新型硅磷酸钙用于大鼠拔牙位点保存的早期成骨性能研究

目的    通过SD大鼠拔牙窝模型研究硅磷酸钙（CPS）骨粉的体内成骨性能。方法    选择45只6周龄SD大鼠,全麻下拔除右侧上颌2颗磨牙后按照拔牙窝充填材料随机分为3组,每组15只。CPS组：拔牙后于拔牙窝内放入CPS骨粉,用Bio-Gide膜覆盖拔牙窝并缝合;Bio-Oss组：拔牙后于拔牙窝内放入Bio-Oss骨粉,用Bio-Gide膜覆盖拔牙窝并缝合;对照组：拔牙后不放置充填材料,直接用Bio-Gide膜覆盖拔牙窝并缝合。于术后2、4、8周分别处死每组大鼠5只并取材上颌骨,采用影像学和组织学检测方法测量并评价拔牙窝牙槽骨愈合情况。结果  所有大鼠样本在术后2、4、8周这3个时间点的拔牙位点骨体积分数、骨密度及骨小梁厚度均随着术后时间延长而增大。术后4周时,Bio-Oss组拔牙位点骨体积分数、骨小梁厚度大于CPS组和对照组（P < 0.05）。术后8周时,CPS组的拔牙位点骨体积分数、牙槽骨宽度、牙槽骨高度及骨密度略高于Bio-Oss组和对照组, CPS组的骨小梁厚度介于Bio-Oss组和对照组之间,但3组间各指标的差异均无统计学意义（均P > 0.05）。组织学观察发现,术后8周CPS组和Bio-Oss组仅可见少量的未降解材料,周围有较多新骨形成,骨质较致密。结论    CPS在体内具有良好的促成骨能力和降解性能,可有效减少拔牙后牙槽骨萎缩,具有作为位点保存充填材料的潜力。     

组织工程骨促进犬牙槽骨再生的体内研究

目的：探讨以犬骨髓间充质干细胞（bone marrow mesenchymal stem cells,BMSCs）为种子细胞,Bio-Oss小牛无机骨粉为支架,构建组织工程化骨,结合Bio-Gide胶原膜促进犬牙槽骨再生的可行性。方法：在3只犬的口腔里人工制作12个三壁骨缺损,每只犬的左侧为实验组,右侧为对照组。实验组：植入组织工程化骨;对照组：单纯植入Bio-Oss骨粉。手术后即刻及术后4周,8周,通过影像学和组织学方法（HE,Masson染色）检测骨缺损的再生效果。结果：术后8周,实验组X-ray可见缺损区新生骨骨量明显增加,切片HE染色见新生牙槽骨已充满骨缺损处,骨小梁成团状,Masson染色为红色;对照组X-ray可见骨缺损区阴影变浅,HE染色骨小梁排列凌乱,Masson染色为蓝绿色。结论：组织工程化骨促进犬牙槽骨再生是可行的。     

Bio-Oss骨代用品同引导骨再生膜联合应用效果的观察

目的 通过组织学观察Bio-Oss作为骨移植材料同引导骨再生膜技术联合应用治疗牙槽骨局部骨缺损及种植体周围骨缺损的临床效果。方法 从6例牙槽骨局部缺损患者的6处骨再生区取少量骨组织，采取Donath硬组织切片磨片技术行组织学观察。结果 组织学显示浅红色新生骨同淡黄色的Bio-Oss颗粒区别明显，Bio-Oss颗粒表面有新骨形成，并与之紧密结合。未见纤维结缔组织长入包裹Bio-Oss颗粒及炎症细胞浸润。结论 Bio-Oss骨有良好的生物相容性和骨引导作用，作为骨移植材料同引导骨再生膜技术联合应用的效果是可靠的。     

