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1.
复合羟基磷灰石糊剂在诱导根尖成形术中的应用研究   总被引:1,自引:0,他引:1  
根尖孔尚未完全发育形成的年轻恒牙,若受到龋病、外伤等外界因素影响。会导致其牙髓坏死,从而影响其牙根的继续发育形成。临床上常采用根尖诱导成形术促进其发育完成。笔者于1996年起采用复合羟基磷灰石糊剂对38例无牙髓年轻恒牙进行诱导根尖形成术,取得了满意疗效,现报道如下。 1 临床资料 1.1 一般资料:患者38例,年龄9~13岁,共42颗患牙,前牙36颗,其中外伤冠折所致24颗,龋病所致12颗:双尖牙6颗,均为畸形中央尖所致。术前均摄x线片,X线片显示患牙牙根尖呈喇叭口状,6例伴有根尖病灶,就诊时牙髓均已坏死。 1.2 材料:粉末型羟基磷灰石(华西医科大学口腔科技开发部生产),替硝唑(珠海丽珠制药厂生产),齿科用丁香油。 1.3 治疗方法:通过术前X线片了解牙根发育情况,  相似文献   

2.
背景:慢性根尖周炎症导致根尖周骨质破坏及缺损并不少见,若不能及时消除炎症终止骨吸收和牙龈组织的破坏,修复根尖周组织缺损,最终将导致牙丧失。脱细胞真皮基质和珊瑚羟基磷灰石在动物实验中常用于修复牙周损伤。目的:评价异体脱细胞真皮基质与珊瑚羟基磷灰石两种材料联合修复根尖周组织缺损的临床疗效。方法:选择76例慢性根尖周炎患者作为研究对象,患者等分为实验组和对照组。实验组患者采用异体脱细胞基质与珊瑚羟基磷灰石联合修复根尖周组织缺损;对照组患者不植入任何材料。2组患者均行根尖切除及根尖倒充。修复后1周及6,12个月复诊,通过临床症状和×射线片检查评价修复效果。结果与结论:修复1个月后,实验组患者异体脱细胞真皮基质全部存活,因修整瘘管口周围炎性的肉芽组织导致的牙龈组织缺损已经愈合。在修复12个月后,实验组患者的修复有效率明显高于对照组(P〈0.05)。实验组患者修复6个月后骨缺损区阴影基本消失,珊瑚羟基磷灰石颗粒间的透射影减小,出现有一定致密度的影像,提示有新骨长入;12个月后珊瑚羟基磷灰石颗粒密度已接近正常的骨组织密度,与正常骨组织之间有密度移行改变,逐渐与牙槽骨形成骨融合。异体脱细胞基质与珊瑚羟基磷灰石的生物相容性良好。提示异体脱细胞真皮基质与珊瑚羟基磷灰石联合修复根尖周组织缺损具有良好的临床疗效。  相似文献   

3.
根尖切除术是治疗慢性根尖周炎 ,特别是长期不愈而形成瘘管又需保留患牙的最重要的手段[1] 。为了提高该手术的成功率 ,本科自 1993年采用根尖切除术后即刻充填羟基磷灰石微粒 ,效果良好 ,现报道如下。1 临床资料1.1 一般资料 选择有长期瘘管不愈 ,牙片示根尖阴影小于 2mm ,临床确诊为慢性根尖周炎患者 82例 (计82颗患牙 )为手术对象 ,患者年龄 18~ 6 5岁 ,并与同期38例 (计 38颗患牙 ) ,仅做单纯根尖切除术患者进行了比较。两组患者一般情况及病情具可比性。1.2 操作方法 术前摄牙X线片 ,对所有患者先作根尖治疗 1周后再做根尖切…  相似文献   

4.
目的:在动物实验的基础上,研究临床应用膜诱导组织再生技术治疗牙种植体周围炎,以观察治疗的临床效果。方法:选择符合牙种植体周围炎诊断标准的患者作为研究对象,在牙种植体周翻瓣刮治的同时运用胶原膜覆盖种植暴露面和骨面,观察种植体周骨组织再生情况和种植体的稳固性。结果:经过一年的放射学和临床观察,发现炎症未复发,种植体稳固性提高,种植体周骨组织有不同程度的再生。结论:膜诱导组织再生技术可用于牙种植体周围炎的治疗。  相似文献   

