四环素骨诱导活性材料整复牙缺损的实验研究

目的：将盐酸四环素处理的人离体非功能牙块用于诱导骨再生技术中,观察和比较其对牙槽骨再生修复的影响。方法：拔除大鼠第一磨牙近中根做人工牙槽缺损。置入盐酸四环素处理的离人牙块,以盐酸处理的离体人牙块为阳性对照,未做任何处理的离体人牙块为阴性对照。不同时期取材做组织观察和评价。结果：四环素处理组炎症反应小,早期成骨明显。中晚期成骨量明显高于对照组。结论：盐酸四环素处理的人离体非功能牙块有抑制骨吸收,诱导     

牵引成骨在正畸牙快速移动中成骨速度的研究

目的 观察牙周膜牵引成骨在正畸牙快速移动中牵引侧牙槽骨的成骨速度。方法 6只犬采用自身对照，对照侧用传统方法以第三前磨牙为支抗牙移动第一前磨牙向远中，实验侧用自制牙周膜牵引装置。用序列四环素荧光标记法标记被移动的牙张力侧新形成的牙槽骨，荧光显微镜下观察切片，拍照，用计算机图象分析系统测量新骨量。结果 实验侧和对照侧新骨形成的量有显著性差别，实验侧大于对照侧。结论 牙周膜牵引成骨术在正畸牙快速移动中比传统的牙齿移动方法可加快新骨的形成。     

无机诱导因子在牙槽骨缺损牙再植中的应用

目的：观察无机诱导因子在伴有牙槽骨缺损的牙再植中的应用效果。方法：对9例因外伤或颌骨病变引起牙槽骨缺损的病灶进行治疗，将传统治疗需拔除的病灶牙经离体处理后，与无机诱导因子一起植入，同时修复牙列和牙槽骨缺损，术后定期复诊，拍摄牙片，对临床和影像学结果进行评价。结果：9例无机诱导因子与牙再植病例均获得满意效果，随访6个月-2a未见骨吸收。无机诱导因子能诱导牙周骨缺损区新骨形成，再植牙根与新生骨形成骨结合并重新获得稳固，能正常行使咀嚼功能。结论：无机诱导因子可作为骨移植修复材料，使因牙槽骨缺损而失去支持的病灶牙得以保存。     

人牙周膜干细胞的多向分化潜能实验

目的:体外培养分离人牙周膜干细胞(hPDLSC),做成骨诱导和成脂诱导实验。方法:取新鲜拔除正畸牙的牙周膜为材料制成组织块,加入培养液以组织块法分离培养,免疫磁珠法筛选人牙周膜干细胞,加入成骨诱导液诱导牙周膜干细胞成骨,加入成脂诱导液诱导牙周膜干细胞向脂肪细胞转化。结果:成功筛选出人牙周膜干细胞,成骨及成脂诱导成功。结论:免疫磁珠法是筛选人牙周膜干细胞的有效方法,牙周膜干细胞可以向成骨细胞和脂肪细胞分化。     

无机诱导因子复合支架材料修复狗牙槽骨缺损的初步观察

目的观察无机诱导因子在狗牙槽骨缺损修复中的作用效果。方法在5只狗双侧下颌第1、2前磨牙牙周，制备1．0cm高的全牙槽骨缺损，植入无机诱导因子，在术后2、3个月随机选取2只狗，分次取材后进行影像和组织学评价。结果无机诱导因子植入1周后，软组织愈合正常，2个月后缺损区X线影像开始出现阻射，牙槽嵴高度变化不明显，部分牙周膜影消失，硬组织切片观察到新生牙槽骨与牙根直接连接，形成骨结合，3个月时尚可见到未完全降解材料。结论无机诱导因子促进了牙槽骨成骨，可作为修复牙槽骨缺损的人工骨替代材料。     

非血管化游离骨移植同期种植骨活力的实验研究

目的观察非血管化骨移植同期种植的骨块在不同离体时间点植入体内后细胞活力及成骨情况.方法拔除狗前磨牙,口腔粘膜完全愈合后,截除长度3 cm的无牙下颌骨段,取不带血管和软组织的髂骨全层,植入直径2 mm带自攻螺纹的纯钛种植体2～3枚,分别在离体60、120分钟内植入下颌缺损区.术后4、8周取出植骨块,观察游离移植的非血管化骨块内细胞活力和新骨形成情况.结果非血管化游离骨移植同期种植恢复了下颌骨节段性缺损的连续性.游离骨块在离体60分钟植入体内4～8周为活骨块,可见到大量成活的骨细胞,并有数量不等的新骨形成.离体120分钟的游离骨块植入体内后4～8周为死骨块,其中未见成活骨细胞,部分骨块中见到破骨细胞.结论在以狗为对象的实验中,非血管化游离髂骨块移植同期种植可以修复长度3cm的下颌骨节段性缺损,植入体内骨块能否成活与其离体时间有关.     

