注射骨替代物异位成骨的研究

目的 :检验珊瑚 (NC)、异体脱钙骨基质 (DBM )、自体骨髓 (AM )复合可注射骨替代材料的异位诱导成骨能力。方法 :将 2 4只新西兰兔随机分为 4组 ,分别在背部皮下注射NC/DBM /AM、NC/DBM、NC/AM、NC ,术后 2、4周取材 ,通过X线、组织学检查、碱性磷酸酶 (ALP)测定 ,进行比较观察。结果 :X线、组织学检查结果均表明NC/DBM /AM组有较多新骨形成 ,NC/AM组诱导出少量骨 ,NC/DBM组仅见微量软骨和骨新生 ,NC组未见新生骨。NC/DBM /AM组ALP水平较NC/DBM组、NC/AM组、NC组高 ,统计学上具有显著性差异 (P <0 .0 1)。结论 :NC/DBM /AM复合可注射骨替代材料具有良好的骨诱导性和临床应用价值     

Denaturation of demineralized bone matrix significantly reduces bone formation by guided tissue regeneration

AIM: To examine in a discriminating capsule model whether denaturation of demineralized bone matrix (DBM) by heating may influence bone formation. MATERIALS AND METHODS: DBM was produced from the long bones of rats. Half the portion of DBM was denatured by heating in distilled water for 20 min at temperatures between 70 degrees C and 90 degrees C. Prior to the study, the destruction of the osteoinductive properties of the DBM was confirmed in three rats following intramuscular implantation. Thirty, 4-month-old, male albino rats of the Wistar strain were used in the study. Following surgical exposure of the mandibular ramus, a hemispherical Teflon capsule (internal diameter = 5.0 mm) was placed, with its open part facing the lateral aspect of the ramus. On one side (test side), the capsule was loosely packed with denatured DBM, while on the contralateral side, serving as control, the capsule was loosely packed with the same amount of non-denatured DBM. After healing periods of 30, 60, and 120 days, groups of 10 animals were killed and 40-70 microm thick undecalcified sections of the capsules were produced. Three sections from each specimen, representing the mid-portion of the capsule, were subjected to histological analysis and computer-assisted planimetric measurements. RESULTS: Increasing amounts of newly formed bone were observed in both test and control capsules during the experimental period. At 4 months, the new bone formed in the control capsules occupied 46.7% of the cross-sectional area of the capsules, while it was only 19.1% in the test capsules (P<0.05). CONCLUSION: Denaturation of DBM by heating significantly reduces bone formation by guided tissue regeneration.     

膜引导齿槽突裂骨缺损区组织再生的实验动物研究

目的 :评价膜引导齿槽突裂骨再生的效果。方法 :全麻下 ,分别在每组 2只兔双上颌形成人工齿槽突裂 ,随机作 :①聚乳酸 (PLA) 胶原 rhBMP 2膜覆盖 ;②PLA膜覆盖 ;③胶原膜覆盖 ;④空白对照。分别于术后 2周 ,1、2、3、6月处死动物切取标本 ,摄X线片 ,组织学观察 ,酶组化分析。结果 :膜覆盖骨裂 ,新生骨外形良好 ,骨改建成熟早 ,特别是PLA 胶原 rhBMP 2膜组 ,可持续控释rhBMP 2并提高骨缺损区浓度 ;空白对照组 ,生成骨质量、外形不良。结论 :引导组织再生膜具有促进齿槽突裂骨修复的作用。     

异种脱细胞真皮基质联合珊瑚羟基磷灰石在GBR术中的应用

目的：评价异种脱细胞真皮基质联合珊瑚羟基磷灰石在引导骨组织再生术中的应用效果。方法：17例共27颗牙缺失患者作为研究对象,其中10颗上前牙牙槽骨宽度约4mm的延期种植先行骨挤压术植入种植体再行GBR术,其余12颗延期即刻种植上前牙及5颗环状骨缺损后牙常规植入种植体后行GBR术。6-8m后观察成骨效果。结果：除一例患者右上侧切牙植体颈部唇侧暴露约1.5mm左右,其余患者植体均被新生骨包绕,成骨效果显著。结论：异种脱细胞真皮基质联合珊瑚羟基磷灰石在牙种植术中引导骨组织再生效果良好。     

