CAJ | 학술논문

背景:自体骨、骨替代材料及骨诱导再生技术可修复颌骨缺损,但由于新骨形成周期长、骨替代材料及骨诱导再生膜吸收快,缺损区新骨的体积和塑形受到影响.目的:探讨个性化钛模板与纳米羟基磷灰石及自体骨在兔上颌骨牙槽嵴缺损修复中的作用.方法:18只日本大耳白兔,随机分为2组,制作长10 mm,高5 mm的上颌牙槽嵴骨缺损,实验组骨缺损区由自体髂骨颗粒及缺损区制作中产生的自体骨颗粒与纳米羟基磷灰石填充,表面覆盖个性化钛模板,并螺钉固定;对照组缺损区只覆盖个性化钛模板并螺钉固定,缺损区不充填任何骨移植材料.观察术后4,8,12周的新骨生成情况、X射线表现及苏木精-伊红染色组织学改变.结果与结论:术后4周时,实验组新骨形成明显优于对照组;术后8及12周时,两组形成的新骨无明显区别.经配对t检验,实验组和对照组在术后4周时新骨密度差异有显著性意义(P<0.01),而在术后8周和12周时,新骨灰度值差异无显著性意义(P>0.05).提示自体骨及纳米羟基磷灰石可很好地修复上颌牙槽嵴缺损;个性化钛模板可起到屏障膜和新骨形成外支架的作用,有利于新骨的塑形.
배경:자체골、골체대재료급골유도재생기술가수복합골결손,단유우신골형성주기장、골체대재료급골유도재생막흡수쾌,결손구신골적체적화소형수도영향.목적:탐토개성화태모판여납미간기린회석급자체골재토상합골아조척결손수복중적작용.방법:18지일본대이백토,수궤분위2조,제작장10 mm,고5 mm적상합아조척골결손,실험조골결손구유자체가골과립급결손구제작중산생적자체골과립여납미간기린회석전충,표면복개개성화태모판,병라정고정;대조조결손구지복개개성화태모판병라정고정,결손구불충전임하골이식재료.관찰술후4,8,12주적신골생성정황、X사선표현급소목정-이홍염색조직학개변.결과여결론:술후4주시,실험조신골형성명현우우대조조;술후8급12주시,량조형성적신골무명현구별.경배대t검험,실험조화대조조재술후4주시신골밀도차이유현저성의의(P<0.01),이재술후8주화12주시,신골회도치차이무현저성의의(P>0.05).제시자체골급납미간기린회석가흔호지수복상합아조척결손;개성화태모판가기도병장막화신골형성외지가적작용,유리우신골적소형.
BACKGROUND: Autologous bone, bone substitute materials and guided bone regeneration (GBR) technique can repair jaw defects, but the absorption speed of bone substitute materials and GBR membrane are faster than the formation speed of new bone, therefore, it affects the volume and shape of new bone.OBJECTIVE: To investigate the role of personalized prefabricated titanium template, autologous bone and nano-hydroxyapatite on restoration of maxillary defect in rabbit.METHODS: A total of 18 rabbits were randomly divided into two groups, and maxillary alveolar defect with 10 mm length and 5 mm high was created. The template was implanted in both two groups, and fastened with titanium screws. Autologous and nano-hydroxyapatite were placed into the defect in experimental group; neither autologous bone nor bone substitute materials were implanted into the defect in control group. New bone formation, X-ray findings, and histological changes with HE stain were carded out 4, 8 and 12 weeks postoperatively.RESULTS AND CONCLUSION: The quality of new bone in experimental group was batter than that in control group 4 weeks postoperatively, but the quality of new bone was almost the same 8 and 12 weeks postoperatively. By paired t-test, there was significant difference in new bone density between the experimental group and the control group 4 .weeks after operation (P<0.01), but there was no significant difference in new bone density between the experimental group and the control group 8 and 12 weeks after operation (P > 0.05). Autologous bone and nano-hydroxyapatite can restore the defect of maxillary alveola.Personalized prefabricated titanium template can play an important role of screen membrane and external scaffold in new bone formation, and remain shape of new bone.