自固化磷酸钙骨水泥修复牙种植体周围骨缺损实验研究

目的:本研究旨在应用国产自固化磷酸钙骨水泥修复牙种植体骨缺损的动物实验研究,观察磷酸钙骨水泥引导骨再生的方式,为将来磷酸钙骨水泥能修复牙种植体周围骨缺损奠定实验基础。方法:选取40只日本大耳白兔,在白兔右侧股骨大转子区植入BLB种植体(Φ=3.3 mm,L=8.0 mm),同时种植体冠部制造宽度为2.0 mm、深度为4.0 mm的环行骨缺损,骨缺损区充填CPC进行修复。实验组术后1、2、4、6个月随机处死大白兔10只,对骨缺损区X线骨密度分析,带种植体的硬组织磨片的组织学观察新骨的生成量,并进行统计学分析。结果:实验组磷酸钙骨水泥随时间延长而逐渐发生降解,新生骨组织沿降解裂隙长入,与种植体发生直接的接触,统计学分析结果表明各个月内的新骨量有显著性差别。结论:表明磷酸钙骨水泥在修复牙种植体周围骨缺损中展示了较好的引导骨再生性质。     

磷酸钙骨水泥及其复合材料研究进展

磷酸钙骨水泥是一种新型骨替代材料，综合性能优于其他骨替代材料，且操作简便，与其他材料复合后性能进一步提高，较适合于颌面部骨修复，具有很好的应用前景。     

磷酸钙骨水泥与骨形成蛋白复合修复即刻种植牙骨缺损的实验研究

目的：探讨磷酸钙骨水泥(CPC)与人重组骨形成蛋白-2(rhBMP-2)复合修复即刻种植牙骨缺损的效果，为其临床应用于种植牙骨缺损修复的可行性奠定理论基础。方法：在兔股骨大转子上模拟即刻种植模型，种植体周围骨缺损区植入CPC／rhBMP-2及CPC进行修复，通过X线片，骨密度测量及组织学检查，观察新骨形成情况和材料的微观结构变化以及新骨与种植体的关系。结果：CPC／-rhBMP-2复合物可以有效地修复即刻种植牙骨缺损，材料被逐渐降解吸收，新骨与种植体表面更早地结合。结论：CPC／rhBMP-2是一种比较理想的新型骨移植材料.     

磷酸钙骨水泥及其复合材料研究进展

磷酸钙骨水泥是一种新型骨替代材料,综合性能优于其他骨替代材料,且操作简便,与其他材料复合后性能进一步提高,较适合于颌面部骨修复,具有很好的应用前景。     

三种骨替代材料修复犬下颌种植体周围骨缺损的实验研究

目的:本研究旨在通过自固化磷酸钙活性人工骨(CPC/rhBMP-2)、自固化磷酸钙(calcium phosphate cement,CPC)、生物活性玻璃倍骼生(PerioGlas)修复种植体周围骨缺损的动物实验研究,比较三种材料修复种植体周围骨缺损的效果。方法:选取3只beagle犬,每侧下颌各拔除第三、四前磨牙及第一磨牙,3个月后,制备种植窝,然后在每侧下颌骨分别植入2枚纯钛骨融合式螺旋状种植体(直径3.3 mm,长度10 mm),同时在每个种植体冠部制成宽1～1.25 mm,深5 mm的环沟型骨缺损。采用自身对照,每只犬下颌的4枚种植体周的骨缺损作不同处理,随机分组结果如下:A组空置,B组植入PerioGlas,C组植入CPC,D组植入CPC/rhBMP-2。术后3个月取样本,制成带种植体的超硬组织切片,进行组织形态学观察,骨结合百分率测定和计算机组织图像分析。结果:B、C、D组种植体周围骨缺损均有新骨形成,植骨区骨-种植体结合率D组(49.48%)最高,C组(46.16%)次之,B组(42.71%)再次,A组(33.68%)最低,但差异无统计学意义(P>0.05)。结论:自固化磷酸钙活性人工骨、自固化磷酸钙、倍骼生这3种材料均能促进种植体周围骨缺损的骨再生。组织学结果显示自固化磷酸钙活性人工骨的新骨形成及成熟度,材料降解均优于其余3组。     

