钛膜及胶原膜对兔人造牙槽突裂自体骨移植术后骨再吸收影响的实验研究
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摘要
目的：采用成年期的实验动物探讨钛膜及胶原膜对牙槽突裂自体骨移植术后骨再吸收的影响。
方法：选取12只12周龄的本地白兔,随机分3组,均采用前颌骨缝与臼齿之间的骨段作为造裂部位,自体肋骨作为移植骨源。其中一组行单纯骨移植作为对照组,另一组在移植骨表面覆盖钛膜,第三组在移植骨表面覆盖胶原膜。术后12周取出颅骨,对标本进行CT扫描分析并测量造裂部位的骨量,计算骨再吸收率并行形态学观察分析。
结果：可认为组间的骨再吸收率不同,差异有统计学意义(P<0.05)。其中胶原膜组的骨再吸收率低于对照组,差异有统计学意义(P<0.05)。钛膜组的骨再吸收率与对照组及胶原膜组的差异无统计学意义(P>0.05)。
结论：兔牙槽突裂自体骨移植修复术中,在移植骨表面覆盖胶原膜,可以减少移植骨再吸收。钛膜在此方面的作用尚不明显。
Objective:Using the mature stage experimental animal to investigate using titanium membrane or collagen membrane in secondary alveolar autogenous bone grafting to influence on bone resorption.
Methods:Random divided three groups of twelve three month old local rabbits, uses between the premaxillary bone seam and the molar bone section makes the cleft spot, takes the supply bone source from the body rib.And a group of pure bone grafting takes the control group, another group in transplant bone surface cover titanium membrane, the third group in transplant bone surface cover collagen membrane.Axial computed tomography scans of all skulls were taken immediately 12 weeks postoperatively. Volumetricanalysis was performed on three-dimensional models of the cleft defecty, calculate bone resorption rate and morphology observation analysis.
Result:Bone resorption rate is considered to be difference among groups (p< 0.05).Significant difference between control group and collagen membrane group is found about bone resorption rate (p<0.05).No significant difference between control group and titanium membrane, and no significant difference between titanium membrane and collagen membrane group is found about bone resorption rate (p>0.05).
Conclusion:To cover grafting bone with collagen membrane in rabbit secondary alveolar bone grafting is beneficial to reduce bone resorption rate. The effect of titanium membrane is not obvious.
方法：选取12只12周龄的本地白兔,随机分3组,均采用前颌骨缝与臼齿之间的骨段作为造裂部位,自体肋骨作为移植骨源。其中一组行单纯骨移植作为对照组,另一组在移植骨表面覆盖钛膜,第三组在移植骨表面覆盖胶原膜。术后12周取出颅骨,对标本进行CT扫描分析并测量造裂部位的骨量,计算骨再吸收率并行形态学观察分析。
结果：可认为组间的骨再吸收率不同,差异有统计学意义(P<0.05)。其中胶原膜组的骨再吸收率低于对照组,差异有统计学意义(P<0.05)。钛膜组的骨再吸收率与对照组及胶原膜组的差异无统计学意义(P>0.05)。
结论：兔牙槽突裂自体骨移植修复术中,在移植骨表面覆盖胶原膜,可以减少移植骨再吸收。钛膜在此方面的作用尚不明显。
Objective:Using the mature stage experimental animal to investigate using titanium membrane or collagen membrane in secondary alveolar autogenous bone grafting to influence on bone resorption.
Methods:Random divided three groups of twelve three month old local rabbits, uses between the premaxillary bone seam and the molar bone section makes the cleft spot, takes the supply bone source from the body rib.And a group of pure bone grafting takes the control group, another group in transplant bone surface cover titanium membrane, the third group in transplant bone surface cover collagen membrane.Axial computed tomography scans of all skulls were taken immediately 12 weeks postoperatively. Volumetricanalysis was performed on three-dimensional models of the cleft defecty, calculate bone resorption rate and morphology observation analysis.
Result:Bone resorption rate is considered to be difference among groups (p< 0.05).Significant difference between control group and collagen membrane group is found about bone resorption rate (p<0.05).No significant difference between control group and titanium membrane, and no significant difference between titanium membrane and collagen membrane group is found about bone resorption rate (p>0.05).
Conclusion:To cover grafting bone with collagen membrane in rabbit secondary alveolar bone grafting is beneficial to reduce bone resorption rate. The effect of titanium membrane is not obvious.
