NPHA/BMP应用于根管充填的动物实验及临床研究

The studies on the curative effect of NPHA/BMP complex used in pulp capping MA

目的:研制一种理想的根充剂并观察其临床疗效。方法;采用天然型网孔羟基磷灰石(NPHA)与骨形成蛋白(BMP)复合物进行家兔肌内植入实验,以及羟基磷灰石(HA)、NPHA家兔胫骨内植入实验。同时选择口腔门诊需进行根管治疗的患者随机分为实验组(NPHA/BMP)99例,99个牙;对照组(氢氧化钙)93例,95个牙,进行根充治疗。结果:NPHA植入肌肉未见诱导幼稚间充质细胞的增殖、分化及成骨作用,但该材料不引起组织排斥反应,生物相容性好。NPHA/BMP复合物植入肌内,可见明显新生骨形成,新生骨成长活跃且与材料呈直接界面。NPHA植入胫骨内无免疫排斥反应,其生物相容性良好,其成骨量明显多于致密性羟基磷灰石。1年随访观察:NPHA/BMP复合物的根充明显优于氢氧化钙。结论:NPHA有利传导成骨,NPHA/BMP复合物,具有诱导成骨活性的作用。该材料生物相容性良好,是目前根管充填术中理想的充填剂。

Objective： To explore an ideal root-fill material. Method：The natural porous hydroxylapatite （NPHA） and bone morphogenesis protein （BMP） were combined as NPHA/BMP complex. Animal experiment： NPHA/BMP complex was implanted into the rabbits＇muscles to evaluate its osteoinduce effect. Hydroxylapatite （HA） and NPHA were implanted into the rabbits＇ shankboes respeetivdy to compare their osteoconduetivity. Clinical observation. The patients were randomly selected to the experiment group （NPHA/BMP group） and the control group（Ca（OH）2 group）. The root canal therapy were operated with NPHA/BMP and Ca（OH）2 respectively. Result：The animal experimental histopathological observation showed that NPHA which implanted into the rabbits＇muscles can＇t induce the multiplication and polarization of the infantile mesenehyme cell and hasn＇t ostcoconduetibity. But NPHA has good biocompatibility. After the NPHA/BMP was implanted into the rabbits＇ muscles, new bone was formed obviously and has a direct interface with the comlex. The experiment of NPHA implanted into rabbits＇shankbones showed that the communicated , porous structure is valuable for o,steoconconductivity. NPHA can induce more new bone than the intensive hydroxylapatite. One year follow up showed that the NPHA/BMP was more efficacious than Ca（OH）2 significantly, Conclusion： NPHA has more valuable for osteoconductivity. The animal experiment and clinical observation exhibited NPHA/BMP has excellent biocompatibility and osteoinduce effet and osteoconduetivity. So the NPHA/BMP complex should be an ideal mot-fill material.