BIO-OSS人工骨与不同比例自体骨联合植入修复骨质缺损的实验研究

目的:建立种植体周围骨缺损的模型,植入自体骨、Bio-Oss人工骨、以及不同组成比例的骨移植物,比较新骨生成的效果.方法:拔除4条犬双侧下颌8颗双尖牙,拔牙12周后在每只实验犬两侧下颌植入8个钛钉,共32枚.分别于钛钉颊侧制造3ram*3mm*3mm的骨缺损.两侧自前向后依次植入收集的自体骨、1:2的Bio-Oss骨粉和自体骨混合物、2:1的Bio-Oss骨粉和自体骨混合物、单纯Bio-Oss骨粉,左侧覆盖钛膜,右侧覆盖胶原膜,严密缝合所有创口.植骨17周后取材,拍摄X线片,制作含钛钉的硬组织切片,光镜下观察.结果:4条试验犬32颗种植体术后均无感染,植骨区创口愈合良好.钛膜及胶原膜组均无暴露.切开粘膜可见32个人工制造骨缺损处光滑,坚硬,已经被新生骨组织充满.X线可见两种膜覆盖的区域种植体与骨结合紧密,无透射阴影,骨密度略有增高.全自体骨处骨密度略高于混合人工骨处.不同比例混合骨粉和自体骨以及全骨粉处成骨未见差异.在光镜下观察硬组织切片可见自体骨处成骨质量较高,其他三种植骨方式成骨差异不大,钛膜及胶原膜组相比亦未见成骨差异.讨论:本试验显示不同比例的骨移植物成骨效果未见差异,证实了Bio-Oss具有良好的生物相容性.与其他骨移植材料联合使用可获得理想的成骨效果.屏障膜可以完全封闭缺损区,且从缺损区周围正常骨组织获得足够的支撑.结论:不同组成比例的骨移植物对新骨生成作用未见差异,胶原膜与钛膜联合骨移植材料在引导骨再生中均能获得理想效果.     

上颌窦底提升术中应用组织工程化骨的实验研究

目的评价组织工程化骨在上颌窦底提升术中的效果。方法取犬骨髓基质干细胞（bone marrow stromal cells，BMSC）体外培养，并向成骨细胞定向诱导。将BMSC与多孔矿化骨（Bio-Oss）复合在体外培养5d。健康成年犬16只，行双侧上颌窦底提升术，选取一侧将BMSC-Bio-Oss复合物填充于上颌窦底提升形成的空腔中，另一侧植入单纯Bio-Oss骨粉作为空白对照。分别于术后30、90d行大体观察、CT检查、组织学检查和新生骨量分析。应用t检验对实验结果进行统计学分析。结果术后30、90d大体观察和CT检查均显示上颌窦内有新骨生成。新生骨量分析显示，单纯Bio-Oss组骨小梁总面积14．17±4．28，植入BMSC-Bio-Oss复合物组为21．31±5．14，新生骨量显著增多（P〈0．05）。结论将组织工程化骨应用于上颌窦底提升术可获得良好的成骨效果。     

胶原膜的应用及固定对人工骨粉成骨效果的影响

目的:评价可吸收性胶原膜的应用及固定与否对Bio-Oss人工骨粉成骨效果的影响。方法:4只实验用犬,在双侧下颌骨颊侧骨面随机形成3处约1 cm×1 cm的实验区,同体同侧的3个缺损区采用不同处理方法分为3组:A组为单纯应用Bio-Oss人工骨粉组;B组为骨粉与胶原膜联合应用并以钛钉固定组;C组为应用骨粉与胶原膜,但膜不予固定组。术后12周行大体、组织学及扫描电镜观察,对新生骨面积百分比进行统计分析。结果:3组均有新骨形成。B组新生骨较成熟,骨小梁结构排列有序,可见哈佛氏骨系统。A组可见软骨化骨组织及无规则骨小梁。C组有大量成骨细胞以及骨陷窝,新骨较A组成熟。结论:使用Bio-Oss骨粉与胶原膜联合应用并对膜加以固定的方法,其成骨效果要优于单纯应用Bio-Oss骨粉或骨粉与胶原膜联合应用但膜不作固定处理的这两种方法。     

