第三代生物医用材料在口腔领域中的应用

生物医用材料是指以医疗为目的,用于修复或替换人体组织器官或增进其功能的材料。医学尤其是口腔医学的发展史是与医用材料的发展密切相关的,随着材料科学、生命科学和临床医学的不断发展,生物医用材料的研究也取得了很大的进步。新一代（第三代）生物医用材料因其良好的生物活性及生物降解性,在口腔医学领域得到了广泛应用,如骨组织工程支架材料、促进牙周组织再生的生物膜、运载药物的缓释载体等。本文就生物医用材料的发展历程以及第三代生物医用材料在口腔领域的应用研究进展作一综述,旨在使读者能够简单了解第三代生物医用材料的基本知识,并在此基础上为其在口腔医学领域的选择、应用提供参考。     

生物材料表面细菌生物膜形成与理化特征

随着人工心瓣膜、人工关节、人工血管、人工晶体和经皮/穿龈器件等医用材料的广泛应用,通过医用器件产生的细菌感染性疾病已经成为临床各科室关注的重要问题。本文对细菌到达及吸附到生物材料表面的假说及医用器件材料的理化特征与细菌生物膜形成关系的研究进展进行综述。     

医用高分子材料的体外细胞毒性研究

目的 研究１１种医用高分子材料的细胞毒性。方法 应用体外细胞培养琼脂覆盖法对９种医用硅橡胶材料和２种聚氨酯材料的细胞毒性进行评价。结果 １１种实验材料的材料周围和材料下脱色区范围及脱色区内细胞溶解评价（Ｚ／Ｌ值）除Ｄ．Ｃ硅橡胶材料为０／０、复旦聚氨酯材料为２／２外、其余９种材料均为１／１。结论 琼脂覆盖法快速,简便,是评价生物医用材料细胞毒性的一种有效方法。     

智能生物材料在口腔领域中的应用

生物医用材料是一类用于修复或替换病损组织和器官,或增进其功能的生物功能性材料。近年来,在材料学、材料制造学、分子细胞生物学等多学科的协同发展下,生物医用材料的研究和应用取得了巨大的进步。智能生物材料是能感知和响应外部刺激的新一代生物材料。与以往的生物材料相比,它更强调材料与组织之前的相互作用和动态调控。智能生物材料因其良好的组织反应性,在药物靶向递送载体和组织工程支架等口腔医学领域中表现出了优良的性能和疗效。本文就生物医用材料的发展历程及智能生物材料在口腔医学领域中的研究现状进行综述,以推动其在口腔医学领域中的研究和临床应用。     

医用纯镁骨植入后降解产物的体内代谢及重要脏器分布的定量评价

目的 探讨医用纯镁主要降解产物的体内代谢过程及其在重要脏器中的蓄积和分布,为医用纯镁的临床应用提供安全性依据.方法 选择医用纯镁骨植入材料,参照ISO 10993-6标准,以HDPE为对照材料,运用ICP-MS研究兔骨植入4 w、12 w和26 w后主要降解产物Mg2+的体内分布、血镁和尿镁的浓度变化.运用全自动生化分...     

口腔科门诊常用材料选择与保管要点

口腔材料的发展,从单纯地利用天然材料过渡到活性金属、生物陶瓷、医用高分子材料等多种材料的广泛应用,对材料的选择与保管提出了相应的要求。     

磁性胶体根管充填材料的研究现状

医用胶和磁性材料目前已在临床各科扩大使用,在口腔医学中的应用也逐步增多,一些学者[1—4]已经注意到利用磁性材料的特性治疗根尖周病。磁性胶体根管充填材料[5](Statinary field Magnetic Glueg asa root Canal Filling Material简称SG材料),主要由医用胶和磁粉组成,本文从SG材料的生物相容性、密封性能,及其抑菌作用等方面综述其研究现状。     

同种骨植入材料应用于颌骨缺损的临床效果观察

［摘要］ 目的同种骨植入材料加医用诱导骨基质应用于颌骨术后骨缺损,观察成骨效果的回顾性研究。方法 颌骨手术患者43例,术后骨缺损直径2~5 cm,彻底清除病灶后植入同种骨植入材料及医用诱导骨基质,术后1周、1、3、6个月进行临床检查,术后6个月摄口腔全景片,根据临床症状及影像学结果评价术后感染率及术区骨质愈合情况。 结果 术区愈合不良率2.33%(1/43),6个月术区骨质愈合率 88.37%(38/43)。 结论 同种骨植入材料加医用诱导骨基质具有良好的生物相容性,能够促进硬组织的形成,骨缺损修复临床效果好,术后疼痛、肿胀、感染率低。     

