无机骨材料对上颌窦提升术后骨再生的影响

目的：研究兔上颌窦提升术后扩增区域内新生骨的改建过程和破骨细胞的分布情况,探讨无机骨颗粒对上颌窦提升术后骨再生的影响。方法：对8只日本大耳白兔施行上颌窦提升术。实验组扩增区植入无机骨颗粒,对照组仅使血凝块充满扩增区,不填充移植材料。结果：术后4周,对照组扩增区近窦黏膜处的新生骨表面可见大量破骨细胞。组织形态测量学分析表明,术后4周至8周实验组窦底提升高度显著大于对照组;术后8周时实验组新生骨面积较对照组明显增加。结论：上颌窦内存在的空气压力可导致上颌窦提升术后新生骨发生吸收。在上颌窦提升术中使用无机骨填充材料可抵抗上颌窦内的空气压力,并具有良好的骨重建效果。     

无机骨材料对上颌窦提升术后骨再生的影响

目的：研究兔上颌窦提升术后扩增区域内新生骨的改建过程和破骨细胞的分布情况,探讨无机骨颗粒对上颌窦提升术后骨再生的影响。方法：对8只日本大耳白兔施行上颌窦提升术。实验组扩增区植入无机骨颗粒,对照组仅使血凝块充满扩增区,不填充移植材料。结果：术后4周,对照组扩增区近窦黏膜处的新生骨表面可见大量破骨细胞。组织形态测量学分析表明,术后4周至8周实验组窦底提升高度显著大于对照组;术后8周时实验组新生骨面积较对照组明显增加。结论：上颌窦内存在的空气压力可导致上颌窦提升术后新生骨发生吸收。在上颌窦提升术中使用无机骨填充材料可抵抗上颌窦内的空气压力,并具有良好的骨重建效果。     

富血小板血浆对表面多孔性种植体周骨再生的作用

目的:研究钛合金颗粒熔附表面多孔性种植体在植入时应用富血小板血浆(PlateletRichPlasma,PRP),对种植体周围骨再生的影响。方法:钛合金颗粒熔附表面多孔性种植体30枚分别植入5条狗的双侧下颌骨,左侧种植体在植入时局部应用PRP,右侧为对照组。术后3天、1、3、6及12周分别将动物处死,进行组织学和组织形态学分析。结果:术后3天和1周时,两组的组织学表现及骨-种植体接触率(Bone-implantcontact,BIC)均相似。术后3周时,实验组可观察到骨单位已开始形成,两组的骨-种植体接触率具有显著性差异(PRP组为68.11±17.63%,对照组为44.26±31.79%)。术后6周及12周时两组无明显区别。结论:表面多孔性种植体局部应用PRP可更有利于种植体周围早期骨再生,但PRP加快种植体周围骨再生的机制还有待于进一步的研究。     

腺相关病毒介导血管内皮生长因子复合无机骨促进骨再生的实验研究

目的:将血管内皮生长因子(VEGF)与腺相关病毒(AAV)重组,并与无机骨颗粒复合,探讨其对骨组织再生的影响。方法:将24只成年新西兰大白兔随机分为2组,在兔颅骨上建立引导骨再生模型。体外构建承载VEGF基因的腺相关病毒,实验组填充复合有AAV-VEGF的无机骨颗粒,对照组仅填充无机骨颗粒。分别在术后2、4、8周对术区进行组织学观察及形态测量学分析。结果:术后4周及8周时,实验组新生骨量和毛细血管数量均较对照组为多,且骨成熟度更高。免疫组化结果显示实验组VEGF蛋白呈强阳性表达。结论:在引导骨再生时配合AAV-VEGF,较单纯植入无机骨能更快、更有效地促进新生骨形成。     

胶原-羟基磷灰石人工骨与胶原膜引导牙周组织再生的动物实验研究

目的：将胶原-羟基磷灰石人工骨与胶原膜联合应用于修复牙周缺损的动物实验,探讨其用于引导牙周组织再生的可行性。方法：人工构建4只成年Beagle犬下颌后牙区牙周缺损模型,分别随机采用：胶原-羟基磷灰石人工骨/胶原膜、胶原-羟基磷灰石人工骨、空白对照治疗,每组8颗牙,12周后处死动物,进行组织学观察并测量新生组织高度。结果：与单纯植入胶原-羟基磷灰石人工骨组相比,胶原-羟基磷灰石人工骨/胶原膜组获得了更多的新附着,表现为有较多的新生牙槽骨、新生牙周膜和新生牙骨质样组织生长,2组之间新生组织差异有显著性（P〈0.05）。结论：胶原-羟基磷灰石人工骨与胶原膜联合运用修复牙周牙槽骨缺损引导牙周组织再生的效果优于单纯植入人工骨。     