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目的评价前牙区牙槽骨水平宽度不足的患者联合应用骨劈开、骨挤压和骨引导再生术行同期种植体植入的临床效果。方法 2004—2009年福州市第一医院口腔科就诊的前牙区牙缺失伴前牙区牙槽骨水平宽度不足的种植患者28例,联合应用骨劈开、骨挤压,填入骨粉,行骨引导再生术后同期植入40颗种植体,术后4～6个月内完成上部修复。术后1年,通过临床检查、全景片等观察效果。结果术前、后牙槽骨平均宽度分别为(3.2±0.89)mm、(6.5±0.75)mm,平均增加了(3.3±0.34)mm。术后牙槽骨宽度与术前相比,差异有统计意义(t=2.47,P<0.05)。术后无明显并发症发生,种植体行使功能良好,仅1例患者的1颗牙种植失败,种植近期成功率达97.5%。结论对前牙区牙槽骨水平宽度不足的患者,联合应用骨劈开、骨挤压和骨引导再生术行同期种植体植入,可增加骨量,获得种植体的同期植入,减少患者痛苦,改善种植修复的临床效果。     

Healing patterns in calvarial bone defects following guided bone regeneration in rats. A micro-CT scan analysis

OBJECTIVE: The objective of this study was to evaluate healing patterns of critical-size calvarial bone defects treated according to principles of guided bone regeneration using micro-CT scan analysis. Specifically, the contribution of bone, periosteum and dura mater to the amount and mineralization of newly formed bone was evaluated. MATERIAL AND METHODS: Surgically induced, critical-size calvarial bone defects in 48 adult male Wistar rats received the following: an occlusive expanded polytetrafluoroethylene (ePTFE) membrane at the exo- and endocranial aspect (OO; n = 12); an occlusive membrane at the exocranial and a perforated membrane at the endocranial aspect (OP; n = 12); a perforated membrane at the exocranial and an occlusive membrane at the endocranial aspect (PO; n = 12); and a perforated membrane at the exo- and endocranial aspect (PP; n = 12). The animals were euthanized at 4 weeks for quantitative analysis of bone volume fraction and mineralization in the region of interest (ROI) as well as in the external, middle and central area of the defect using micro-CT. RESULTS: Bone volume fraction ranged from 31.4% (OP) to 24.5% (PP). No differences were found among the groups. Bone volume fraction and mineralization in the middle area were significantly greater in group OP than in group PP, and in the central area in group OO and PO than in group PP. CONCLUSIONS: The results of this study suggest that use of occlusive ePTFE membranes enhances bone formation and maturation in the calvarial skeleton. When occlusion of endo- and exocranial tissues was compromised by membrane perforation, impaired bone formation and mineralization were observed.     

Osteogenesis by guided tissue regeneration and demineralized bone matrix

AIM: To evaluate in a discriminating capsule model whether bone formation by guided tissue regeneration (GTR) may be influenced by concomitant implantation of demineralized bone matrix (DBM). MATERIALS AND METHODS: Thirty 4-month-old male albino rats of the Wistar strain were used in the study. Following surgical exposure of the mandibular ramus, a hemispherical, Teflon capsule (5.0 mm in diameter), loosely packed with a standardized amount of DBM, was placed with its open part facing the lateral bone surface of the ramus. At the contralateral side, an empty capsule was placed, serving as control. After healing periods of 15, 30, and 120 days, groups of 10 animals were sacrificed and 40-70 microm thick undecalcified sections of the capsules were produced. In the sections, the cross-sectional areas of (1) the space created by the capsule, (2) newly formed bone, (3) DBM particles, (4) loose connective tissue as well as the (5) height of the capsules, and (6) that of the newly formed bone were measured. RESULTS: Increasing bone fill was observed in both test and control sites from 30 to 120 days. After 30 days of healing, the mean amount of bone was approx. 3% of the cross-sectional area of the capsules at the test sites while it was 8% in the control sites (p<0.05). However, no statistically significant differences were observed between the test (46%) and control (64%) sites after 120 days regarding any of the measured parameters (p>0.05). The newly formed bone in the DBM group at 120 days, on the other hand, appeared more dense than that in the control capsules. CONCLUSION: DBM used as an adjunct to GTR did not provide any added effect on bone formation but increased the density of the newly formed bone.     

可吸收性胶原膜引导即刻植入种植体周围骨组织再生的实验研究

目的探讨可吸收性胶原膜引导即刻植入种植体周围骨组织再生的效果。方法在12只成年杂种狗下颌第3、4前磨牙新鲜拔牙创即刻植入种植体的近中形成3 mm×3 mm×5 mm骨缺损区,按自身同期对照研究设计,右侧为实验侧,骨缺损区上覆盖Co膜;左侧为空白对照侧,骨缺损区不覆盖Co膜。术后1、2、4、6个月分别处死一组动物,摘取下颌骨,采用大体观察、X线摄片、组织学观察、扫描电镜及生物力学（拔出实验）测定等方法检测缺损区骨组织再生的情况。结果实验侧种植体周围骨缺损区较空白对照侧新骨形成量多、外形好、骨成熟时间早,加速了骨组织的再生过程。结论可吸收性胶原膜具有良好的生物相容性和可降解性,可用作骨组织引导再生膜,以期促进骨缺损的再生修复,其促进作用主要表现在骨组织愈合的早期。