富血小板纤维蛋白新生诱导骨的组织学观察

BACKGROUND: In previous experiments, we have confirmed that platelet rich fibrin has the ability of osteoinduction, and have conducted a preliminary study on its microstructure and biomechanics. However, little is reported on its histology research. OBJECTIVE: To compare the histological changes after implanting platelet-rich fibrin, Bio-Oss and autologous bone and to analyze the pros and cons of platelet-rich fibrin implantation for repair of bone defects. METHODS: As previously reported, animal models of critical bone defects were established respectively on the bilateral femoral condyles of 12 beagle dogs. Then, platelet-rich fibrin, Bio-Oss+collagen membrane (Bio-Oss group) and autologous bone (autologous bone group)+collagen membrane were respectively implanted. At 3, 6, 8 and 12 months, one experimental dog from each group was killed, respectively, and histological observation was performed. Another beagle dog as blank control was enrolled to establish the animal model of critical bone defects, with no implantation. RESULTS AND CONCLUSION: At 3, 6, 8 and 12 months after implantation, there were significant differences in the new bone formation speed and amount between the platelet-rich fibrin group, Bio-Oss group and autologous bone group. These three kinds of bone grafts all had osteoinductive ability to different extents. In the platelet-rich fibrin group, the osteogenic effects were better at 3 and 6 months, and the new bone was similar to natural one; in the autologuos bone group, bone necrosis was noticeable at 3 and 6 months, but the osteogenic effects became better at 8 months, and the new bone was similar to natural one at 12 months; in the Bio-oss group, the osteogenic effects were similar to those in the platelet-rich fibrin group, but the residual of Bio-oss was visible at 12 months; in the blank control group, no bone formed at 3 months, indicating the animal model of critical bone defects was made successfully. In brief, the platelet-rich fibrin has good osteoinductive ability, with shorter time and better quality.       

两种麻醉技术在上颌前牙牙周治疗中的应用体会

目的 探讨两种麻醉技术在上颌前牙牙周治疗中的应用体会.方法 将需要在局部麻醉条件下对上颌前牙进行牙周治疗的患者随机分为2组,试验组采用单颗牙麻醉(STA)系统行上牙槽前、中神经麻醉(AMSA),对照组采用传统手推注射法行上颌前牙骨膜上麻醉.注射后,患者均通过视觉模拟评分法(VAS)评定注射时的疼痛程度,在治疗过程中医师评定麻醉效果.结果 试验组与对照组的麻醉效果均较好,统计学检验无显著差异(P＞0.05),试验组注射疼痛的VAS平均值低于对照组(P＜0.01).结论 采用STA系统行AMSA在上颌前牙牙周治疗中的麻醉效果与传统的手推注射法相当,但前者的注射疼痛远较后者小.     

代谢组学及其在口腔研究中的应用

代谢组学主要研究参与生物体新陈代谢,维持生物体正常机能及生长发育的一系列代谢产物,是继蛋白质组学和基因组学之后兴起的一种新技术。随着代谢组学研究的深入,目前广泛应用于疾病的诊断与治疗,微生物的鉴定,药物的开发及应用等。在口腔医学的研究中,代谢组学也起着重要的作用。     

富血小板纤维蛋白修复犬股骨髁骨缺损的微观结构研究

目的:通过建立beagle犬股骨髁的骨缺损模型,观察富血小板纤维蛋白(platelet-rich fibrin,PRF)诱导骨再生过程中新生骨的微观结构,评价PRF修复骨缺损的特点和优势,为PRF在诱导骨再生及颌骨重建的临床应用提供新的实验依据。方法:在实验犬股骨髁制备骨缺损,按Choukroun方法制备PRF膜,将PRF膜、Bio-Oss骨替代材料及自体骨骨松质随机填入3处骨缺损。12周、24周处死动物并取材,采用微焦点计算机断层摄影系统(microfocus computerizedtomography system,Micro-CT)检测分析新生骨的几何信息和结构信息。结果:PRF新生诱导骨骨小梁结构呈板状,厚度较厚,连续性和成熟度良好,数量稍少,接近自体骨组的成骨情况,优于Bio-Oss组;观察期内均数随时间延长,有向天然骨组衍变的趋势;PRF诱导成骨表现为向心性的特点。结论:PRF可诱导新生骨形成,成骨效果接近生理状态,表现为向心性成骨方式,具有良好的应用前景。     

口腔软组织缺损兔模型的构建

BACKGROUND: In clinical, the research on the method and the material of the soft tissue defect of the operation area has been in depth. It will have a positive impact on our exploration and research in this field through the establishment of reliable experimental animal oral soft tissue defect model.     

