天津医药

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珊瑚羟基磷灰石与β-磷酸三钙用于修复种植体周骨缺损的实验研究

吕晓飞1,彭诚2,赖红昌3   

  1. 1. 天津医科大学第二医院口腔科
    2. 天津市医科大学第二医院
    3. 上海交通大学医学院附属第九人民医院
  • 收稿日期:2012-03-12 修回日期:2012-05-25 出版日期:2012-10-15 发布日期:2012-10-15
  • 通讯作者: 吕晓飞

An Experimental Study On the Restorative Effect of Coralline Hydroxyapatite versus Beta-tricalcium Phosphate Filled the Bone Defects around Implants

  • Received:2012-03-12 Revised:2012-05-25 Published:2012-10-15 Online:2012-10-15

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摘要： 目的：评价珊瑚羟基磷灰石（CHA）与β-磷酸三钙（β-TCP）对种植体周围骨缺损的修复效果。方法：拔除6只Beagle犬双侧下颌前磨牙和第一磨牙。3个月愈合期后，在每侧下颌骨选择4个拔牙位点常规制备种植窝，然后于其冠方制备宽1-1.25mm、深5mm的环形骨缺损，每侧各植入4颗种植体，冠方骨缺损区分别按血凝块充填、植入CHA或β-TCP材料3种方式处理，非埋入式愈合。分别于术后4周、12周和16周处死动物，收获含种植体的骨组织标本，制成硬组织切片经苦味酸品红染色，应用Image-Pro Plus 6.0软件测算新骨与种植体接触的最冠方水平至缺损底部的距离（B-D)，缺损区种植体骨结合率（BIC％)，缺损区内新生骨面积百分比（NFB%）及未降解骨替代材料的面积百分比（RBS%）。结果：术后无一种植体发生松动脱落，种植体周围软组织无炎症。植入4、12周时，3组种植体B-D、BIC%值差异均无统计学意义（P>0.05）；16周时，β-TCP组种植体B-D、BIC%值高于CHA组（P<0.01）。骨缺损区内，CHA组在12、16周时 RBS%值高于β-TCP组（P<0.01）；16周时，β-TCP组NFB%值高于CHA组（P<0.01）。结论：β-TCP较CHA能促进种植体周围骨缺损区的骨再生，β-TCP应用于种植体周围骨缺损的修复更具优势。

关键词: 珊瑚羟基磷灰石, β-磷酸三钙, 牙种植体, 骨缺损

Abstract: Objective: To investigate the restorative effect of coralline hydroxyapatite and beta-tricalcium phosphate on the defect healing around implants. Methods: All mandibular premolars and 1st molars were extracted bilaterally in six Beagle dogs. After a healing period of three-month, four experimental canals were prepared on each side of the mandible. The margin of the canal was further drilled to create the 1-1.25mm circumferential and 5mm deep bone defect around the coronal portion. Then, four implants were inserted in extraction sites on each side. The standardized bone defects were filled with blood clot, CHA or with β-TCP，respectively. All implants were non-submerged. Each two dogs were sacrificed at weeks 4, 12 and 16 following implant placement, and the specimens were prepared and stained with trinitrophenol fuchsin for histological and histomorphometric analyses to acquire the data about the distance between the most coronal level of bone-to-implant contact and the bottom of the surgically created bone defect(B-D), and the data about the bone-to-implant contact (BIC%) within the defect area. Values for newly formed bone area percentage (NFB%) and remaining bone substitutes percentage (RBS%) were additionally calculated for all biomaterial-grafted samples utilizing the Image-Pro Plus 6.0 software. Results: No implant was loosen or lost after installation, the peri-implant soft tissue was indicated no inflammation. At weeks 4 and 12, the differences in B-D and BIC% were not statistically significant between three treatment groups(P>0.05); the B-D, BIC% values for β-TCP –grafted group were significantly higher than for CHA-grafted group at week 16(P<0.05). There were statistically significant differences in RBS% within bone defect area between CHA-grafted and β-TCP –grafted groups at week 12、16，and the NFB% value of β-TCP –grafted group was shown significantly greater than that of CHA-grafted group(P<0.05).Conclusion: Bone regeneration within defects surrounding the implant could be accelerated with the use of β-TCP than CHA, it was suggested that the application of β-TCP was one more predictable treatment with respect to restoring bone defects around implants.

Key words: Coralline hydroxyapatite, Beta-tricalcium phosphate, Dental implant, Bone defect