生物活性玻璃陶瓷植入下颌骨缺损区远期临床疗效及组织学观察

目的：观察生物活性玻璃陶瓷植入下颌骨缺损区的远期临床疗效，材料内部以及材料与骨界面的显微结构。方法：对两例患者因肿瘤行部分下颌骨切除生物活性玻璃陶瓷（bioactive glass ceramics,BGC）植入术后8－10年的临床疗效进行观察。将原植入的BGC取出，陶瓷标本福尔马林磷酸缓冲液脱钙，HE染色，进行组织学观察。对57例较完整病例进行回顾分析。结果：BGC在尚有少量下颌骨支架残存或与自体骨复合移植时骨替代效果良好，但存在不能随颌骨同步生长发育的缺点，因而术后可导致面部外形或错颌畸形。大体标本观察发现，骨组织可以完全长入10mm厚度的材料中，材料与其外侧的板状骨几科无明显界限，多数板状骨以钉突形式长入材料中。组织学观察发现，材料中心有骨组织长入，表现为骨细胞、板状骨及骨样组织沉积。结论：BGC复合自体骨植入有良好的临床效果，克服其脆性后有较大的临床应用前景。

The Long-term Clinical Effect and Histological Observation of Bioactive Glass Ceramics Implanted as Bone Substitute

Objectives: To investigate the long-term clinical effect of bioactive glass ceramics after it were implanted in the bone defect of mandibles,the microscopic structures in the material and at the interface between the material and the host bone. Methods: The specimens of two patients whose part of mandibles were dissected and bioactive glass ceramics were implanted as bone substitutes have been retrieved ,decalcified and fixed with formalin-phosphate buffer solution,then routine HE stains were performed.Results: Bioactive glass ceramics(BGC) present good fixation with the host bone,bone tissue can penetrate the whole thickness of the material(almost 10 mm),both sides of the BGC were covered by lamellae bone nearly 1.5mm in thickness.Histological findings prove the same in a corresponding way. Clinical results of 57 cases also present in the article. Conclusion: BGC and host bone or bone marrow complex implantation have a good results in satisfactory functional and esthetic outcomes, but it cannot grow with the host bone at the same speed.To overcome its fatigue and to choose indicative cases are the key points of successful substitution .