复合羧聚陶瓷和羟磷灰石的致突变性检测——Ames试验测定结果

口腔材料引入人体后,可能会发生各种生物学反应。因此要求材料具有良好的生物相容性。医用材料,特别是植入材料,必须进行严格的生物学检测。材料的生物相容性鉴定六十年代由美国提出并开始实行。     

医用生物胶加氢氧化钙盖髓的实验研究

目的：观察ＺＴ医用胶加氢氧化钙作为盖髓剂的性能。方法：分别用ＺＴ医用胶加氢氧化钙、ＺＴ医用胶、氢氧化钙和Ｄｙｃａｌ进行狗牙盖髓实验，２只狗共４０个牙，观察４、８周。结果：４、８周时４种材料的牙髓组织学反应基本相似：牙髓组织反应较轻，无坏死层出现，除４周时Ｄｙｃａｌ组有２例出现微小脓肿外无明显炎细胞浸润，８周时ＺＴ医用胶加氢氧化钙组和Ｄｙｃａｌ组均有钙化组织出现。结论：上述结果说明ＺＴ医用胶加氢氧化钙的盖髓性能不亚于Ｄｙｃａｌ。     

泊洛沙姆在创伤敷料中的应用进展

颌面部皮肤因处于暴露部位而易产生伤口创面,敷料作为一种促进创伤愈合的优良方式,近年来受到广泛应用.泊洛沙姆因其良好的两亲性、双响应性和生物相容性等在人工合成敷料中极具优势,常被用于载药及缓释系统或作为非离子表面活性剂与其他敷料复合改性.本文通过广泛查阅近年来泊洛沙姆的相关应用文献,就泊洛沙姆在医用敷料领域中的具体应用类...     

Evaluation of 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer-coated dressing on surgical wounds

The ideal dressing material is bio-inert and keeps the wound site moist. It is equally important that no regenerative tissue is peeled off on the removal of the dressing. 2-Methacryloyloxyethyl phosphorylcholine (MPC) has a phospholipid polar group that mimics a biomembrane. We prepared poly [MPC-co-n-dodecyl methacrylate (DMA)] (PMD), using conventional radical polymerization with 2,2'-azobisisobutyronitrile as an initiator, and coated it on polyurethane (PU; Tecoflex 60 Thermedics Inc.) membrane. Full-thickness surgical wounds were made on the dorsal skin of rats and wound healing was compared under the following three conditions: air-exposed control (no dressing), PU dressing, and PMD dressing. At 3, 4 and 7 days after the operation, the wound sizes of the PMD dressings were smaller than the non-dressed wound, and at 6 and 7 days after the operation, the wound sizes of PU dressing were smaller than that of the air-exposed group. But there were no significant difference between the PMD dressing group and PU dressing group. Histologically, scab formation was not observed on the PU or PMD-dressed wounds. However, in the air-exposed control, a scab was formed and re-epithelialization of the wound site was prevented. Additionally, no damage was observed in the histological section of PMD dressed wound after the wound was cured. These results indicate that PMD dressing (PMD-coated PU membrane) has the potential to provide an inert environment for wound healing as well as PU.     

新型含药聚乙烯醇水凝胶创面敷膜的细胞毒性研究

本研究采用改进的细胞相对增殖度法和细胞形态学方法研究了新型含药聚乙烯醇创面敷膜的组织相容性。含药ＰＶＡ敷膜第２，４，７天的细胞相对增殖度分别为８６％，９５％和１０２％，基本无细胞毒性。通过分别于第２４。４８，７２小时的形态学观察可见，与敷膜接触的细胞生长状态良好。因此此敷膜具有良好的组织相容性     

Antiseptic negative pressure instillation therapy for the treatment of septic wound healing deficits in oral and maxillofacial surgery

Introduction

Impaired wound healing, chronic wounds and extended soft tissue defects present a crucial problem in reconstructive surgery of the head and neck region, even more after radiation therapy. In such cases the standard is a prolonged open wound treatment. The negative pressure instillation therapy might present an alternative therapy option.

封闭负压引流术(VSD)应用进展

封闭负压引流技术(VSD)将负压引流与封闭敷料相结合,早期用于治疗开放性骨折,后来被不断改良和推广。在综合各类相关文献的基础上,对该技术在软组织创面、骨组织创面、慢性难愈性创面、皮肤及骨组织移植中的特点及临床应用进行了初步总结,并对VSD在口腔颌面外科领域的应用进行了展望。     

Alginate fiber dressing for oral mucosal wounds

The aim of this study was to evaluate the effect on hemostasis and wound healing of a proprietary alginate fiber dressing when applied to a wound of the buccal mucosa of approximately 2 mm depth. The study showed a significant reduction in the number of residual bleeding points in shallow wounds when the alginate fiber dressing was applied for 5 minutes as compared with the use of non-alginate-impregnated surgical gauze. There was no significant difference in the rate of epithelial repair of the test and control sites nor in the area of the resulting mucosal scar. In addition, there was no significant difference in the numbers of tissue components in the submucosa. It is concluded that the alginate fiber dressing material evaluated in this study may be effective as a hemostatic mucosal dressing in shallow wounds, but it does not accelerate mucosal wound healing.     