引文
[1]傅豫川.唇腭裂畸形的治疗[M].武汉：湖北科学技术出版社,2002
[2]欧阳东,葛兴亮,罗奕.牙槽嵴裂骨移植修复术后骨吸收影响因素的分析[J].武警医学院学报,2005,14(2)：120-122
[3]Buser D,Duar K, Belser U,et al. Int J Periodont Restorat Dent,1993,13:29-45
[4]Melcher AH. On the repair potential of periodontal tissues[J]. J Periodontol,1976, 47:256-260
[5]Nyman S, Gottlow J, Karring T, et al. The regenerative potential of the periodontal ligament: An experimental study in the monkey. J Clin Periodontol,1982,9:257
[6]Meelcher AH.On the repair of periodontal tissues[J].J Periodontol,1976,47:256
[7]Hardwick R, Hayes BK, Flynn C, et al. Devices for dentoalveolar regeneration:An up-to-date literature review(J).J Preiodontol,1995,66:495
[8]Peled M, Aizenbud D, Horwitz J, et al. Treatment of osseous cleft palate defects:a preliminary evaluation of novel treatment modalities. Cleft Palate Craniofac J,2005,42: 344-348
[9]Scott JK, Webb RM, Flood TR. Premaxillary osteotomy and guided tissue regeneration in secondary bone grafting in children with bilateral cleft lip and palate. Cleft Palate Craniofac J,2007,44:469-475
[10]Nwoku AL, Al Atel A, Al Shlash S, et al. Retrospective analysis of secondary alveolar cleft grafts using iliac of chin bone. J Craniofac Surg,2005,16:864-868
[11]Feichtinger M, Mossbock R, Karcher H. Assessment of bone resorption after secondary alveolar bone grafting using three-dimensional computed tomography:a three-year study. Cleft Palate Craniofac J,2007,44:142-148
[12]Stavropoulos F, Dahlin C, Ruskin JD, et al. A comparative study of barrier membranes as graft protectors in the treatment of localized bone defects. An experimental study in a canine model. Clin Oral Implants Res,2004,15:435-442
[13]王光和.唇腭裂的序列治疗[M].人民卫生出版社,1995：236-237
[14]石冰,龙洁,王晴.唇裂伴牙槽突裂动物模型的建立及对上颌骨生长发育影响的观察.口腔颌面外科杂志,2000,10：138-140
[15]Dalia EB,Steven JS,Nicholas G.New technique for creating permanent experimental alveolar clefts in a rabbit model.Cleft palate-Craniofacial Journal,1993,30:542-547
[1]Arctander K, Kolbenstvedt A, Aalokken TM, et al.Computed tomography of alveolar bone grafts 20 years after repair of unilateral cleft lip and palate. Scand J Plast Reconstr Surg Hand Surg,2005,39(1):11-14.
[2]Nwoku AL, Al Atel A,Al Shlash S, et al.Retrospective analysis of secondary alveolar cleft grafts using iliac of chin bone. J Craniofac Surg,2005,16(5):864-868.
[3]Boyarskiy S, Choi HJ, Park K. Evaluation of alveolar bone support of the permanent canine in cleft and noncleft patients. Cleft Palate Craniofac J,2006,43(6):678-682.
[4]Swan MC, Goodacre TE. Morbidity at the iliac crest donor site following bone grafting of the cleft alveolus. Br J Oral Maxillofac Surg,2006,44(2):129-133.
[5]Nyman S, Lang NP, Buser D, et al. Bone regeneration adjacent to titanium dental implants using guided tissue regeneration:A report of two case. Int J Oral Maxillofac Implants,1990, 5(1):9-14.
[6]Nyman S,Gottlow J, Karring T, et al.The regenerative potential of the periodontal ligament: An experimental study in the monkey. J Clin Periodontol,1982,9(3):257-265.
[7]Buser D, Dula K, Belser U, et al.Localized ridge augmentation using guided bone regeneration.1.Surgical procedure in the maxilla. Int J Periodont Rest Dent 1993, 13(1):29-45.
[8]Koyama Y, Kikuchi M, Edamura K, et al.Reconstruction of bone fenestration on mandiblar by the guided bone regeneration methods with beta-TCP/PLGC membranes. J Nanosci Nanotechnol,2007,7(3):859-861.
[9]Duskova M, Leamerova E, Sosna B,et al.Guided tissue regeneration, barrier membranes and reconstruction of the cleft maxillary alveolus. J Craniofac Surg,2006,17(6):1153-1160.
[10]McGinnis M, Larsen P, Miloro M, et al.Comparison of resorbable and nonresorbable guided bone regeneration materials:A preliminary study. Int J Oral Maxillofac Implants,1998, 13(1):30-35.
