非血管化髂骨和下颌骨与钛种植体结合的比较研究

目的 :研究非血管化髂骨和下颌骨与钛种植体结合的组织学特点。方法 :12只杂种犬随机分为 6组。切取 15mm× 5mm的下颌骨骨质 ,将骨块移植于对侧下颌骨人工骨缺损区 ,然后切取同样大小的髂骨骨块 ,移植于下颌骨骨缺损区 ,同时植入 2枚钛种植体 ,用种植体固定骨块。术后不同时间点取材 ,组织学观察。结果 :髂骨移植后早期以溶解坏死为主 ,6周时开始重建 ,种植体为混合界面 ;12周时改建基本完成 ,种植体形成骨结合。而下颌骨移植后早期移植骨吸收不明显 ,只是哈佛氏管扩大 ,与种植体界面间未见新骨形成 ;12周时移植骨内出现新生骨 ,骨吸收停止 ,种植体为混合界面 ,界面有不成熟的新生骨沉积 ,新骨与原骨结合不紧。 18周 ,种植体形成骨结合。 2 4周 ,移植的髂骨和下颌骨与骨床均融为一体 ,下颌骨与髂骨相比整体致密。结论 :髂骨与下颌骨移植后的修复过程及它们与钛种植体的骨结合过程不同 ,但均能形成骨性结合。下颌骨与种植体形成骨结合的时间比髂骨长     

生物复合材料微孔钛种植牙的实验研究

作者通过光镜、扫描电镜、X线能谱分析对骨形成蛋白(BMP)/生物陶瓷/微孔钛种植体、BMP/微孔钛种植体、生物陶瓷/微孔钛种植体、微孔钛种植体进行了比较。实验表明:复合BMP种植体成骨早、成骨量大、骨成熟早,未复合BMP的生物陶瓷涂层与未涂层微孔钛种植体比较,两者在成骨时间上无明显差异,但界面结合方式有明显不同。     

基因重组人骨形成蛋白—2与珊瑚／聚乳酸复合异位诱导成骨的实验研究

目的：观察基因重组人骨形成-2(rhBMP-2)和珊瑚／聚乳酸形成复合人工骨的异位诱导成骨活性。方法：把rhBMP-2和珊瑚／聚乳酸形成复合人工骨。进行小鼠肌内种植1，3，6周后，组织学观察其异位诱导成骨活性。结果：rhBMP-2赋予珊瑚／聚乳酸骨诱导能力，珊瑚／聚乳酸则充当rhBMP-2的载体和释放系统，对BMP的活性未不利影响。与单纯的珊瑚／聚乳酸相比，这种复合人工骨以软骨内成骨的方式诱导成骨。结论：rhBMP-2／珊瑚／聚乳酸复合人工骨具有良好的生物相容性和骨诱导活性，是一种较理想的骨移植替代材料。     

胶原-珊瑚复合骨作为高嵌体的实验研究

牙槽嵴吸收萎缩影响义齿修复和恢复咬合功能。本研究通过将骨形成蛋白 胶原 珊瑚复合骨植入狗下颌骨 ,研究复合骨在皮质骨表面的成骨作用 ,观察骨形成蛋白 胶原 珊瑚复合骨在成骨过程中与牙种植体的结合 ,探讨此复合骨以高嵌体植入式加高狗下颌骨的可行性。方法 :将珊瑚制成 5ｍｍ× 8ｍｍ×2 5ｍｍ大小 ,每块珊瑚与 2ｍｇ骨形成蛋白、0 .5ｍｌⅠ型胶原复合 ,真空抽干 ,术前用环氧乙烷消毒。将复合骨植入狗下颌骨体部颊侧 ,采用直径 2ｍｍ、长 10ｍｍ螺纹式纯钛种植体固定 ,1 5、3个月取材 ,通过测量、Ｘ线片、组织学等观测指标 ,分析骨…     

