中国组织工程研究

中国组织工程研究 ›› 2018, Vol. 22 ›› Issue (30): 4806-4811.doi: 10.3969/j.issn.2095-4344.0947

• 组织工程口腔材料 tissue-engineered oral materials • 上一篇    下一篇

异种牙本质颗粒复合骨髓浓缩物在上颌窦提升中的成骨效应

崔婷婷1，邱泽文2，邵 阳3，仲维剑1   

  1. 1大连医科大学口腔医学院口腔颌面外科，辽宁省大连市 116023；2大连医科大学实验动物中心，辽宁省大连市 116044；3宁波口腔医院口腔颌面外科，浙江省宁波市 315000
  • 收稿日期:2018-04-02 出版日期:2018-10-28 发布日期:2018-10-28
  • 通讯作者: 仲维剑，副教授，硕士生导师，大连医科大学口腔医学院口腔颌面外科，辽宁省大连市 116023
  • 作者简介:崔婷婷，女，1993年生，辽宁省铁岭市人，汉族，大连医科大学口腔医学院在读硕士，主要从事种植牙和骨再生技术的研究。
  • 基金资助:

     辽宁省自然科学基金(2015010313-301)

Osteogenic effects of heterogeneous dentin particles in conjunction with bone marrow concentrate in the maxillary sinus lift

Cui Ting-ting1, Qiu Ze-wen2, Shao Yang3, Zhong Wei-jian1   

  1. 1Department of Oral and Maxillofacial Surgery, School of Stomatology, Dalian Medical University, Dalian 116023, Liaoning Province, China; 2Animal Laboratory Center, Dalian Medical University, Dalian 116044, Liaoning Province, China; 3Department of Oral and Maxillofacial Surgery, Ningbo Dental Hospital, Ningbo 315000, Zhejiang Province, China
  • Received:2018-04-02 Online:2018-10-28 Published:2018-10-28
  • Contact: Zhong Wei-jian, Associate professor, Master’s supervisor, Department of Oral and Maxillofacial Surgery, School of Stomatology, Dalian Medical University, Dalian 116023, Liaoning Province, China
  • About author:Cui Ting-ting, Master candidate, Department of Oral and Maxillofacial Surgery, School of Stomatology, Dalian Medical University, Dalian 116023, Liaoning Province, China
  • Supported by:

     the Natural Science Foundation of Liaoning Province, No. 2015010313-301

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摘要：

文章快速阅读：

 

文题释义：
骨髓浓缩物：是将穿刺抽吸出的骨髓，通过离心、分离后获得富含单核细胞和血小板的浓缩物，其中含有大量的骨髓干细胞，能够有效促进骨组织的生成，而血小板能为间充质干细胞的分化和扩增提供高浓度生长因子。目前，临床上将自体骨髓浓缩物应用于骨科及相关学科，能够有效地改善新骨生成的质和量，同时也缩短了骨再生时间。
牙本质颗粒：是将拔除的牙齿经过清洁、粉碎处理，制成的由牙本质组成的颗粒状骨移植替代物，使用前需通过煮沸、脱矿或者冷冻等方法去除其免疫原性，提高其成骨活性。牙本质基质由Ⅰ型胶原纤维和钙和磷等无机物组成，与骨骼成分基本一致。作为骨移植材料，牙本质不仅可为骨再生提供磷和钙，其中的胶原成分也是成骨细胞生长的载体。此外，牙本质中含有骨形成蛋白，通过缓慢释放可促进骨再生重建。