引导再生术用于下颌第三磨牙拔除后牙槽骨再生的疗效评估

目的观察联合应用Bio-oss骨代材料和Bio-gide胶原膜的引导骨再生术(guided bone regeneration,GBR)治疗下颌阻生第三磨牙拔除后邻牙远中牙槽骨缺损的疗效。方法将24例下颌阻生第三磨牙拔除患者随机分为GBR组和对照组,GBR组12例,对照组12例。GBR组拔牙后行Bio-oss、Bio-gide引导骨再生术。对照组拔牙后常规处理拔牙创。分别记录术前、术后3个月拔牙区域牙槽骨再生情况,邻牙远中牙周探诊深度(probing depth,PD)、牙槽嵴顶到釉牙骨质界的距离、松动度及敏感度。结果与术前相比两组术后拔牙区域均存在牙槽骨再生,X线片显示,GBR组疗效优于对照组,且有显著性差异。GBR组新骨形成量较多,牙周探诊深度减小,邻牙远中牙槽嵴顶到釉牙骨质界的距离减小。无邻牙松动和敏感病例,对照组新骨形成量较少,牙周探诊深度和邻牙远中牙槽嵴顶到釉牙骨质界的距离变化不明显,存在部分邻牙松动和敏感病例。结论联合应用Bio-oss骨代材料和Bio-gide胶原膜行引导骨再生术可促进拔牙区域牙槽骨再生和邻牙远中牙槽骨高度的改善。     

牙源性干细胞在牙槽骨再生领域的研究进展

目前所采用的骨增量技术均存在各自的不足,骨组织工程的出现为牙槽骨再生提供了新的治疗方法。研究证实,多种牙源性干细胞具有易于获取、自我更新能力强、成骨分化潜力大、免疫原性低等特点,成为骨再生治疗的重要种子细胞来源。本文就牙槽骨再生中牙源性干细胞的研究进展作一综述。     

牙体硬组织表面电位影响骨改建的实验研究

目的研究牙体硬组织表面电位与骨生长改建的关系。方法将人牙釉质试件、牙釉质-牙本质试件、牙本质-牙骨质试件和多孔羟基磷灰石试件各25个植入25只家兔胫骨中,通过组织病理学、酶组织化学染色和四环素荧光标记方法,在术后不同时间段观察、评价各试件正负极侧的家兔胫骨骨组织改建情况。结果光镜观察各时间段牙体试件的负极侧成骨较正极侧活跃,破骨细胞数量计数正极侧较负极侧多(P<0.01)。四环素荧光标记显示负极侧荧光面积多于正极侧(P<0.05)。结论牙体硬组织表面电位可影响骨改建:荷正电的牙釉质面促进骨的吸收破坏,荷负电的牙骨质面促进成骨。牙齿过萌与无牙颌牙槽骨萎缩可能与此有关。     

骨挤压联合骨引导再生术在上颌前牙种植中的应用

目的 评价上颌前牙区牙槽骨吸收的患者应用骨挤压联合骨引导再生术行种植体植入的临床效果。方法 16例上前牙单牙缺失伴牙槽骨萎缩的患者，应用骨挤压联合骨引导再生术植入16颗种植体，术后6个月暴露种植体，最终完成烤瓷冠修复。结果 术后无明显并发症发生，修复完成后观察7～26个月，种植体行使功能良好，无种植体丧失。结论 对上颌前牙区牙槽骨吸收的患者，应用骨挤压联合骨引导再生术行种植体植入，可改善牙槽骨质，保存骨量，临床效果良好。     

Dentin resorption and cementum-like tissue formation by bone morphogenetic protein application