牙种植术钻孔骨碎作植骨的临床研究

目的:评价在牙种植术中,钻备种植窝时收集到的自体骨颗粒单独或与Bio-Oss人工骨混合作为骨移植材料应用的临床效果。方法:34例52枚牙种植术的病例分成四组。第一组(对照组)22枚植体,单纯植入种植体,种植区无植入自体骨或人工骨。第二组6枚植体,植入螺纹种植体后,在部分暴露的植体处植入Bio-Oss人工骨。第三组8枚植体,收集种植术中准备植体窝时,在各种钻针上的自体骨颗粒,植入种植体周骨量不足区域。第四组16枚植体,自各种钻针上收集到的自体骨颗粒与Bio-Oss人工骨混合,植入种植体周骨缺损区。记录I、II期手术种植体周围骨组织高度。结果:植入术后3-12个月,II期手术时,实验组有新生骨形成,第四组(即Bio-Oss人工骨与自体骨颗粒混合物植入组),新生骨形成的量较其余组别多。结论:研究表明牙种植术中钻备种植窝时收集到的自体骨颗粒可作为有效的植骨材料,这种简单的方法避免从他处手术获得自体骨,对扩大牙种植适应症有重要意义。RRRR     

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。     

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。     

rhBMP-2在种植体周围骨缺损修复中应用的组织学观察

目的:研究rhBMP-2及不同载体在种植体周围骨缺损修复中的应用。方法:在beagle犬下颌骨植入种植体,颊侧形成裂开性骨缺损,置入复合了不同浓度rhBMP-2的珊瑚羟基磷灰石人造骨(CHA)或可吸收胶原海绵(ACS)。种植体植入后2、4、8、12周,获取含种植体骨标本,进行组织学观察。结果:2周时,rhBMP-2组可见极少量的新生骨组织。4周时,rhBMP-2/ACS组新骨组织由牙槽骨顶端向缺损区中心方向生长;rhBMP-2/CHA组人造骨颗粒内部和周围出现呈岛状生长的新生骨组织。8周时,rhBMP-2/ACS组的新骨形成大片状结构;rhBMP-2/CHA组人造骨颗粒周围较多骨岛形成。12周时,rhBMP-2组的缺损区内骨量和骨高度进一步增加,与种植体形成骨性结合。浓度为0.05 mg/ml和0.2 mg/ml,载体为CHA或ACS促进骨再生作用差异无统计学意义。结论:以CHA或ACS为载体rhBMP-2能促进种植体周围骨缺损区内的骨组织再生并与种植体表面较好地结合。     

不同愈合时间下挤压植入种植体对Beagle犬骨界面改建的组织形态学测定

目的：研究不同愈合时间下挤压植入微种植体对其周围骨界面改建的影响。方法：采用自身对照原则,将36枚微种植体植入6只成年Beagle犬上颌后牙区。左右各植入3枚种植体,一侧为实验组以骨挤压植入,对侧为对照组。每侧随机分配植入不同愈合时间（2周,4周和8周）的种植体,取带有种植体骨标本制备不脱钙的超硬组织切片,采用组织形态学定量测定的方法,对钛种植体骨界面改建过程进行动态观察,从定量的角度分析其变化的差异。结果：实验组与对照组种植体骨接触率均随愈合时间的延长而增加。实验组愈合2周,4周时种植体骨接触率明显高于对照组,8周时趋于一致。实验2周组与8周组种植体骨接触率表现出显著性差异,对照2周组与4周组存在显著性差异。结论：愈合早期骨挤压可以提高种植体骨整合率,提示需要早期加载的微种植体以骨挤压术式植入可提高种植体稳定一I生。     

Osteoconduction of different sizes of anorganic bone particles in a model of guided bone regeneration

