改良型富血小板纤维蛋白复合β-磷酸三钙诱导的新生骨整合
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摘要
背景:前期兔临界性骨缺损修复实验显示,β-磷酸三钙与改良型富血小板纤维蛋白复合材料可诱导新生骨形成,促进骨组织的修复,效果优于单独使用β-磷酸三钙或改良型富血小板纤维蛋白。目的:进一步探索β-磷酸三钙与改良型富血小板纤维蛋白复合材料引导的新生骨与种植体骨整合性能。方法:取18只日本大耳兔(成都达硕生物科技有限公司提供),建立双侧股骨髁部骨缺损模型(直径6 mm、深度10mm),随机分3组:β-磷酸三钙组将β-磷酸三钙材料填入骨缺损处,改良型富血小板纤维蛋白组将改良型富血小板纤维蛋白填入骨缺损处,复合组将质量比为1∶1的β-磷酸三钙与改良型富血小板纤维蛋白混匀,填入骨缺损处;材料植入后3个月,植入DIO种植体,种植体植入后第4,12周获取带种植体的新生骨标本,进行Micro-CT及种植体推出实验,检测骨结合界面质量与推出最大荷载值。结果与结论:(1)Micro-CT检测显示,随着时间的延长,各组新生骨量逐渐增加,并且复合组植入后第4,12周的新生骨量多于β-磷酸三钙组、改良型富血小板纤维蛋白组(P <0.05);(2)种植体推出实验显示,随着时间的延长,各组最大推出力增加,并且复合组植入后第4,12周的最大推出力高于β-磷酸三钙组、改良型富血小板纤维蛋白组(P <0.05);(3)结果表明相对于单独应用,β-磷酸三钙与改良型富血小板纤维蛋白复合材料可优化新骨与种植体的结合。
BACKGROUND: Preliminary studies have shown that β-tricalcium phosphate loaded with advanced platelet-rich fibrin can induce bone formation and promote bone repair, which is better than β-tricalcium phosphate or advanced platelet-rich fibrin alone. OBJECTIVE: To further explore the osseointegration properties of newly formed bone induced by β-tricalcium phosphate loaded with advanced platelet-rich fibrin. METHODS: Eighteen Japanese rabbits provided by Chengdu Dashuo Biotechnology Co., Ltd. in China were used for establishing the bilateral femoral condyle defect models(6 mm in diameter and 10 mm in depth). There were three groups implanted with advanced platelet-rich fibrin, β-tricalcium phosphate or β-tricalcium phosphate loaded with advanced platelet-rich fibrin(mass ratio 1:1) composite, respectively. At 3 months after implantation, the DIO implant was implanted. The newly bone samples with the implants were then obtained to perform micro-CT and push-out test of implants at 4 and 12 weeks. The osteogenic properties and maximum load of the implant-bone interface were detected. RESULTS AND CONCLUSION: Micro-CT findings revealed that the amount of newly formed bone in each group was increased with time, which was significantly higher in the combined group than the other two groups at 4 and 12 weeks after implantation(P < 0.05). Results from the push-out test of implants showed that as time went on, the maximum push strength of each group was increased, which was significantly higher in the combined group than in the other two groups at 4 and 12 weeks after implantation(P < 0.05). In summary, the combined strength of the implant-bone interface of β-tricalcium phosphate loaded with advanced platelet-rich fibrin is superior to that of advanced platelet-rich fibrin or β-tricalcium phosphate.
BACKGROUND: Preliminary studies have shown that β-tricalcium phosphate loaded with advanced platelet-rich fibrin can induce bone formation and promote bone repair, which is better than β-tricalcium phosphate or advanced platelet-rich fibrin alone. OBJECTIVE: To further explore the osseointegration properties of newly formed bone induced by β-tricalcium phosphate loaded with advanced platelet-rich fibrin. METHODS: Eighteen Japanese rabbits provided by Chengdu Dashuo Biotechnology Co., Ltd. in China were used for establishing the bilateral femoral condyle defect models(6 mm in diameter and 10 mm in depth). There were three groups implanted with advanced platelet-rich fibrin, β-tricalcium phosphate or β-tricalcium phosphate loaded with advanced platelet-rich fibrin(mass ratio 1:1) composite, respectively. At 3 months after implantation, the DIO implant was implanted. The newly bone samples with the implants were then obtained to perform micro-CT and push-out test of implants at 4 and 12 weeks. The osteogenic properties and maximum load of the implant-bone interface were detected. RESULTS AND CONCLUSION: Micro-CT findings revealed that the amount of newly formed bone in each group was increased with time, which was significantly higher in the combined group than the other two groups at 4 and 12 weeks after implantation(P < 0.05). Results from the push-out test of implants showed that as time went on, the maximum push strength of each group was increased, which was significantly higher in the combined group than in the other two groups at 4 and 12 weeks after implantation(P < 0.05). In summary, the combined strength of the implant-bone interface of β-tricalcium phosphate loaded with advanced platelet-rich fibrin is superior to that of advanced platelet-rich fibrin or β-tricalcium phosphate.