BACKGROUND AND OBJECTIVE: Recent studies have shown that bone morphogenetic protein-2 (BMP-2) stimulates mineralization and osteoclast differentiation. Osteoclastic resorption by BMP-2 application may play an important role in the regulation of new cementum-like tissue formation on the dentin surfaces. Therefore, this study aimed to examine the effect of BMP-2 application on dentin resorption and cementum-like tissue formation at the dentin surfaces. MATERIAL AND METHODS: Seventy-two flat dentin blocks were prepared from rat roots and treated with 24% EDTA. Each block was assigned to group 0, group 100, or group 400, and immersed correspondingly in 0, 100, or 400 microg/ml BMP-2. The dentin blocks were then implanted into palatal connective tissue of rats, and specimens were prepared 2, 4 and 8 wk after surgery for histologic and histomorphometric analyses. RESULTS: BMP-2 caused a dose-dependent increase in dentin resorption by osteoclastic cells. New cementum-like tissue was randomly formed on parts of the nonresorbed and resorbed dentin surfaces in groups 100 and 400. Dentin resorption in groups 100 and 400 was significantly greater than group 0 (p < 0.01). However, at 8 wk, new cementum-like tissue formed in 41.8% of group 100, as compared with 16.2% of group 400 (p < 0.05). CONCLUSION: Dentin resorption was stimulated by a high dose of BMP-2, and cementum-like tissue was induced by a low dose of BMP-2, effectively suggesting that BMP-2 application, at an appropriate dose, to a dentin surface may enhance periodontal regeneration.     

Effect of recombinant human platelet-derived growth factor-BB and bone morphogenetic protein-2 application to demineralized dentin on early periodontal ligament cell response

The purpose of this study is to investigate the early responses of human periodontal ligament cells attached to recombinant human platelet-derived growth factor-BB and bone morphogenetic protein-2 applied EDTA-demineralized dentin. One hundred and seventy-four root-planed flat dentin blocks were prepared from the mid-third of periodontally diseased human tooth roots. After demineralization with 24% EDTA (pH 7.02) 120 dentin blocks were treated with 0.5 and 1 microgram/ml rhPDGF-BB, 1 and 3 micrograms/ml rhBMP-2 and only MEM as control (24/group). Human periodontal ligament cells (HPLC) were seeded on these dentin surfaces and incubated. The alkaline phosphatase (ALP) activity and protein concentration of the attached cell were assessed at d 2, 4 and 7. Fifty-four dentin blocks were seeded with HPLC after application of 1 microgram/ml rhPDGF-BB, 3 micrograms/ml rhBMP-2 and MEM (18/group) and then incubated. At d 2, 4 and 7, the attached cells were stained and counted under light microscope. The results showed a significant increase of protein concentration and cell number in PDGF-BB treated groups than control (p < 0.05, p < 0.01) but not the ALP activity, and a significant increase of ALP activity was observed in BMP-2 treated groups than control (p < 0.05) but protein concentration and cell number remained almost the same over time. Thus, rhPDGF-BB and rhBMP-2 application to EDTA demineralized dentin surfaces promote the early human periodontal ligament cell responses by increasing cell proliferation and differentiation, respectively, which would ultimately enhance periodontal regeneration.     

Bio-Oss骨粉联合富血小板纤维蛋白在牙槽骨缺损种植引导骨再生后的骨量变化

目的：探讨Bio-Oss骨粉联合富血小板纤维蛋白在牙槽骨缺损种植引导骨再生后骨量的变化。方法：选择106例单颗前牙缺失伴唇侧骨缺损患者,进行种植体种植同期引导骨再生。按随机数字表法随机分为2组,实验组（53例）采用Bio-Oss骨粉联合富血小板纤维蛋白+生物膜引导骨再生,对照组（53例）采用Bio-Oss骨粉联合生物膜引导骨再生。评价2组种植成功率、术后并发症率、种植体唇侧骨壁厚度、骨缺损再生情况。采用SPSS 25.0软件包对数据进行统计学分析。结果：2组种植体种植成功率差异无统计学意义（96.23%:88.68%,P>0.05）。种植后12个月,实验组种植体唇侧骨壁厚度显著大于对照组[（2.72±0.43） mm:（2.51±0.36） mm,P<0.05],不同位点种植体唇侧骨壁厚度大于对照组（P<0.05）,出血指数[（0.32±0.02）:（0.42±0.03）]、探诊深度[（3.31±0.69） mm:（4.32±0.95） mm]、附着丧失[（3.06±0.52） mm:（5.24±1.35） mm]均显著小于对照组（P<0.05）,植骨高度[（2.61±0.52） mm:（2.31±0.35） mm]、成骨高度[（2.59±0.32） mm:（2.01±0.16） mm] 显著大于对照组（P<0.05）。2组患者并发症发生率相比差异无统计学意义（1.89%:5.66%, P>0.05）。结论：Bio-Oss骨粉联合富血小板纤维蛋白可减少骨缺损种植引导骨再生后骨量丢失,促进骨缺损再生。     

