重组人骨形成蛋白—2—珊瑚复合人工骨修复骨缺损的生物力…

将珊瑚与具有骨诱导特性的重组形成蛋白－２（ｒｈＢＭＰ－２）复合，制成ｒｈＢＭＰ－２＝ｃｏｒａｌ复合人工骨，将其植入兔颅骨标准大小缺损，并与单纯珊瑚植入作对照。通过Ｘ线片、组织学和生物力学方法来评价此复合人工骨的骨修复能力。结果显示：ｒｈＢＭＰ－２－ｃｏｒａｌ复合人工骨具有较强的骨修复作用，植入骨缺损后，材料被逐渐降解吸收，新骨不断形成，机械强度不断增大；１２周后，植入物完全被成熟的骨组织取代，缺损     

重组人骨形成蛋白-2-珊瑚复合人工骨修复骨缺损的生物力学研究

将珊瑚与具有骨诱导特性的重组人骨形成蛋白－２（ｒｈＢＭＰ－２）复合，制成ｒｈＢＭＰ－２－ｃｏｒａｌ复合人工骨，将其植入兔颅骨标准大小缺损，并与单纯珊瑚植入作对照。通过Ｘ线片、组织学和生物力学方法来评价此复合人工骨的骨修复能力。结果显示：ｒｈＢＭＰ－２－ｃｏｒａｌ复合人工骨具有较强的骨修复作用，植入骨缺损后，材料被逐渐降解吸收，新骨不断形成，机械强度不断增大；１２周后，植入物完全被成熟的骨组织取代，缺损区抗压强度接近正常的骨组织。该复合人工骨是一种较理想的骨移植替代材料。     

珊瑚人工骨在下颌骨缺损中的应用

珊瑚人工骨在下颌骨缺损中的应用解放军１４６医院（２７６００３）胡宝琪，温献州，刘加成，魏顶富，李翠兰，吴玉堂珊瑚人工骨具有良好的生物相容性和骨亲和性。美国Ｃｈｉｌｅｓ教授来我区讲学时，详细报告了珊瑚人工骨的制作及应用过程。我院在动物试验的基础上，于１...     

生物珊瑚、胶原和rhBMP-2合成人工骨修复兔下颌骨缺损的实验研究

目的：研究生物珊瑚、胶原和ｒｈＢＭＰ－２复合人工骨修复兔下颌骨缺损的效果。方法：选择３６只兔下颌骨缺损模型，分别采用新鲜自体骨，生物珊瑚和生物珊瑚、胶原和ｒｈＢＭＰ－２复合人工骨修复，大体、组织切片、Ｘ线、统计学等方法进行分析。结果：修复兔下颌骨缺损，合成人工骨形成新骨的时间比生物珊瑚早，２个月时修复效果优于生物珊瑚；３个月时，复合骨修复效果与自体骨无明显差别。结论：生物珊瑚、胶原和ｒｈＢＭＰ－２复合人工骨能够引导和诱导新骨形成。     

重组人骨形成蛋白─2和珊瑚复合移植的超微结构观察

为了弥补单纯珊瑚无骨诱导活性、骨修复能力较差的缺陷，本研究将具有骨诱导特性的重组人骨形成蛋白-2（rhBMP－2）和珊瑚复合，制备出rhBMP-2／珊瑚复合人工骨。将其植入免颅骨标准大小缺损，以单纯珊瑚植入作对照；术后2、6、12周取材，通过X残片和扫描电镜观察，评价其骨修复能力。结果显示；rhBMP－2／珊瑚复合人工骨的骨修复能力和骨修复效果明显优于单纯的珊湖，是一种较为理想的骨移植替代材料。     

重组人骨形成蛋白—2和珊瑚复合移植的超微结构观察

为了弥补单纯珊瑚无骨诱导活性，骨修复能力较差的缺陷，本研究将具有骨诱导特性的且人骨形成蛋白－２（ｒｈＢＭＰ－２）和珊瑚复合，制备出ｒｈＢＭＰ－２／珊瑚复合人工骨，将其植入兔颅骨标准大小缺损，以单纯珊瑚植入作对照：术后２，６，１２周取材，通过Ｘ线片和电镜观察，评价其骨修复能力。结果显示：ｒｈＢＭＰ－２／珊瑚复合人工骨的骨修复能力和骨修复效果明显优于单纯的珊瑚，是一种较为理想的骨移植替代材料。     

