局部运用双磷酸盐对糖尿病大鼠种植体周骨整合的影响的相关研究

发布时间：2018-03-13 05:25

本文选题：糖尿病　切入点：骨质疏松　出处：《重庆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:2型糖尿病好发于老年群体,其并发症糖尿病骨质疏松给老年患者带来了严重的危害[1]。老年群体中,牙缺失的现象非常常见。对于这一类病人,牙种植是一种重要的治疗方式。然而,糖尿病骨质疏松对老年患者牙种植的稳定性造成了严重影响。本实验的目的为如何提高糖尿病骨质疏松患者种植周的骨整合。方法:60只雄性SD大鼠适应性喂养1周,随机分为三组:1)正常组;2)2型糖尿组;3)糖尿病+双磷酸盐(Bisphosphonates,BPs)组。均在所有大鼠的双侧股骨头植入种植钉。组1)和组2)的大鼠在种植钉置入种植窝前于种植窝内注入不含BPs的凝胶,组3)的大鼠于种植窝内注入含有BPs的凝胶。分别于种植体植入后4w和8w处死各组大鼠,取股骨进行相关检测。运用荧光双标法检测种植体周围骨矿化沉积率(MAR),Micro-CT检测骨体积率(BV/TV),骨小梁厚度(Tb.Th),骨小梁数量(Tb.N),骨小梁间距(Tb,Sp),组织形态学法检测种植体周围的骨分布率(BA)和骨表面接触率(BIC),同时运用最大推力和最大剪切力两种生物力学实验来评价骨质量。通过BMSCs在高糖环境下的成骨分化情况,检测ALP染色,Runx2及Osterix的m RNA的表达,以及Runx2和OC的基因表达,从而判断高糖环境下BPs介导的BMSCs的成骨能力。结果:和糖尿病组相比,正常组和糖尿病+双磷酸盐组大鼠种植体周围的骨矿沉积率(MAR)增加,组织形态学检测结果显示BA和BIC增加,Micro-CT检测结果显示BV/TV,Tb.Th,Tb.N升高而Tb,Sp降低,生物力学检测结果显示最大推力实验和最大剪切力均增加。体外实验结果显示高糖抑制了BMSCs的成骨分化,而BPs可以在一定程度减轻这种抑制效应。结论:糖尿病骨质疏松对牙种植体的稳定性具有不利影响。局部小剂量运用双磷酸盐对糖尿病骨质疏松患者的种植体骨整合具有有利作用。
[Abstract]:Objective to study the prevalence of type 2 diabetes mellitus in the elderly population. The complications of diabetes mellitus osteoporosis bring serious harm to the elderly patients [1] .Tooth loss is very common in the elderly population. Dental implants are an important treatment. However, The aim of this study was to improve the bone integration in the implants of diabetic osteoporosis patients. Methods 60 male Sprague-Dawley rats were fed adaptively for one week. The rats were randomly divided into three groups: normal group (n = 1), normal group (n = 3), bisphosphate bisphosphate bisphosphate group (n = 3). All rats were implanted in bilateral femoral head of rats. Group 1) and group 2) rats were injected with BPs free gel in implant fossa before the implantation of implant nail. Rats in group 3 were injected with gel containing BPs in the implant fossa. The rats in each group were killed at 4 weeks and 8 weeks after implantation, respectively. Bone mineral deposition rate around implants and bone volume ratio (BV / TVV), bone trabecular thickness (Tb. Thn), trabecular number (TB. Nu), bone trabecular spacing (TbN), bone trabecular spacing (TbN), and histopathology were detected by fluorescence double labeling method (BV / TVV) and bone trabecular thickness (Tb 路Th), bone trabecular spacing (TbN), and histomorphology (histomorphology) of bone around implants. Bone distribution rate (BAA) and bone surface contact rate (BMSCs) were used to evaluate the bone mass by using two biomechanical experiments, maximum thrust and maximum shear force. The expression of m RNA in Runx2 and Osterix and the gene expression of Runx2 and OC in ALP staining were detected to determine the osteogenic ability of BMSCs mediated by BPs in high glucose environment. The bone mineral deposition rate around implants was increased in normal group and diabetic bisphosphate group. Histomorphologic examination showed that BA and BIC increased and Micro-CT showed that BV / TVT Tb. Thn increased and TbSp decreased. The results of biomechanical test showed that both the maximum thrust test and the maximum shear force were increased. In vitro, high glucose inhibited the osteogenic differentiation of BMSCs. Conclusion: diabetic osteoporosis has adverse effects on the stability of dental implants. Local small dose of bisphosphate on implant bone in diabetic patients with osteoporosis. Integration is beneficial.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2;R783.6

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