胶原膜与碳化硅复合物的成骨作用研究

目的：评价碳化硅／胶原复合膜对大鼠颅骨缺损修复的作用。方法：将碳化硅与胶原膜复合,在大鼠颅骨制备直径5mm的骨缺损,分别给予双侧覆盖复合膜、外侧覆盖复合膜,外侧覆盖胶原膜作为空白对照。于术后4周,取标本进行常规组织学观察。结果：覆盖复合膜的缺损区新生骨面积明显高于覆盖胶原膜的缺损对照组（P〈0．01）。结论：胶原膜与碳化硅的复合物不但具有机械性的阻挡作用,而且具有骨诱导性,可加速骨愈合。     

胶原与骨形成蛋白复合物促进大鼠下颌角缺损成骨作用的研究

目的：评价rhBMP-2／胶原复合物对大鼠下颌角缺损愈合的促进作用：方法：在大鼠双侧下颌角各制备一个直径4mm的骨缺损，一侧植入rhBMP-2／胶原复合物，另一侧植入单纯胶原，分别于术后2、4及8周处死动物，行X线检查及制作脱钙石蜡切片进行组织形态计量学分析，评价骨愈合情况。结果：植入rhBMP-2／胶原复合物的骨缺损成骨面积百分比及新生骨面积均明显高于植入胶原的骨缺损：术后两周，实验侧骨缺损已基本为骨桥所连接，术后8周，骨缺损已完全骨性愈合对照缺损术后8周仍基本保持原状。结论：rhBMP-2服原复合物具有较强的成骨作用，可加速大鼠下颌角骨缺损的愈合     

海藻酸钙膜引导成骨作用的初步研究

目的 评价海藻酸钙膜在骨缺损应用中的有效性和优越性。方法 以家兔为研究对象,在其双侧下颌角前切迹处形成直径5mm的骨缺损,以覆盖海藻酸钙膜作为实验组,以覆盖胶原膜以及不作处理作为两个对照组。术后1、2、4、6周时取出下颌骨,进行常规组织学观察并进行组织计量学分析,计算成骨面积。结果 在各组内,覆盖海藻酸钙膜的缺损区新生骨面积均明显高于覆盖胶原膜以及空白对照组（P<0.01）。术后4周,覆盖海藻酸钙膜的缺损区已达骨性愈合,而覆盖胶原膜组组织反应明显,空白组纤维结缔组织较多。结论 海藻酸钙膜比胶原膜效果更好,能更快地促进骨缺损的愈合,组织反应过程短、程度轻。     

重组人骨形成蛋白-2结合胶原膜在兔颅骨引导骨再生模型中的成骨效应研究

目的    探讨重组人骨形成蛋白-2（rhBMP-2）与胶原膜靶向结合后在兔颅骨引导骨再生（GBR）模型中的成骨效应。方法    将20只普通级雌性健康新西兰大白兔随机分成2周组和6周组,每组10只。所有大白兔均制备颅骨GBR模型,在颅顶骨植入4个钛筒,分别盖rhBMP-2/CBD胶原膜（rhBMP-2/CBD胶原膜组）、rhBMP-2胶原膜（rhBMP-2胶原膜组）、胶原膜（胶原膜组）和不盖膜（空白组）。分别在2周和6周时处死各对应组的大白兔,取样制作硬组织切片和石蜡切片,染色后进行组织学观察。结果    2周时可见胶原膜阻挡了纤维组织的长入,4组钛筒上层均无新骨生成,其中rhBMP-2/CBD胶原膜组钛筒顶端毛细血管增生量明显较其余3组多。6周时可见rhBMP-2/CBD胶原膜组钛筒上层大量新骨生成,与来源于颅骨骨面的新骨界限明显,而其余3组钛筒顶端未见新骨生成。结论    rhBMP-2与胶原膜靶向结合可形成具有骨诱导性的胶原膜,缓释rhBMP-2使胶原膜下方大量新骨生成,表层成骨可阻止纤维组织的长入和防止植骨床的塌陷,使成骨速度加倍。     