[11]Matsui Y, Ohta M, Ohno K, et al.Alveolar bone graft for patients with cleft lip/palate using bone particles and titanium mesh:A quantitative study. J Oral Maxillofac Surg,2006, 64(10):1540-1545.
[12]Duskova M, Kotova M, Sedlackova K, et al.Bone reconstruction of the maxillary alveolus for subsequent insertion of a dental implant in patients with cleft lip and palate.J Craniofac Surg,2007,18(3):630-638.
[13]Giudice G,Gozzo G,Sportelli P, et al. The role of functional orthodontic stress on implants in residual alveolar cleft. Plast Reconstr Surg,2007,119(7):2206-2217.
[14]Feichtinger M, Mossbock R, Karcher H. Assessment of bone resorption after secondary alveolar bone grafting using three-dimensional computed tomography:a three-year study. Cleft Palate Craniofac J,2007,44(2):142-148.
[15]Stavropoulos F, Dahlin C, Ruskin JD, et al.A comparative study of barrier membranes as graft protectors in the treatment of localized bone defects. An experimental study in a canine model.Clin Oral Implants Res,2004,15(4):435-442.
[16]Peled M, Aizenbud D, Horwitz J, et al.Treatment of osseous cleft palate defects:a preliminary evaluation of novel treatment modalities. Cleft Palate Craniofac J,2005,42(4): 344-348.
[17]Scott JK, Webb RM,Flood TR. Premaxillary osteotomy and guided tissue regeneration in secondary bone grafting in children with bilateral cleft lip and palate. Cleft Palate Craniofac J,2007,44(5):469-475.
[18]Fang TD, Nacamuli RP, Song HJ, et al.Guided tissue regeneration enhances bone formation in a rat model of failed osteogensis. Plast Reconstr Surg,2006,117(4):1177-1185.
[19]Taguchi Y, Amizuka N, Nakadate M, et al. A histological evaluation for guided bone regeneration induced by a collagenous membrane.Biomaterials,2005,26(31):6158-6166.
[20]Kawata T, Yuki M, Miyamoto Y, et al.Guided bone regeneration to repair an alveolar bone defect in a girl whose cleft lip and palate had been repaired. Br J Oral Maxillofac Surg,2005, 43(5):420-422.
[2]欧阳东,葛兴亮,罗奕.牙槽嵴裂骨移植修复术后骨吸收影响因素的分析[J].武警医学院学报,2005,14(2)：120-122
[3]Buser D,Duar K, Belser U,et al. Int J Periodont Restorat Dent,1993,13:29-45
[4]Melcher AH. On the repair potential of periodontal tissues[J]. J Periodontol,1976, 47:256-260
[5]Nyman S, Gottlow J, Karring T, et al. The regenerative potential of the periodontal ligament: An experimental study in the monkey. J Clin Periodontol,1982,9:257
[6]Meelcher AH.On the repair of periodontal tissues[J].J Periodontol,1976,47:256
[7]Hardwick R, Hayes BK, Flynn C, et al. Devices for dentoalveolar regeneration:An up-to-date literature review(J).J Preiodontol,1995,66:495
[8]Peled M, Aizenbud D, Horwitz J, et al. Treatment of osseous cleft palate defects:a preliminary evaluation of novel treatment modalities. Cleft Palate Craniofac J,2005,42: 344-348
[9]Scott JK, Webb RM, Flood TR. Premaxillary osteotomy and guided tissue regeneration in secondary bone grafting in children with bilateral cleft lip and palate. Cleft Palate Craniofac J,2007,44:469-475
[10]Nwoku AL, Al Atel A, Al Shlash S, et al. Retrospective analysis of secondary alveolar cleft grafts using iliac of chin bone. J Craniofac Surg,2005,16:864-868
[11]Feichtinger M, Mossbock R, Karcher H. Assessment of bone resorption after secondary alveolar bone grafting using three-dimensional computed tomography:a three-year study. Cleft Palate Craniofac J,2007,44:142-148
[12]Stavropoulos F, Dahlin C, Ruskin JD, et al. A comparative study of barrier membranes as graft protectors in the treatment of localized bone defects. An experimental study in a canine model. Clin Oral Implants Res,2004,15:435-442
[13]王光和.唇腭裂的序列治疗[M].人民卫生出版社,1995：236-237
[14]石冰,龙洁,王晴.唇裂伴牙槽突裂动物模型的建立及对上颌骨生长发育影响的观察.口腔颌面外科杂志,2000,10：138-140
[15]Dalia EB,Steven JS,Nicholas G.New technique for creating permanent experimental alveolar clefts in a rabbit model.Cleft palate-Craniofacial Journal,1993,30:542-547
[1]Arctander K, Kolbenstvedt A, Aalokken TM, et al.Computed tomography of alveolar bone grafts 20 years after repair of unilateral cleft lip and palate. Scand J Plast Reconstr Surg Hand Surg,2005,39(1):11-14.
