膜结合骨形成蛋白和单独用膜引导种植体周围骨组织再生的比较研究

A COMPARISON OF MEMBRANES ALONE OR IN COMBINATION WITH BONE MORPHOGENETIC PROTEIN IN PROMOTING BONE FORMATION AROUND IMMEDIATE EXTRACTION SOCKET IMPLANTS

为研究单纯用膜及膜结合ＢＭＰ修复与种植体有关的骨缺损的愈合速度及界面情况，应用ＨＡ喷涂钛种植体植入伴有裂状缺损的拔牙窝内。实验分两组进行，一组用聚四氟己烯膜（ＰＥＴＥ膜）结合ＢＭＰ，另一组单纯用聚四氟己烯膜。术后２、４、８、１２周分别行大体，Ｘ线，光镜观察。结果发现：单纯用膜能促进种植体周围新骨生成，而膜结合ＢＭＰ处理的种植体骨修复启动早，骨界面愈合速度较单纯用膜可提前约４～６周。两种方法为扩大种植体的适应证范围。

The purpose of this study was to observate the condition of the healing spread and bone-implant interface which PTFE membranes alone or in combination with BMP was made to repair bone defect around implants. The HA-coated implants were placed into immediate extraction socket. There were approximately 5×5mm implants surface exposed within the dehescience defect. The experiment divided into two groups:one group used PTFE membranes combination with BMP, another membranes alone. The specimens were analyzed with gross observation, radiography and light microscope at 2nd, 4th,8th,12th week postimplantively. Gross observation: In membranes and BMP group, the hard bone-like material were macroscopically seen over extensive buccal dehiscences on the implant surfaces at 2nd week. Radiography: In membranes and BMP group, there were no transparent areas around the implants and the density of new bone was approximate to the host at 8th week. In membranes alone group, the new bone basically filled with the space around the implants and the density of new bone was lower than that of the host at 12th week. Light microscopy: In membranes and BMP group, the osteoblasts arranged on the surface of the bone matrix in single line at 4th week. Some of new bone in the interface had matured and lamellar bone could be seen. Haversion system and cementing line appeared at 8th week. In membranes group, the osteoblasts proliferate actively and the new bone had been formed at 8th week the new bone gradually matured into lamellar bone at 12th week. This results indicated that PTFE membranes alone or in combination with BMP could improve new bone formation around the implants placed fresh extraction sockets with bony dehiscences, which made the bone implants interface form osseointegration., While the bone reparing of the implants which received membanes and BMP startd earlier and completed fastly. It healed of four to six weeks than the implants which received membranes alone. The composite grafts of BMP and coral powder was an ideal filling material of the space under the membranes,which could enhance sharply the effect of the membranes.Two manners will provied possibilities to increase the indication of the dental implants and solute the quantity of the bed into which implants are placed, and which shorten the period of implanation.