Beagle犬不植骨上颌窦外提升成骨效能的研究

目的评估不植骨的上颌窦外提升术上颌窦黏膜撕裂和不撕裂两种情况下的成骨效能,以及钛钉维持提升空间的效果。方法 6只Beagle犬12个上颌窦进行上颌窦外提升,不使用任何骨代用品。每个上颌窦用2枚钛钉维持窦膜提升空间,随机决定一侧为非黏膜撕裂组,保持上颌窦黏膜完好;对侧为黏膜撕裂组,上颌窦黏膜撕裂长度约5mm。术后6个月处死实验动物,锥形束CT对上颌骨进行定位,了解钛钉所在位置后,进行大体标本观察。制作硬组织切片观察新骨形成情况。结果大体标本检查12个上颌窦无明显炎症,24枚钛钉均位于原始位置,上颌窦黏膜均有塌陷,黏膜撕裂组12枚钛钉中有11枚穿孔,8枚钛钉周围可见骨隆突。非黏膜撕裂组12枚钛钉中有10枚穿孔,8枚钛钉周围可见骨隆突。硬组织切片后经甲苯胺蓝染色,观察到钛钉周围为矿化的成熟骨组织,未见明显的细胞间质。未见明显新骨沉积。结论 Beagle犬不植骨的上颌窦外提升上颌窦黏膜撕裂和不撕裂两种情况下的成骨效能并不明显,且钛钉作为空间维持装置容易造成黏膜穿孔,空间维持效果欠佳。

Osteogenesis in maxillary sinus elevation without bone transplantation in beagle dogs

Objective To assess the osteogenesis in maxillary sinus elevation without bone transplantation, and toevaluate the effect of titanium screws for space-maintaining. Methods The maxillary sinuses in 6 beagle dogs were selected for maxillary sinus elevation surgery without using any bone substitutes. Randomly, in one side of the sinuses, maxillary sinus elevation was received in teared mucosa, and in the other side, the mucosa was integrant acting as their own control. Two titanium screws were affixed in each side for space-maintaining. Six months later, all dogs were sacrificed and CBCT was taken. The gross specimen were observed and histology examination of hard tissue slices were used to evaluate the bone formation. Results The gross specimen observation showed that all 12 maxillary sinuses were not infected, and 24 titanium screws were located in the original position, but sinus mucosa was collapsed. In the 12 titanium screws in mucosa breakage group, 11 of them perforated tissue, but bone apophysis was found around 8 screws. While in the mucosa integrant group, 12 of them perforated and bone apophysis were found around 8 screws. Toluidine blue staining was used for hard tissue slices. And there was mineralized mature bone around titanium screws, but no intercellular substances and no new bone was observed. Conclusion There was no new bone formation found in maxillary sinus elevation without bone transplantation, whether the mucosa was teared or not. And the space-maintaining of the titanium screws was still uncertain.