富血小板纤维蛋白骨诱导动物模型的建立

BACKGROUND: At present, many studies have focused on platelet-rich fibrin combined with other bone substitute materials in repair of peri-implant bone defects and sinus lifting, but there is still a lack of research  about the platelet-rich fibrin alone in repair of critical-size bone defects. OBJECTIVE: To compare the effect of three kinds of bone substitutes, platelet-rich fibrin, Bio-Oss bone substitute and autogenous cancellous bone, in repair of bone defects. METHODS: Four areas of cylindrical critical bone defects with a diameter of 6.0 mm and depth of 10.0 mm were prepared in the medial femoral condyle of beagle dogs. Three areas of bone defects were implanted with autologous platelet-rich fibrin, Bio-Oss bone substitutes and autologous cancellous bone, respectively. The remaining one area of bone defect was not implanted any substance, as control group. X-ray and Micro-CT detections in bone defect area were conducted after 12 weeks of surgery. RESULTS AND CONCLUSION: (1) X-ray: the density of platelet-rich fibrin group was more higher, but still slightly lower than that of the surrounding normal bone tissue; the density of the Bio-Oss bone substitute group was more lower, but still higher than that of the surrounding bone tissues; the density of autologous cancellous bone group was more higher, which was close to that of the surrounding bone tissues; circular low-density images were visible in the control group. (2) Micro-CT: platelet-rich fibrin group was similar with the autogenous cancellous bone group, and their density was slightly lower than that of the surrounding normal bone tissues; the trabecular bone exlibited a clear regular arrangement, and no obvious interface; the Bio-Oss bone substitute group showed a high density image with clear interface; the bone defect area was still clearly visible in the control group, with a low-density image. The bone volume fraction and trabecular number in the platelet-rich fibrin and autologous cancellous bone groups were both higher than those in the Bio-Oss bone substitute group (P < 0.05). These results demonstrate that platelet-rich fibrin and autogenous cancellous bone have a similar bone repair effect.      

富血小板纤维蛋白诱导口腔缺损软组织的修复与再生

BACKGROUND: Insufficient oral soft tissues in the implant zone may have a negative effect on the wound healing and the aesthetic restoration in the late stage. Platelet-rich fibrin can promote the wound healing of soft tissue defects. But there is still a lack of in-depth studies on the promotion of oral soft tissue defects in animal experiments. OBJECTIVE: To compare the repairing effects of platelet-rich fibrin and collagen membrane on soft tissue defects of the hard palate in New Zealand rabbits. METHODS: Fifty-four New Zealand rabbits were randomly divided into three groups (n=14 per group): platelet-rich fibrin group, collagen membrane group and blank control group. A 5 mm-diameter circular full-thickness soft tissue defect was made in the front of the hard palate, 2 mm distant to the rear maxillary incisors and mucosal edge of the bilateral hard palates. Autologous platelet-rich fibrin membrane or collagen membrane were implanted into the defect in the platelet-rich fibrin group and collagen membrane group, respectively. No treatment was given in the blank control group. General observation of the wound and wound healing analysis were performed at days 3, 7, 14, 21, 28, 56 post operation. Hematoxylin-eosin staining, CD31 immunohistochemical staining and Masson staining were used to observe inflammatory reaction, angiogenesis and collagen formation in the surgical site. RESULTS AND CONCLUSION: The wound healing rate was fastest in the platelet-rich fibrin group, and no obvious scar formed. At 3 days post operation, there was no difference in the wound healing rates among the three groups; at 7 days, the wound healing rate in the platelet-rich fibrin group was significantly higher than that in the collagen membrane group and blank control group (P < 0.05). At 3 and 7 days after operation, the inflammatory reaction in the platelet-rich fibrin group was less than that in the collagen membrane and blank control groups (P < 0.05); at 14, 21, 28 and 56 days, there was no significant difference between the three groups. At 7, 14, 21 days after operation, the average absorbance value of CD31 in the platelet-rich fibrin group was significantly higher than that in the collagen membrane and blank control groups (P < 0.05). The average absorbance value of collagen formation in the platelet-rich fibrin group was significantly higher than that in the collagen membrane and blank control groups at 7 days after operation (P < 0.05), significantly higher than that in the blank control group at 14 days (P < 0.05), but lower than that in the collagen membrane and blank control groups at 21, 28 and 56 days after operation (P < 0.05). These findings show that platelet-rich fibrin can reduce inflammatory reactions in the process of wound healing, accelerate the angiogenesis, regulate the metabolism of collagen, reduce the formation of scar and improve the quality of wound healing, thereby promoting the repair of oral soft tissue defects. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

