脱细胞松质骨/骨形态发生蛋白-2/胶原海绵重建兔上颌窦外侧骨壁伴黏膜缺损实验研究

目的利用胶原海绵及复合骨形态发生蛋白-2（BMP-2）的脱细胞松质骨,原位修复兔上颌窦外侧骨壁伴黏膜缺损,观察BMP-2原位诱导成骨及上颌窦外侧骨壁、黏膜修复状况。方法制备复合BMP-2的片状脱细胞松质骨,单侧以生物蛋白胶固定薄层胶原海绵作为修复材料,未加BMP-2材料用做对照。手术去除兔上颌窦外侧骨壁及附着黏膜,胶原海绵侧面向窦腔,原位修复缺损,术后3个月进行大体标本及病理切片观察,了解其修复效果及成骨情况。结果兔术后健康状况良好,术后3个月大体观察兔上颌窦外侧壁缺损修复良好,窦腔内侧面有新生黏膜覆盖。病理学检查发现实验组脱细胞松质骨内有新骨形成,对照组仅有纤维结缔组织长人。结论BMP-2具有诱导成骨能力,胶原海绵可用作黏膜再生支架,脱细胞松质骨／BMP-2／胶原海绵,可用于修复上颌窦局部骨壁伴黏膜缺损。

Reconstruction of maxillary sinus lateral bone wall and mucosa defect of with collagen sponge and acellular cancellous bone combined with bone morphogenetic protein-2

OBJECTIVE: To investigate the effects of reconstruction of maxillary sinus lateral bone wall and mucosa defect with collagen sponge and acellular cancellous bone combined with bone morphogenetic protein (BMP)-2 in situ. We observed the effect of the reparation and the BMP-2 induced osteogenesis. METHODS: Ten New Zealand white rabbits underwent removal of part of unilateral maxillary sinus lateral bone wall with mucosa, and then divided into 2 equal groups: experimental group and control group. Acellular porcine cancellous vertebral bone was obtained, combined with BMP-2, trimmed to suit the defect, and put into the defect of the experimental group with collagen sponge soaked in venous blood, fixed by protein glue. Same porcine cancellous vertebral bone without BMP-2 was used in the control group. After 3 months the rabbits were killed to observe the osteogenesis of the defects. RESULTS: The rabbits recovered soon after surgery. The implanted acellular cancellous bones were banded tightly with the bones around the defects, the medial surfaces of the materials were covered with mucosa, and new bone tissue entered into the pores of the complex BMP-2 materials. In the control group, only fibrillar connective tissue was filled in the pores. CONCLUSION: BMP-2 can induce osteogenesis, and collagen sponge serves to support the mucosal regeneration. Collagen sponge and acellular cancellous bone combined with BMP-2 can be used to repair the defects of the maxillary sinus bone wall and mucosa.