异种冻干骨及其与PRF复合物对骨缺损修复与骨整合作用的实验研究

发布时间：2018-07-05 03:18

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：通过对兔双侧下颌无牙区牙槽骨行骨极限缺损造模后分别植入富血小板纤维蛋白（Platelet-rich fibrin, PRF）异种冻干骨复合物及异种冻干骨,并同期植入钛螺纹钉,观察并检测缺损区新骨形成及钉周骨整合情况,探讨PRF和异种冻干骨在骨修复及骨整合中的作用机制，为临床应用提供实验参考。方法： 1分组：健康成年新西兰大白兔12只，雌雄不限，随机分为3组，每组4只，分别于术后4812周处死。所有实验动物采取自身对照方法，右侧下颌骨极限缺损区为实验组，植入PRF"异种冻干骨复合物；左侧下颌骨极限缺损区为对照组，，植入异种冻干骨。 2异种冻干骨获取及制备：取自人骨组织，经骨髓清洗深冻冻干和射线辐照等过程制备。 3PRF的制备：于兔耳中央动脉处快速抽取5ml血置于未添加抗凝剂的采血管中，迅速置于已配平的离心机中，以3000r／min的速度离心10min,停止后取出离心管静置，可见管内血液分为3层：最上层为贫血小板血浆层，中间层为纤维蛋白凝胶层，最底层为红细胞碎片层。弃上清液，分离中间的纤维蛋白凝胶，即为PRF。5ml兔动脉血可制备约7.5×4.0×0.4mm的PRF。 4造模及干预：在每只实验动物的双侧下颌骨门齿远中无牙区牙槽骨各造一约5×4×3mm的缺损，缺损后缘位于颏孔前约4mm处，其下缘与颏孔平齐。分别自缺损区近远中壁远离缺损区方向以钛螺纹钉配套钻针制备一约直径1.5mm，深3.5mm的种植窝，将钛螺纹钉拧入种植窝，右侧为实验组，缺损区充填PRF"异种冻干骨复合物；左侧为对照组，缺损区仅植入异种冻干骨，逐层缝合，术后正常饮食。 5观察结果：分别于术后4812周以空气栓塞法处死实验动物，沿兔口角做切口，分离出下颌骨，去净其上附丽组织，大体肉眼观察骨极限缺损区愈合修复情况；扭矩实验测试钛螺纹钉-骨界面的结合强度，收集数据进行统计学分析；组织学观察，各标本切片行HE染色后，采集图像，通过多功能真彩色细胞图像分析管理系统分析计算新骨形成面积占视野区面积的百分比，进行新生骨定量分析。结果： 1标本大体肉眼观察结果：实验组及对照组中所植入的钛螺纹钉均无松动脱落，所造骨组织缺损区均逐渐被骨组织覆盖，表面有不同程度凹陷，实验组显示表面形态恢复更为理想。 2术后4812周同一时间点扭矩测试实验组种植体-骨结合强度高于对照组，结果有显著性差异，有统计学意义（P＜0.05）。 3组织学观察术后4812周同一时间点实验组新生骨面积与对照组比较，有统计学意义（P＜0.05）。结论： 1在下颌牙槽骨极限缺损情况下，PRF"异种冻干骨复合物及异种冻干骨均有助于骨缺损修复及钛螺纹钉周骨整合。 2PRF"异种冻干骨复合物有更好的骨传导和骨诱导能力，可以加快骨整合，促进修复进程，较单独使用异种冻干骨效果好。
[Abstract]:Objective: to model the alveolar bone defect in bilateral edentulous region of rabbits and to implant platelet-rich fibrin (PRF) xenogeneic freeze-dried bone complex and xenogeneic freeze-dried bone respectively, and to implant titanium thread nail simultaneously. To investigate the mechanism of PRF and xenogeneic freeze-dried bone in bone repair and bone integration, to observe and detect the formation of new bone and bone integration around nail in defect area, and to provide experimental reference for clinical application. Methods: 1 A total of 12 healthy adult New Zealand white rabbits were randomly divided into 3 groups with 4 rabbits in each group. The rabbits were killed at 812 weeks after operation. All experimental animals were treated with self-control method. The right mandibular limit defect region was used as experimental group and PRF "xenogeneic freeze-dried bone complex" was implanted into the experimental group, while the left mandibular limiting defect area was used as the control group. Xenogeneic freeze-dried bone was implanted. 2 xenogeneic freeze-dried bone was obtained and prepared: from human bone tissue, cleaned by bone marrow? Deep freeze? Rapid extraction of 5ml blood from the central artery of rabbit ear and placement of 5ml blood in the blood vessel without anticoagulant, and in a leveled centrifuge. After centrifugation at 3000r/min speed for 10 mins, the centrifuge tube was taken out to rest, and the blood in the tube was divided into three layers: the highest layer was the platelet-poor plasma layer, the middle layer was the fibrin gel layer, and the bottom layer was the red blood cell fragment layer. The fibrin gel was separated from the supernatant, that is, PRF.5ml rabbit arterial blood could be used to prepare a PRF.4 model of 7.5 脳 4.0 脳 0.4mm and its intervention: a defect of about 5 脳 4 脳 3mm was made in the alveolar bone of each bilateral mandibular incisor in the distal part of the mandibular incisor. The posterior edge of the defect was located about 4mm in front of mental foramen, and the lower margin was level with mental foramen. Respectively from the defect area near? The distal wall is far away from the defect area and the titanium thread screw matching needle is used to prepare the implant nest, which is 1.5mm in diameter and deep in 3.5mm. The titanium thread nail is screwed into the implant nest, the right side is the experimental group, the defect area is filled with the 3.5mm "dissimilar freeze-dried bone complex", the left side is the control group, and the left side is the control group. Only allogeneic freeze-dried bone was implanted in the defect area and sutured layer by layer. 5 observation results: the experimental animals were killed by air embolization 12 weeks after operation, and the mandible was separated from the mandible by incision along the rabbit mouth angle. After removing the attached tissue, the healing and repairing of the ultimate defect area was observed with the naked eye; the binding strength of the interface between the titanium thread nail and the bone was measured by torque experiment, and the data was collected for statistical analysis; the histological observation was performed on the sections of each specimen after HE staining. The image was collected and the percentage of the area of new bone formation to the area of visual field was calculated by the analysis and management system of multifunctional true color cell image, and the quantitative analysis of new bone was carried out. Results: 1 the results of gross naked eye observation: the titanium screw implanted in the experimental group and the control group had no loosening and falling off, the defect area of the bone tissue was gradually covered by bone tissue, and the surface of the bone tissue was sunken in varying degrees. The surface morphology of the experimental group was better than that of the control group. (2) the strength of implant osseous bond in the experimental group was higher than that in the control group at the same time point at 12 weeks after operation, and there was significant difference in the results. There was significant difference between the experimental group and the control group (P < 0.05). 3 there was significant difference in bone area between the experimental group and the control group at the same time point at 12 weeks after operation (P < 0.05). Conclusion: 1 under the condition of limiting defect of mandibular alveolar bone, PRF "dissimilar freeze-dried bone complex and xenogeneic freeze-dried bone are helpful to repair bone defect and integrate bone around titanium screw. Better bone conduction and bone induction, It can speed up bone integration and promote the process of repair, which is better than using xenogeneic freeze-dried bone alone.
【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】：R783.4

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