胶原与骨形成蛋白复合物在大鼠皮下的骨诱导活性

目的 评价Ⅰ型胶原与rhBMP-2复合物在大鼠皮下骨诱导活性。方法 将150mg牛皮来源的Ⅰ型胶原与1mg的rhBMP-2相复合，冻干压成圆盘状，同时制备单纯胶原作为对照。将rhBMP-2/胶原，胶原及1mg的rhBMP-2植于大鼠背部皮下，于术后1、2及4周处死动物，常规组织学观察。结果 rhBMP-2/胶原复合物在大鼠皮下术后1周可诱导骨形成：术后4周，已完全由骨所代替，较单纯BMP植入组成骨时间早且致密。结论 Ⅰ型胶原可作为rhBMP-2的良好载体。可增强rhBMP-2的诱导活性。     

rhBMP-2复合生物活性玻璃诱导成骨的实验研究

目的：探讨生物活性玻璃(bioactive glass BG)对重组人骨形成蛋白-2(recombinant human bone morphogenetic protein-2,rhBMP-2)诱导骨形成的影响。方法：6只大鼠皮下袋植入rhBMP-2／BG,0．2mg 0．5mg rhBMP-2,并设空白对照组。植入后3周行组织学检查。结果：0．5mg组rhBMP-2／BG具有成骨作用,其骨化过程类似于膜内化骨的直接骨形成。结论：rhBMP-2／BG复合物能诱导新骨形成,表明BG适合作为rhBMP-2载体。     

钛膜和胶原膜联合应用引导种植体周骨缺损骨再生的临床研究

目的：评价钛膜与胶原膜联合应用引导种植体骨缺损骨再生的临床效果。方法：将34颗种植体植入30例患者的狭窄形牙槽嵴或唇颊骨壁缺损拔牙窝,所有种植体的唇、颊侧面部分暴露,种植体周骨缺损空间维持能力较差。测量种植暴露部分的最大长度,将羟基磷灰石珊瑚骨粉置于骨缺损处,采用钛膜覆盖稳定骨移植材料,然后将胶原膜覆盖于钛膜表面,无张力缝合伤口,术后6个月行Ⅱ期手术,取下钛膜,检查骨缺损骨再生的状况,再次测量种植暴露部分的最大长度。结果：2例患者于手术3个月左右因钛膜局部暴露,将钛膜取出。钛膜暴露率为6.6%。术后6个月Ⅱ期手术时见,所有种植体暴露部分完全被再生骨覆盖,种植体暴露部分长度为0。结论：在空间维持能力较差的骨缺损处,钛膜和胶原膜联合应用引导骨再生可获得理想结果。钛膜和胶原膜联合应用可显著降低钛膜的暴露率,延迟发生膜暴露的时间,从而使引导骨再生的结果更加具有可预测性。     

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目的 探讨重组人骨形成蛋白-2(rhBMP-2)与胶原膜靶向结合后在兔颅骨引导骨再生(GBR)模型中的成骨效应。方法 将20只普通级雌性健康新西兰大白兔随机分成2周组和6周组,每组10只。所有大白兔均制备颅骨GBR模型,在颅顶骨植入4个钛筒,分别盖rhBMP-2/CBD胶原膜(rhBMP-2/CBD胶原膜组)、rhBMP-2胶原膜(rhBMP-2胶原膜组)、胶原膜(胶原膜组)和不盖膜(空白组)。分别在2周和6周时处死各对应组的大白兔,取样制作硬组织切片和石蜡切片,染色后进行组织学观察。结果 2周时可见胶原膜阻挡了纤维组织的长入,4组钛筒上层均无新骨生成,其中rhBMP-2/CBD胶原膜组钛筒顶端毛细血管增生量明显较其余3组多。6周时可见rhBMP-2/CBD胶原膜组钛筒上层大量新骨生成,与来源于颅骨骨面的新骨界限明显,而其余3组钛筒顶端未见新骨生成。结论 rhBMP-2与胶原膜靶向结合可形成具有骨诱导性的胶原膜,缓释rh BMP-2使胶原膜下方大量新骨生成,表层成骨可阻止纤维组织的长入和防止植骨床的塌陷,使成骨速度加倍。     

口腔修复膜与自体髂骨联合移植在牙槽嵴裂植骨中的临床观察

目的：观察9～12岁单侧牙槽嵴裂具恒牙阻萌者,自体髂骨松质骨在口腔修复膜作用下在牙槽嵴裂植骨中的应用方法和效果。方法：对9例牙槽嵴裂患者,采用自体髂骨松质骨移植同期口腔修复膜覆盖修复,术后给予临床效果评价及分别于第1周、1月、3月、6月进行x线检查。结果：7例正常愈合,2例术后1周出现牙龈缘局部裂开,1周后黏膜自愈;随访6～12月,植骨效果满意。结论：自体髂骨与胶原膜联合应用于牙槽嵴裂植骨,方法简便、成骨快、效率高,为后续治疗提供了保障。     

重组人骨形成蛋白-2促进兔下颌牵张成骨的研究

目的　研究局部应用基因重组人骨形成蛋白-2(rhBMP-2)对兔下颌牵张成骨的影响。方法　在12只成年大耳白兔的双侧下颌骨前部行骨切开术,将rhBMP-2与胶原复合植入一侧下颌骨切开处,另一侧单纯植入胶原作对照。用自行研制牵张器延长双侧下颌骨6 mm,在牵张结束后第4周处死动物,取双侧牵张区新生骨痂行组织学、扫描电镜及Ca/P元素测定。结果　下颌延长后两侧牵张间隙均有新骨形成,应用rhBMP-2的一侧牵张骨痂中的新骨组织比对照侧多而成熟,钙化程度较高。结论　基因重组人骨形成蛋白-2可能有促进兔下颌牵张成骨的作用。     

