骨替代材料在上颌窦底外提升同期牙种植中的作用探讨

doi:10.19438/j.cjoms.2023.03.002

中国口腔颌面外科杂志 ›› 2023, Vol. 21 ›› Issue (3): 218-224.doi: 10.19438/j.cjoms.2023.03.002

骨替代材料在上颌窦底外提升同期牙种植中的作用探讨

王荷静¹, 张采欣², 寻兴祥³, 韩林孜⁴, 闫婷婷¹, 许晓^3,*, 袁荣涛^3,*

1.青岛大学口腔医学院,山东青岛 266003;
2.康复大学青岛医院（青岛市市立医院）病理科,3.口腔医学中心,山东青岛 266071;
4.大连医科大学口腔医学院,辽宁大连 116044

收稿日期:2022-12-13 修回日期:2023-02-02 出版日期:2023-05-20 发布日期:2023-08-16
通讯作者: 袁荣涛,E-mail：yuanrongtao@163.com;许晓,E-mail：15266257389@163.com。^*共同通信作者
作者简介:王荷静（1997-）,女,在读硕士研究生,E-mail：whj__1997@163.com
基金资助:
山东省自然科学基金（ZR2016HM34,ZR2022QC034）

Osteogenic role of bone substitute in maxillary sinus augmentation and simultaneous implantation

WANG He-jing¹, ZHANG Cai-xin², XUN Xing-xiang³, HAN Lin-zi⁴, YAN Ting-ting¹, XU Xiao³, YUAN Rong-tao³

1. School of Stomatology, Qingdao University. Qingdao 266003, Shandong Province;
2. Department of Pathology, 3. Department of Stomatology, Qingdao Municipal Hospital & Qingdao Hospital of Rehabilitation University. Qingdao 266071, Shandong Province;
4. School of Stomatology, Dalian Medical University. Dalian 116044, Liaoning Province, China

Received:2022-12-13 Revised:2023-02-02 Online:2023-05-20 Published:2023-08-16

摘要/Abstract

摘要： 目的：探讨牙种植术中上颌窦底外提升时是否需植入骨替代材料,并对比不同骨替代材料促进骨再生的作用。方法：构建兔上颌窦底外提升同期种植体植入模型,12只3月龄雄性新西兰大白兔,共24侧上颌窦,随机分为4组（n=6）,即单纯血凝块组、空白脂质体-水凝胶组、载药脂质体-水凝胶组、同种异体骨粉组,3个月后将上颌窦完整取出,行micro-CT、H-E染色、Masson染色、免疫组织化学染色及骨组织磨片H-E染色等,评价不同实验组上颌窦底外提升后种植体周围骨再生效果。结果：Micro-CT、H-E染色和Masson染色显示,4组样本上颌窦底外提升后种植体周围均有不同程度的新骨形成。空白脂质体-水凝胶组较单纯血凝块组可见更多的新骨形成;与单纯血凝块组及空白脂质体-水凝胶组相比,载药脂质体-水凝胶组及同种异体骨粉组均可见更多的新骨形成,但载药脂质体-水凝胶组较同种异体骨粉组的骨基质中可见更多的新生血管。成血管指标免疫组织化学结果显示,载药脂质体-水凝胶组表达量更高;成骨指标免疫组织化学结果显示,载药脂质体-水凝胶组、同种异体骨粉组表达量更高。骨组织磨片H-E染色显示,种植体骨结合良好,载药脂质体-水凝胶组种植体周围有更多骨质包围。结论：上颌窦底外提升同期牙种植术中植入骨替代材料,既能维持上颌窦底黏膜的提升高度,又能提高成骨效率。可注射的载药脂质体-水凝胶较同种异体骨粉更适用于微创植入不规则的骨缺损部位,载药复合体通过持续缓释药物,有效发挥促血管化骨再生的作用。

关键词: 上颌窦底外提升, 牙种植, 骨替代材料, 骨再生, 兔

Abstract: PURPOSE: To explore whether it is necessary to implant bone substitute materials for maxillary sinus augmentation and simultaneous implantation, and to compare the osteogenic role of different bone substitutes. METHODS: Twelve New Zealand white rabbits (3-month, male) were used for maxillary sinus augmentation and simultaneous implantation, and 24 maxillary sinuses in 12 rabbits were randomly divided into 4 groups(n=6): blood clot group, blank liposome-hydrogel group, medicine-loaded liposome-hydrogel group, and bone allograft group. At 3 months, all samples were entirely taken and the effects of different bone substitutes on promoting bone regeneration were evaluated by micro-CT, H-E staining, Masson staining, immunohistochemistry (IHC), and H-E staining of bone tissue grinding slices. RESULTS: Micro-CT, H-E staining and Masson staining displayed that there were different degrees of new bone formation around the implants in 4 groups. Compared to blood clot group, more new bone formation was observed in blank liposome-hydrogel group. Compared with blood clot group and blank liposome-hydrogel group, more new bone formation was observed in medicine-loaded liposome-hydrogel group and bone allograft group. Moreover, compared to bone allograft group, more new blood vessels were observed in bone matrix in medicine-loaded liposome-hydrogel group. IHC showed the expression of angiogenesis indexes in medicine-loaded liposome-hydrogel group was highest in 4 groups. The expression of osteogenic indexes in medicine-loaded liposome-hydrogel group and bone allograft group was higher than other groups. H-E staining of bone tissue grinding slices showed that the osseointegration of the implants was good. The medicine-loaded liposome-hydrogel group had more bone surrounding the implants. CONCLUSIONS: Using bone substitute in maxillary sinus augmentation surgery and simultaneous implantation not only maintains the height of maxillary sinus mucosa, but also improves the efficiency of osteogenesis. Compared to bone allograft, medicine-loaded liposome-hydrogel with injectability is more suitable for irregular bone defect by minimally invasive filling. Medicine-loaded liposome-hydrogel effectively promotes angiogenic bone regeneration by steady drug release.

Key words: Maxillary sinus augmentation, Dental implant, Bone substitute, Bone regeneration, Rabbit

中图分类号:

R782.1

王荷静, 张采欣, 寻兴祥, 韩林孜, 闫婷婷, 许晓, 袁荣涛. 骨替代材料在上颌窦底外提升同期牙种植中的作用探讨[J]. 中国口腔颌面外科杂志, 2023, 21(3): 218-224.

WANG He-jing, ZHANG Cai-xin, XUN Xing-xiang, HAN Lin-zi, YAN Ting-ting, XU Xiao, YUAN Rong-tao. Osteogenic role of bone substitute in maxillary sinus augmentation and simultaneous implantation[J]. China J Oral Maxillofac Surg, 2023, 21(3): 218-224.

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骨替代材料在上颌窦底外提升同期牙种植中的作用探讨

Osteogenic role of bone substitute in maxillary sinus augmentation and simultaneous implantation

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