应用螺旋CT三维重建技术对无机活性元素骨组织工程支架材料在颌骨缺损修复重建作用的评价

发布时间：2018-03-17 18:27

本文选题：组织工程　切入点：螺旋CT　出处：《安徽医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：研究目的在口腔颌面外科的科学研究及临床工作方面，颌面部肿瘤、外伤或先天疾病等是造成颌面部组织缺损的常见原因。颌骨及软组织的缺损不仅导致口腔颌面部的生理功能障碍，也会对患者的心理造成严重的不良影响，因此组织缺损尤其是颌骨缺损的修复重建已成为口腔颌面外科领域和范畴迫切需要解决的难题之一。近年来发展的各种无机和有机，且具有生物相容性的骨代用品拓宽了骨缺损修复与重建的研究领域，使骨组织工程支架材料为这一难题的解决提供了可行的办法。经过前期的一系列动物实验证实无机诱导因子复合性骨组织工程支架材料具有良好的生物相容性，，植入骨缺损区后可在降解过程中释放具有骨生长诱导作用并由特定比例构成的无机元素，从而起到促进骨组织增殖、分化和新骨形成的功能。为临床的应用研究提供了可靠的理论依据，可以作为修复人体颌骨缺损的材料之一。本实验研究应用64排128层螺旋CT来观察应用无机诱导因子复合性骨组织工程支架材料修复颌骨缺损术后患者颌骨骨质缺损修复与重建的情况。意图通过相关实验数据来评估骨组织工程支架材料在修复重建骨缺损和促进成骨方面的功能。旨在为材料治疗提供更加准确、直观的影像学依据。研究方法选择2008年1月—2010年12月，安徽省立医院口腔颌面外科收治入院的颌骨囊肿或囊性肿瘤患者138例。术前均有我院全景片及CT等影像提示。手术均由同一组外科医生采用外科切开刮除的方法。充分暴露病变骨质后去除囊肿表面骨质，彻底刮除囊壁，实验组在缺损处置入本材料，待骨腔内鲜血浸润材料后，分层对位缝合创面。对照组患者骨残腔内不放置任何材料即对位缝合。通过两组患者于术后1,3,12个月来我院复诊，行CT检查，分析其CT值得出数据，并将结果进行对比研究。结果由CT值结果显示对照组患者因未行任何修复措施，囊肿破坏的骨质得不到较好的修复，只能靠患者自身骨修复，速度较缓慢，因此骨密度与术前无异。而实验组患者由于在骨腔内置入预制型无机活性诱导元素支架材料，所有患者患区的骨质都得到了很好的修复，且有68.12%的患者骨质恢复情况与正常骨质无异。结论无机活性诱导元素骨组织工程支架材料在用于骨缺损修复时能有效促进成骨细胞生长、分化，提高其成骨特性。螺旋CT三维重建技术对材料的成骨特性提供了准确、直观的影像学依据。
[Abstract]:Research purpose. In the scientific research and clinical work of oral and maxillofacial surgery, maxillofacial tumors, trauma or congenital diseases are the common causes of maxillofacial tissue defects. Therefore, the reconstruction of tissue defects, especially jaw defects, has become one of the most urgent problems in the field and field of oral and maxillofacial surgery. And the biocompatible bone substitute broadens the research field of bone defect repair and reconstruction. The bone tissue engineering scaffold materials provide a feasible method for solving this problem. A series of animal experiments have proved that inorganic inducible factor composite bone tissue engineering scaffold materials have good biocompatibility. After implantation of bone defect area, inorganic elements with bone growth induction and a specific proportion of inorganic elements can be released during the degradation process, thus promoting the proliferation of bone tissue. The function of differentiation and new bone formation provides a reliable theoretical basis for clinical application and can be used as one of the materials for repairing human jaw defects. In this study, 64-slice 128-slice spiral CT was used to observe the repair and reconstruction of mandibular bone defects after the repair of jaw defects with inorganic inducible factor composite bone tissue engineering scaffolds. To evaluate the function of bone tissue engineering scaffolds in repairing bone defects and promoting osteogenesis. Visual imaging evidence. Research method. Choose January 2008-December 2010, 138 cases of maxillary cyst or cystic tumor were admitted to the Department of Oral and Maxillofacial surgery in Anhui Provincial Hospital. The panoramic films and CT images of our hospital were all shown before operation. The surgical procedures were all performed by surgical incision and curettage by the same group of surgeons. ... to remove the bony surface of the cyst after full exposure of the diseased bone, After completely scraping the cyst wall, the experimental group will dispose of the material in the defect, and after the material has been infiltrated with blood in the bone cavity, The patients in the control group were sutured at the same position without any material placed in the bone remnant cavity. The patients in the two groups were re-diagnosed in our hospital for 12 months after the operation. The CT scan was performed, and the CT data were analyzed and the results were compared and studied. Results. The results of CT showed that the bone damaged by cysts could not be repaired better in the control group because of no repair measures, but only by the patients' own bone repair, and the speed was slow. So BMD was the same as before surgery, and the patients in the experimental group were well repaired because of the placement of prefabricated inorganic active inducer scaffolds in the bone cavity. And 68.12% of the patients had the same status of bone recovery as normal bone. Conclusion. Bone tissue engineering scaffolds with inorganic active inducing elements can effectively promote the growth and differentiation of osteoblasts and improve their osteogenic characteristics when they are used for bone defect repair. The three-dimensional reconstruction of spiral CT provides an accurate method for the osteogenic characteristics of the materials. Visual imaging evidence.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R318.08

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