5.
背景:羟基磷灰石生物陶瓷以天然优质海洋珊瑚为原料,在珊瑚骨架上形成羟基磷灰石薄层,保留珊瑚天然孔孔相同的支架结构,为组织生长提供了良好空间。目的:观察羟基磷灰石生物陶瓷膜引导骨再生修复牙刷骨缺损的临床效果。方法:将42例下颌第一磨牙牙周病致骨缺损患者随机分组:实验组采用羟基磷灰石生物陶瓷结合u腔修复膜充填修复骨缺损,对照组采用单独羟基磷灰石生物陶瓷充填修复。结果与结论:临床随访观察12个月,两组牙周组织附着丧失、牙剧探诊深度较治疗前明显改善(P〈0.05),且实验组牙周组织附着丧失、牙周探诊深度改善优于对照组(P〈0.05);实验组骨缺损区新骨形成密度和骨量均优于对照组(P〈0.05)。表明采用羟基磷灰石生物陶瓷充填骨缺损区同时覆盖生物膜的引导骨再生技术可获得良好的骨引导再生效果,修复骨缺损。  相似文献   

6.
目的利用外科手术造成的狗颊侧牙周骨板缺损模型,观察应用膜诱导组织再生技术后牙周骨组织再生的效果。方法应用外科手术造成4只狗双侧第一、二、三磨牙颊侧牙周骨板缺损分别6 mm×8 mm,3月后双侧进行翻瓣刮治术,应用胶原膜一侧为实验组,另一侧为对照组。分别于3、6、12月拍X射线片,测量牙周骨组织再生效果。结果实验组术后6月牙周骨组织再生平均为3 mm,与对照组比较差异有显著性意义(P<0.05)。结论膜诱导组织再生技术治疗牙周骨缺损效果较好。  相似文献   

7.
目的:为临床应用膜诱导组织再生技术扩大牙种植适应症提供理论依据。方法:在拔除狗前磨牙的同时,造成颊侧骨板缺损,即刻种植羟基磷灰石涂层钛种植体或纯钛种植体,并运用胶原膜覆盖颊侧种植体暴露面和骨面,现察种植体周骨组织再生情况。结果:经过一年的放射学和组织学观察,种植体周骨组织有不同程度的再生,大多数种植体稳固。结论:应用膜诱导组织再生技术扩大牙种植适应症乃是一种有良好应用前景的可行方法,但对相关因素的控制值得重视。  相似文献   

8.
目的 探讨氧化铁纳米粒子(iron oxide nanoparticles, IONPs)复合纳米羟基磷灰石(nano-hydroxyapatite, nHA)对大鼠下颌牙周骨缺损组织再生的促进作用及可能机制。方法 SPF级SD雄性大鼠30只,随机分为模型组、nHA组、IONPs/nHA组,每组各10只。3组大鼠均于下颌牙周骨以牙科手机钻1个大小为3 mm×2 mm的骨缺损模型,模型组不给予材料植入,nHA组缺损区植入nHA,IONPs/nHA组缺损区植入IONPs复合nHA。术后6周,3组大鼠取下颌牙周骨,肉眼观察骨组织缺损情况,应用钼靶摄影机检测下颌牙周骨缺损区骨密度,行组织病理检查HE染色观察下颌牙周骨缺损区组织形态学变化,拍照计算缺损区新生骨面积百分比,采用Western blot法检测缺损区骨组织碱性磷酸酶(alkaline phosphatase, ALP)、骨钙素(osteocalcin, OCN)、Ⅰ型胶原蛋白(collagen-Ⅰ, Col-Ⅰ)相对表达量。结果 术后6周,模型组可见下颌牙周骨标本缺损区有明显凹陷,HE染色可见有成骨细胞聚集及骨基质,新生组织分布不均;...  相似文献   

9.
目的:为临床应用膜诱导组织再生技术治疗种植体周围炎提供理论依据。方法:在狗的前磨牙区种植羟基磷灰石涂层钛种植体或纯钛种植体,并手术造成颊侧骨板缺损和感染,然后应用膜诱导组织再生技术进行治疗。结果:经过一年的放射学和临床观察,种植体周围炎症消失,并且有不同程度的骨组织再生,种植体松动度减小。结论:应用膜诱导组织再生技术治疗种植体周围炎是一种行之有效的办法。为提高治疗效果,应重视加强对相关影响因素的控制。  相似文献   