可注射磷酸钙骨水泥修复骨缺损的动物实验研究

目的通过动物实验观察分析两种新型可注射磷酸钙骨水泥的生物相容性、生物降解性和成骨特性。方法选取24只新西兰大白兔,在双侧股骨髁部钻取直径4mm深6mm的骨缺损,实验侧注入材料A(α-磷酸三钙骨水泥)或材料B(β-磷酸三钙骨水泥),术后3天摄X线片观察骨水泥充填情况。术后2、4、8周取实验侧α-磷酸三钙骨水泥植入处和空白对照侧标本,每组4只,共12只。术后8、16、24周取实验侧β-磷酸三钙骨水泥和对照侧α-磷酸三钙骨水泥植入处标本,每组4只,共12只。HE染色后光镜下观察骨水泥在骨内的降解及新骨生成情况。扫描电镜观察骨-骨水泥界面超微结构。结果4周时α-磷酸三钙骨水泥周围骨小梁增粗,8周时可见新生骨小梁,但材料降解缓慢。β-磷酸三钙骨水泥在体内8周时已降解,16周降解吸收显著,24周降解反应大部分完成,降解同时有大量新骨生成。结论两种磷酸钙骨水泥可操作性强,生物相容性好,具有骨传导作用。β-磷酸三钙骨水泥在降解性和成骨特性上表现更优异。     

磷酸钙骨水泥修复髓室底穿孔的临床研究

目的：研究CPC修复髓室底穿孔的临床效果。方法：将68颗髓室底穿孔患牙随机分为CPC组（46颗）和对照组（22颗）,均先行根管治疗,然后穿孔处分别采用CPC和氢氧化钙充填修复,并作永久性充填,所有治疗牙均随访观察18－24月。结果：CPC组成功43颗,失败3颗,其疗效明显优于对照组（P＜0．05）;医源性和龋源性穿孔之间,其疗效无显著性差异（P＞0．05）。结论：CPC是修复髓室底穿孔较好的一种材料,其疗效与穿孔大小有关。     

骨形态蛋白复合物联合引导组织再生技术修复牙周骨缺损的实验研究

目的评价骨形态蛋白复合物联合引导组织再生技术修复牙周骨缺损的效果。方法选择6只新西兰兔，制备下前牙牙周骨缺损模型，将其分为3组：GTR组(牙周骨缺损处植入胶原膜)、BMP组(牙周骨缺损处植入骨形态蛋白复合物和胶原膜)和OFD组(牙周骨缺损处未植入任何物，对照组)。术后12周分别观察各组缺损处的组织学变化。结果BMP组骨缺损处只见少量的软组织，新生骨组织的量及其成熟程度明显优于GTR组和OFD组，显示骨组织修复良好。结论骨形态蛋白复合物联合GTR技术修复牙周骨缺损，与传统的GTR术和牙周翻瓣术相比，更能有效促进牙周骨组织再生与修复。     

CSA／α—TCP骨水泥修复根尖周骨缺损的初步临床研究

CSA/α-TCP是新型骨缺损修复材料,是以无水硫酸钙作为α-TCP基骨水泥的添加组分。无水硫酸钙具有转化为二水硫酸钙的趋势[1],在体液中的二水硫酸钙逐渐降解形成孔隙,有利于新骨长入,从而加速磷酸钙骨水泥的降解[2]。本研究旨在将其应用于临床根尖周病伴明显骨缺损的治疗,评价其     

自固化磷酸钙与BMP复合植入修复牙周骨缺损的实验研究

目的：评价骨形成蛋白(bone morphogenetic protem,BMP)和磷酸钙骨水泥(calcium phosphate cement,CPC)复合应用于牙周组织再生的疗效。方法：在狗下颌后牙区制备牙周骨缺损。缺损处分别植入CPC／BMP复合人工骨、CPC。以常规翻瓣术为对照。术后10周取材做组织学观察和评价。结果：两组实验组均有明显新附着形成,其中BMP／CPC组有大量新生牙周组织生长,CPC组新生组织量较BMP／CPC组少,对照组新生组织量很少。结论：CPC／BMP具有较强骨诱导活性,可有效地提高牙周组织再生。     

A pilot study of repair of periodontal bone defects with carbonated phosphate bone cement modified with synthesized peptides in dogs]

OBJECTIVE: To explore the possibility of repairing periodontal defects with carbonated calcium phosphate bone cement (CCPBC) modified with synthesized peptides. METHODS: Periodontal bone defects in 4 dogs were surgically created and then restored directly with hydroxyapatite (HA), Perioglass, CCPBC and CCPBC modified with peptides. The results were compared at different levels. RESULTS: Bone replacement materials were lost in HA and Perioglass groups. In the HA group defects were restored with connective tissue. Perioglass group had only a little new bone around materials by alveolar bone. CCPBC could firmly stay in bone defects to maintain the space of bone defects even without membrane use. CCPBC modified with peptides was superior to HA, Perioglass, and CCPBC, surrounded by a great deal of new bone. CONCLUSION: Under limitation of this study, CCPBC modified with peptides has some osteoinuctive activity and may have good prospect for the clinical application in periodontal defect repair.     

