骨膜牽張成骨術(shù)聯(lián)合PRF擴(kuò)增兔牙槽嵴的實(shí)驗(yàn)研究
發(fā)布時(shí)間：2018-11-27 07:26
【摘要】：目的:應(yīng)用課題組專利牽張器,進(jìn)行骨膜牽張成骨(periosteum distraction osteogenesis,PDO)聯(lián)合富血小板纖維蛋白(platelet-rich fibrin,PRF)擴(kuò)增兔下頜牙槽嵴,評(píng)價(jià)新骨生成情況。材料與方法:成年新西蘭大白兔36只,隨機(jī)分為A、B、C三組,每組12只。所有實(shí)驗(yàn)動(dòng)物均拔除左側(cè)下頜第一前磨牙,1個(gè)月后納入實(shí)驗(yàn)。A組(PDO組):左側(cè)拔牙區(qū)安置牽張器。B組(PDO+PRF):手術(shù)方法同A組,在牽引鈦網(wǎng)表面放置PRF膜。C組(異種骨移植組):左側(cè)拔牙區(qū)行5*5*5mm異種骨塊移植術(shù),表面生物膜覆蓋。A、B組術(shù)后間歇7天,以0.25mm/次,2次/天的速度,連續(xù)牽張9天,固定第60天、120天分別處死6只動(dòng)物;C組術(shù)后60天、120天分別處死6只動(dòng)物。取材觀察新骨生成情況:大體觀察、新骨高度的測(cè)量、X線分析、Micro-CT檢查、不脫鈣硬組織切片觀察、HE組織學(xué)觀察、BMP-2免疫組化觀察。結(jié)果:PDO組固定60天時(shí),牽張區(qū)鈦網(wǎng)下及牽引釘周圍可見部分新骨形成,新骨平均高度為2.65±0.37mm;影像學(xué)顯示,鈦網(wǎng)下可見中、低密度新骨影像,結(jié)構(gòu)疏松;硬組織切片及HE染色可見術(shù)區(qū)大量新生骨小梁,成骨活躍。固定120天時(shí),鈦網(wǎng)下新骨趨于成熟與自體骨融為一體,新生骨高度:4.13±0.31mm;影像學(xué)顯示,鈦網(wǎng)下新骨高密影,骨小梁結(jié)構(gòu)清晰,與周圍牙槽骨融為一體;組織學(xué)觀察,新生骨趨于成熟,可見成熟哈弗系統(tǒng),與自體牙槽骨相延續(xù)。B組上述觀察結(jié)果與A組相類似,C組移植骨塊呈現(xiàn)出逐漸吸收,被新生骨“爬行替代”的過程。結(jié)論:使用課題組專利牽張器牽張兔下頜牙槽嵴骨膜,固定60天、120天發(fā)現(xiàn)牽張間隙有新骨形成。PRF對(duì)PDO未發(fā)現(xiàn)明顯促進(jìn)作用。PDO操作簡(jiǎn)便、手術(shù)創(chuàng)傷小、無需植骨,有著很大的臨床應(yīng)用價(jià)值。
[Abstract]:Objective: to investigate the effects of periosteum distraction osteogenesis (periosteum distraction osteogenesis,PDO) combined with platelet-rich fibrin (platelet-rich fibrin,PRF) on mandibular alveolar ridge in rabbits. Materials and methods: Thirty-six adult New Zealand white rabbits were randomly divided into three groups: group A (n = 12) and group C (n = 12). All the experimental animals extracted the left mandibular first premolars and were included in the experiment one month later. Group A (PDO group): the left tooth extraction area was placed with distractor. Group B was treated with the same method of (PDO PRF): operation as group A. PRF membrane was placed on the surface of traction titanium mesh. Group C (heterotopic bone graft group): the left extraction area was implanted with 5*5*5mm xenograft, and the surface was covered by biofilm. The interval of 7 days after operation in group A was 7 days, and the rate of 0.25mm/ was 2 times a day. 6 animals were killed after 9 consecutive days of distraction, 60 days of fixation and 120 days of fixation. In group C, 6 animals were killed 60 days and 120 days after operation. To observe the new bone formation: gross observation, new bone height measurement, X-ray analysis, Micro-CT examination, non-decalcification hard tissue section observation, HE histological observation, BMP-2 immunohistochemical observation. Results: after 60 days of fixation in PDO group, some new bones were formed in the distraction zone and around the traction nail, the average height of the new bone was 2.65 鹵0.37 mm, and the imaging showed that the middle and low density new bone could be seen under the titanium mesh and the structure was loose. Hard tissue sections and HE staining showed a large number of new trabeculae and active osteogenesis. After 120 days of fixation, the new bone under the titanium mesh tended to be mature and fused with the autogenous bone, the height of the new bone was 4.13 鹵0.31 mm.Imaging showed that the new bone under the titanium mesh was high dense, the trabecular structure of the bone was clear, and the new bone fused with the surrounding alveolar bone. Histologically, the new bone tended to mature, and the mature Hafer system was observed. The results in group B were similar to those in group A. the grafts in group C were gradually absorbed and replaced by the new bone. Conclusion: the patented distractor was used for distraction of mandibular alveolar ridge periosteum in rabbits for 60 days. After 120 days of fixation, new bone formation was found in distraction space. PRF had no significant effect on PDO. PDO was simple and easy to operate, and no bone graft was needed. It has great clinical application value.