10.
目的:骨诱导再生膜材料对骨组织损伤后的重建和再生起着屏蔽和诱导的作用.拟进一步验证羟基磷灰石(Hydroxyapatite,HA),聚氨酯(Polyurethane,PU)复合骨诱导再生膜体内外的细胞相容性和降解性能.方法:实验于2007-03/07在四川大学华西口腔医学国家重点实验室及四川大学纳米生物材料研究中心完成.①HA/PU复合膜制备成10 mm×10 mm大小,选择成熟的成骨细胞株MG63,体外细胞培养,在1,4,7 d内观察细胞在膜上的生长和增殖情况,并采用MTT法测定细胞的增殖率,判断其细胞的毒性.②把HA/PU复合膜制备成直径1.5 mm大小,选择健康的SD雌性大鼠3只,在脊柱一侧肌肉内埋植HA/PU复合膜,在1,4,12周后取出.以苏木精一伊红染色和Masson染色,组织切片观察材料的细胞相容性和自身降解性.结果:①HA/PU复合膜上细胞增殖良好,无坏死和悬浮细胞出现,细胞在膜上的增殖能力均高于MG63的增殖能力(P<0.05),细胞毒性为0级.②组织学切片观察,1-4周时材料在体内依旧是有形固体,材料被周围组织包裹,有巨噬细胞聚集,未见多核细胞,胶原纤维逐渐变得致密.12周时,材料发生降解,有纤维组织长入,周围与组织结合良好,未见有炎症发生.结论:HA/PU复合膜具有良好的细胞相容性和自身降解性能,可作为骨组织诱导再生膜材料.  相似文献   

11.
Cellulose scaffolds containing nano‐ or micro‐hydroxyapatite (nHA or μHA) were prepared by the regeneration of cellulose from its acetylated derivative and the mechanical immobilization of inorganic particles, followed by freeze‐drying. Microtomographic (micro‐computed tomography) evaluation revealed that both scaffolds presented a highly interconnected porous structure, with a mean pore diameter of 490 ± 94 and 540 ± 132 μm for cellulose/nHA and cellulose/μHA, respectively. In vitro and in vivo characterizations of the developed scaffolds were investigated. Commercially available bone allograft was used as a control material. For the in vitro characterization, osteoblastic cell cultures were used and characterized over time to evaluate cell adhesion, metabolic activity, and functional output (alkaline phosphatase activity and osteoblastic gene expression). The results revealed greater spreading cell distribution alongside an increased number of filopodia, higher MTT values, and significantly increased expression of osteoblastic genes (Runx‐2, alkaline phosphatase, and BMP‐2) for cellulose/nHA, compared with cellulose/μHA and the control. The in vivo biocompatibility was evaluated in a rabbit calvarial defect model. The investigated scaffolds were implanted in circular rabbit calvaria defects. Four‐ and 12‐week bone biopsies were investigated using micro‐computed tomography and histological analysis. Although both cellulose/HA scaffolds outperformed the assayed control, a significantly higher amount of newly formed mineralized tissue was found within the defects loaded with cellulose/nHA. Within the limitations of this study, the developed cellulose/HA scaffolds showed promising results for bone regeneration applications. The biological response to the scaffold seems to be greatly dependent on the HA particles' characteristics, with cellulose scaffolds loaded with nHA eliciting an enhanced bone response.  相似文献   

12.
目的从患者角度评估引导组织再生术(GTR)与单纯翻瓣刮治术治疗牙周骨内缺损的临床疗效。方法选取40例牙周炎重度垂直骨吸收的患牙,随机平均分为翻瓣术组及GTR组,采用问卷调查的方式记录患者感知的术后反应并记录局部组织的愈合情况。结果局部疼痛、龈组织水肿及牙根面敏感为患者主诉的常见术后反应,两组差异无显著性。术后创口的裂开GTR组显著高于翻瓣组,两组后期的疗效未见有显著性差异,1年后两组患者对所取得的临床效果均较为满意。结论与单纯翻瓣术相比,引导组织再生术中膜的植入治疗牙周骨内缺损并不会加重组织的术后反应,对牙周组织术后的早期愈合无明显影响。  相似文献   