纳米羟基磷灰石-聚酰胺人工骨修复犬下颌骨体缺损的实验研究

目的　研究新型纳米羟基磷灰石 聚酰胺 (n HA PA6 6 )复合人工骨修复犬下颌骨缺损的效果。方法　在犬下颌骨体上设计两个 15mm× 10mm× 5mm的箱状缺损 ,在其中一个植入相应大小的n HA PA6 6预制块 ,另一缺损作空白对照。于术后 2、4、8、12、16周切取组织标本 ,进行X线摄片和组织学切片检查 ,观察骨缺损修复情况。结果　术区未见明显的排斥反应。第 2～ 8周人工骨周围被纤维结缔组织包裹 ,12周时人工骨—组织界面上出现膜性成骨迹象 ,第 16周n HA PA6 6人工骨被新生骨组织完全包裹 ,受植床与人工骨形成骨性结合。结论　n HA PA6 6人工骨有良好的生物相容性 ,具有骨引导和潜在的骨诱导作用     

犬骨髓间充质干细胞复合磷酸钙骨水泥修复骨缺损的实验研究

目的:评价骨髓间充质干细胞复合磷酸钙骨水泥支架材料修复下颌骨缺损的效果。方法:分离培养犬骨髓间充质干细胞(BMSCs)。成骨诱导培养14 d后,分别采用茜素红染色与碱性磷酸酶染色,观察其诱导效果。将细胞与磷酸钙骨水泥(CPC)支架材料复合,用于动物实验。在4只Beagle犬的下颌骨每侧制作3处大小一定的骨缺损。随机将骨缺损分为3组进行处理:BMSCs-CPC组(移植复合种子细胞的支架材料)、CPC组(只移植支架材料)和空白组(不做任何处理)。分别于移植后第4、8周处死2只犬,行大体、X线、骨缺损修复区组织形态观察与计量分析。采用SPSS 13.0软件包对数据进行统计学分析。结果:术后各组均有不同程度的骨再生。BMSCs-CPC组、CPC组中骨组织再生情况优于空白组。BMSCs-CPC组支架材料降解程度与新骨形成情况优于CPC组。术后第4、8周,BMSCs-CPC、CPC组新生骨面积百分比均显著高于空白对照组(P<0.05),BMSCs-CPC组新生骨面积百分比显著高于CPC组(P<0.01);BMSCs-CPC组中剩余支架材料面积百分比显著低于CPC组(P<0.01)。结论:BMSCs种子细胞复合CPC支架材料是一种有效的、促进新骨再生的骨缺损修复方法,有利于颌骨高度及宽度的保存。     

Effects of EMD in combination with bone swaging and calcium phosphate bone cement on periodontal regeneration in one‐wall intrabony defects in dogs

Background and Objective: Although the application of EMD is a widely accepted periodontal‐regenerative therapy, its effects on noncontained intrabony defects are unpredictable because of the lack of a space‐making property. The combined use of EMD and autogenous bone grafts reportedly stimulates significant periodontal regeneration in intrabony defects. The aim of the present study was to evaluate the effects of EMD in combination with bone swaging (BS) and injectable calcium phosphate bone cement (CPC), which was placed into the spaces between the grafted swaged bone and the proximal host bone, on periodontal healing in one‐wall intrabony defects in dogs. Material and Methods: One‐wall intrabony defects (3 mm wide and 5 mm deep) were surgically created on the mesial and distal sides of the bilateral mandibular premolars in four dogs. The 16 defects were assigned to one of the following treatments: EMD only, BS only, EMD with BS (EMD + BS), or EMD with BS and CPC (EMD + BS + CPC). The animals were killed 8 wk after surgery for histologic evaluation. Results: The height of newly formed bone was significantly greater in the EMD + BS + CPC group (3.73 ± 0.30 mm) than in the BS‐only (2.74 ± 0.33 mm; p < 0.05) and EMD + BS (2.88 ± 0.98 mm; p < 0.05) groups. The area of newly formed bone was significantly larger in the EMD + BS + CPC group (5.68 ± 1.66 mm²) than in the EMD‐only (3.68 ± 0.33 mm²; p < 0.05), BS‐only (3.48 ± 1.26 mm²; p < 0.05) and EMD + BS (3.38 ± 1.37 mm²; p < 0.05) groups. The EMD‐only (4.63 ± 0.42 mm), EMD + BS (4.67 ± 0.30 mm) and EMD + BS + CPC (4.78 ± 0.54 mm) groups showed significantly greater cementum formation than did the BS‐only group (3.93 ± 0.56 mm; p < 0.05). Conclusion: These results indicate that treatment with EMD + BS + CPC promotes favorable periodontal healing in one‐wall intrabony defects in dogs.     