引文
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[15]刘伟,陈杰,胡开进,等.负载CGRP及SP的明胶缓释微球用于修复家兔骨质疏松模型骨缺损的研究[J].口腔医学研究,2016,32(3):228-233.
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[20]Goldberg M,Marchadier A,Vidal C,et al.Differential effects of fibromodulin deficiency on mouse mandibular bones and teeth:a micro-CT time course study.Cells Tissues Organs.2011;194(2-4):205-210.
[21]王军,毕龙,白建萍,等.显微CT与组织切片技术在骨形态计量研究中的比较[J].中国矫形外科杂志,2009,17(5):381-384.
[22]Abduljabbar T,Kellesarian SV,Vohra F,et al.Effect of Growth Hormone Supplementation on Osseointegration:ASystematic Review and Meta-analyses.Implant Dent.2017;26(4):613-620.
[23]Pan W,Wei Y,Zhou L,et al.Comparative in vivo study of injectable biomaterials combined with BMP for enhancing tendon graft osteointegration for anterior cruciate ligament reconstruction.J Orthop Res.2011;29(7):1015-1021.
[24]王程越,赵远,杨曼,等.组织工程化骨修复兔下颌骨缺损同期种植体植入的实验研究[J].口腔医学,2016,36(1):12-17.
[25]Degidi M,Daprile G,Piattelli A,et al.Development of a New Implant Primary Stability Parameter:Insertion Torque Revisited.Clin Implant Dent Relat Res.2013;15(5):637-644.
[26]?ncüE,Bayram B,Kantarci A,et al.Positive effect of platelet rich fibrin on osseointegration.Med Oral Patol Oral Cir Bucal.2016;21(5):e601-607.
[27]邵磊,赵宝红.钛种植体骨结合界面组织学研究进展[J].中国实用口腔科杂志,2014,7(7):440-445.
[28]Masuki H,Okudera T,Watanebe T,et al.Growth factor and pro-inflammatory cytokine contents in platelet-rich plasma(PRP),plasma rich in growth factors(PRGF),advanced platelet-rich fibrin(A-PRF),and concentrated growth factors(CGF).Int J Implant Dent.2016;2(1):19.
[29]Thuaksuban N,Pannak R,Boonyaphiphat P,et al.In vivo biocompatibility and degradation of novel PolycaprolactoneBiphasic Calcium phosphate scaffolds used as a bone substitute.Biomed Mater Eng.2018;29(2):253-267.
[30]Matsuki K,Sugaya H,Takahashi N,et al.Degradation of Cylindrical Poly-Lactic Co-Glycolide/Beta-Tricalcium Phosphate Biocomposite Anchors After Arthroscopic Bankart Repair:A Prospective Study.Orthopedics.2018;41(3):e348-e353.
[31]Del RC,Rodríguez-évora M,Reyes R,et al.BMP-2,PDGF-BB,and bone marrow mesenchymal cells in a macroporousβ-TCP scaffold for critical-size bone defect repair in rats.Biomed Mater.2015;10(4):45008.
[32]尚文博.锰掺杂β-磷酸三钙多孔仿骨材料性能研究[D].长春:吉林大学,2016.
[33]周骁,钱玉芬.组织工程骨修复骨缺损的稳定性:材料降解与新骨形成[J].中国组织工程研究,2015,19(12):1938-1942.
[2]Elnayef B,Monje A,Gargallo-Albiol J,et al.Vertical Ridge Augmentation in the Atrophic Mandible:A Systematic Review and Meta-Analysis.Int J Oral Maxillofac Implants.2017;32(2):291-312.
[3]马士卿,张旭,孙迎春,等.引导骨组织再生膜的研究进展[J].口腔医学研究,2016,32(3):308-310.
[4]Masoudi Rad M,Nouri Khorasani S,Ghasemi-Mobarakeh L,et al.Fabrication and characterization of two-layered nanofibrous membrane for guided bone and tissue regeneration application.Mater Sci Eng C Mater Biol Appl.2017;80:75-87.
[5]Arunjaroensuk S,Panmekiate S,Pimkhaokham A.The Stability of Augmented Bone Between Two Different Membranes Used for Guided Bone Regeneration Simultaneous with Dental Implant Placement in the Esthetic Zone.Int J Oral Maxillofac Implants.2018;33(1):206-216.
[6]Benic GI,Bernasconi M,Jung RE,et al.Clinical and radiographic intra-subject comparison of implants placed with or without guided bone regeneration:15-year results.J Clin Periodontol.2017;44(3):315-325.
[7]陈卓凡,刘泉,Matinlinna JP.口腔种植中磷酸钙类骨替代材料的应用(英文)[J].口腔颌面外科杂志,2016,26(1):1-12.
[8]Ghanaati S,Booms P,Orlowska A,et al.Advanced platelet-rich fibrin:a new concept for cell-based tissue engineering by means of inflammatory cells.J Oral Implantol.2014;40(6):679-689.
[9]焦志立,谢晓玲,付冬梅,等.改良型富血小板纤维蛋白在兔颅骨诱导成骨中的组织学观察[J].中国组织工程研究,2017,21(14):2208-2214
[10]毛俊丽,孙勇,赵峰,等.兔PRF、A-PRF制备方法的筛选[J].西南国防医药,2016,26(6):593-596.