基因重组人骨形成蛋白-2与珊瑚/聚乳酸复合异位诱导成骨的实验研究

目的 :观察基因重组人骨形成蛋白 - 2 (rhBMP - 2 )和珊瑚 /聚乳酸形成复合人工骨的异位诱导成骨活性。方法 :把rhBMP - 2和珊瑚 /聚乳酸形成复合人工骨。进行小鼠肌内种植 1、3、6周后 ,组织学观察其异位诱导成骨活性。结果 :rhBMP - 2赋予珊瑚 /聚乳酸骨诱导能力 ,珊瑚 /聚乳酸则充当rhBMP - 2的载体和释放系统 ,对BMP的活性未产生不利影响。与单纯的珊瑚 /聚乳酸相比 ,这种复合人工骨以软骨内成骨的方式诱导成骨。结论 :rhBMP - 2 /珊瑚 /聚乳酸复合人工骨具有良好的生物相容性和骨诱导活性 ,是一种较理想的骨移植替代材料     

负载骨结合式牙种植体的骨构建实验研究

目的 观察骨结合式牙种植体与骨髓基质成骨细胞(MSO)及松质骨基质(CBM)支架复合人工骨皮下移植后，新骨的形成及与种植体的愈合情况。方法 将骨结合式牙种植体置于圆柱状的CBM中，在其表面及孔洞内接种培养扩增的MSO，形成负载骨结合式牙种植体的骨髓基质成骨细胞-藻酸盐-松质骨基质复合人工骨(MCCAB)，然后植入裸鼠背部皮下组织中，对照组植入负载骨结合式牙种植体的藻酸盐-松质骨基质复合物。植入4、8周取材，通过大体标本观察、X线检查、组织学观察和组织学定量分析评价新骨形成情况。结果 负载骨结合式牙种植体的MCCAB皮下成骨效果明显优于负载骨结合式牙种植体的藻酸盐-松质骨基质复合物组。复合人工骨标本内有大量新骨形成，兼有膜内成骨和软骨内成骨的特点，并以前者为主；种植体与新骨结合。对照组成骨作用不明显，为单纯软骨内成骨，与种植体未见结合。结论 骨结合式牙种植体与复合人工骨复合植入后，在支架材料与种植体表面均有大量新骨形成，并可与种植体结合，表明用组织工程学方法进行颌面部骨修复时，可以同期植入种植体。     

两种钛种植体与骨结合界面的组织学研究

目的　对两种表面形态不同的钛种植体在不同种植时期骨结合界面情况进行研究。方法　在恒河猴下颌磨牙区分期分别植入CDIC和ITI-TPS钛种植体,采用同体对照的方法,对两种种植体与骨结合界面情况进行组织学观察。结果　口腔检查未见种植体松动及周围组织明显炎症表现。各期种植体骨界面X线影像均未见明显透射暗影,仅种植1个月的CDIC种植体颈部见少量角形吸收。光镜和扫描电镜观察见种植1个月后两种种植体骨界面有少量骨形成;1~3个月ITI-TPS种植体界面骨形成较明显,成骨量统计分析,差异有显著性;种植后1年,两者未见明显差别。结论　无载荷条件下,种植体植入后1~3个月内,ITI-TPS种植体表面骨结合形成优于CDIC种植体。随植入时间的增加,两种种植体均形成良好的骨性结合界面。     

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     

羟基磷灰石复合骨形成蛋白骨表面种植的组织学观察

本研究采用组织学观察方法,比较单纯羟基磷灰石与羟基磷灰石复合骨形成蛋白在兔颅骨骨皮质表面的种植情况。结果表明:羟基磷灰石—骨形成蛋白复合材料有极高的成骨率,成骨现象十分活跃,可达种植材料全层,材料与骨皮质之间的界面为骨性连接。而单纯羟基磷灰石成骨率低,成骨范围局限,这种成骨可能是手术创伤所致,材料与骨皮质之间的界面多为纤维结缔组织。我们认为,羟基磷灰石复合骨形成蛋白是较理想的骨皮质表面种植材料,而单纯羟基磷灰石材料不适宜作为骨皮质表面的种植材料,特别不适宜用作牙槽嵴再造。     