Acceleration of de novo bone formation with a novel bioabsorbable film: a histomorphometric study in vivo

Objective:  Different types of barrier membranes have been used in periodontal applications for the technology of guided tissue regeneration (GTR). The aim of this study was to characterize the biological effect of novel calcium alginate film (CAF) on bone tissue regeneration by using rabbit mandible defects model.
Methods:  A critical size defect (5 mm in diameter) was created in the bilateral corner of mandible of 45 adult rabbits. The defects were covered with CAF served as the experimental group, or conventional collagen membrane (CCM) or left empty as the controls. Animals were killed after 1, 2, 4, 6 and 8 weeks. Morphological and histomorphometric studies were performed to evaluate their bone regeneration pattern and biological effects.
Results:  Histological sections showed that bone regeneration pattern was centripetal in growth from defect rim. The quantitative histometry analysis revealed a significantly greater percentage of newly generated bone in CAF defects than that in CCM defects and empty defects from 2 to 6 weeks post-operation ( P  < 0.01). After 6 and 8 weeks, significantly more mature lamella bone had formed with CAF than with CCM. Empty control defects showed bone formation starting from the defect margins and incomplete healing even after 8 weeks.
Conclusion:  The CAF guided early bone growth and appeared more effective as a bioabsorbable GTR membrane than CCM. This study with mandible defect model suggests that bone defects augmented with CAF may offer most promising results from a histological and histomorphometric perspective.     

新型GBR胶原膜的早期动物体内植入实验研究

目的:探讨新型国产GBR胶原膜体内植入后,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,于双侧下颌骨骨体处用牙科裂钻制备8mm×8mm全层骨缺损3个,分别应用实验胶原膜、Bio-gide^@、无覆盖膜覆盖骨缺损。术后1个月处死动物,分别在处死前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,但新生骨量少于对照组。 结论:新型国产胶原膜在1个月时无明显降解,具备良好的膜下成骨能力,需进行实验组胶原膜的改性,以增加膜下成骨量。     

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。     

Guided bone regeneration of cranial defects, using biodegradable barriers: an experimental pilot study in the rabbit.

The aim of this study was to test if a biodegradable barrier could be used to achieve proper bone healing of full-thickness trephine skull defects, applying the biological principle of guided tissue regeneration (GTR). Two New Zealand white rabbits were used. In each animal, 2 circular through-and-through bone defects with a diameter of 8 mm were created in the midline of the frontal and parietal bones of the calvarium. One defect was covered with the mucoperiosteal flaps without placement of an intervening membrane barrier (control). One test defect (test 1) was covered by a biodegradable, non-porous polylactic acid membrane on the outer (supra-calvarial) side of the defect, and 2 test defects (tests 2 and 3) were covered by similar membranes on both the outer and the inner aspects of the defects, prior to flap closure. 6 weeks postsurgically, the animals were sacrificed and the defect areas including surrounding tissues were harvested for histological preparation. The control defect was essentially occupied by supra-calvarial soft tissue, located in direct contact with the dural tissue. In the test cavities, there was a continuous bridge of regenerated bone extending from one edge of the defect to the other, although in test 1 not attaining the same thickness as the bone bordering the defect. In the 2 other test defects, the regenerated bone had reached a thickness almost corresponding to that of the surrounding bone. The bone regeneration was achieved without recourse to adjunctive bone graft materials.(ABSTRACT TRUNCATED AT 250 WORDS)     

A comparative study of barrier membranes as graft protectors in the treatment of localized bone defects. An experimental study in a canine model

Guided bone regeneration is a predictable and well-documented surgical approach for the treatment of deficient alveolar ridges prior to endosseous implant placement. The purpose of this study was to compare a new resorbable membrane (GORE RESOLUT ADAPT Regenerative Membrane, i.e. 67% glycolide (PGA) : 33% trimethyline carbonate (TMC)) with Bio-Gide, a resorbable collagen membrane. Five canines were used in the study. Three saddle-type osseous defects were created bilaterally in edentulous areas of the mandible. The defects were filled with assayed, canine demineralized freeze-dried bone (DFDB) in a thermoplastic gelatin matrix. Using a randomized block design, four sites were covered with PGA : TMC membranes of four different porosities, one site was covered with a collagen membrane and one site consisted of DFDB alone (control). At 3 months, the animals were euthanized and the mandibles were removed en bloc for laboratory processing. A total of 30 sites were reviewed microradiographically and underwent histomorphometric analysis for bone regeneration, soft tissue presence and remaining graft material. All sites exhibited uneventful healing. A significantly higher percentage of bone regeneration was seen in the sites protected by the PGA : TMC membrane. A higher component of soft tissue was visible beneath the collagen membrane as compared with the PGA : TMC membrane. The control sites exhibited noticeable deformation of the regenerated bone secondary to collapse of the overlying periosteum. The authors conclude that the PGA : TMC membrane protected the DFDB-filled defect and allowed a greater amount of bone regeneration than the defect protected by the collagen membrane or the control.     

