异种冻干骨及其复合PRF修复钛螺纹钉周围骨缺损的实验研究

发布时间：2018-04-15 00:19

本文选题：富血小板纤维蛋白 + 异种冻干骨　；参考：《河北医科大学》2014年硕士论文

【摘要】：目的：通过建立兔下颌骨骨缺损模型，并即刻植入钛螺纹钉、异种冻干骨及其复合富血小板纤维蛋白（Platelet-rich fibrin，简称PRF)，，观察异种冻干骨及其复合PRF在修复钛螺纹钉周围骨缺损的效果，进一步探讨异种冻干骨修复骨缺损的能力及PRF在异种冻干骨修复骨缺损中的作用。方法∶ 1实验动物的分组：总共有12只新西兰大耳白兔，将所有实验动物随机分成3组，根据实验设计，分别于术后4周、8周、12周处死。所有实验动物均为右侧下颌骨为实验组（植入异种冻干骨复合PRF），左侧下颌骨为对照组（植入异种冻干骨），进行自身对照。 2异种冻干骨的制备：取自人骨组织，经骨髓清洗深度冷冻冷冻干燥和射线辐照等过程制备。 3PRF的制备：麻醉前，自兔耳中心动脉采血5ml，置于无抗凝剂的离心管中。将离心管放入离心机中离心，转速3000r/min，离心10min，静置备用。离心后离心管内血液由上至下分为三层：上层无细胞血浆，中间层PRF凝胶，下层红细胞层。去除上层和下层，剩余部分即为PRF凝胶。然后用两层纱布轻柔挤出PRF中血清，PRF凝胶变成坚韧的膜状。 4动物骨缺损模型的建立：麻醉下，在兔右侧（实验组）颊侧皮肤沿下颌骨上缘走向作出一长约15mm的切口，钝性分离其下肌层、骨膜，充分暴露其无牙区牙槽骨上缘和颊侧。在暴露的无牙区牙槽骨形成一约5mm×4mm×3mm的缺损，生理盐水冲洗。左侧（对照组）手术方法相同。 5钛螺纹钉的植入：紧贴骨缺损近中及远中边缘牙槽骨各制备1个种植窝，造成种植窝周围一壁骨缺损，植入1.5mm×3.5mm钛螺纹钉。 6异种冻干骨及其复合PRF的植入：实验组骨缺损区植入异种冻干骨复合PRF，对照组骨缺损区仅植入异种冻干骨。 7观察结果：术后4、8、12周处死各组动物。大体观察两侧缺损愈合情况及钛螺纹钉有无松动脱落情况。拍X线片观察新生骨密度和缺损区骨吸收情况，骨密度用灰度值表示，将测量的灰度值进行统计检验，比较实验组与对照组骨密度的差别。将组织取材切片HE染色，光镜下观察。结果： 1大体观察：各期钛螺纹钉无松动脱落。各期实验组较对照组成骨情况好，新生骨骨质较硬、表面更平整。 2X线观察：各期钛螺纹钉骨界面无明显透射影像，未见异常骨吸收区，随时间增加周围骨组织密度逐渐升高。 3骨密度分析：采用统计分析软件对X线片灰度值进行统计学处理。结果表明，在相同的时间点（术后4周、8周或12周），实验组近中远中钛螺纹钉骨缺损侧新生骨灰度值比对照组的大，p 0.05，差异有统计学意义。 4组织学观察：术后4、8、12周，实验组的新生骨组织更成熟，可见大量成骨细胞和骨细胞，骨小梁粗大致密排列规则，钙化程度高；而对照组的成骨细胞、骨细胞比实验组少，骨小梁数量较少且钙化程度较低。结论： 1异种冻干骨作为一种骨替代材料可以修复钛螺纹钉周围骨缺损 2富血小板纤维蛋白在异种冻干骨修复骨缺损中有较显著的促进成骨的作用。
[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.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R782.2

【参考文献】