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R782.1
本文編號(hào)：2359862
[Abstract]:Objective: to investigate the effects of periosteum distraction osteogenesis (periosteum distraction osteogenesis,PDO) combined with platelet-rich fibrin (platelet-rich fibrin,PRF) on mandibular alveolar ridge in rabbits. Materials and methods: Thirty-six adult New Zealand white rabbits were randomly divided into three groups: group A (n = 12) and group C (n = 12). All the experimental animals extracted the left mandibular first premolars and were included in the experiment one month later. Group A (PDO group): the left tooth extraction area was placed with distractor. Group B was treated with the same method of (PDO PRF): operation as group A. PRF membrane was placed on the surface of traction titanium mesh. Group C (heterotopic bone graft group): the left extraction area was implanted with 5*5*5mm xenograft, and the surface was covered by biofilm. The interval of 7 days after operation in group A was 7 days, and the rate of 0.25mm/ was 2 times a day. 6 animals were killed after 9 consecutive days of distraction, 60 days of fixation and 120 days of fixation. In group C, 6 animals were killed 60 days and 120 days after operation. To observe the new bone formation: gross observation, new bone height measurement, X-ray analysis, Micro-CT examination, non-decalcification hard tissue section observation, HE histological observation, BMP-2 immunohistochemical observation. Results: after 60 days of fixation in PDO group, some new bones were formed in the distraction zone and around the traction nail, the average height of the new bone was 2.65 鹵0.37 mm, and the imaging showed that the middle and low density new bone could be seen under the titanium mesh and the structure was loose. Hard tissue sections and HE staining showed a large number of new trabeculae and active osteogenesis. After 120 days of fixation, the new bone under the titanium mesh tended to be mature and fused with the autogenous bone, the height of the new bone was 4.13 鹵0.31 mm.Imaging showed that the new bone under the titanium mesh was high dense, the trabecular structure of the bone was clear, and the new bone fused with the surrounding alveolar bone. Histologically, the new bone tended to mature, and the mature Hafer system was observed. The results in group B were similar to those in group A. the grafts in group C were gradually absorbed and replaced by the new bone. Conclusion: the patented distractor was used for distraction of mandibular alveolar ridge periosteum in rabbits for 60 days. After 120 days of fixation, new bone formation was found in distraction space. PRF had no significant effect on PDO. PDO was simple and easy to operate, and no bone graft was needed. It has great clinical application value.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R782.1
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