[11]Hoshino A,Hanada S,Yamada H,et al.Mycobacterium tuberculosis escapes from the phagosomes of infected human osteoclasts reprograms osteoclast development via dysregulation of cytokines and chemokines.Pathog Dis.2014;70(1):28-39.
[12]何通文,徐庚池,韩耀辉,等.构建兔颅顶骨临界骨缺损模型:确立颅顶临界骨缺损的参考值[J].中国组织工程研究,2014,18(18):2789-2794.
[13]韦从云.重组人骨形成蛋白-2结合胶原骨粉/无胶原骨粉在兔股骨远端标准骨缺损模型中成骨效能的研究[D].广州:南方医科大学,2010.
[14]邓威,郑欣,谌业帅,等.3D打印多孔钛材料修复兔股骨髁骨缺损的实验研究[J].实验动物与比较医学,2017,37(4):266-272.
[15]刘伟,陈杰,胡开进,等.负载CGRP及SP的明胶缓释微球用于修复家兔骨质疏松模型骨缺损的研究[J].口腔医学研究,2016,32(3):228-233.
[16]Walsh WR,Oliver RA,Christou C,et al.Critical Size Bone Defect Healing Using Collagen-Calcium Phosphate Bone Graft Materials.PloS One.2017;12(1):e0168883.
[17]焦志立,谢晓玲,付冬梅,等.改良型富血小板纤维蛋白在兔颅骨诱导成骨中的组织学观察[J].中国组织工程研究,2017,21(14):2208-2214.
[18]Jacobsson M,Tjellstr?m A,Thomsen P,et al.Integration of titanium implants in irradiated bone.Histologic and clinical study.Ann Otol Rhinol Laryngol.1988;97(4 Pt 1):337-340.
[19]He T,Cao C,Xu Z,et al.A comparison of micro-CT and histomorphometry for evaluation of osseointegration of PEO-coated titanium implants in a rat model.Sci Rep.2017;7(1):16270.
[20]Goldberg M,Marchadier A,Vidal C,et al.Differential effects of fibromodulin deficiency on mouse mandibular bones and teeth:a micro-CT time course study.Cells Tissues Organs.2011;194(2-4):205-210.
[21]王军,毕龙,白建萍,等.显微CT与组织切片技术在骨形态计量研究中的比较[J].中国矫形外科杂志,2009,17(5):381-384.
[22]Abduljabbar T,Kellesarian SV,Vohra F,et al.Effect of Growth Hormone Supplementation on Osseointegration:ASystematic Review and Meta-analyses.Implant Dent.2017;26(4):613-620.
[23]Pan W,Wei Y,Zhou L,et al.Comparative in vivo study of injectable biomaterials combined with BMP for enhancing tendon graft osteointegration for anterior cruciate ligament reconstruction.J Orthop Res.2011;29(7):1015-1021.
[24]王程越,赵远,杨曼,等.组织工程化骨修复兔下颌骨缺损同期种植体植入的实验研究[J].口腔医学,2016,36(1):12-17.
[25]Degidi M,Daprile G,Piattelli A,et al.Development of a New Implant Primary Stability Parameter:Insertion Torque Revisited.Clin Implant Dent Relat Res.2013;15(5):637-644.
[26]?ncüE,Bayram B,Kantarci A,et al.Positive effect of platelet rich fibrin on osseointegration.Med Oral Patol Oral Cir Bucal.2016;21(5):e601-607.
[27]邵磊,赵宝红.钛种植体骨结合界面组织学研究进展[J].中国实用口腔科杂志,2014,7(7):440-445.
[28]Masuki H,Okudera T,Watanebe T,et al.Growth factor and pro-inflammatory cytokine contents in platelet-rich plasma(PRP),plasma rich in growth factors(PRGF),advanced platelet-rich fibrin(A-PRF),and concentrated growth factors(CGF).Int J Implant Dent.2016;2(1):19.
[29]Thuaksuban N,Pannak R,Boonyaphiphat P,et al.In vivo biocompatibility and degradation of novel PolycaprolactoneBiphasic Calcium phosphate scaffolds used as a bone substitute.Biomed Mater Eng.2018;29(2):253-267.
[30]Matsuki K,Sugaya H,Takahashi N,et al.Degradation of Cylindrical Poly-Lactic Co-Glycolide/Beta-Tricalcium Phosphate Biocomposite Anchors After Arthroscopic Bankart Repair:A Prospective Study.Orthopedics.2018;41(3):e348-e353.
[31]Del RC,Rodríguez-évora M,Reyes R,et al.BMP-2,PDGF-BB,and bone marrow mesenchymal cells in a macroporousβ-TCP scaffold for critical-size bone defect repair in rats.Biomed Mater.2015;10(4):45008.
[32]尚文博.锰掺杂β-磷酸三钙多孔仿骨材料性能研究[D].长春:吉林大学,2016.
[33]周骁,钱玉芬.组织工程骨修复骨缺损的稳定性:材料降解与新骨形成[J].中国组织工程研究,2015,19(12):1938-1942.