穿心莲滴丸联合金栀洁龈含漱液治疗复发性阿弗他溃疡的临床观察

目的：观察穿心莲滴丸联合金栀洁龈含漱液治疗复发性阿弗他溃疡的疗效。方法：将86位RAU的患者随机分为试验组和对照组(n=43),试验组使用穿心莲滴丸联合金栀洁龈含漱液治疗RAU,对照组仅用金栀洁龈含漱液,两组在治疗后的第1、3、5、7和10天观察患者的疼痛程度、溃疡的愈合情况,并进行总有效率的比较。结果：试验组在治疗后第1、3、5和7天的疼痛程度均低于对照组(P<0.05);试验组溃疡愈合时间小于对照组(P<0.05);治疗后第1天,两组WHR无明显差异(P>0.05),治疗后第3天,试验组WHR大于对照组(P<0.05);试验组总有效率大于对照组(P<0.05)。结论：穿心莲滴丸联合金栀洁龈含漱液能加快RAU愈合,减轻疼痛,缩短病程。     

下颌第一磨牙拔牙后即刻种植的临床观察

目的评价下颌第一磨牙拔牙后即刻种植的临床效果。方法 23例下颌第一磨牙经微创拔牙后,植入Nobel Replace根形种植体,记录种植体完全就位时的植入扭矩值;以骨替代材料和胶原生物膜完成种植体周围骨缺损的处理,安装宽颈愈合基台,采用开放愈合方式,分别于种植体植入10d后拆线,第1、3、6个月复诊,6个月后完成上部结构修复,完成修复后随诊3个月。记录受植区软组织情况及愈合基台稳固情况,评价修复后的咀嚼功能。结果 23颗种植体植入时平均扭矩值为(38.90±10.97)N·cm;愈合基台周围的牙龈组织在术后1~2w趋于稳定,术后6个月时愈合基台周围上皮袖口形成,符合软组织生物封闭的要求,修复后正常行使咀嚼功能。结论严格控制适应证,下颌第一磨牙即刻种植可获得良好的初期稳定性及修复效果;下颌第一磨牙区采用宽颈愈合基台开放愈合,可获得良好的软组织封闭和软组织愈合。     

左上侧切牙、多生牙融合牙1例

患者,男,13 岁,汉族,因牙齿不整齐需要矫正于2016年6月30日来我院就诊. 检查:患者恒牙列, 22 牙远中扭转,22 与23 牙之间有一多生牙且近中扭转,22牙与多生牙唇侧牙冠相对,相距约1 mm,两牙之间探及深凹槽,底部质硬. 口腔根尖片及曲面断层摄影均不能清晰显示22牙和多生牙的位置关系. 经患者家属同意后拍摄锥形束CT(CBCT),结果显示:22牙和多生牙根尖发育完成,根颈、根中、根尖部牙本质融合,髓腔各自独立走形,通畅且不融合(图1).诊断:牙列拥挤;多生牙;22、多生牙融合牙. 处理:经与患者家属沟通,给予本病例以下治疗方案:1、22牙行根管治疗后,进行 22 牙与多生牙完全分离术,并拔除多生牙,正畸预留22牙正常牙冠的修复空间,待正畸结束,患者年满18岁以后,22牙行烤瓷冠修复;2、拔除融合牙,正畸预留22牙正常牙冠的修复空间,待患者年满18岁后,行22 牙种植修复. 患者家属经过考虑选择最后一项治疗方案.在签署拔牙治疗同意书后,于局麻下拔除融合牙.