RhBMP-2-珊瑚复合修复腭板缺损的动物模型研究

目的：探讨RhBMP-2－珊瑚复合在腭板缺损修复中的可行性。方法：将珊瑚与RhBMP-2复合，制成rhBMP-2-coral复合人工骨，将其嵌入人造狗腭板骨缺损区。通过X片、扫描电镜、生物力学方法，观察复合人工骨在受植区的骨修复效果。结果：RhBMP-2－coral复合人工骨具有很强的骨修复能力，珊瑚逐渐被降解、吸收，新骨不断形成，其抗压强度不断增大，三个月后抗压强度接近正常腭板，复合人工骨完全被成熟骨组织替代。结论：RhBMP-2－coral复合人工骨是一种比较理想的腭板缺损修复材料。     

重组人骨形成蛋白2-珊瑚复合人工骨修复骨质缺损的实验研究

目的弥补珊瑚无骨诱导活性、成骨能力弱等缺陷。方法将珊瑚与重组人骨形成蛋白２（ｒｅｃｏｍｂｉｎａｎｔｈｕｍａｎｂｏｎｅｍｏｒｐｈｏｇｅｎｅｔｉｃｐｒｏｔｅｉｎ－２，ｒｈＢＭＰ－２）复合，制备出ｒｈＢＭＰ－２－珊瑚复合人工骨。将其植入兔颅骨直径１５ｍｍ的圆形缺损，以单纯珊瑚植入作对照。术后２、６、１２周取材，通过组织学观察和计算机图像分析，评价其骨修复能力。结果ｒｈＢＭＰ－２－珊瑚复合人工骨以传导成骨和诱导成骨双重机制完成骨修复过程，骨修复能力和骨修复效果明显优于单纯的珊瑚。结论此复合人工骨是一种较理想的骨移植替代材料。     

重组人骨形成蛋白-2/珊瑚复合人工骨的动物实验研究

本研究将重组人骨形成蛋白－２（ｒｈＢＭＰ－２）和珊瑚以一定的方式复合后,植入小鼠股部肌袋和兔颅骨标准大小缺损,以单纯珊瑚植入作对照,术后不同时间取材,通过组织学方法检测其骨诱导活性和骨修复能力．结果显示：ｒｈＢＭＰ－２／珊瑚复合人工骨植入小鼠肌袋１周,诱导软骨形成,３周,形成编织骨,６周,形成含骨髓的板层骨,同时,珊瑚被部分降解吸收;复合人工骨植入兔颅骨缺损后,以引导成骨和诱导成骨双重机制完成骨修复过程,术后１２周,植入物完全被成熟的骨组织取代,其骨修复效果明显优于单纯的珊瑚．此复合人工骨具有骨传导和骨诱导活性,骨修复能力较强,是一种较理想的新型生物性植骨材料     

应用珊瑚／骨髓基质细胞／富血小板血浆组织工程骨修复兔颅骨缺损

目的：评价珊瑚／骨髓基质细胞（MSCs）／富血小板血浆（PRP）组织工程骨修复骨缺损的效果。方法：将兔MSCs悬液与同一供体来源的PRP混合后滴加到珊瑚团片上,形成珊瑚／MSCs／PRP复合物,用其修复MSCs和PRP来源兔颅骨极限缺损。自体颅骨或单纯珊瑚植入作为对照。术后6周和12周,通过组织学观察和组织形态测量分析．评价其骨修复效果。实验数据采用SPSS11．0软件包处理,两组之间差异采用t检验。结果：组织学观察显示,珊瑚／MSCs／PRP组,术后第6周,在整个缺损区珊瑚表面及其孔洞内有大量新骨形成;第12周,缺损区珊瑚完全降解吸收,被成熟的板层骨取代,缺损表现为完全的骨修复.图像分析显示：术后第6周和第12周,珊瑚／MSCs／PRP组的成骨量显著多于珊瑚组（P〈0．01）;术后第12周,珊瑚／MSCs／PRP组成骨量与自体骨组接近（P〉0．05）。结论：应用珊瑚作为支架材料、MSCs作为种子细胞、PRP作为内源性生长因子构建的组织工程骨修复骨缺损效果良好,与自体骨移植相近．是较理想的骨移植替代材料．     

