生物膜对不同范围BLB种植体周骨缺损修复的影像学观察

背景：即刻种植体周与骨之间常存在着间隙，究竟是否需要应用生物膜进行引导骨再生目前仍无定论。目的：通过在犬的股骨植入种植体创造不同的骨缺损间隙，观察生物膜对不同范围骨缺损骨组织再生修复的影响。设计、时间及地点：同体对照动物实验，于2005-03/12在吉林大学白求恩医学院实验动物中心及吉林大学口腔医院完成。材料：BLB羟基磷灰石涂层种植体由北京莱顿公司提供，BME-10X医用胶原膜由福建省博特生物科技有限公司提供。方法：在犬两侧股骨近心端植入种植体，并形成水平宽度3 mm、垂直深度约5 mm、水平长度分别为0，1，2，3，4 mm的标准梯度骨缺损。左侧直接分层严密缝合，右侧于骨缺损区覆盖生物膜后分层缝合。术后3个月处死动物，取含种植体的骨段，制成组织块进行影像学观察。主要观察指标：表面及剖面观察种植体周围骨缺损区新骨形成的量、色泽、质地等情况。应用软X射线观察种植体与骨组织界面的骨结合情况以及骨缺损区新骨形成情况。结果：大体观察：3 mm以下骨缺损区与原皮质骨无界限，有膜组与无膜组基本相同；4 mm缺损区与正常骨之间有模糊界限，有膜组比无膜组新生骨组织更致密。软X射线观察：3 mm以下缺损区无论有无生物膜，缺损区骨密度、骨小梁形态及骨小梁排列方向与周围骨组织无明显差异；故有膜组与无膜组未见明显区别；4 mm缺损区种植体与新生骨直接接触，但新生骨钙化程度欠佳，小梁较细且走行不规则，有膜组钙化程度略高于无膜组。结论：生物膜对3 mm以下的骨缺损组织有较强的再生修复能力，在较大骨缺损修复方面起重要作用。

Biological membrane for repair of different sizes of bone defects surrounding BLB implants

BACKGROUND: There is often space between implant and bone during immediate implantation. Whether biological membrane is needed to guide bone regeneration remains poorly understood. OBJECTIVE: To create different sizes of space between femur and implants in dogs and to observe the effects of biological membrane on bone regeneration capacity of bone defects surrounding implants. DESIGN, TIME AND SETTING: A self-control animal experiment was performed at the Laboratory Animal Center, Norman Bethune College of Medicine, Jilin University and School of Stomatology, Jilin University between March and December 2005.MATERIALS: BLB hydroxyapatite-coated implant was provided by Beijing Leiden Biomaterial Co.,Ltd., China; BME-10X collagen membrane was purchased from Fujian Better Biotechnology Co., Ltd., China. METHODS: BLB implants were installed in the bilateral proximal femoral bone to create standard gradient bone defects with horizontal width 3 mm, vertical depth 5 mm, and horizontal lengths of 0, 1, 2, 3, and 4 mm. Bone defects on the left femur were sutured directly and those on the right femur were covered with biological membrane prior to suture. All animals were sacrificed at 3 months after surgery. Specimens containing implants were harvested to prepare tissue blocks for radiological observation. MAIN OUTCOME MEASURES: The quantity, color, and texture of newly formed bone surrounding implants were observed from the surface and profile levels. The implant-bone integration and new bone formation were also examined by soft X-ray photography.RESULTS: Gross observation results revealed that when the horizontal length of bone defect was 3 mm or less, there was no significant difference in bone density between the newly formed bone and the host bone no matter whether biological membrane existed or not; when the horizontal length of bone defect was 4 mm, the bone density was better when biological membranes were used than not. Soft X-ray photography results revealed that when the horizontal length of bone defect was 3 mm or less, no significant difference in bone density and bone trabecular morphology and orientating was found between newly formed bone and host bone no matter whether biological membrane was used or not; in the 4-mm-length bone defect areas, implants contacted with newly formed bone directly, but the calcified degree of newly formed bone was poor, bone trabecula was thin, and bone trabecular course was irregular, nevertheless, the calcified degree of newly formed bone was better under the condition of being with biological membrane than without biological membrane. CONCLUSION: Biological membrane exhibits strong capacity to promote the regeneration and repair of bone defect tissue with a horizontal length of 3 mm or less, and plays an important role in repair of large sizes of bone defect.