本文選題：富血小板纖維蛋白 + 異種凍干骨��； 參考：《河北醫(yī)科大學》2014年碩士論文

【摘要】：目的： 通過建立兔下頜骨骨缺損模型，并即刻植入鈦螺紋釘、異種凍干骨及其復合富血小板纖維蛋白（Platelet-rich fibrin，簡稱PRF)，，觀察異種凍干骨及其復合PRF在修復鈦螺紋釘周圍骨缺損的效果，進一步探討異種凍干骨修復骨缺損的能力及PRF在異種凍干骨修復骨缺損中的作用。 方法∶ 1實驗動物的分組：總共有12只新西蘭大耳白兔，將所有實驗動物隨機分成3組，根據(jù)實驗設計，分別于術(shù)后4周、8周、12周處死。所有實驗動物均為右側(cè)下頜骨為實驗組（植入異種凍干骨復合PRF），左側(cè)下頜骨為對照組（植入異種凍干骨），進行自身對照。 2異種凍干骨的制備：取自人骨組織，經(jīng)骨髓清洗深度冷凍冷凍干燥和射線輻照等過程制備。 3PRF的制備：麻醉前，自兔耳中心動脈采血5ml，置于無抗凝劑的離心管中。將離心管放入離心機中離心，轉(zhuǎn)速3000r/min，離心10min，靜置備用。離心后離心管內(nèi)血液由上至下分為三層：上層無細胞血漿，中間層PRF凝膠，下層紅細胞層。去除上層和下層，剩余部分即為PRF凝膠。然后用兩層紗布輕柔擠出PRF中血清，PRF凝膠變成堅韌的膜狀。 4動物骨缺損模型的建立：麻醉下，在兔右側(cè)（實驗組）頰側(cè)皮膚沿下頜骨上緣走向作出一長約15mm的切口，鈍性分離其下肌層、骨膜，充分暴露其無牙區(qū)牙槽骨上緣和頰側(cè)。在暴露的無牙區(qū)牙槽骨形成一約5mm×4mm×3mm的缺損，生理鹽水沖洗。左側(cè)（對照組）手術(shù)方法相同。 5鈦螺紋釘?shù)闹踩耄壕o貼骨缺損近中及遠中邊緣牙槽骨各制備1個種植窩，造成種植窩周圍一壁骨缺損，植入1.5mm×3.5mm鈦螺紋釘。 6異種凍干骨及其復合PRF的植入：實驗組骨缺損區(qū)植入異種凍干骨復合PRF，對照組骨缺損區(qū)僅植入異種凍干骨。 7觀察結(jié)果：術(shù)后4、8、12周處死各組動物。大體觀察兩側(cè)缺損愈合情況及鈦螺紋釘有無松動脫落情況。拍X線片觀察新生骨密度和缺損區(qū)骨吸收情況，骨密度用灰度值表示，將測量的灰度值進行統(tǒng)計檢驗，比較實驗組與對照組骨密度的差別。將組織取材切片HE染色，光鏡下觀察。 結(jié)果： 1大體觀察：各期鈦螺紋釘無松動脫落。各期實驗組較對照組成骨情況好，新生骨骨質(zhì)較硬、表面更平整。 2X線觀察：各期鈦螺紋釘骨界面無明顯透射影像，未見異常骨吸收區(qū)，隨時間增加周圍骨組織密度逐漸升高。 3骨密度分析：采用統(tǒng)計分析軟件對X線片灰度值進行統(tǒng)計學處理。結(jié)果表明，在相同的時間點（術(shù)后4周、8周或12周），實驗組近中遠中鈦螺紋釘骨缺損側(cè)新生骨灰度值比對照組的大，p 0.05，差異有統(tǒng)計學意義。 4組織學觀察：術(shù)后4、8、12周，實驗組的新生骨組織更成熟，可見大量成骨細胞和骨細胞，骨小梁粗大致密排列規(guī)則，鈣化程度高；而對照組的成骨細胞、骨細胞比實驗組少，骨小梁數(shù)量較少且鈣化程度較低。 結(jié)論： 1異種凍干骨作為一種骨替代材料可以修復鈦螺紋釘周圍骨缺損 2富血小板纖維蛋白在異種凍干骨修復骨缺損中有較顯著的促進成骨的作用。
[Abstract]:Objective:
Through the establishment of rabbit model of mandibular bone defect, and immediate implantation of titanium screw, dissimilar freeze-dried bone and composite platelet rich fibrin (Platelet-rich fibrin, referred to as PRF), to observe the xenogeneic freeze-dried bone and composite PRF nail bone defect around the effect in the repair of titanium screw, further investigate the effects of xenogeneic freeze-dried and PRF bone repair the bone defect in xenogeneic freeze-dried bone in repairing the bone defect in the role.
Methods:
1 animal grouping: a total of 12 New Zealand white rabbits, all the experimental animal were randomly divided into 3 groups according to the experimental design, respectively after 4 weeks, 8 weeks, 12 weeks of death. All experimental animal are the right mandible as experimental group (xenogeneic freeze-dried bone composite PRF), the left mandible for the control group (freeze-dried bone implants), self-control.
2 the preparation of xenolyophilized bone: from human bone tissue, by bone marrow cleaning, deep freezing, freeze drying, and ray irradiation.
Preparation of 3PRF: before anesthesia, from the rabbit ear central artery blood 5ml, centrifugal placed in non anticoagulant tube. The centrifugal tube into the centrifuge centrifuge, speed 3000r/min, centrifugal 10min, static reserve. After centrifugation tubes of blood from top to bottom is divided into three layers: the upper layer cell free plasma, the middle layer of PRF gel. The lower red cell layer. The removal of the upper and lower layers, the remaining part is PRF gel. Then with two layers of gauze gently out of the PRF in serum, PRF gel into membrane tough.
The establishment of animal model of 4 bone defects: anesthesia in rabbits (experimental group) of buccal skin along the upper edge of the mandible to make an incision about 15mm long, blunt dissection of the muscle layer, periosteum, fully exposed the alveolar bone on the edentulous area and buccal margin. In the defect exposed without teeth alveolar bone formation about 5mm * 4mm * 3mm, physiological saline (control group). The operation method of the same.
5 screw implantation: close to the bone defect near the distal edge of the alveolar bone and preparation of 1 planting nest, by planting a nest around the bone defect, the implantation of 1.5mm * 3.5mm screw.
6 implants of xenofreeze-dried bone and its compound PRF: in the experimental group, the bone defect area was implanted with the xenofreeze-dried bone combined with PRF, and the control group was only implanted with the xenofreeze-dried bone in the bone defect area.
7 observations: after 4,8,12 weeks killed each animal. The general observation on both sides of defect healing and screw loosening loss. X-ray observation of bone density and defect new bone resorption, bone mineral density represented by gray value, will measure the gray value of the statistical test, compared with the control the bone mineral density was different. The tissues were stained with HE, were observed under light microscope.
Result:
1 gross observation: there was no loosening of the titanium screw in each period. The experimental group was better than the control group. The bone of the new bone was hard and the surface was more smooth.
2 x - ray observation: there was no obvious transmission image on the bone interface of titanium screw, no abnormal bone resorption area was not found, and the bone tissue density increased gradually with time.
3 Analysis of bone mineral density: X-ray gray value was analyzed by statistical analysis software. The results show that at the same time (4 weeks, after 8 or 12 weeks), the experimental group mesiodistal titanium screw bone defect side of newborn bone values than the control group of P, 0.05, a the statistical significance of differences.
4 histological observation: 4,8,12 weeks after operation, new bone tissue of the experimental group is more mature, showing a large number of osteoblasts and bone cells, bone trabecular thick dense arrangement, calcification degree is high; while the control group, the osteoblasts, bone cells less than the experimental group, trabecular bone volume and less calcium level low.
Conclusion:
1 xenogeneic freeze-dried bone can be used as a bone substitute material to repair the bone defect around the titanium screw
2 platelet rich fibrin can significantly promote osteogenesis in the repair of bone defects in xenofreeze-dried bone.