The use of coral as a substitute for maxillofacial bone reconstruction]

A kind of coral, Porites, which was originated from the Madreporaria reef builders in Hainan Province, was studied as a bone substitute. It is almost composed of aragonite (CaCO(s)) and the structure shows interconnected micropores with a-mean diameter of 150-200 microns which is suitable for bone ingrowth. The coral was implanted successfully into the defects in inferior border of mandibles of 8 rabbits for 6 months. Then it was used clinically as a bone substitute in maxillofacial surgery for 22 patients who were followed up for 6-24 months. With X-ray, histological and clinical examination, the results showed that the coral had a good tolerance and elicited no deleterious host response. After implanted, the coral is acted as a bone conductor and can promote the bone repair of defects. It seems to be a useful bone substitute.     

Influence of the structure of three corals on their resorption kinetics

The aim of this study was to investigate the influence of the structure of corals on their resorption kinetics after implantation in subcutaneous areas. Three types of coral ( Porites astreoides, Montastrea annularis and Dichocenia stokesi ) identical in composition but different in structure were implanted, for periods of 1 and 2 months in subcutaneous sites in OF l mice. The resorption of the implants was studied by means of qualitative (histology, scanning electron microscopy, fluorochrome labelling method) and quantitative approaches (gravimetric method). The results of the qualitative study revealed a process of irregular deterioration of the coral, linked to the detachment of crystals at the surface of the implant. The results of the quantitative study showed that the speed of resorption increases with the implantation time and the open porosity of the coral. These reactions are explained by the increase of the surface exchange area in contact with factors responsible for resorption: biological medium and cells. When considering the choice of coral as a bone substitute, these factors must be taken into account to allow the in situ maintenance of the implant over a sufficiently long period of time according to the clinical situation.     

珊瑚人工骨的实验研究

研究珊瑚人工骨在成骨过程中所起作用、其生物降解与新骨形成的关系。方法选用６只杂交狗，将珊瑚人工骨植入下颌下缘，以对侧作为对照，采用Ｘ线片、扫描电镜及能谱分析进行观察。结果术后第四、第五个月，实验侧下缘有纤维钙结构和新骨形成，很少有珊瑚人工骨残留，能谱分析钙盐含量很高。     

珊瑚人工骨和自体骨髓复合移植修复颌骨缺损临床应用研究

选用珊瑚人工骨和自体骨髓复合移植修复１６例颌骨肿瘤术后颌骨缺损，观察１０至２４个月，术后行Ｘ线检查，＾９９ｍＴｃ－ＭＤＰ核素骨三相显像，结果发现，１３例Ｉ期愈合，２例延迟愈合，１例失败；术后１个月植骨区开始出现核素浓聚，３个月珊瑚骨开始被吸收，１２个月完全被宿主骨取代，不留痕迹。结果表明，珊瑚骨和自体骨髓复合移植可以加速颌骨缺损的修复，是可供选择的骨代用品。     

Frei modellierbare Hydroxylapatit-Kollagen-Komposite zur Sanierung ossärer Defekte

Aim

In the following study we evaluated the biological response of a new freely moldable bone substitute in an animal model.

Material and methods

Critically sized defects were created surgically in the lower jaw of ten adult minipigs. The drill defects were filled with hydroxyapatite collagen paste. After observation periods of 1, 3, 6, 12, and 18 months the mandibles were harvested without wound healing defects for histological evaluation of resorption and bone ingrowth with a sawing and grinding technique.

Results

The result of the remodeling process was a complete degradation of hydroxyapatite collagen implants after 12–18 months with reorganization of vital trabeculae oriented in a mature pattern.