13.
We described a combined periodontal–endodontic lesion, which was caused by a palatogingival groove and an additional root. An interdisciplinary approach involving endodontic therapy, mineral trioxide aggregate (MTA) filling, root resection, guided tissue regeneration, and papillary reconstruction was used for the case. The tooth presents morphologically and functionally normal except tooth discoloration caused by MTA.  相似文献   

14.
Guided bone regeneration (GBR) has been utilized for several decades for the healing of cranio‐maxillofacial bone defects and, particularly in the dental field, by creating space with a barrier membrane to exclude soft tissue and encourage bone growth in the membrane‐protected volume. Although the first membranes were non‐resorbable, a new generation of GBR membranes aims to biodegrade and provide bioactivity for better overall results. The Inion GTR? poly(lactide‐co‐glycolide) (PLGA) membrane is not only resorbable but also bioactive, since it includes N‐methylpyrrolidone (NMP), which has been shown to promote bone regeneration. In this study, the effects of loading different amounts of NMP onto the membrane through chemical vapour deposition or dipping have been explored. In vitro release demonstrated that lower levels of NMP led to lower NMP concentrations and slower release, based on total NMP loaded in the membrane. The dipped membrane released almost all of the NMP within 15 min, leading to a high NMP concentration. For the in vivo studies in rabbits, 6 mm calvarial defects were created and left untreated or covered with an ePTFE membrane or PLGA membranes dipped in, or preloaded with, NMP. Evaluation of the bony regeneration revealed that the barrier membranes improved bony healing and that a decrease in NMP content improved the performance. Overall, we have demonstrated the potential of these PLGA membranes with a more favourable NMP release profile and the significance of exploring the effect of NMP on these PLGA membranes with regard to bone ingrowth. Copyright © 2014 John Wiley & Sons, Ltd.  相似文献   