富血小板血浆与骨诱导活性材料复合物促种植体周骨缺损修复的实验研究

目的:观察富血小板血浆(platelet-rich plasma,PRP)、PRP复合骨诱导活性材料(osteoinduction active material,OAM)对种植体周围骨缺损的修复效果,探讨其作为种植体周围骨缺损修复材料的可行性.方法:Beagle犬4只,拔除双侧下颌第一、二、四前磨牙,3个月后植入种植体,制备种植体周围骨缺损并植入相应骨移植材料.A组植入PRP/ OAM,B组植入PRP,磷酸三钙,对照组植入磷酸三钙.种植术后8、16周各处死2只动物,进行组织学观察,能谱分析种植体-新骨界面Ca2+含量,采用SPSS13.0软件包对数据进行单因素方差分析.结果:8周时,实验A组新骨与种植体形成区段性骨结合;实验B组种植体边缘可见新骨形成,但量较少;对照组种植体边缘为纤维性界面.16周时,实验A组可见哈佛系统,实验A、B组新骨与种植体形成骨整合;对照组为纤维性结合.能谱分析显示,8、16周时各组间钙含量百分比均存在显著差异.实验A组最高,实验B组其次,对照组最低.结论:PRP及PRP/OAM应用于种植体周围骨缺损中,可以促进骨缺损的修复,并形成理想的种植体-骨结合界面.     

Bone formation at recombinant human bone morphogenetic protein-2-coated titanium implants in the posterior mandible (Type II bone) in dogs

Background: Conventional oral/maxillofacial implants reach osseointegration over several months during which the titanium fixtures interact with alveolar bone. The objective of this study was to determine if adsorbing recombinant human bone morphogenetic protein‐2 (rhBMP‐2) onto a titanium porous oxide (TPO) implant surface might enhance or accelerate local bone formation and support osseointegration in a large animal oral/maxillofacial orthotopic model. Material and Methods: Endosseous implants with a TPO surface were installed into the edentulated posterior mandible in eight adult Hound Labrador mongrel dogs. The implant surface had been adsorbed with rhBMP‐2 at 0.2 or 4.0 mg/ml. TPO implants without rhBMP‐2 served as control. Treatments were randomized between jaw quadrants. Mucosal flaps were advanced and sutured leaving the implants submerged. Clinical and radiographic evaluations were made immediately post‐surgery, at day 10 (suture removal), and week 4 and 8 post‐surgery. The animals received fluorescent bone markers at week 3, 4, and at week 8 post‐surgery, when they were euthanized for histologic analysis. Results: TPO implants coated with rhBMP‐2 exhibited dose‐dependent bone remodelling including immediate resorption and formation of implant adjacent bone, and early establishment of clinically relevant osseointegration. The resulting bone–implant contact, although clinically respectable, appeared significantly lower for rhBMP‐2‐coated implants compared with the control [rhBMP‐2 (0.2 mg/ml) 43.3±10.8%versus 71.7±7.8%, p<0.02; rhBMP‐2 (4.0 mg/ml) 35.4±10.6%versus 68.2±11.0%, p<0.03]. Conclusions: rhBMP‐2 adsorbed onto TPO implant surfaces initiates dose‐dependent peri‐implant bone re‐modelling resulting in the formation of normal, physiologic bone and clinically relevant osseointegration within 8 weeks.     

重组人骨形成蛋白-2-珊瑚复合人工骨修复骨缺损的生物力学研究

将珊瑚与具有骨诱导特性的重组人骨形成蛋白－２（ｒｈＢＭＰ－２）复合，制成ｒｈＢＭＰ－２－ｃｏｒａｌ复合人工骨，将其植入兔颅骨标准大小缺损，并与单纯珊瑚植入作对照。通过Ｘ线片、组织学和生物力学方法来评价此复合人工骨的骨修复能力。结果显示：ｒｈＢＭＰ－２－ｃｏｒａｌ复合人工骨具有较强的骨修复作用，植入骨缺损后，材料被逐渐降解吸收，新骨不断形成，机械强度不断增大；１２周后，植入物完全被成熟的骨组织取代，缺损区抗压强度接近正常的骨组织。该复合人工骨是一种较理想的骨移植替代材料。     

Bone formation at recombinant human bone morphogenetic protein-2-coated titanium implants in the posterior maxilla (Type IV bone) in non-human primates