Reconstruction of anatomically complicated periodontal defects using a bioresorbable GTR barrier supported by bone mineral. A 6-month follow-up study of 6 cases

Abstract . 6 anatomically complicated periodontal intrabony defects in 6 patients were surgically reconstructed using a bioresorbable GTR barrier supported by cancellous bovine bone mineral. Following cause-related periodontal treatment, open-flap surgery was performed to expose the defects. After debridement, the defects were filled with the bone mineral and covered with the barrier. All patients were advised to rinse 2× daily with an 0.2% chlorhexidine digluconate solution and to avoid brushing in the operated area for 6 weeks. The treatment results were evaluated clinically and radiographically 6 months after surgery. All defects healed uneventfully and all patients maintained a high standard of plaque control throughout the study. Probing assessments during surgery showed a bone defect depth and width of on average 7.2 and 2.8 mm. The corresponding measures on presurgical intra-oral radiographs were 7.9 and 2.6 mm, respectively. Clinical attachment level (CAL) gain averaged 5.3 mm, corresponding to 73% of the original bone defect depth. Radiographically, the defect fill averaged 6.2 mm or 80% of the original radiographic bone defect. It was concluded that the placement of bovine bone mineral beneath bioresorbable GTR barriers facilitates the clinical handling of the barrier and enhances the space for potential periodontal reconstruction of anatomically complicated defects. It remains, however, to be ascertained to what degree the achieved clinical and radiographic results reflect a gain in new connective tissue attachment and alveolar bone.     

Vivosorb, Bio-Gide, and Gore-Tex as barrier membranes in rat mandibular defects: an evaluation by microradiography and micro-CT

Objectives: The objectives of this study were to determine whether a new degradable synthetic barrier membrane (Vivosorb^®) composed of poly(dl ‐lactide‐?‐caprolactone) (PDLLCL) can be useful in implant dentistry and to compare it with collagen and expanded polytetrafluoroethylene (ePTFE) membranes. Material and methods: In 192 male Sprague–Dawley rats, a standardized 5 mm circular defect was created through the right angle of the mandible. New bone formation was evaluated by post‐mortem microradiography and micro‐CT (μCT) imaging. Four groups (control, PDLLCL, collagen, ePTFE) were evaluated at three time intervals (2, 4, and 12 weeks). In the membrane groups the defects were covered; in the control group the defects were left uncovered. Data were analysed using a multiple regression model. Results: New bone formation could be detected by post‐mortem microradiography in 130 samples and by μCT imaging in 112 samples. Bone formation was progressive in 12 weeks, when the mandibular defect was covered with a membrane. Overall, more bone formation was observed underneath the collagen and ePTFE membranes than the PDLLCL membranes. Conclusions: In contrast to uncovered mandibular defects, substantial bone healing was observed in defects covered with a PDLLCL membrane. However, bone formation in PDLLCL‐covered defects tended to be less than in the defects covered with collagen or ePTFE. The high variation in the PDLLCL samples at 12 weeks may be caused by the moderate adherence of this membrane to bone compared with collagen. These results indicate that further study is needed to optimize the properties of PDLLCL membranes.     

高压氧结合胶原膜引导组织再生作用的实验研究

引导组织再生术（GuidedTissueRegeneration，GTR）近年来已逐渐用于临床。本研究选择20只日本大耳兔进行高压氧结合胶原膜引导组织再生作用的研究，于20只兔的股骨中段制备直径4mm的骨缺损，表面覆盖15×12mm的胶原膜。动物分为两组，一组进行高压氧治疗，一组为对照组。分别于2、3、4、6、8周后处死，进行肉眼、X光及组织学观察。结果显示，高压氧组于术后2周缺损边缘及中央形成新骨，对照组仅在缺损边缘有新骨产生；术后4周，高压氧组基本完成骨修复，形成的新骨结构成熟而且致密。而对照组于6周后才取得类似结果。研究表明高压氧与胶原膜结合对引导组织再生有协同作用，能加快缺损区的新骨形成，促进新骨成熟。