15.
目的 利用组织工程方法结合显微外科技术在动物体内构建兼有血管化与膜引导作用的非细胞型组织工程复合物,通过与单纯采用膜引导性骨再生技术构建的非细胞型组织工程复合物修复动物体内大段骨缺损的对比研究,观察带蒂筋膜瓣包裹法及单纯生物膜包裹构建的组织工程骨对骨缺,损修复的效果,为临床应用提供实验依据.方法 24只5个月龄新西兰大白兔,制备双侧尺骨中段连同骨膜1 cm骨缺损模型,自体红骨髓(ARBM)接种于含骨形态发生蛋白(BMP)的骨诱导活性材料(OAM)制备组织工程骨.将制成的非细胞型组织工程复合物植入骨缺损区,右侧采用单纯可吸收生物膜包裹(生物膜组),左侧采用带血运深筋膜瓣包裹(筋膜瓣组).各组在4、8、12、16周后进行X线检查、吸光度比测量、大体观察和组织学检查、修复区内骨形态计量分析,并在12周行生物力学检测,将数据作统计学处理,用以比较骨缺损修复情况.结果 X线片、大体形态和组织学观察显示,植入物内部血管的长入、骨小梁及软骨组织形成的数量和速度、成熟骨结构的形成、骨干结构的重塑、骨髓腔的再通、植入物的吸收降解,筋膜瓣组均明显优于生物膜组.术后4、8、12、16周的骨小梁面积占修复区面积比值筋膜瓣组为(20.35±2.41)%、(40.21±1.97)%、(66.67±3.44)%、(86.47±3.99)%,生物膜组为(7.46±2.64)%、(20.66±2.28)%、(40.22±1.84)%、(58.18±1.79)%;吸光度值筋膜瓣组为0.636±0.012、0.596±0.062、0.552±0.009、0.451±0.008,生物膜组为0.742±0.032、0.713±0.022、0.655±0.018、0.606±0.015;骨修复交界区单位面积内血管再生面积筋膜瓣组为(18.75 ±2.09)%、(37.41±3.22)%、(53.06±2.18)%、(36.72±4.73)%,生物膜组为(5.34±1.17)%、(9.48±2.%)%、(22.43±2.21)%、(26.27±3.14)%;术后12周生物力学测定筋膜瓣组为26.62±3.96,生物膜组为18.38±0.71,2组比较差异均有统计学意义(P均<0.05).结论 带血运筋膜瓣具有明显的促组织工程骨血管化作用并通过促血管化而促进成骨.膜引导性骨再生技术应用于大段骨缺损治疗,尽管有效限制了纤维结缔组织长入但也同时限制了有效快速血管化能力,需要漫长的爬行替代过程,单纯应用生物膜可以通过外骨痂生长弥补植入材料爬行替代缓慢的弊端.
Abstract:
Objective The tissue engineering technique and the microsurgery technology is combined to construct the uncellular tissue engineering complex with vascularization and membrane guided dual effect. Through comparing study of using the simple biomembrane guided bone regeneration technique to construct the uncellular tissue engineering complex to repair the large segment bone defect in the animal body,the bone reparative effect of the tissue engineering bone wrapped by pedical fascial flap with vessels and that wrapped by the simple biomembrane was compared, thus to provide experimental evidence for the clinical application. Methods Twenty-four Newzland 5-month-old rabbits were used to build the bilateral periosteumincluded bone defect modelsin the middle piece of the ulna and the length of the defect was 1 cm. Autologous red bone marrow was implanted in the tissue engineering bone which was prepared by osteoinductive absorbing material including BMP. The prepared tissue engineering bone was implanted in the bone defect area. The right side was wrapped by the simple absorbable biomembrane, whereas the left side was wrapped by pedical fascial flap with blood supply. At the fourth, eighth, twelfth and sixteenth week after the operation each group was examined by the radiograph (x-ray), the light density measurement, gross morphology and histological inspection,bone shape measurement analysis in the repairing area and the biomechanics measurement at the twelfth week. The data was analyzed to test the difference of the bond defect repair. Results The radiograph, gross morphology and histological inspection showed the growth of vessels in the implant area, the quantity and the forming speed of the bone trabecula and, the cartilaginous tissue, the formation of the mature bone structure,remodeling of the diaphysis, recanalization of the cavum ossis and the absorption and the degradation of the implant of the group of pedical fascial flap with blood supply was superior to that of the group of the simple absorbable biomembrane. At the fourth, eighth, twelfth and sixteenth week after the operation the bone trabecula area were( 20. 35 ± 2. 41 ) %, ( 40. 21 ± 1.97 ) %, (66. 67 ± 3.44 ) % and ( 86. 47 ± 3.99) % respectively in the group of pedical fascial flap with blood supply, and were ( 7. 46 ± 2.64 ) %, ( 20. 66 ± 2. 28 ) % , ( 40. 22 ±1.84)% and(58. 18 ± 1.79) respectively in the group of the simple absorbable biomembrane. At the same time point after the operation the light density were 0. 636 ± 0. 012,0. 596 ± 0. 062,0. 552 ± 0. 009 and 0. 451 ±0. 008 respectively in the group of pedical fascial flap with blood supply, and 0. 742 ± 0. 032,0. 713 ± 0. 022,0. 655 ±0. 018 and 0. 606 ±0. 015 respectively in the group of the simple absorbable biomembrane. The units of blood vessel reproductive area in the bone repair junctional zone were ( 18.75 ± 2. 09 ) %, ( 37.41 ± 3.22 ) %,(53. 06 ±2. 18)% and (36.72 ±4. 73)% respectively in the group of pedical fascial flap with blood supply,and (5. 34 ± 1.17 ) %, (9. 48 ± 2.96) %, ( 22.43 ± 2. 21 ) % and ( 26. 27 ± 3. 14 ) % respectively in the group of the simple absorbable biomembrane. The biomechanics intension was 26.62 ± 3.96 in the group of pedical fascial flap with blood supply and 18. 38 ±0. 71 in the group of the simple absorbable biomembrane at the twelfth week after the operation. All of the differences were significant( P <0. 05 ). Conclusion The pedical fascial flap with blood supply has significant effect in promoting the tissue engineering bone to vascularize and promoting the bone formation by vascularization. The membrane guided bone regeneration technique restricted not only the growth of the fibrous connective tissue in the reparative process of the large segment bone defect effectively, but also the ability of fast and effective vascularization, thus the chronic creep and substitution process would be needed. Simple application of the biomembrane can compensate the shortcoming of chronic creep of the implanted material by the growth of the external callus.  相似文献   