Histocompatible healing of periodontal defects after application of an injectable calcium phosphate bone cement. A preliminary study in dogs

BACKGROUND: A novel injectable, fast setting calcium phosphate cement (CPC) is currently used in orthopedic therapy for bone fractures. This study evaluated the possibility of applying this cement to healing periodontal defects. METHODS: Fenestrations and 3-walled periodontal defects were surgically created on bilateral first molars and canines in 5 beagle dogs. CPC was applied to the defects on one side of the mandible. Untreated defects on the contralateral side served as controls. CPC was applied to all defects in the maxilla. Twelve weeks after surgery, the animals were sacrificed and decalcified and undecalcified specimens were prepared. Periodontal tissue healing was evaluated histologically and histometrically under a light microscope. RESULTS: Healing of periodontal tissues in terms of bone and cementum formation was consistently observed in the CPC-applied sites. CPC was partly replaced by new bone. The residual CPC appeared detached from the denuded root surface. New cementum and periodontal ligament-like tissue were observed between the detached CPC and root surface. No unfavorable reaction was noted in the CPC-applied sites. No statistically significant difference was noted in the experimental or control sites under histometric analysis. CONCLUSIONS: Although there were no statistically significant differences between the 2 treatment groups, histological observation indicated that CPC seemed to act as a scaffold for bone formation and provided histocompatible healing of periodontal tissues in this study. This cement might be applicable to periodontal therapy; however, further investigations are required.     

种植体周围炎导致骨缺损的再结合研究

目的探索种植体周围炎症所致骨缺损的治疗方法,从组织学角度评价治疗后种植体周围骨再生和再结合情况。方法Beagle犬5条,双侧下颌植入标准型Br nemark种植体30颗,建立种植体周围炎骨缺损模型,随机分组进行治疗(1)单纯去除种植体周围炎性肉芽组织;(2)植入不可吸收生物膜;(3)生物膜 骨粉植入;(4)生物膜 生物活性玻璃植入。采用X线和手术直接测量以及荧光标记组织切片和不脱钙硬组织切片,观察种植体周围骨量。采用SPSS12.0软件对数据作方差分析。结果直观测量种植体周围骨量、X线测量骨接触水平、组织学测量矿化沉积率,各组间有显著性差异,P<0.05。骨粉植入组,种植体周围能形成较多的新生骨。结论炎症导致的种植体周围骨缺损,可通过治疗手段达到缺损骨的再生。     

人重组骨形成蛋白2与异种骨复合移植的实验研究

为检验新型复合异种骨的骨修复能力，作者将人重组骨形成蛋白２与经综合化学处理的小羊骨松质结合，制备成复合异种骨。小鼠肌袋生物活性分析表明：复合异种骨具有活跃诱导成骨活性。将其植入兔下颌骨缺损内，复合异种骨术后４周显示明显骨诱导现象，１２周时大部分移植骨已被新骨代替；单纯异种松质骨组骨缺损仅有部分修复。结论为复合异种骨是一种较理想的植骨材料。     

低强度脉冲超声波联合引导组织再生术促进牙周骨开窗缺损修复的动物实验

目的 探讨低强度脉冲超声波(low intensity pulsed ultrasound,LIPUS)联合引导组织再生术(guided tissue regeneration,GTR)对Beagle犬尖牙牙周骨开窗缺损的修复效应.方法 构建4只Beagle犬尖牙颊侧区根中1/3处牙周骨开窗缺损模型.将4只Beagle犬的16颗双侧上、下颌尖牙(实验牙)按简单随机法平均分配为4组:①实验1组,LIPUS(60 mW/cm2,20 min/d)处理+GTR+牙周骨质缺损组;②实验2组,LIPUS(60 mW/cm2,20 min/d)处理+牙周骨质缺损组;③实验3组,GTR+牙周骨质缺损组;④空白对照组,牙周骨质缺损组.实验共进行28 d.每14天分别测量各组处理前后实验牙牙龈表面温度,并行Wilcoxon符号秩和检验.4周后观察脱钙骨组织切片,分析各组尖牙牙周骨开窗缺损的组织学修复效果.结果 临床观察各组实验牙牙周均愈合良好.各组处理前后的牙龈表面温度差值[M(Q)]分别为:实验1组:0.225(0.463)℃;实验2组:0.265(0.133)℃;实验3组:0.09(0.115)℃;空白对照组:-0.175(0.370)℃,实验1、2组每次处理前后温度变化差异均有统计学意义(P值均为0.027).脱钙骨组织切片观察显示实验1组骨缺损内充满团状新生骨组织,成骨细胞增生活跃,骨胶原较成熟,Masson染色红染明显;实验3组新生牙骨质、牙槽骨较实验2组和空白对照组多,新生骨胶原成熟度不高,Masson染色呈红蓝相间;实验2组新生骨胶原成熟度较实验3组和空白对照组高,Masson染色红染明显;空白对照组可见少量新生牙骨质沿切迹处生长,新生骨胶原不成熟,Masson染色呈红蓝相间.结论 LIPUS具有促进牙周骨开窗缺损修复的潜能,LIPUS与GTR结合可能更利于牙周组织缺损的修复.