【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R782.2

【參考文獻】

相關期刊論文 前7條

1 馬偉光;丁鴻才;;建立下頜骨植骨材料實驗研究動物模型的探討[J];國外醫(yī)學.口腔醫(yī)學分冊;1987年04期

2 徐燕;葉眉;陳芳;姜大川;孫曉瑜;林瀟;沈繼龍;;富血小板血漿的三次離心法制備及其對脂肪干細胞增殖、成骨礦化的影響[J];國際口腔醫(yī)學雜志;2011年01期

3 楊爍;徐淑蘭;肖希娟;姚鐘雄;王朝;;計算機灰度法對可降解珊瑚羥基磷灰石與脫礦無機牛骨在上頜竇提升中改變的對比研究[J];廣東醫(yī)學;2013年06期

4 孫潔;張劍明;李彥秋;;富血小板纖維蛋白超微結(jié)構(gòu)的觀察與探討[J];口腔醫(yī)學研究;2010年01期

5 宓努;生長分化因子在骨再生研究中的進展[J];中國口腔種植學雜志;2002年02期

6 鄧悅;王萬春;徐棣;權(quán)鐘縉;Kwon Jongjin;;富血小板血漿對表面多孔性種植體周骨再生的作用[J];中國口腔種植學雜志;2006年02期

7 楊世茂;王明國;李靜;劉金盼;林夏蓮;徐煒;;富血小板纖維蛋白與富血小板血漿體外釋放生長因子的比較及其對脂肪干細胞增殖分化的影響[J];華西口腔醫(yī)學雜志;2012年06期

本文編號：1751678