The aim of this study was to evaluate the effect of two different sizes of anorganic bone particles (300-500 and 850-1000 μm) on the formation of new bone in a model of guided bone regeneration. In both groups, newly formed bone was seen histologically adjacent to the original surface of the skull, and there were outgrowths to the centre of the secluded graft 4 weeks after implantation. Some particles near the surface were in contact with the newly formed bone, and osteoconductive bone growth was present along their surface. Ten weeks after implantation the area created by grafting with small particles seemed to have a denser structure than that created with large particles. Histomorphometric analysis showed a higher density of newly formed bone in the small-particle group than in the large-particle group both 4 and 10 weeks after implantation. The total contact length between newly formed bone and particles and the ratio of bone:space between the particles were also significantly higher in the small-particle group at both time points. We conclude that the size of grafted particles of bone and the spaces between particles are important determinants of osteogenesis during guided bone regeneration.     

Experimental sinus grafting with the use of deproteinized bone particles of different sizes

This study compared the osteoconductive capability of deproteinized bone particles of two different sizes (300-500 and 850-1000 microm) in rabbits undergoing maxillary sinus lift. Histologically, deproteinized bone particles of both sizes induced osteoconduction 1 week after implantation. Bone initially formed at the sinus wall and proliferated into the center of the augmented sinus cavity. In the small-particle group, newly formed bone showed many interconnections and appeared in most areas of the cavity 8 weeks after implantation. In the large-particle group, newly formed bone showed limited intercommunications, and the center of the sinus cavity contained fibrous connective tissue with no evidence of ossification 8 weeks after implantation. Histomorphometric analysis revealed a significantly higher density of newly formed bone in the small-particle group than in the large-particle group both 4 and 8 weeks after implantation. The total newly formed bone-particle contact length was also significantly higher in the small-particle group. The total surface length of the small particles was larger than that of the large particles, but the ratio of the newly formed bone-particle contact length to the total particle surface length did not differ significantly between the groups at any time. The interparticular spaces of the small particles were larger than those of the large particles. The bone area ratio in the interparticular spaces of the small particles was significantly higher than that of the large particles both 4 and 8 weeks after implantation. We conclude that graft bone particle size and interparticular space are important determinants of osteoconduction.     

Grafting of deproteinized bone particles inhibits bone resorption after maxillary sinus floor elevation

OBJECTIVES: To evaluate the value of deproteinized bone particles on bone resorption in the augmented space after maxillary sinus floor elevation in rabbits. MATERIAL AND METHODS: A total of 20 rabbits underwent bilateral grafting, using blood clots (control group) and deproteinized bone particles (experimental group), and followed with histologic and histomorphometric analysis. RESULTS: Two weeks after grafting, the augmented space was almost completely obliterated by both newly formed bone and fibrous connective tissue in the control group. Some osteoclasts were found on the surface of newly formed bone, especially near the elevated sinus membrane. In the experimental group, newly formed bone was found along the elevated sinus membrane, the cortical wall of the augmented space, and the surface of deproteinized bone particles near the cortical wall. Some osteoclasts were found along the deproteinized bone particles and a few adhered to the surface of the newly formed bone. Eight to 10 weeks after implantation in the control group, most of the newly formed bone had been resorbed. In the experimental group, newly formed bone was found in most parts of the convex augmented space. Histomorphometrical analysis showed that the augmented height was significantly higher in the experimental group than in the control group at all evaluation times. Bone area was significantly higher in the experimental group than in the control group at 6, 8, and 10 weeks after implantation. The area of grafted deproteinized bone particles did not change significantly from 2 to 10 weeks. CONCLUSION: Slowly resorbed deproteinized bone particles contribute to stable augmentation of the maxillary sinus floor by inhibiting bone resorption.     

The bone regenerative effect of platelet-rich plasma in combination with an osteoconductive material in rat cranial defects

The effect of platelet-rich plasma (PRP) on bone regeneration, in combination with an osteoconductive material, was evaluated in a rat model. Cranial defects, 6.2 mm in diameter, were filled with HA/beta-TCP particles, HA/beta-TCP particles combined with PRP and HA/beta-TCP particles combined with PRP gel, where some were left empty as a control. After 4 weeks of implantation histological, histomorphometrical and micro-computed tomography analyses revealed no difference in new bone formation among the groups. Further, no additional effect of PRP gel in comparison with PRP liquid was detected, except for the increased handling capacity of the graft. These findings suggest that PRP had no positive effect on bone formation in addition to an osteoconductive material after an implantation period of 4 weeks. Also, no negative effect was seen, and neither PRP nor HA/beta-TCP hampered bone ingrowth into the defects.     

