局部应用唑来膦酸与纳米银对即刻种植骨结合影响的比较

背景:有研究表明局部应用唑来膦酸和局部应用纳米银都可促进骨形成,但两者效果的差异尚未见研究报道。目的:观察局部应用唑来膦酸和局部应用纳米银对兔拔牙窝即刻种植钛螺纹钉骨结合的影响差异。方法:将24只新西兰大白兔随机分为唑来膦酸和纳米银组,每组12只,在拔除兔上下颌4个切牙后,分别在2组的拔牙窝内填唑来膦酸-纳米羟基磷灰石复合物和纳米银-纳米羟基磷灰石混合物,并均同期植入钛螺纹钉。术后4,8,12周取兔上、下颌骨离体标本,通过一般形态观察、扭矩测试、骨密度检测及组织形态学观察。实验于2015年12月经河北医科大学第三医院医学伦理委员会批准(批准号:Z2015-021-1)。结果与结论:①扭矩力学实验测试结果显示,两组钛钉扭矩峰值的平均值随着时间延长而增加(扭矩峰值平均值数值),均在12周时达到最大(扭矩峰值平均值数值),术后4,8,12周,唑来膦酸组钛螺纹钉扭矩峰值平均值均略高于同期纳米银组,唑来膦酸组钛螺纹钉稳定性略优于纳米银组,但差异无显著性意义(P>0.05);②一般形态和组织学观察发现,术后4,8,12周唑来膦酸组种植体周围骨硬度和结构均明显优于同期纳米银组;③骨密度分析结果显示,术后4,8,12周,唑来膦酸组钛螺纹钉周围骨组织灰度值略高于同期纳米银组,但差异无显著性意义(P>0.05);④结果证实,从植入材料对影响种植体周围骨替代材料成骨的效果来看,用唑来膦酸纳米羟基磷灰石复合物进行即刻种植骨结合的效果略优于纳米银与纳米羟基磷灰石混合植骨。

Comparison of the effects of topical application of zoledronic acid and silver nanoparticles on osseointegration of immediate implant

BACKGROUND:Some studies have shown that topical application of zoledronic acid and topical application of silver nanoparticles can promote bone formation,but the difference between two methods has not been reported.OBJECTIVE:To investigate the effect of topical application of zoledronic acid versus topical application of silver nanoparticles on rabbit tooth extraction socket immediate implantation of titanium screw bonding.METHODS:Twenty-four New Zealand white rabbits were randomly divided into zoledronic acid and silver nanoparticles groups(n=12/group).After removing four incisors of the upper and lower jaws,the mixture of nanometer silver and nanometer hydroxyapatite and nanometer zoledronic acid hydroxyapatite were respectively filled in the tooth extraction pit of the two groups,and titanium screw was implanted at the same time.The isolated specimens of the upper and lower mandibles were taken at 4,8 and 12 weeks after surgery.The data reflecting the osseointegration around the implant were obtained through gross observation,torque test,bone density test and histomorphological observation.The study was approved by the Ethical Committee of the Third Hospital of Hebei Medical University in December 2015,approval No.Z2015-021-1.RESULTS AND CONCLUSION:(1)The test results of torque mechanics showed that the average torque peak value of all titanium nails increased with the extension of time(the average value of torque peak value)and reached the maximum value at 12 weeks(the average value of torque peak value).At 4,8 and 12 weeks after surgery,the torque peak value of titanium screw in the zoledronic acid group was higher than that in the silver nanoparticles group,and the stability of titanium screw in zoledronic acid group was better than that in silver nanoparticles group,but the difference was insignificant(P>0.05).(2)General observation and histological observation showed that at 4,8 and 12 weeks after surgery,the hardness and structure of bone around the implants in the zoledronic acid group were significantly better than those in the silver nanoparticles group.(3)Bone mineral density analysis results showed that,at 4,8 and 12 weeks after surgery,the gray value of bone tissue around the titanium screw in the zoledronic acid group was higher than that in the silver nanoparticles group at the same period(P>0.05).(4)These results suggest that the osseointegration of immediate implantation using nanometer zoledronic acid hydroxyapatite is better than that of the mixture of nanometer silver and nanometer hydroxyapatite.