三种比例CGF与异种骨Bio-Oss联合应用于重度牙周炎位点保存的疗效评价

目的:通过影像学和组织学比较3种比例的浓缩生长因子(concentrated growth factors, CGF)与Bio-Oss骨粉混合物应用于重度牙周炎患牙位点保存术中的成骨效果。方法:将30颗患牙随机分为3组，调整CGF凝胶碎片的质量使CGF:Bio-Oss骨粉=1:1、1:2、2:1,分别对应A、B、C组。并拟合CBCT模型测量分析，种植术中取骨组织样本进行组织学分析。结果:术后6个月，C组颊侧垂直骨高度的增量(1.97±0.75 mm)均大于其余组，且与B组(0.92±1.01 mm)有统计学差异；C组牙槽骨体积的增量(339.77±101.94 mm³),与另2组差异均有统计学意义。C组组织学图像显示大量新生骨和分布均匀的骨细胞，骨小梁排列紧密，骨成熟度高。结论:CGF与Bio-Oss骨粉以2:1的比例应用于重度牙周炎患牙位点保存术成骨效果相对更佳。     

珊瑚骨粉、口腔修复膜应用于即刻种植的临床研究

目的:选择合适的适应征进行微创拔牙后行即刻种植术,观察人工珊瑚颗粒、海奥生物膜行GBR技术,应用于前牙区即刻种植成骨效果.方法:25例前牙冠根折伴骨吸收患者进行即刻种植手术.微创拔除残根,牙槽窝嵴周少量骨缺损或伴唇侧骨壁洞穿,常规预备后植入种植体,种植体与牙槽窝骨壁间隙内、骨缺损处植入人工珊瑚颗粒(天博骨粉),盖海奥口腔修复膜,种植体均为潜入式愈合,二期手术后常规修复.观察二期手术及修复后6月或1年植骨区外形及牙龈状况.结果:二期手术时牙槽嵴成骨明显,包绕种植体颈周,二期手术修复后6月或1年牙槽外形均较植骨前丰满,牙龈质地、色泽良好.结论:珊瑚骨粉颗粒联合海奥生物膜应用于即刻种植修复少量骨缺损,成骨效果可靠.     

辛伐他汀与骨粉复合物填充大鼠胫骨骨缺损修复作用的实验研究

目的研究辛伐他汀作为激活物对大鼠胫骨骨缺损修复的促进作用。方法实验组用辛伐他汀与Bio-Oss骨粉复合物填入大鼠胫骨骨缺损模型,对照组骨缺损单纯填入Bio-Oss骨粉,空白组骨缺损部位不放入骨粉。术后4、8、12周分别处死大鼠,定性、定量分析,观测骨增量变化和骨缺损修复进程。结果空白组无法正常愈合;实验组在新骨生成和改建速度上明显好于对照组。结论辛伐他汀有促进新骨生成作用,加速了骨缺损修复进程。     

脱矿牙本质基质和脱细胞牙本质基质成骨效果的对比研究

目的 比较骨缺损区植入脱矿牙本质基质和脱细胞牙本质基质的成骨效果。方法 制备脱矿牙本质基质和脱细胞牙本质基质。将24只SPF级SD雄性大鼠随机分为脱矿组（A组）、脱细胞组（B组）、Bio-Oss骨粉组（C组）、空白组（D组）,每组6只大鼠,在麻醉条件下制备双侧股骨骨缺损。A、B、C组大鼠分别在骨缺损区植入脱矿牙本质基质、脱细胞牙本质基质、Bio-Oss骨粉,D组大鼠不植入任何材料。术后4周和8周,每组各随机处死3只大鼠。大体观察骨缺损区愈合情况,血清学检测成骨指标骨形态发生蛋白（BMP）-2及碱性磷酸酶（ALP）浓度,影像学观察骨缺损区高密度灰色区（代表骨愈合）分布情况,组织形态学观察新骨形成情况,计算新骨形成率。结果 术后4周和8周,大体观察见A组成骨能力较其他组活跃,血清学检测A组BMP-2及ALP浓度均高于其他组,差异有统计学意义（P<0.05）。8周时,影像学观察可见A组骨缺损区高密度灰色区分布均匀,组织形态学观察见A组排列规则的骨基质。A组4、8周时的新骨形成率分别为28.51%±0.55%、32.57%±2.28%,均高于其他组,差异有统计学意义（P<0.05）...     