自体髂骨游离移植同期种植体植入修复骨量不足区牙缺失的动物实验研究

目的:利用自体髂骨游离移植一期植入种植体的动物实验研究,揭示自体髂骨游离移植同期植入种植体的愈合过程,为临床工作提供理论依据和借鉴。方法:选择16只健康成年雄性日本大耳白兔,在双侧髂骨制备髂骨缺损模型,游离移植自体髂骨,并同期分别在双侧髂骨植骨区及非植骨区植入自制圆柱状羟基磷灰石种植体。随机分成4组,每组4只。术后2周、4周、8周、12周各处死一组动物,切取标本。进行大体标本观察,放射线、组织学(脱钙HE染色)、扫描电镜检查、力学测试。结果:大体标本观察见各组种植体和髂骨结合紧密。肉眼见种植体和髂骨之间多为骨性结合,仅2周标本及4周实验组标本一些区域可见一薄层纤维样组织。放射线检查:2周标本可见有放射线透射区,实验组密度稍低于对照组密度;余各组种植体周围均未见明显的放射线透射区;4周标本实验组密度稍低于对照组;8周标本、12周标本实验组密度与对照组密度基本无差别。组织学及扫描电镜检查实验组与对照组种植体均与骨质形成不同程度的骨结合;对照组种植体比实验组形成更好的骨结合;各组种植体4周、8周、12周依次形成更好的骨结合。力学测试(反向推出实验)显示2周、4周、8周、12周骨结合实验组最大负荷分别是66.3N/cm2、143.9N/cm2、194.6N/cm2、248.3N/cm2。对照组最大负荷分别是108.6N/cm2、229.2N/cm2、307.1N/cm2、377.6N/cm2。结论:自体髂骨游离移植同期种植修复骨量不足区牙缺失是切实可行的修复方法。     

基因重组人骨形成蛋白-2与珊瑚/聚乳酸复合修复骨质缺损的实验研究

目的　观察生物珊瑚、聚乳酸和rhBMP-2合成人工骨(复合骨)修复兔颅骨缺损后复合骨的变化情况。方法　选择24只新西兰兔,随机分成2组,每组12只,建立兔颅骨缺损标准模型。植入复合骨,用珊瑚/聚乳酸作为对照。术后4、8、12周每组各处死4只动物,取出植入体进行扫描电镜观察和机械强度测定。结果　复合骨在植入缺损后,不仅在植入体周边部有骨组织长入,而且在整个植入体内均有新骨形成,即出现多中心成骨。复合骨在同一时间点的成骨量明显多于对照组,随时间推移,成骨量递增。在植入前,两材料间的抗压强度无明显差异;在植入后,两植入体的抗压强度则差异显著,复合骨明显高于同期的对照组。结论　生物珊瑚、聚乳酸和rhBMP-2合成人工骨在体内以传导成骨和诱导成骨双重机制完成骨修复,且有良好的机械强度,作为植骨材料具有良好的应用前景。     

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     

腺相关病毒介导的骨形态发生蛋白7基因促种植体周骨缺损修复的实验研究

目的观察载bmp7基因的腺相关病毒（rAAV- BMP7）复合Bio- Oss的基因治疗方法对种植体周骨缺损修复的影响。方法体外构建载bmp7基因的腺相关病毒,并与Bio- Oss复合。6只雄性新西兰大白兔双侧胫骨植入种植体,并制备直径8 mm、深4 mm的种植体周骨缺损,A组骨缺损区填入rAAV- BMP7/Bio- Oss复合物;B组仅填入Bio-Oss;C组不充填材料。术后4、8周分期处死动物,取样进行组织学观察和形态学分析。结果A、B组骨缺损处均有新骨形成,A组较B组新骨形成更早、新生骨量更多、骨成熟程度更高（P<0.05）。结论rAAV- BMP7复合Bio- Oss较单纯植入Bio- Oss能更快、更有效地促进种植体周围骨缺损形成新骨,新骨量大且成熟度高,并能形成理想的种植体- 骨结合界面。