[2]Nwoku AL, Al Atel A,Al Shlash S, et al.Retrospective analysis of secondary alveolar cleft grafts using iliac of chin bone. J Craniofac Surg,2005,16(5):864-868.
[3]Boyarskiy S, Choi HJ, Park K. Evaluation of alveolar bone support of the permanent canine in cleft and noncleft patients. Cleft Palate Craniofac J,2006,43(6):678-682.
[4]Swan MC, Goodacre TE. Morbidity at the iliac crest donor site following bone grafting of the cleft alveolus. Br J Oral Maxillofac Surg,2006,44(2):129-133.
[5]Nyman S, Lang NP, Buser D, et al. Bone regeneration adjacent to titanium dental implants using guided tissue regeneration:A report of two case. Int J Oral Maxillofac Implants,1990, 5(1):9-14.
[6]Nyman S,Gottlow J, Karring T, et al.The regenerative potential of the periodontal ligament: An experimental study in the monkey. J Clin Periodontol,1982,9(3):257-265.
[7]Buser D, Dula K, Belser U, et al.Localized ridge augmentation using guided bone regeneration.1.Surgical procedure in the maxilla. Int J Periodont Rest Dent 1993, 13(1):29-45.
[8]Koyama Y, Kikuchi M, Edamura K, et al.Reconstruction of bone fenestration on mandiblar by the guided bone regeneration methods with beta-TCP/PLGC membranes. J Nanosci Nanotechnol,2007,7(3):859-861.
[9]Duskova M, Leamerova E, Sosna B,et al.Guided tissue regeneration, barrier membranes and reconstruction of the cleft maxillary alveolus. J Craniofac Surg,2006,17(6):1153-1160.
[10]McGinnis M, Larsen P, Miloro M, et al.Comparison of resorbable and nonresorbable guided bone regeneration materials:A preliminary study. Int J Oral Maxillofac Implants,1998, 13(1):30-35.
[11]Matsui Y, Ohta M, Ohno K, et al.Alveolar bone graft for patients with cleft lip/palate using bone particles and titanium mesh:A quantitative study. J Oral Maxillofac Surg,2006, 64(10):1540-1545.
[12]Duskova M, Kotova M, Sedlackova K, et al.Bone reconstruction of the maxillary alveolus for subsequent insertion of a dental implant in patients with cleft lip and palate.J Craniofac Surg,2007,18(3):630-638.
[13]Giudice G,Gozzo G,Sportelli P, et al. The role of functional orthodontic stress on implants in residual alveolar cleft. Plast Reconstr Surg,2007,119(7):2206-2217.
[14]Feichtinger M, Mossbock R, Karcher H. Assessment of bone resorption after secondary alveolar bone grafting using three-dimensional computed tomography:a three-year study. Cleft Palate Craniofac J,2007,44(2):142-148.
[15]Stavropoulos F, Dahlin C, Ruskin JD, et al.A comparative study of barrier membranes as graft protectors in the treatment of localized bone defects. An experimental study in a canine model.Clin Oral Implants Res,2004,15(4):435-442.
[16]Peled M, Aizenbud D, Horwitz J, et al.Treatment of osseous cleft palate defects:a preliminary evaluation of novel treatment modalities. Cleft Palate Craniofac J,2005,42(4): 344-348.
[17]Scott JK, Webb RM,Flood TR. Premaxillary osteotomy and guided tissue regeneration in secondary bone grafting in children with bilateral cleft lip and palate. Cleft Palate Craniofac J,2007,44(5):469-475.
[18]Fang TD, Nacamuli RP, Song HJ, et al.Guided tissue regeneration enhances bone formation in a rat model of failed osteogensis. Plast Reconstr Surg,2006,117(4):1177-1185.
[19]Taguchi Y, Amizuka N, Nakadate M, et al. A histological evaluation for guided bone regeneration induced by a collagenous membrane.Biomaterials,2005,26(31):6158-6166.
[20]Kawata T, Yuki M, Miyamoto Y, et al.Guided bone regeneration to repair an alveolar bone defect in a girl whose cleft lip and palate had been repaired. Br J Oral Maxillofac Surg,2005, 43(5):420-422.