Background: Studies using ectopic rodent and orthotopic canine models (Type II bone) have shown that titanium porous oxide (TPO) surface implants adsorbed with recombinant human bone morphogenetic protein‐2 (rhBMP‐2) induce local bone formation including osseointegration. The objective of this study was to evaluate local bone formation and osseointegration at such implants placed into Type IV bone. Material and Methods: rhBMP‐2‐coated implants were installed into the edentulated posterior maxilla in eight young adult Cynomolgus monkeys: four animals each received three TPO implants adsorbed with rhBMP‐2 (2.0 mg/ml) and four animals each received three TPO implants adsorbed with rhBMP‐2 (0.2 mg/ml). Contra‐lateral jaw quadrants received three TPO implants without rhBMP‐2 (control). Treatments were alternated between left and right jaw quadrants. Mucosal flaps were advanced and sutured to submerge the implants. The animals received fluorescent bone markers at weeks 2, 3, 4, and at week 16 when they were euthanized for histologic analysis. Results: Clinical healing was uneventful. Extensive local bone formation was observed in animals receiving implants adsorbed with rhBMP‐2 (2.0 mg/ml). The newly formed bone exhibited a specific pinpoint bone–implant contact pattern regardless of rhBMP‐2 concentration resulting in significant osseointegration; rhBMP‐2 (2.0 mg/ml): 43% and rhBMP‐2 (0.2 mg/ml): 37%. Control implants exhibited a thin layer of bone covering a relatively larger portion of the implant threads. Thus, TPO control implants bone exhibited significantly greater bone–implant contact (～75%; p<0.05). There were no statistically significant differences between rhBMP‐2‐coated and control implants relative to any other parameter including peri‐implant and intra‐thread bone density. Conclusion: rhBMP‐2‐coated TPO implants enhanced/accelerated local bone formation in Type IV bone in a dose‐dependent fashion in non‐human primates resulting in significant osseointegration. rhBMP‐2‐induced de novo bone formation did not reach the level of osseointegration observed in native resident bone within the 16‐week interval.     

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。     

膜结合骨形成蛋白和单独用膜引导种植体周围骨组织再生的比较研究

为研究单纯用膜及膜结合ＢＭＰ修复与种植体有关的骨缺损的愈合速度及界面情况，应用ＨＡ喷涂钛种植体植入伴有裂状缺损的拔牙窝内。实验分两组进行，一组用聚四氟己烯膜（ＰＥＴＥ膜）结合ＢＭＰ，另一组单纯用聚四氟己烯膜。术后２、４、８、１２周分别行大体，Ｘ线，光镜观察。结果发现：单纯用膜能促进种植体周围新骨生成，而膜结合ＢＭＰ处理的种植体骨修复启动早，骨界面愈合速度较单纯用膜可提前约４～６周。两种方法为扩大种植体的适应证范围，解决植床质和量问题提供了可能     

块状珊瑚兔颅骨骨膜下种植

为观察珊瑚人工骨在皮质骨表面的骨传导作用，将块状珊瑚植入兔一侧颅骨骨膜下，另一侧为空白对照组，分别于术后２、４、８及１２周时处死动物，进行光镜、扫描电镜及组织形态测量学观察。结果显示：珊瑚植入颅骨表面２周时即有新骨向珊瑚孔内长入，珊瑚被进行性吸收；１２周时珊瑚块大部分被吸收，新骨改建成板层骨，新骨所修复的骨高度较珊瑚块的高度低，珊瑚组新骨修复的骨高度明显大于空白对照组。结论：珊瑚骨在皮质骨表面有良好的骨传导作用。     

Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-2: histologic observations

Background: Studies using ectopic rodent, orthotopic canine, and non‐human primate models show that bone morphogenetic proteins (BMPs) coated onto titanium surfaces induce local bone formation. The objective of this study was to examine the ability of recombinant human BMP‐2 (rhBMP‐2) coated onto a titanium porous oxide implant surface to stimulate local bone formation including osseointegration and vertical augmentation of the alveolar ridge. Material and Methods: Bilateral, critical‐size, 5 mm, supra‐alveolar, peri‐implant defects were created in 12 young adult Hound Labrador mongrel dogs. Six animals received implants coated with rhBMP‐2 at 0.75 or 1.5 mg/ml, and six animals received implants coated with rhBMP‐2 at 3.0 mg/ml or uncoated control. Treatments were randomized between jaw quadrants. The mucoperiosteal flaps were advanced, adapted and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at weeks 3, 4, 7 and 8 post‐surgery when they were euthanized for histologic evaluation. Results: Jaw quadrants receiving implants coated with rhBMP‐2 exhibited gradually regressing swelling that became hard to palpate disguising the contours of the implants. The histologic evaluation showed robust bone formation reaching or exceeding the implant platform. The newly formed bone exhibited characteristics of the adjoining resident Type II bone including cortex formation for sites receiving implants coated with rhBMP‐2 at 0.75 or 1.5 mg/ml. Sites receiving implants coated with rhBMP‐2 at 3.0 mg/ml exhibited more immature trabecular bone formation, seroma formation and peri‐implant bone remodelling resulting in undesirable implant displacement. Control implants exhibited minimal, if any, bone formation. Thus, implants coated with rhBMP‐2 at 0.75, 1.5 and 3.0 mg/ml exhibited significant bone formation (height and area) compared with the sham‐surgery control averaging (±SD) 4.4±0.4, 4.2±0.7 and 4.2±1.2 versus 0.8±0.3 mm; and 5.0±2.2, 5.6±2.2 and 7.4±3.5 versus 0.7±0.3 mm², respectively (p<0.01). All the treatment groups exhibited clinically relevant osseointegration. Conclusions: rhBMP‐2 coated onto titanium porous oxide implant surfaces induced clinically relevant local bone formation including vertical augmentation of the alveolar ridge and osseointegration. Higher concentrations/doses were associated with untoward effects.     

致密型珊瑚骨修复皮质骨缺损的实验研究

为了寻找新的骨代用品，作者采用产自海南岛的角蜂巢珊瑚（ｆａｖｉｔｅｓ）作原料，制成珊瑚人工骨。理化测定显示Ｆａｖｉｔｅｓ的化学成分与滨珊瑚（ｐｏｒｉｔｅｓ）相同，但孔隙结构不同，孔率较少，质地较致密，强度较高。植入狗下颌骨和股骨皮质缺损内，具有良好的生物相容性和骨亲和性，６～８个月后植入物逐渐降解而被新骨完全替代，皮质骨缺损得到完全修复并保持其强度。结果表明该人工骨可能成为颌骨节段性缺损的修复材料之一。     

HISTOMORPHOMETRIC ANALYSIS OF PURE TITANIUM IMPLANTS WITH POROUS SURFACE VERSUS ROUGH SURFACE

The purpose of this study was to analyze the bone repair around commercially pure titanium implants with rough and porous surface, fabricated using powder metallurgy technique, after their insertion in tibiae of rabbits. Seven male rabbits were used. Each animal received 3 porous-surface implants in the left tibia and 3 rough-surface implants in the right tibia. The rabbits were sacrificed 4 weeks after surgery and fragments of the tibiae containing the implants were submitted to histological and histomorphometric analyses to evaluate new bone formation at the implant-bone interface. Means (%) of bone neoformation obtained in the histomorphometric analysis were compared by Student''s t-test for paired samples at 5% significance level.. The results of the histological analysis showed that osseointegration occurred for both types of implants with similar quality of bone tissue. The histomorphometric analysis revealed means of new bone formation at implant-bone interface of 79.69 ± 1.00% and 65.05 ± 1.23% for the porous- and rough-surface implants, respectively. Statistically significant difference was observed between the two types of implants with respect to the amount new bone formation (p<0.05). In conclusion, the porous-surface implants contributed to the osseointegration because they provide a larger contact area at implant-bone interface.     

重组人骨形成蛋白-2、胶原、珊瑚复合人工骨异位诱导成骨的实验研究

目的 采用珊瑚作为载体,胶原作为缓释系统,制血出重组人骨形成蛋白－２（ｒｈＢＭＰ－２）胶原／珊瑚复合人工骨,并评价其骨诱导活性。方法 ｒｈＢＭＰ－２、胶原和珊瑚以一定的方式复合后,植入小鼠股部肌袋内,以单纯珊瑚植入用对照,术后不同取材,通过组织学方法检测骨诱导活性。结果 复合人工骨植入１周诱导软骨形成,２周形成编织骨,４周形成含骨髓的板层骨,同时珊瑚被降解吸收。结果 胶原、珊瑚是ｒｈＢＭＰ－２较理