鼠哺乳期二(噁)英暴露对子代牙槽骨生长发育的影响

目的 研究鼠哺乳期二(噁)英类物质2,3,7,8-四氯二苯对二(噁)英暴露对大鼠仔鼠牙槽骨生长发育的影响.方法 60天龄2,3,7,8-四氯二苯对二(噁)英暴露组和对照组仔大鼠被处死,将其带有磨牙的上颌骨行树脂包埋,制备硬组织磨片并在荧光显微镜下观察,对两实验组牙槽骨的组织形态、荧光标记情况及组织形态计量学参数进行比较.结果 与对照组相比,二(噁)英暴露组牙槽骨骨小梁结构较为疏松,荧光标记较紊乱.实验组与对照组骨小梁宽度分别为(52.5±5.2)μm及(59.4±6.6)μm,二者差异有统计学意义(P<0.05);骨小梁数目分别为(3.27±0.23)mm-1及(3.75±0.29)mm-1,差异有统计学意义(P<0.01);骨小梁分离度分别为(217.3±37.6)μm及(177.6±33.8)μm,差异有统计学意义(P<0.05);矿化沉积率分别为(0.68±0.08)μm/d及(0.95±0.12)μm/d,差异亦有统计学意义(P<0.05).结论 二(噁)英类物质哺乳期暴露显著降低了大鼠仔鼠牙槽骨的质、量,并影响其空间构型.     

Enhanced vertical alveolar bone augmentation by recombinant human bone morphogenetic protein-2 with a carrier in rats

This study aimed to evaluate the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) on vertical bone regeneration of edentulous ridge. Bilateral upper first and second molars of 8-week-old Wistar rats were extracted and the ridges were allowed to heal for 3 weeks. Compressed poly(lactic-co-glycolic acid) copolymer/gelatin sponge (PGS) was used as a carrier of rhBMP-2. PGS alone (control group) or PGS with 5 mug rhBMP-2 (test group) was implanted at the top part of alveolar ridge. The sham group received no implantation. The rats were killed at 1, 2, 4, 8 and 12 weeks after implantation and examined histologically and histomorphometrically. In the test group, significant bone augmentation was evident on the alveolar ridge throughout the experimental period. Histomorphometric analysis revealed greater tissue volume and height of alveolar bone in the test group compared with the control and sham groups (P < 0.05) from 4 weeks onward and the augmented tissues (5 mm3 in tissue volume and 1.5 mm in bone height) were maintained until 12 weeks. Osteoblast surface increased at 2 and 4 weeks and osteoid thickness reached a peak (25 microm) at 2 weeks. Dynamic variables, which represented calcification, were higher in the test group than the control and sham groups at 4 and 8 weeks (P < 0.05). These results suggest that use of rhBMP-2/PGS may achieve vertical bone augmentation, and stabilizes denture prosthesis or makes up for inadequate bone mass for implant prosthesis.     

自体牙本质颗粒与Bio-Oss骨粉植入引导骨再生治疗牙周骨缺损效果比较

目的: 评价自体牙本质颗粒与Bio-Oss骨粉植入引导骨再生治疗牙周骨缺损的效果。方法: 选择2018年5月—2020年5月张掖人民医院收治的82例行引导骨再生治疗的牙周骨缺损患者,依照随机数表法分为实验组和对照组,每组41例。对照组植入Bio-Oss骨粉,实验组植入自体牙本质颗粒。比较2组患者牙周袋深度和附着丧失,颊侧软组织剖面、颊侧软组织厚度,红色美学评分,修复成功率及并发症。采用SPSS 22.0软件包对数据进行统计学分析。结果: 术后1个月和术后1年,2组患者牙周袋深度和附着丧失均显著降低（P<0.05）;且术后1年,2组患者牙周袋深度和附着丧失均低于术后1个月（P<0.05）。术后1个月和术后1年,实验组患者牙周袋深度和附着丧失显著低于对照组（P<0.05）。术后1个月和术后1年,2组患者颊侧软组织剖面显著高于术前（P<0.05）;术后1年,2组颊侧软组织剖面显著低于术后1个月（P<0.05）。术后1年,实验组患者颊侧软组织剖面显著高于对照组（P<0.05）。术后1个月和术后1年,2组患者颊侧软组织厚度显著高于术前。各时间点,2组患者颊侧软组织厚度相比,差异无统计学意义（P>0.05）。术后1个月和术后1年,2组患者红色美学评分显著高于术前（P<0.05）;且术后1年2组红色美学评分显著高于术后1个月（P<0.05）。术后1个月和术后1年,实验组患者红色美学评分显著高于对照组（P<0.05）。术后1年,实验组和对照组修复成功率分别为90.24%（37/41）和85.37%（35/41）,2组修复成功率相比,差异无统计学意义（P>0.05）。2组患者并发症发生率无统计学差异（P>0.05）。结论: 自体牙本质颗粒引导骨再生治疗牙周骨缺损患者,能够降低牙周袋深度和附着丧失,提高颊侧软组织剖面和红色美学评分,且修复成功率与Bio-Oss骨粉植入相当,是一种安全可靠的治疗方法。     

