Three kinds of heterogeneous bone materials for repair of periodontal bone defects

doi:10.3969/j.issn.2095-4344.2015.08.005

Abstract

Abstract:

BACKGROUND: Currently, the treatment methods for periodontal disease mainly include autogenous bone graft, bone allograft, bone xenograft, and bone substitute implantation, and each method has its own merits and demerits.

OBJECTIVE: To compare the effects of calcined bone, freeze-dried bone and Bio-oss bone used alone on the repair of periodontal bone defects.

METHODS: A total of 36 healthy rabbits were randomly divided into four groups, and unilateral periodontal tissue defect model was established in each group. These four groups were respectively treated with calcined bone, freeze-dried bone and Bio-oss bone, and nothing (blank control group). After 4, 8 and 12 weeks, animals were sacrificed respectively for a complete specimen used in gross, X-ray and histological observations.

RESULTS AND CONCLUSION: Compared with the blank control group, the bone density, new cementum height, new alveolar height and new periodontal ligament height were all higher in the calcined bone, freeze-dried bone and Bio-oss bone groups at 4, 8, 12 weeks after treatment. As time went on, defected bone tissues gradually became continuous, newborn periodontal tissues were visible on the root surface and gradually became mature and increased in number. At 4 weeks after treatment, the new alveolar bone height was higher in the calcined bone group than the freeze-dried bone group (P < 0.05); at 12 weeks after treatment, the new periodontal ligament height was significantly higher in the freeze-dried bone group than the calcined bone group and Bio-oss bone group (P < 0.05). These results show that the calcined bone is superior to the freeze-dried bone and Bio-oss bone in terms of osteogenic induction, but the freeze-dried bone is better than the calcined bone and Bio-oss bone to promote the periodontal ligament regeneration.

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

全文链接：

Key words: Alveolar Bone Loss, Periodontium, Guided Tissue Regeneration, Periodontal

CLC Number:

R318

Dong Hong-bin, Zhang Qin, He Hui-yu, Keyimu Kelimu, Wang Huan-huan. Three kinds of heterogeneous bone materials for repair of periodontal bone defects[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(8): 1170-1176.

Figures/Tables 3

2.1 实验动物数量分析 36只兔均进入结果分析。 2.2 大体观察所有动物术后伤口愈合良好，牙周组织无炎症表现，无材料暴露情况，煅烧骨组、冻干骨组和Bio-oss骨组牙龈附着愈合良好，龈沟深度不超过1 mm，无牙周袋和脓肿形成；空白对照组术后8周牙齿牙槽骨高度降低，牙龈退缩2 mm。 2.3 不同骨材料修复牙周骨缺损的影像学观察见图2。术后4周：空白对照组可见术区牙槽窝空虚，可见低密度影像，缺牙区临近牙槽嵴高度与邻牙区牙槽嵴高度呈现出不连续状；煅烧骨组拔牙窝可见明显骨小梁影像；冻干骨组拔牙窝可见部分骨小梁影像，阻射较煅烧骨组、Bio-oss骨组骨密度降低；Bio-oss骨组可见未降解颗粒状材料。术后8周：空白对照组出现少量骨小梁影像，透射影明显，缺损处骨组织仍不连续；煅烧骨组、冻干骨组和Bio-oss骨组骨小梁影像清晰，新生骨阻射明显，术区可见少量低密度影，缺损处骨组织可见部分连续，提示骨改建正在进行中。术后12周：各组骨密度均增加，未见明显凹坑状的低密度影，空白对照组处骨组织只可见部分连续，骨密度仍低于其他各组，相当于煅烧骨组、冻干骨组和Bio-oss骨组术后第8周；冻干骨组阻射较煅烧骨组、Bio-oss骨组略降低，提示有骨组织形成，但效果没有其他两组明显；煅烧骨组与Bio-oss骨组骨组织密度相当，无可见明显差异；冻干骨组、煅烧骨组、Bio-oss骨组缺损处骨组织较连续。 2.4 不同骨材料修复牙周骨缺损的组织病理学观察见图3，4。术后4周：空白对照组拔牙窝结内可见大量炎细胞，血管扩张充血，成骨细胞少，侧壁可见少量新生骨生成及结绨组织，牙周组织生成较少；煅烧骨组成骨细胞增生比空白对照组活跃，可见大量成熟纤维组织，新生骨沉积于纤维组织中，不断连接成片，并有少量骨陷窝形成，同时可见大量软骨细胞；冻干骨组新生骨小梁周围可见大量成骨细胞呈单层紧密排列在表面，同时可见未降解材料；Bio-oss骨组新生骨部分连续，可见未降解材料；冻干骨组、煅烧骨组、Bio-oss骨组可见少量新生的牙骨质在根面薄层排列，牙周膜生长不规则。术后8周：空白对照组新生骨增多，夹杂纤维结缔组织，较多新生血管，新生骨小梁小而纤细，但新生骨数量、成熟度新生牙周膜、牙骨质均不及其他各组，相当于冻干骨组、煅烧骨组、Bio-oss骨组术后4周；煅烧骨组牙槽窝内充满新生骨小梁，紧密连接，可见成熟的板层状骨质，与周围牙槽骨结合；冻干骨组新生骨部分连接，成骨细胞呈单层紧密排列在其表面，大量结绨组织包绕着未降解材料，骨改建正在形成；Bio-oss骨组可见大量软骨细胞、骨陷窝形成；冻干骨组、煅烧骨组、Bio-oss骨组均可见新生的牙周膜，牙骨质增生明显。术后12周：空白对照组新生骨趋向成熟，部分连接，仍可见少量新生血管；煅烧骨组成熟的骨陷窝形成，向周围延伸形成致密板层状骨质，骨反折线明显，与正常牙槽骨几近相同并结合紧密；冻干骨组新生骨组织成熟，骨小梁钙化程度高，但仍可见部分活跃的成骨细胞；Bio-oss骨组骨小梁粗大致密，不断成熟，可见成熟的板层状骨质，仍可见未降解材料；冻干骨组、煅烧骨组、Bio-oss骨组均可见新生牙周膜，牙骨质增生更明显，牙骨质在根面厚层排列。 2.5 牙周组织形态学测量分析方差分析显示4组的总体均数不同，牙周组织形态计量学指标结果差异有显著性意义(P < 0.05)，说明各组牙周组织形态计量学指标结果不全相同。进一步进行两两比较(LSD)，术后4周时，冻干骨组、煅烧骨组、Bio-oss骨组新生牙槽骨高度、新生牙周膜高度均高于空白对照组(P < 0.05)，煅烧骨组新生牙槽骨高度明显高于冻干骨组(P < 0.05)，见表1。术后8，12周时，冻干骨组、煅烧骨组、Bio-oss骨组新生牙槽骨高度、新生牙周膜高度及新生牙骨质高度均明显高于空白对照组(P < 0.05)；术后12周时，冻干骨组、煅烧骨组、Bio-oss骨组之间新生牙骨质高度、新生牙槽骨高度无明显差异，但冻干骨组新生牙周膜高度明显高于煅烧骨组、Bio-oss骨组(P < 0.05)，见表2，3。"

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