中国组织工程研究 ›› 2017, Vol. 21 ›› Issue (34): 5558-5564.doi: 10.3969/j.issn.2095-4344.2017.34.024

• 生物材料综述 biomaterial review • 上一篇    下一篇

骨移植和组织工程支架材料在上颌窦提升口腔种植修复中的应用

李林峰1,李  月2,李瑞玉1,郝跃玲3,李  蒙4,张俊会5,党  莹5,李  兵5,王文杰5 
  

  1. 1邢台医学高等专科学校第二附属医院,河北省邢台市  054000;2承德医学院心理学系,河北省承德市  067000;3冀中能源邢台矿业集团显德汪分公司职工医院,河北省邢台市  054103;4武警新疆总队和田支队卫生队,新疆维吾尔自治区和田市  848011;5邢台医学高等专科学校,河北省邢台市  054000
  • 收稿日期:2017-06-28 出版日期:2017-12-08 发布日期:2018-01-04
  • 通讯作者: 李瑞玉,教授,主任医师,邢台医学高等专科学校第二附属医院中西医结合科,邢台医学高等专科学校第二附属医院中西医结合研究所,河北省邢台市 054000
  • 作者简介:李林峰,男,1971年生,河北省平乡县人,汉族,1991年河北工程大学毕业,副主任医师,主要从事骨科临床、外科教学及科研工作。
  • 基金资助:

    河北省中医药管理局资助项目(2014115)

Application of bone grafting and tissue engineering scaffold in oral implantation involving maxillary sinus elevation

Li Lin-feng1, Li Yue2, Li Rui-yu1, Hao Yue-ling3, Li Meng4, Zhang Jun-hui5, Dang Ying5, Li Bing5, Wang Wen-jie5
  

  1. 1Second Affiliated Hospital of Xingtai Medical College, Xingtai 054000, Hebei Province, China; 2Department of Psychology, Chengde Medical University, Chengde 067000, Hebei Province, China; 3Worker’s Hospital of Xiandewang Branch Office of Jinzhong Energy Xingtai Mining Industry Group Co., Ltd., Xingtai 054103, Hebei Province, China; 4Health Team of Hetian Detachment of Xinjiang Armed Police Corps, Hetian 848011, Xinjiang Uygur Autonomous Region, China; 5Xingtai Medical College, Xingtai 054000, Hebei Province, China
  • Received:2017-06-28 Online:2017-12-08 Published:2018-01-04
  • Contact: Li Rui-yu, Professor, Chief physician, Second Affiliated Hospital of Xingtai Medical College, Xingtai 054000, Hebei Province, China
  • About author:Li Lin-feng, Associate chief physician, Second Affiliated Hospital of Xingtai Medical College, Xingtai 054000, Hebei Province, China
  • Supported by:
    the Funded Project of Henan Provincial Administration of Traditional Chinese Medicine, No. 2014115

摘要:

文章快速阅读:

 

文题释义:
上颌窦提升:当上颌后牙缺失后,上颌窦的底壁就会下降到缺失牙原来的牙根的位置,此时一旦种植就有可能穿透上颌窦壁,为了植入种植体,经常需要移植一些合成的骨的替代品将其提升到原先的位置,这样可保证种植体在上颌骨中,这个手术过程就叫上颌窦提升。
骨移植材料:要有较好的生物相容性和骨传导性,自体骨长期以来被认为是上颌窦提升骨移植物的金标准,但是自体骨移植物有限和高发病率也是自体骨移植物的潜在缺点,目前多种移植材料已经用于上颌窦增强以弥补骨量不足,如异体移植物、异体移植物、异种移植物和人工骨移植材料,各种骨移植材料的应用可以作为自体骨的可靠替代物,每种骨移植材料有其特有的优势但又存在着各自的不足,因此将多种材料复合也可以诱导新骨生成,保证种植体周围稳定性。
 
背景:骨萎缩和上颌窦的持续气化可以引起上颌骨后牙的高度不足,在此部位进行牙种植体植入非常困难,增加上颌骨的骨量将有利于种植体植入物,采用骨移植材料进行上颌窦提升以弥补骨量不足是目前公认的方法。
目的:分析骨移植材料、人工作骨材料以及组织工程支架材料在上颌窦提升中的应用效果。
方法:以“上颌窦提升,种植体,自体骨,异体骨,人工骨,组织工程支持材料”为中文关键词,以“maxillary sinus elevation,dental implants,autologous bone,allograft,artificial Bone,scaffold”为英文关键词检索PubMed和万方数据库有关上颌窦提升移植材料应用的相关文献,分析各移植材料对上颌窦提升后新骨形成、种植体稳定性和骨-种植体结合率的影响。
结果与结论:自体骨是上颌窦提升中骨移植材料的金标准,可保证种植体周围骨量及种植的长期稳定性,但自体取骨造成供区二次损伤,容易产生感染。同种异体骨可作为自体骨的替代材料,可生成新生骨并保证种植体植入,达到足够的稳定性。人工骨材料如羟基磷灰石、β-磷酸三钙、双相复合磷酸钙等具有良好的骨传导性,可达到高骨-种植体接触率。组织工程骨移植物将干细胞、细胞因子与生物支架材料相结合用于上颌窦提升,可促进新骨形成,提高骨量,使种植体成功植入且稳定性良好。

关键词: 生物材料, 植骨材料, 同种异体骨, 上颌窦提升, 骨愈合, 牙种植

Abstract:

BACKGROUND: The persistence of bone atrophy and maxillary sinus gasification can cause a deficiency in the height of maxillary posterior teeth. It is very difficult to place dental implants at this site. Increasing bone mass in the maxilla is beneficial for dental implantation, and it is a currently accepted method to lift the maxillary sinus to compensate for bone loss.
OBJECTIVE: To analyze the application effect of bone graft material, human working bone material and tissue engineering scaffold material in maxillary sinus elevation.
METHODS: “Maxillary sinus elevation, dental implant, autologous bone, allograft, artificial bone, scaffold” were used as the key words in Chinese and English to retrieve relevant articles concerning materials used in maxillary sinus elevation included in PubMed and WanFang. Then, we analyzed the effects of different bone grafting materials on new bone formation, implant stability and bone-implant binding rate after maxillary sinus elevation.
RESULTS AND CONCLUSION: Autologous bone is the gold standard of bone graft material in maxillary sinus elevation, which can ensure the bone mass and the long-term stability of implantation around the implant, but it is easy to cause secondary damage to the donor area and to produce infection. Allogeneic bone can be used as an alternative material of autogenous bone, such as deproteinized bovine bone minerals, inorganic bovine bone, etc., which can generate new bone and ensure dental implantation to achieve sufficient stability. Artificial bone materials such as hydroxyapatite, beta-tricalcium phosphate, biphasic calcium phosphate compound, etc. have good bone conduction and can achieve a high bone-implant contact rate. Tissue-engineered bone grafts that can combine stem cells and cytokines with bio-scaffolds for maxillary sinus elevation can promote new bone formation, increase bone mass, and ensure dental implantation to achieve good stability.

Key words: Bone Transplantation, Dental Implantation, Tissue Engineering

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