Rh-bFGF与Bio-Oss骨胶原联合促进牙周骨缺损再生的实验研究

目的:评价重组人成纤维细胞生长因子(rh-bFGF)与牛无机骨胶原(Bio-Oss collagen)复合物和Bio-Gide联合应用对犬牙周组织再生的作用。方法:选用4只成年杂种犬,在双侧上、下颌前磨牙缺失区的近、远中牙槽嵴手术制备5mm×5mm×5mm的3壁骨内缺损。采用3种不同方法进行处理,实验组1:rh-bFGF与Bio-Oss胶原复合物植入, Bio-Gide覆盖;实验组2:Bio-Oss胶原复合物植入,Bio-Gide覆盖;对照组:单纯Bio-Gide覆盖。根据临床、影像学和组织学测量指标对治疗结果进行评价。采用SAS 6．2统计软件包进行配对t检验。结果:术后8周,所有3壁骨内缺损均有数量不等的新生牙槽骨、牙骨质和结缔组织。其中2个实验组的新生牙槽骨(3．7mm±0．3mm,2．3mm±0．2mm)与对照组(1．2mm±0．1mm)相比有显著性差异(P<0．01);实验组1与实验组2相比也有显著性差异(P<0．05)。而新生牙骨质和新生结缔组织附着在各组之间均无显著性差异(P>0．05)。结论:应用rh-bFGF／Bio-Oss胶原复合物更有利于牙槽骨再生,并且不会出现根吸收和骨固连等牙周再生治疗常见的不良结局。植入rh-bFGF／Bio-Oss胶原复合物对牙骨质再生和牙周韧带形成无显著作用。     

Bio-Oss骨粉和Bio-Oss骨胶原位点保存的效果评价

目的：研究Bio-Oss 骨粉+胶原膜（海奥）和骨胶原在位点保存中的临床效果。方法：选取患牙26颗,随机分为 2 组。骨粉组13例,于拔牙窝内植入Bio-Oss骨粉,表面覆盖胶原膜（海奥）;骨胶原组13例,于拔牙窝内仅植入Bio-Oss 骨胶原。3个月后复查,观察2组患牙牙槽窝愈合情况,于位点保存术后即刻和术后3个月进行锥形束 CT（CBCT）检查 ,测量牙槽骨垂直向高度与水平颊舌向厚度、CBCT灰度值的变化,临床观察新骨外形轮廓的改变,评价位点保存的临床效果。采用 SPSS 17.0 软件包对数据进行处理。结果： 2组在新骨外形轮廓方面无显著差异（P>0.05）;术后3个月,2组牙槽骨高度、厚度均减低,灰度值升高,均有统计学差异（P均<0.01）,但2组疗效无显著差异（P均>0.05）。结论：2种材料用于位点保存时效果无显著差异,但使用骨胶原的位点保存技术操作简单,创伤小,费用低。     

钛网在上前牙唇侧重度骨缺损种植中的临床研究

目的:探讨在上前牙种植时使用钛网联合胶原膜和富血小板纤维蛋白(platelet rich fibrin,PRF)在修复唇侧骨板重度缺损的骨再生效果.方法:选择20例上前牙种植唇侧骨板重度缺损的患者,随机分为两组.一组使用骨粉+胶原膜+PRF进行骨增量,一组使用钛网+骨粉+胶原膜+PRF进行骨增量.埋入式愈合6个月二期手...     

Evaluation of periodontal regeneration following grafting intrabony defects with bio-oss collagen: a human histologic report

This study evaluated the clinical, radiographic, and histologic response to Bio-Oss Collagen when used alone or in combination with Bio-Gide bilayer collagen membrane for the treatment of four intrabony defects (5 to 7 mm) around single-rooted teeth. After reflecting a full-thickness flap, thorough degranulation and root planing were accomplished. In all cases, Bio-Oss Collagen was then used to fill the defects, and in two cases, a Bio-Gide membrane was placed over the filled defect. Radiographs, clinical probing depths, and attachment levels were obtained before treatment and immediately preceding en bloc resection of teeth and surrounding tissues 9 months later. Reduction in pocket depth and gain in clinical attachment level were observed for both treatment protocols. The histologic evaluation demonstrated the formation of a complete new attachment apparatus, evidencing periodontal regeneration that varied with defect morphology. This human histologic study demonstrated that Bio-Oss Collagen has the capacity to induce regeneration of the periodontal attachment apparatus when placed in intrabony defects.     