Abstract：

Objective To evaluate the effects of low intensity pulsed ultrasound(LIPUS)combined with guided tissue regeneration(GTR) for the repair of the periodontal fenestration defect at the canines in Beagle dogs. Methods Four Beagle dogs were used for establishing the periodontal fenestration defect. Sixteen canines of four Beagle dogs were simple randomly assigned into experimental group 1[LIPUS(60 mW/cm2,20 min/d)irradiation + GTR + the periodontal fenestration defect], experimental group 2[LIPUS(60 mW/cm2,20 min/d)irradiation + the periodontal fenestration defect], experimental group 3(GTR+ the periodontal fenestration defect) and control group(the periodontal fenestration defect). Experiments conducted 28 d. The temperature of the gingive′s surface of each group was tested every 14 days(analyzed by Wilcoxon rank sum test with SPSS 13.0). The demineralized bone tissue slices of the periodontal fenestration were obtained for histologic staining after 4 weeks treatment. Results Clinically all the treatment groups healed well. The change of gingive′s surface temperature[M(Q)] before and after LIPUS irradiating were:0.225(0.463)℃(experimental group 1),0.265(0.133)℃ (experimental group 2),0.090(0.115)℃(experimental group 3);-0.175(0.370)℃(control group). The P value of experimental group 1 and 2 with pre-and post-treatment each time were both 0.027. Histology of the demineralized bone tissue revealed that in experimental group 1, the bone defect was filled with fresh bone-like tissues, proliferatively active osteoblasts and newly formed cementum-like tissues along the defect surface. In experimental group 3, there were more new cementum-and bone-like tissues than in experimental group 2 and control group. In experimental group 2,the new bone collagen was more mature than in experimental group 3 and control group. In control group,there was less growth of new cementum along the notch, and the new bone collagen was immature. Conclusions LIPUS combined with GTR may have the potential of promoting the repair of periodontal fenestration defect.     

Development of a nonrigid, durable calcium phosphate cement for use in periodontal bone repair

BACKGROUND: Calcium phosphate cement (CPC) hardens in situ to form hydroxyapatite and has been used in dental and craniofacial restorative applications. However, when CPC was used in periodontal osseous repair, tooth mobility resulted in the fracture and exfoliation of the brittle CPC implant. The objective of the authors' study was to develop a strong and nonrigid CPC to provide compliance for tooth mobility without fracturing the implant. METHODS: The authors used tetracalcium phosphate, dicalcium phosphate anhydrous and biopolymer chitosan to develop a strong and nonrigid CPC. They used a powder:liquid ratio of 2:1, compared with the 1:1 ratio of a previously developed nonrigid CPC control. Specimens were characterized using a flexural test, scanning electron microscopy and powder X-ray diffraction. RESULTS: After 28 days of immersion, the new cement had a flexural strength (mean +/- standard deviation; n = 6) of 5.2 +/- 1.0 megapascals, higher than 1.8 +/- 1.5 MPa for the control (P < .05) and overlapping the reported strengths of sintered hydroxyapatite implants and cancellous bone. This cement showed a high ductility with a strain at peak load of 6.5 +/- 1.3 percent, compared with 4.4 +/- 1.9 percent for the control; both were 20-fold higher than the 0.2 percent of the conventional CPC. Nanosized hydroxyapatite crystals, similar to those in teeth and bones, were formed in the cements. CONCLUSIONS: The new nonrigid cement, containing nanohydroxyapatite crystals, possessed a high ductility and superior fracture resistance. This strong, tough and nonrigid CPC may be useful in periodontal repair to provide compliance for tooth mobility without fracture. CLINICAL IMPLICATIONS: The results of this study may yield the first self-hardening and nonrigid hydroxyapatite composite with high strength and durability and large deformation capability to be useful in the regeneration of periodontal osseous defects.