两种植骨材料促进即刻种植体周骨组织再生效果比较

Comparison of Impact of Two Bone Substitutes on Promoting Bone Regeneration around Fresh Extraction Socket Implant

【目的】比较两种植骨材料PepGen P15 Flow(简称P15)和Bio-Oss引导即刻种植体周骨组织再生能力及骨-种植体结合能力。【方法】将beagle犬下颌单侧双尖牙全部拔除,然后在新鲜拔牙窝内植入种植体3颗。植入后于种植体颊侧制备标准骨缺损并作如下处置:A组空置,B组植入P15,C组植入Bio-Oss;覆盖Bio-Gide,初期缝合伤口。于术后第6周、12周将beagle犬分期处死获取标本,进行大体、影像学、组织学观测。【结果】B、C组植骨区外形均较A组膨隆,尤其是C组。X线观察可见B、C组X线阻射影几乎覆盖整个植骨区,而A组的X线阻射影仅局限于骨缺损周边区域。组织学检查发现:植骨区范围内的新生骨比例和骨-种植体结合率B组最高,C组其次,A组最低;未降解的植骨材料比例B组低于C组;植骨材料-新生骨结合率B组高于C组。【结论】与Bio-Gide联合应用,P15与Bio-Oss均能有效促进即刻种植体周骨组织再生数量与质量,且能促进骨-种植体结合率,前者较有利于促进植骨区新生骨改建成熟,而后者较有利于保障植骨区体积稳定性。

[Objective] To compare the impact of two bone substitutes （PepGen P15 Flow and Bio-Oss） on promoting bone regeneration around fresh extraction socket implant and bone-to-implant contact. [Methods] All the beagle dogs＇ mandibular bicuspids of one side were extracted and then three implants were inserted into the fresh extraction sockets. Standard bone defects were prepared on the buccal side of the implants and then filled with blank （group A）, P15 （group B）, and Bio-Oss （group C）, respectively. After the application of bone substitutes the wound was covered with membrane Bio-Gide and the elevated gingival flap was then sutured to form primary closure. At 6 weeks and 12 weeks postoperatively the dogs were sacrificed for clinical check, radiology, and histological analysis. [Results] In the socket areas, group C rather than group B shaped much more bulge than group A. Radiographic analysis demonstrated there was obvious shade area around the neck of the implant in group A, but no signs of shade area in group B and C. Histological analysis showed： the percentage area of new bone formation and bone-to- implant contact ratio, B〉C〉A; and the percentage of residual bone substitute, B〈 C; and the percentage contact length between new born bone and residual bone substitute, B 〉C. [Conclusion] In combination with membrane Bio-Gide, both bone substitutes P15 and Bio-Oss can effectively promote bone regeneration around immediate extraction socket implant and also the bone-to-implant contact ratio. P15 is more suitable to rebuild and mature the new born bone, while Bio-Oss to maintain the volume of bone grafted area.