A controlled re-entry study on the effectiveness of bovine porous bone mineral used in combination with a collagen membrane of porcine origin in the treatment of intrabony defects in humans

AIM: The purpose of this study was to evaluate the clinical effectiveness of a bovine porous bone mineral used in combination with a porcine derived collagen membrane as a barrier in promoting periodontal regeneration in intrabony defects in humans. MATERIAL AND METHODS: The study employed a split-mouth design. 22 paired intrabony defects were treated and surgically re-entered 6 months after treatment. Experimental sites were grafted with bovine porous bone mineral and received a collagen membrane for guided tissue regeneration. Control sites were treated with an open flap debridement. RESULTS: Preoperative pocket depths, attachment levels and trans-operative bone measurements were similar for control and experimental sites. Post surgical measurements revealed a significantly greater reduction in pocket depth (differences of 1.89 +/- 0.31 mm on buccal 0.88 +/- 0.27 mm on lingual measurements) and more gain in clinical attachment (differences of 1.51 +/- 0.33 mm on buccal and 1.50 +/- 0.35 mm on lingual measurements) in experimental sites. Surgical reentry of the treated defects revealed a significantly greater amount of defect fill in favor of experimental sites (differences of 2.67 +/- 0.91 mm on buccal and 2.54 +/- 0.87 mm on lingual measurements). CONCLUSIONS: The results of this study indicate that clinical resolution of intrabony defects can be achieved using a combination of bovine porous bone mineral and an absorbable, porcine derived collagen membrane when employing a technique based on the principles of guided tissue regeneration. The nature of the attachment between the newly regenerated tissue and the root surfaces needs to be evaluated histologically to confirm the presence of new attachment.     

Bio-Gide膜与钛膜在牙种植术中的临床应用研究

目的:评价可吸收Bio-Gide膜与不可吸收钛膜在牙种植中骨再生修复的方法和效果。方法:对牙槽骨骨量不足的牙种植采用植Bio-Oss骨粉或自体骨,随机盖Bio-Gide膜与钛膜各30例,进行引导骨再生。结果:术后Bio-Gide膜与钛膜的伤口裂开发生率分别为3.3%与26.7%,伤口裂开的发生与手术切口、粘膜的厚度有关,盖钛膜伤口裂开后易发生感染。X光片显示:无感染膜下的Bio-Oss骨粉或自体骨改建形成了新骨,能与种植体形成紧密的骨性结合。结论:Bio-Gide膜与钛膜都能有效阻挡软组织长入植骨区,促进骨组织再生修复;Bio-Gide膜的使用方法简单,适应证广,临床应用方便。     

牛骨粉(Bio-Oss)/人工生物膜(海奥)联合治疗下颌骨缺损骨腔的临床观察

目的　　探讨下颌骨囊肿术中使用牛骨粉(Bio-Oss)/人工生物膜(海奥)联合治疗疗效。方法　选取下颌骨囊肿患者12例病例,囊肿摘除后,分成2组,1组骨粉填塞,并用生物膜覆盖,另1组不作处理。根据临床及影像学资料分析评估囊肿术后骨缺损处的骨质再生和改建情况。结果　骨粉/生物膜联合治疗组术后患者骨缺损区成骨较好。结论　下颌骨囊肿术后骨缺损使用骨粉/生物膜联合治疗,效果确切、可靠。     

Three-dimensional micro-computed tomographic evaluation of periodontal regeneration: a human report of intrabony defects treated with Bio-Oss collagen