背景：自体骨和自体牙本质均可作为骨移植材料应用于骨缺损的再生重建中，但异种或异体的牙本质能否作为骨移植替代材料，仍有待研究。
目的：评价未脱矿异种牙本质颗粒作为骨移植材料的可行性，同时比较骨髓浓缩物和富血小板纤维蛋白在牙本质颗粒骨再生重建中的作用。
方法：将临床获得的牙齿经过清洁、粉碎、煮沸、脱脂、消毒等步骤制成牙本质颗粒。取12只1岁龄雄性比格犬，进行双侧上颌窦提升手术，随机分3组进行窦腔内黏膜下植骨，A组植入未脱矿的异种牙本质颗粒，B组植入未脱矿的异种牙本质颗粒与自体富血小板纤维蛋白混合物，C组植入未脱矿的异种牙本质颗粒和自体骨髓浓缩物混合物。植入后3个月取材，进行植骨区X射线检查和组织学观察分析。
结果与结论：①X射线检查：A组骨移植区可见密度较高的牙本质颗粒影像，与邻近正常骨组织界限较明显；B组、C组骨移植区可见大量密度较低的阻射影，与邻近正常骨组织界限不明显；②组织学观察：A组骨移植区牙本质颗粒周围有少量多核巨噬细胞，新骨生成量较少；B组、C组骨移植区牙本质颗粒外形呈虫蚀状，新骨生成的量均较多，且骨小梁排列较规则；A、B、C组的新骨生成率分别为(13.61±8.57)%，(32.28±4.85)%和(36.85±9.70)%，B组、C组新骨生成率显著高于A组(P <0.05)，B组与C组新骨生成率无差异；③结果表明：经过处理的未脱矿异种牙本质颗粒具有良好的骨传导作用，骨髓浓缩物或富血小板纤维蛋白均能有效促进未脱矿异种牙本质颗粒周围的新骨生成，骨髓浓缩物的作用略优于富血小板纤维蛋白。

ORCID: 0000-0002-1581-1573(崔婷婷)

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

关键词: 牙本质颗粒, 骨髓浓缩物, 富血小板纤维蛋白, 骨再生, 上颌窦提升, 生物材料

Abstract:

 BACKGROUND: Autologous bone and dentin can be used as bone grafting materials for bone regeneration and reconstruction, but it is unclear whether heterogeneous dentin particles can be processed as bone substitutes to facilitate the bone regeneration.

OBJECTIVE: To investigate the feasibility of undemineralized heterogeneous dentin particles to be used as bone grafting materials, and to compare the effects of bone marrow concentrate and platelet-rich fibrin on bone regeneration in combination with dentin particles.
METHODS: The extracted human teeth were harvested and prepared to be dentin particles for bone grafting through cleaning, crushing, boiling, degreasing and disinfection. Twelve healthy male Beagle dogs, 1 year of age, were selected to create the animal models of bilateral maxillary sinus lift and were then randomly divided into three groups. The maxillary sinus surgery was performed on both sides of each dog. In group A, only implantation of heterogeneous dentine particles was given; in group B, implantation of the mixture of rich platelet fibrin and heterogeneous dentine particles was performed; and in group C, the mixture of bone marrow concentrate and heterogeneous dentine particles was implanted. The specimens from each animal were harvested after 3 months of implantation. Gross observation, X-ray examination and histological analysis were used to evaluate bone regeneration effects.

RESULTS AND CONCLUSION: No inflammatory signs were found in the bone grafting areas of each group. X-ray results showed that dentin particles with high density were detected in the bone graft area of group A, with the clear boundary with the adjacent bone tissue. However, lower density and unclear border of the graft area were detected in the groups B and C. Histological observation revealed that there was less new bone formation with a few multinucleated macrophages around the dentin particles in group A, while in groups B and C, dentin particles with worm-eaten shape was visible, and there was more new bone formation with regular trabecular alignment. The new bone formation rates were (13.61±8.57)%, (32.28±4.85)% and (36.85±9.70)% in group A, group B and group C, respectively. Significantly higher new bone formation rate was found in groups B and C than group A (P < 0.05), but there was no significant difference between group B and group C. Experimental findings show that the undemineralized heterogeneous dentin particles possess good biocompatibility and bone conduction capacity. In combination with bone marrow concentrate and platelet-rich fibrin, the new bone formation around the grafted dentin granules can be effectively promoted. Moreover, bone marrow concentrates have a slightly better effect than platelet-rich fibrin.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Key words: Dentin, Bone Marrow, Blood Platelets, Fibrin, Maxillary Sinus, Bone Transplantation, Animal Experimentation, Tissue Engineering

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