MTA与PRF在上颌前牙拔牙患者牙槽骨再生中的应用效果评价

目的：评价骨替代物矿物三氧化物骨料（MTA）与自体富血小板纤维蛋白（PRF）用于上颌前牙拔牙患者牙槽骨再生的效果。方法：选择2017年1月—2019年12月杭州口腔医院收治的上颌前牙拔牙患者66例,根据填塞材料分为MTA组、PRF组、联合组（MTA+PRF）,每组各22例。获取术前和术后1、3、6、12个月的锥形束CT(CBCT)图像,比较3组患者损伤组织愈合、牙槽骨密度和牙槽骨体积。采用SPSS 21.0软件包对数据进行统计学分析。结果：66例患者中,61例获得完整随访记录,随访率为92.42%,其中MTA组、PRF组、联合组分别为20例、20例、21例。3组患者术后3、6、12个月的牙槽骨密度显著高于术前（P<0.05）。联合组术后6、12个月的牙槽骨密度显著高于MTA组和PRF组（P<0.05）,MTA组术后6、12个月的牙槽骨密度显著高于PRF组（P<0.05）。3组患者术后3、6、12个月的牙槽骨体积显著低于术前（P<0.05）,联合组术后6个月、12个月的牙槽骨体积显著低于PRF组（P<0.05）。结论：MTA单独用于上颌前牙拔牙患者牙槽骨修复...     

Prognostic factors for alveolar regeneration: bone formation at teeth and titanium implants

OBJECTIVES: There is a limited understanding of the effect of defect characteristics on alveolar bone healing. The objectives of this study were to assess the effect of alveolar bone width and space provision on bone regeneration at teeth and titanium implants, and to test the hypothesis that the regenerative potentials at teeth and implants are not significantly different. METHODS: Critical size, 5-6-mm, supra-alveolar, periodontal defects were surgically created in 10 young adult dogs. Similarly, critical size, 5-mm, supra-alveolar, peri-implant defects were created in four dogs. A space-providing expanded polytetrafluoroethylene device was implanted for guided tissue regeneration/guided bone regeneration. The animals were euthanized at 8 weeks postsurgery. Histometric analysis assessed alveolar bone regeneration (height) relative to space provision by the device and the width of the alveolar crest at the base of the defect. Statistical analysis used the linear mixed models. RESULTS: A significant correlation was found between bone width and wound area (r=0.55892, p<0.0001). Generally, bone width and wound area had statistically significant effects on the extent of bone regeneration (p<0.0005 and p<0.0001, respectively). Bone regeneration was linearly correlated with the bone width at periodontal (p<0.001) and implant (p=0.04) sites, and with the wound area at periodontal (p<0.0001) and implant (p=0.03) sites. The relationships of bone regeneration with these two variables were not significantly different between teeth and implants (bone width: p=0.83; wound area: p=0.09). When adjusted for wound area, bone regeneration was significantly greater at periodontal than at implant sites (p=0.047). CONCLUSIONS: The horizontal dimension of the alveolar bone influences space provision. Space provision and horizontal dimension of the alveolar bone appear to be important determinants of bone regeneration at teeth and implants. The extent of alveolar bone formation at implant sites is limited compared with that at periodontal sites.     

牙本质作为骨移植材料的研究进展

随着口腔材料学的不断发展,不同类型的骨移植材料被应用于修复牙槽骨。牙本质来源于天然的牙体组织,作为一种新兴的骨移植材料在骨再生领域中应用广泛,其不仅具有优异的生物相容性,骨诱导、骨引导能力,且来源广泛、抗原性低、制作简单。将废弃的牙齿进行再次利用,为患者节省骨粉费用,并且含有骨形态发生蛋白和多种生长因子,吸收速率与新骨形成速率适宜,动物实验和临床研究均证实了其良好的骨再生效果。本文就牙本质在骨再生领域中的研究进展作一综述。