生物玻璃和生物胶原膜联合应用于即刻义齿种植

Bioglass and collagen membrane in immediate denture implant

目的:建立即刻种植动物模型,观察生物玻璃和生物胶原膜在即刻种植中引导骨组织再生、促进骨愈合效果。方法:实验方法:取成年家犬12只,随机编号后分为4个组,在全麻下分别拔除双侧下颌第一双尖牙,制备近中拔牙窝并即刻植入种植体。前3个组分别应用生物玻璃填塞种植体与拔牙窝骨壁之间的间隙,或在种植床上方覆盖生物胶原膜,并尝试两种方法的联合应用,空白组不采用特殊处理。②观察指标:术后观察记录种植床愈合情况。术后4,8,12周分批处死动物并取其下颌骨标本,采用大体观察、X射线、普通光镜组织学方法和扫描电镜方法观察其在种植床中引起的骨组织再生变化过程和骨结合率,统计比较各种方法的成功率。结果:①即刻种植成功率:总体成功率为95.8%,其中应用生物玻璃填塞种植体周围间隙可以诱导骨组织再生,其成功率均为100%,在种植床上方覆盖生物胶原膜者成功率为91.7%。②诱导骨组织再生作用:单用生物玻璃或两种方法联合应用诱导骨再生效果均较快,8周时表现骨质沉积量明显较多,其成骨呈多中心性,12周时可以诱导再生成熟的骨组织,并使种植体达到骨结合;应用生物胶原膜成骨呈向心性,成骨速度稍慢,12周时可以引导再生成熟的骨组织,并使种植体达到骨结合;空白组12周时在种植体的上部仍有较大部分软组织存在。结论:在即刻种植中应用生物玻璃和生物胶原膜均可以诱导骨组织再生,促进骨愈合,获得较高的种植成功率;两者联合应用的成骨效果较单独应用生物胶原膜好。

AIM： To build models of immediate implant, and observe the process of bone regeneration and bone healing by using bioglass and collagen membrane. METHODS： ①Twelve adult dogs were selected and randomly divided into 4 groups. Their first premolars were extracted under general anesthesia to prepare the sockets, which was implanted with pure titanium implants immediately. In the former 3 groups, the bioglass was used to stick the space between the implant and the walls of sockets, or collagen membrane to cover the socket, and the combination of bioglass and collagen membrane. Blank control group was not given any treatment. ②Animals were killed at 4, 8 and 12 weeks after operation to harvest the mandible. The healing of the implant was detected by gross observation, X-ray radiography, histologic observation and electronic microscope. The success rate of various methods was compared by statistical analysis. RESULTS： ①The total success rate of 24 implants in 12 dogs was 95.8%. Bioglass could accelerate the bone tissue to regenerate, and the success rate was 100%; the success rate of collagen membrane was 91.7%. Bioglass alone or combined with collagen membrane could induce bone regeneration. At week 8, bone sediment yield was obviously increased, and the bone presented polycentricity; at week 12, osseointegration was found. Bone formation rate was low by using collagen membrane. In control group, there were still plenty of soft tissues on the surface of implants at week 12. CONCLUSION： Either bioglass or collagen membrane bone healing, and gain high success rate. Moreover collagen membrane alone. n immediate implant could induce bone regeneration, promote combination of two materials shows better effect than that by