Auricular protection after ear surgery using a door knob cover

Resting and protection of wound surface after surgery is important in the promotion of wound healing. However, auricles protrude from the body surface, and there is hair in the surroundings. Therefore, postoperative dressing and protection require some modification. There are commercially available products for this purpose, but time is required for purchasing, and the cost is high for a product used only temporarily. In this study, we made a modification by simply using a doorknob cover for the auricular protection after surgery, and we obtained relatively good results.     

Effects of a fibrin-sealant wound dressing on the healing of full-thickness wounds of the hard palate: preliminary report

The objective of the present study was to determine the effects of a fibrin sealant (Tisseel) on wound healing. The sealant tested is produced from human plasma. This study involved 12 adult beagle dogs, all of which underwent creation of full-thickness palatal wounds. Six animals received immediate application of a fibrin sealant as a wound dressing. Polaroid photographs were taken immediately after creation of the palatal wounds and at regular intervals during the healing period. Six measurements were obtained from these photographs. Longitudinal comparisons of the profile of the mean curves for the relative changes during the 38-day study period indicated that the six parameters investigated have similar curve profiles in both the fibrin-sealant treated wounds and the untreated control wounds. The overall direction of healing was not significantly different in the two groups. However, comparisons of the curve magnitudes indicated that there was a significantly greater reduction in wound size in the fibrin sealant treated group. Cross-sectional comparisons (analysis of variance General Linear Models procedure) indicated that in the first 2 weeks there was a relatively greater reduction in wound width in the fibrin sealant treated group of animals. No significant differences were present at the end of the experimental period. The findings of this study indicated that the fibrin sealant when used as a dressing on palatal wounds of adult beagle dogs resulted in greater wound contraction in the early stages of wound healing.     

Treatment of soft tissue defects with exposed bone in the head and face region with alginates and hydrocolloid dressings.

PURPOSE: In cases of soft tissue defects with exposed bone surfaces in the head and face region, there is the option of treating the defect with free split-thickness skin grafts following appropriate wound granulation. Secondary granulation on free bone surfaces is often a lengthy process, as granulation primarily occurs from the edges of the wound. Hydrocolloid dressings are gaining increasing attention in this context. The question arises as to whether the positive properties of hydrocolloid dressings can bring about rapid and positive conditioning of the base of the wound in soft tissue defects with exposed bone in the head and face region, with a view to subsequent split-thickness skin graft transplantation. MATERIALS AND METHODS: In the period from 1997 to 2000, a total of 25 patients with soft tissue defects with exposed bone surfaces in the head and face region were treated with hydrocolloid dressings in the framework of a prospective clinical study. RESULTS: The average time taken for complete granulation of the bone surface was 39.44 days (minimum, 10 days; maximum, 72 days). As a rule, this necessitated 12.8 changes of dressing (minimum, 3; maximum, 26). The granulation tissue was of good quality, generously vascularized, and occasionally exuberant at the edges of the wound CONCLUSION: On the whole, the combination of hydrocolloid dressing and alginate compress was found to have significant advantages as regards conditioning the exposed bone surface.     

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??Objective    To evaluate the clinical effects of silicone dressing on early wound healing and the prevention of the scars in the maxillofacial-head and neck regions. Methods    Totally 40 patients after surgical excision at our department were randomly and equally divided into treatment group ??20 patients?? and control group ??20 patients??. The control group was treated with regular dressing??and the treatment group was treated with silicone dressing on the basis of regular dressing. The procedure was performed for 3 months. The early wound healing of the two groups was compared by incision healing time and healing rate??while the objective parameters and subjective symptoms were examined to assess the scars. All the patients were followed up for 6 ~ 12 months. Results    The wound healing rate of the two groups was excellent?? and the healing time of the treatment group and control group was??5.2 ± 1.3??d and??7.1 ± 0.7??d??respectively. After 3 months of treatment with silicone dressing??the treatment group showed a significant better improvement in terms of pliability??vascularity and pigmentation than control group??P??0.05??. In terms of itching and pain score??there was also significant difference between the treatment group and control group after one week of treatment??P??0.05??. During the follow-up??the wound scar of both groups showed no relapse or continuing increase. Conclusion    Silicone dressing can be used to improve the wound healing and reduce the formation of the scars.