This study utilized three-dimensional micro-computed tomography (micro-CT) to evaluate the regenerative response to Bio-Oss Collagen when used alone or in combination with a Bio-Gide bilayer collagen membrane for the treatment of four intrabony defects (5 to 7 mm) around single-rooted teeth. The micro-CT observations are compared to the clinical, radiographic, and histologic results, which have been previously reported. After reflecting a full-thickness flap, thorough degranulation and root planing were accomplished. Bio-Oss Collagen was then used to fill the defects, and in two cases a Bio-Gide membrane was placed over the filled defect. Radiographs, clinical probing depths, and attachment levels were obtained before treatment and immediately preceding en bloc resection of teeth and surrounding tissues 9 months later. A mean pocket depth reduction of 5.75 mm and mean clinical attachment level gain of 5.25 mm were recorded. The histologic evaluation demonstrated the formation of a complete new attachment apparatus with new cementum, periodontal ligament, and alveolar bone at the level of and coronal to the calculus reference notch. Micro-CT evaluation confirmed the histologic results and demonstrated the absence of ankylosis or root resorption for all specimens. This human histologic study demonstrated that Bio-Oss Collagen has the capacity to facilitate regeneration of the periodontal attachment apparatus when placed in intrabony defects. Micro-CT observations confirmed the histologic results and enhanced the three-dimensional understanding of periodontal wound healing. The results indicate that micro-CT may be useful for three-dimensional evaluation of periodontal regenerative procedures.     

作为GBR屏障膜的新型胶原膜的体内植入效果分析

［摘要］ 目的 探讨Ⅰ型胶原和矿化Ⅰ型胶原合成的胶原膜作为GBR屏障膜在动物体内植入后,诱导早期膜下成骨的能力。方法 实验于2013年10月—2014年3月在沈阳军区总医院动物实验中心完成。选取小型巴马猪双侧下颌骨,分别于下颌骨骨体处用牙科裂钻制备8 mm×8 mm全层骨缺损3个,分别应用实验胶原膜覆盖、Bio-gide@覆盖、无覆盖膜骨缺损区。术后1个月处死动物,在处死前1、2周分别肌肉注射四环素溶液与二甲酚橙溶液。固定样本后,制备硬组织切片。分别在荧光显微镜及光学显微镜下（甲苯胺蓝、亚甲基蓝-酸性品红染色）观测膜的降解程度及膜下新骨生成能力,评价材料膜下骨形成量和骨成熟程度。结果 实验组胶原膜具备良好的屏障作用,膜下新生骨矿化程度良好;骨小梁排列整齐,但新生骨量少于Bio-gide@覆盖组;无覆盖膜骨缺损区新生骨组织骨小梁排列混乱,新生骨量少。 结论 新型胶原膜在1个月时体内无明显降解,具备良好的膜下成骨能力,下一步需进行实验组胶原膜的改性,以增加胶原膜膜下成骨量。     

Clinical and histologic evaluation of a granular bovine bone biomaterial used as an adjunct to GTR with a bioresorbable bovine pericardium collagen membrane in the treatment of intrabony defects

Background: The aim of the present study is to evaluate the clinical and histologic healing of deep intrabony defects treated with guided tissue regeneration (GTR) with a collagen membrane from bovine pericardium and implantation of granular bovine bone biomaterial. Methods: Thirty patients with one deep, combined 1‐ and 2‐wall intrabony defect exhibiting a probing depth ≥6 mm and an associated intrabony defect ≥3 mm were treated with GTR with a bioresorbable collagen membrane from bovine pericardium and adjunct implantation of a granular bovine bone biomaterial. The clinical results were evaluated 1 and 3 years after surgery. In addition, five teeth fulfilling the inclusion criteria but scheduled for extraction because of advanced periodontitis or restorative considerations were treated similarly and then extracted along with a portion of their surrounding periodontal tissues for histologic evaluation 6 months after surgery. Results: Healing was uneventful in all patients. Significant clinical improvements were observed at 1 and 3 years postoperatively (P <0.01; probing depth averaged 4.4 ± 1.6 and 4.7 ± 1.4 mm and clinical attachment level gain was 3.9 ± 1.4 and 3.5 ± 1.3 mm, respectively). The histologic evaluation revealed formation of new cellular cementum and new periodontal ligament in four of the five cases. In general, the xenograft particles seemed to be mostly embedded in connective tissue without any evidence of new bone formation. Conclusion: GTR treatment of intrabony defects with the collagen membrane from bovine pericardium and adjunct implantation of the new bovine bone biomaterial may result in significant clinical improvements that can be maintained over a period of 3 years, and regeneration of cementum and periodontal ligament, but without bone formation.