16.
Guided bone regeneration (GBR) barrier membranes are used to prevent soft tissue infiltration into the graft space during dental procedures that involve bone grafting. Chitosan materials have shown promise as GBR barrier membranes, due to their biocompatibility and predictable biodegradability, but degradation rates may still be too high for clinical applications. In this study, chitosan GBR membranes were electrospun using chitosan (70% deacetylated, 312 kDa, 5.5 w/v%), with or without the addition of 5 or 10 mm genipin, a natural crosslinking agent, in order to extend the degradation to meet the clinical target time frame of 4–6 months. Membranes were evaluated for fibre diameter, tensile strength, biodegradation rate, bond structure and cytocompatibility. Genipin addition, at 5 or 10 mm , resulted in median fibre diameters 184, 144 and 154 nm for uncrosslinked, 5 mm and 10 mm crosslinked, respectively. Crosslinking, examined by Fourier transform infrared spectroscopy, showed a decrease in N–H stretch as genipin levels were increased. Genipin‐crosslinked mats exhibited only 22% degradation based on mass loss, as compared to 34% for uncrosslinked mats at 16 weeks in vitro. The ultimate tensile strength of the mats was increased by 165% to 32 MPa with 10 mm crosslinking as compared to the uncrosslinked mats. Finally, genipin‐crosslinked mats supported the proliferation of SAOS‐2 cells in a 5 day growth study, similar to uncrosslinked mats. These results suggest that electrospun chitosan mats may benefit from genipin crosslinking and have the potential to meet clinical degradation time frames for GBR applications. Copyright © 2012 John Wiley & Sons, Ltd.  相似文献   

17.
Cholesterol-bearing pullulan (CHP) nanogel is a synthetic degradable biomaterial for drug delivery with high biocompatibility. Guided bone regeneration (GBR) is a bone augmentation technique in which a membrane is used to create and keep a secluded regenerative space. The purpose of the present study was to evaluate the effects of the novel CHP nanogel membrane in GBR. Thirty-six adult Wistar rats were used and bilaterally symmetrical full-thickness parietal bone defects of 5 mm diameter were created with a bone trephine burr. Each defect was covered with the collagen membrane or the CHP nanogel membrane or untreated without any membrane. The animals were sacrificed at 2, 4 and 8 weeks and analysed radiologically and histologically. Furthermore, after incubating human serum with CHP nanogel or collagen, the amount of PDGF in the serum was measured using ELISA. New bone formation in terms of bone volume was higher in the nanogel group than in the control or collagen groups at 2 and 4 weeks. At 8 weeks, both membrane groups showed higher bone volumes than the control group. Notably, the newly-formed bone in the bone defect in the nanogel group was uniform and histologically indistinguishable from the original bone, whereas in the collagen group the new bone showed an irregular structure that was completely different from the original bone. After incubating with CHP nanogel, the amount of PDGF in the serum decreased significantly. CHP nanogel GBR membrane favourably stimulated bone regeneration, in which a unique characteristic of CHP nanogel, the storage of endogenous growth factors, was likely implicated.  相似文献   

18.
A comprehensive understanding of the human body endogenous microbiota is essential for acquiring an insight into the involvement of microbiota in tissue healing and regeneration process in order to enable development of biomaterials with a better integration with human body environment. Biomaterials used for biomedical applications are normally germ‐free, and the human body as the host of the biomaterials is not germ‐free. The complexity and role of the body microbiota in tissue healing/regeneration have been underestimated historically. Traditionally, studies aiming at the development of novel biomaterials had focused on the effects of environment within the target tissue, neglecting the signals generated from the microbiota and their impact on tissue regeneration. The significance of the human body microbiota in relation to metabolism, immune system, and consequently tissue regeneration has been recently realised and is a growing research field. This review summarises recent findings on the role of microbiota and mechanisms involved in tissue healing and regeneration, in particular skin, liver, bone, and nervous system regrowth and regeneration highlighting the potential new roles of microbiota for development of a new generation of biomaterials.  相似文献   

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