Conclusion

The hydroxyapatite collagen cement works as an osteoconductor and shows signs of direct osseointegration and resorption.     

载药珊瑚人工骨修复骨缺损及预防感染的实验研究

目的：探讨载药珊瑚人工骨修复骨缺损及预防感染的可能性。方法：将珊瑚与克林霉素复合，制成载药珊瑚人工骨；将其置于接种有金葡菌的培养基中检测其体外缓释特性及抗菌活性；将其植入金葡菌污染的兔颅骨缺损区，通过细菌培养和组织病理检查评价其骨缺损修复能力及抗感染能力。结果：载药珊瑚人工骨在体外持续释放高浓度抗菌素；植入金葡菌污染的骨缺损后可有效预防骨感染，骨感染的发生率明显低于单纯珊瑚人工骨植入组。结论：载药珊瑚人工骨是伴有污染或感染骨缺损较理想的修复材料。     

Matrix metalloproteinase-9 regulates graft bone resorption

OBJECTIVE: To explore the relationship between bone resorption and matrix metalloproteinase-9 (MMP-9) expression in autogenous and allogenic bone grafts. MATERIALS AND METHODS: A total of 18 critical-size (10 x 15 mm) defects were created in rabbit mandibles bilaterally. Three groups of six defects each were grafted with autogenous endochondral (EC) bone, autogenous intramembranous (IM) bone, and allogenic IM bone. Three months later, the defects were retrieved for quantitative analysis on the basis of histology, immunohistochemistry, and in situ hybridization. RESULTS: A close relationship existed between MMP-9 expression and graft bone resorption. The parallel between MMP-9 expression and graft bone resorption suggested that bone resorption was accomplished in part by increased MMP-9 production evident in preosteoclasts and osteoclasts. CONCLUSIONS: MMP-9 plays an important role in graft bone resorption. Autogenous EC bone grafts express higher levels of MMP-9 leading to more resorption than autogenous or allogenic IM bone grafts.     

A histomorphometric evaluation of factors influencing the healing of bony defects surrounding implants

PURPOSE: The authors' aim was to perform a histomorphometric study of the healing of bone defects created adjacent to titanium and hydroxyapatite (HA) -coated implants and covered with either a resorbable or a nonresorbable membrane in combination with different filler materials and to evaluate to what degree coating, membrane, and/or filler influenced the healing of the defects. MATERIALS AND METHODS: Posterior teeth were extracted from the mandibles of 10 baboons, and 12 implants were placed in each animal in the edentulous areas. The implants were either titanium or HA-coated, the membranes were either Vicryl, Gore-Tex, or Resolut, and the filler was either demineralized freeze-dried bone (DFDB), autogenous bone, or Biocoral. The implants were observed for either 3, 6, 9, 12, or 18 months. The volume of newly generated tissue and the relative contribution of bone, marrow, and filler were evaluated, as was relative extension of resorption, formation, and quiescent surface. RESULTS: The results indicated that autogenous bone is still the gold standard, but both the DFDB and Biocoral compared favorably to it. Both filler materials were being gradually replaced by bone; this process was not yet finished at 18 months postsurgery. DISCUSSION: Since even the sterilization of DFDB cannot exclude the possibility of a disease transmission, it is important to find an appropriate substitute. Both filler and membranes contributed to the re-establishment of the original volume; better results were achieved with the Vicryl and Gore-Tex membranes than with the Resolut. Biocoral can be considered an effective material. CONCLUSION: A bony defect is not necessarily a contraindication for the placement of an implant. (More than 50 references.)     

珊瑚人工骨的生物学评价

目的：评价海南珊瑚人工骨的生物相容性。方法：参考上海市非直接接触血液的医用生物材料生物性能测试标评价珊瑚人工骨的组织相容性进行了一系列体内及体外试验,包括：细胞毒性试验,溶血试验,急性全身毒性试验,热原试验,皮下种植,肌肉种植及骨内种植试验。结果：各实验结果均符合种植材料要求。结论：珊瑚人工骨具有良好的生物相容性,安全无毒,无溶血性,对组织刺激小,不含热原。